This month we talked to Nijole Gimberiene, a Bone Marrow Transplant Clinical Nurse Specialist at the Manchester Royal Infirmary, about her role, the importance of telephone consultations for patients, and how vital it is to have reliable sources of information at your fingertips. Since joining our Nursing Advisory Panel this year Nijole has had a huge impact on our work and has made a significant contribution to the new eLearning resource for nurses, which Bloodwise are developing (more on that later in the year!).
Life as a BMT CNS
I am Macmillan Bone Marrow Transplant Clinical Nurse Specialist at the Manchester Royal Infirmary Adult Bone Marrow Transplantation Unit which treats patients referred for a stem cell transplant from across the North West and beyond. My colleague and I support patients admitted for a stem cell transplant by providing relevant information, assessing their needs and involving appropriate agencies such as social worker, benefits advisor, dietitian, physiotherapist, psychotherapist, etc. We meet patients early on in their transplant journey but the biggest involvement begins a few days before the discharge and once patients leave hospital.
Going home after the major procedure and a lengthy hospital stay can be very daunting especially where patients live a long distance from a transplantation centre. Patients are given many medications to take at home which they will have to manage independently. Some of them will still feel very weak, fatigued, anxious if transplant had worked. The telephone consultation plays a major role in managing these patients at home, providing timely advice and support. It is reassuring to patients and their family to know that they can get hold of us directly, that their concerns are dealt with promptly, be it simple question about do’s and don’ts regarding a diet; or more complex issues leading to an early identification of an infection or acute graft-versus host disease symptoms.
We also see patients post-transplant in a consultant clinic. As a non-medical prescriber, I am able to streamline patient flow by assessing their blood results, prescribing appropriate treatments, co-ordinating outpatient treatments such as blood product transfusions or electrolyte replacement. It is a time where patients are the most vulnerable, their needs are continuously reassessed and appropriate agencies involved. They need constant reassurance that they are doing well, as most of them feel surprised that even couple month out of transplant they still have various side effects. The reassurance that it is normal at that stage puts their mind at rest and allows them on directing their energy on getting better.
Finally, we see post-transplant patients that have been admitted via the haematology 24 hour triage system. We assess these patients, inform the consultant team and co-ordinate specialist treatments to be delivered effectively in non-specialist areas.
It is a very humbling experience to be able to see patients recovering and rebuilding their confidence. I enjoy my job because no day is the same; it’s incredibly busy and unpredictable! I can plan to have an office day but end up seeing patient on the ward or the day unit, co-ordinating their treatments or counselling family members. I get to know not just the patient but their family, too. I enjoy continuity, seeing patients regularly and witnessing their recovery is the most rewarding. It is an absolute privilege to be part of this incredible journey.
Patients require continuous support and the constant presence of someone whom they know and can trust. As a key worker I go to extra lengths to get to know patients and their family well in order to be able to provide