‘Chemotherapy nurses have a big responsibility’

28 June, 2022 | By Ingrid Fuchs

According to my husband and son, I should be finding new hobbies for example, arts and crafts. They are painting the picture of me in 15 years, with the possibility of not being as mobile anymore, and therefore, no ability to run or walk as much. Maybe I’m creative in the clothing I wear, but that's it. I hated art class in school with a passion. I was really bad at it, probably one of the worst students in the class. I feel like I have two left hands. Of course you don’t have to be good at everything you do, but it is definitely more enjoyable if what you create looks plausible. What I do enjoy though is cooking new recipes, reading and listening to music. At least that’s something.

I had my last double chemotherapy on Monday, the one which makes me feel slightly sick. I have had that feeling for a few days now and I hate it. It sounds weird but even brushing my teeth is hard because sometimes it causes me to wretch. I also have a slight tingling feeling in my fingers, it’s not too bad though and I forget about it when I’m distracted. During the first three cycles of chemotherapy I saw the oncologist every three weeks face to face. With these current one I have a telephone conversation with him, also every three weeks.

Chemotherapy nurses have an important job of not only administering the drugs via a central line or cannula, but also assessing the patient physically and emotionally to judge if they are fit for chemotherapy. First of all, they have to check if the blood cells (e.g. the white blood cells, red blood cells, platelets and electrolytes) are within the levels of the protocols. Furthermore, they check weight, blood pressure, heart rate and oxygen level. This is to check everything is within range too. They need to observe and respond if patients have an allergic reaction during the chemotherapy and assess for other side-effects. I have probably not even captured half of their job but what I want to highlight is that they have a big responsibility. Their job requires a good level of experience.

I wonder if patients receiving chemotherapy before surgery (neoadjuvant) do get enough support. These are usually patients with the more aggressive and/or bigger tumours. In my experience, the clinical nurse specialists are often involved briefly at diagnoses and then before and after surgery. Neoadjuvant patients go off to have chemotherapy sometimes for up to six months and don’t see anybody else other than the oncologist during this time. Of course, you can always ring the nurses, but I wonder if many people do, because they haven’t really had a chance to build up a relationship with them yet. Because of my knowledge, background and support system I have been fine, but I wonder if this differs for other patients who are completely new to the process.

At my last chemotherapy treatment I sat next to a lady in her early 30s, it was her first treatment and she said that she was very nervous and had only slept one hour the previous night. She told me she had visited her GP surgery several times with some thickening in her axilla.

Over time, she was seen by at least three different GPs who kept giving her antibiotics. Now she is diagnosed with secondary breast cancer, which has spread to her liver. Why was she not referred earlier? Luckily, she can have herceptin. I will keep my fingers crossed for her.

This blog was originally published in the Nursing Times. Many thanks to them for sharing Ingrid's story.