I feel extremely privileged to support the patients who take the brave step to participate in clinical trials - Sam Corlett

Sam Corlett, clinical research nurse in the Melanoma team 

Sam Corlett

As a clinical research nurse I’ve often been asked what my role is and what a typical day involves. Firstly, there is no such thing as a typical day as a research nurse. The main focus of my role is to ensure the safety of the patients who are taking part in a clinical trial using a new drug treatment. 

My colleagues and I support the patients from the moment they are asked to consider a clinical trial to the point in time when they have completed the study for whatever reason that may be. 

Patients can ask for, or are asked to consider clinical trials at various times throughout their treatment; this could be at diagnosis or after other treatments have stopped working. I get involved at the very beginning by discussing the study with the patient and give them a patient information sheet which has full details of what to expect if they enter a clinical trial. 

Sometimes this happens in the clinic or it can be done via telephone after the consultation, but it is often both; it is important to ensure the patient does not feel coerced at all. 

My role is to ensure they receive all the information they need to make an informed choice about the best treatment path for them. This means I need to have knowledge of not just the trial protocol but also the treatment they would receive if not on a trial. There is no limit to a number of questions I get asked and what is important to one patient may be different to the next patient.    

Once a patient has made a decision to enter a clinical trial I plan with them the next steps. 

These include various screening tests such as scans and blood tests that we do at The Christie and sometimes tests at other hospitals, for example eye tests. This can take a lot of co-ordinating to ensure the least number of visits for the patient. I am constantly keeping the patient informed of what is happening, for example the results of tests.

Screening is done to ensure the patient is eligible for the trial and to ensure that they can receive the trial drugs safely. Not all patients who consent to a trial enter one, they may have a blood test out of allowable range for example, which means they cannot enter a trial. 

Managing their disappointment when this happens can be challenging, especially if they have come to The Christie specifically for a particular trial. 

As a centre specialising in melanoma treatments, patients can come from far and wide. 

From the outset, I ensure they are aware that being considered for and consenting to a clinical trial is no guarantee that they will receive treatment. 

Communication is essential in my role, not just with the patients but with all the departments that support research at The Christie. I work closely with the radiology team to request scans and with the pharmacy team to ensure they have the drugs required and that the prescription is ready.

When all the checks have been done and a patient accepted onto a trial, I then schedule the patient for their treatment. This might be in our dedicated clinical research facility or in the main chemotherapy unit depending on the treatment. The Christie has a strong research culture which is evident throughout the organisation, within all the different departments. 

As many of the trial drugs and treatments are new, not all the nurses at The Christie know how to administer them, how they work, or what the side effects are. That’s why I am also a nurse educator. I use my specialist knowledge of the trial drug to help other nurses in the Trust learn about them.  

Being a clinical research nurse in melanoma has increased my knowledge not just of melanoma as a disease and how we treat it but also how new treatments are introduced into the NHS. 

The mantra of a clinical research nurse is ‘If it isn’t written down then it didn’t happen!’ which means paperwork – lots and lots of paperwork. 

I’m sure most readers have seen the annoying piece of paper that often gets in the way in a packet of paracetamol. Until I became a clinical research nurse I never realised where that came from. All the toxicities the patient experiences are documented, along with every drug they are taking both before during and after taking part in the clinical trial. This information is entered into databases by every hospital taking part in the clinical trial across the globe and once a drug becomes licensed that information becomes the annoying piece of paper in the drug packet. 

Reviewing the patient with the medical staff at every visit to the hospital means I can ask how they are feeling and what symptoms they have had, any new drugs they have taken and ensure that they know how to manage side effects in order that they maintain a good quality of life. This means we have collected the information required for the clinical trial and this can be entered into the database by the clinical research administrator with whom I work really closely. 

Being in a consultation with a patient when they hear good news, like a scan showing that the treatment is working, is an honour. But along with the highs come the lows. It’s all part of my job to support patients and their families when the treatment is no longer working. This is difficult and never gets any easier, particularly if I’ve known the patient for months or even years!  

Any patient taking part in a clinical trial is taking a leap into the unknown; it is a trial because we need to find out if the drug is more effective than existing treatments. Although many patients hope they will benefit personally from the trial, many are also doing it for altruistic reasons in the hope that other people after them will benefit from the research. 

As a research nurse I feel extremely privileged to support the patients who take the brave step to participate in clinical trials and helping them through the decision making process to the end of the trial.

Any patients who are suitable for a clinical trial may be approached by their clinician or a research nurse to discuss a study. Patients can also ask their clinical team at any point if there are any trials they may be eligible for. Anyone with a general enquiry about clinical trials at The Christie can email informationcentre@christie.nhs.uk 

So what is a TNA? - Claire Barnes

Claire Barnes, Trainee Nursing Associate

Claire Barnes

To me it sounds like the beginning of a cheerleader chant so, combine that with a biscuit coloured uniform and we’re good to go! The irony of a biscuit coloured uniform and the link I made to hobnobs might send you running for a brew however, as anyone familiar with Peter Kay will tell you hobnobs are the hard-core dunking biscuits… persistent and refuse to crumble under pressure. I think that describes TNA’S perfectly. 

TNA is short for Trainee Nursing Associate and out of 1,700 applicants nationally, 240 were appointed, and nine of them are based here at The Christie. I am fortunate to be one of those nine. The TNA role has been introduced to help to meet the needs of a changing population within the modern NHS. 

The Nursing Associate will work under the direction of a fully qualified Registered Nurse (RN). The Nursing Associate is not a Registered Nurse but will undertake some of the duties that a RN currently undertakes, enabling the Registered Nurse to spend more time on the assessment and care associated with both complex needs and advances in treatments.

You might be wondering what prompted me to become a cheerleading biscuit coloured TNA. To answer that we need to rewind a little.

Until a couple of years ago, I had never been to The Christie. Life however is full of curve balls and the one I got thrown came with a diagnosis of ovarian cancer for my mum. 
Unfortunately for mum, her cancer had advanced too far and we lost her in April 2015. At the time, I was a home working admin bod and juggled my work and home life together. 

I had been genuinely amazed (I still am) by the care and support both my mum and our family received during her hospital stay. The Christie is a unique environment where despite the somewhat scary circumstances, patients can feel at ease. To put it simply, the people who work at The Christie are wonderful, caring souls and the hospital is something to be proud to be a part of. 

I decided that if I was going to work in admin I’d like to do it at The Christie and give something back. “I want to become a small cog in a big machine that makes a difference to people’s lives on a daily basis” was exactly what I put on my application form when I applied to work here. 

The small cog theory led me to a clerical role based in the endocrine unit. It was a rewarding job and a very friendly team but I quickly realised that I had a desire to play a more hands on role in patient care. This led me to apply for a role as Health Care Assistant (HCA) or a switch to the dark side as I often joke with my colleagues Jen and Steph on reception. As an HCA in endocrinology I become a mini Dracula (taking lots of blood samples from patients). When one of the nurses on the unit pulled me to one side to show me the TNA role advertisement I was intrigued. It was an amazing opportunity not to be missed. 

If you have ever tried to make yourself sound snazzy in 200 words, you’ll know it can be somewhat mission impossible, however that’s the exact amount I had when completing the expression of interest form to be a TNA. I half debated just writing in big text PICK ME!! but was persuaded against that idea and instead opted for something along the lines of “The Nursing Associate Training programme is an amazing opportunity, not only to expand my clinical skills but also to widen my knowledge of various NHS areas, draw from the knowledge gained and apply it to whichever role I undertake.”

Prior to my interview, I directed so many questions to the ward sister Alex and the diabetes nurse Louise, that I am convinced they cringed every time I popped my head round their office door (they didn’t). Their support and encouragement however proved invaluable and helped me to prepare for the interview. After a wait that seemed like forever, I was still surprised when I got the call to say I had been successful!

On Wednesday 4th January I attended a meeting where I got to meet my fellow TNA’s, all from different areas within the hospital. We introduced ourselves, a little about how we got where we were and then learned more about the role. It is still very much a work in progress. 

As the TNA role is a pilot, some of the finer details are still being worked out, such as the community placements and the colour of our uniform has only just been decided (I am still not sure why pink was unpopular!) 

The TNA role begins on January 30th working full time, with Wednesday allocated for university. We will spend the first six months in our original ‘base’ then rotate through three further placements, each lasting six months, taking us to a total of two years at the end of which we hopefully gain our foundation degree. 

I am looking forward to the programme, not only the prospect of developing my clinical skills but also gaining the knowledge behind the how and why of clinical practice. I would be lying if I said the prospect of university level study is not a little daunting but, I am sure with the support of my colleagues it won’t be as scary as I think. 

Our induction at Manchester Metropolitan University was on 18th of January where we met our tutors prior to commencing our roles. There is no doubt the next two years will be hard, combining work with study and home life, however it is without a doubt an exciting role to undertake and I am incredibly proud that I’ll be a part of it!

The expansion of the interventional service for our patients in 2017 is something we look forward to greatly - Alex Gosling

Alex Gosling, Radiology Lead Nurse

Alex Gosling

I have been working at The Christie, within interventional radiology as the radiology lead nurse for just over a year now and I am very lucky to say I work with such a fantastic team. We are a very small but dedicated team of three nurses who work very closely with our coordinator, radiographers and consultant radiologists with the goal of providing the very best patient care. 

Interventional radiology is where X-rays, ultrasound or CT imaging are used to guide very thin wires and catheters into specific parts of the body. This can be for both diagnostic and treatment purposes and can reduce the need for surgery or more invasive treatments. We are able to undertake a very large range of procedures ranging from ultrasound guided biopsies to vascular procedures that can give radiotherapy treatment directly into liver tumours.

Although the role of the nurses is predominantly to support the patients and assist the doctors in the provision of care during interventional procedures, we also run a unique but very successful drop in clinic with the nutritional nurse for patients who have gastrostomy feeding tubes. Within this clinic we are able to provide practical help but more importantly we are there to give support and advice at any time within the working week. We are very fortunate that we are able to build strong and trusting relationships with our patients through this service.

I have found over the last 11 years working in interventional radiology, that there is often a lack of understanding regarding the speciality, not only for patients and their relatives but also for other staff members within the hospital setting. 

As a team, in 2017, it is our intention to raise the profile of interventional radiology especially as we have a very exciting and anticipated move in April to the new integrated procedures unit (IPU). Interventional radiology will be moving to the new unit along with the procedure team, pain team, day case theatre, endoscopy and plastics. This will be a major step forward for us as a team but also for The Christie as a hospital. 

Interventional radiology nursing team

Presently, we are operating at capacity with just one interventional room. With the opening of two new rooms planned in the IPU, the service will not only expand but will have provision for undertaking more advanced and intricate procedures. The addition of the state of the art advanced 3D interventional suite will mean that we will be a European reference centre with the ability to record and live stream complex cases all over the world. 

The amount of charity work that has been carried out to enable this expansion and improvement is overwhelming and as a team we are delighted to be the subject of this year’s Christie charity ball. This can only enhance the status of interventional radiology.

Our priority is always to provide the very best patient care. We wish for our patients to have as smooth a journey as possible and for optimum outcomes to be achieved. The enormity of what we will potentially be able to achieve with the expansion of the interventional service for our patients in the future is tremendous and something we look forward to greatly. 

To find out how you can help to support the new Interventional Radiology suite please visit our fundraising page or you can help to support The Christie's new Integrated Procedures Unit.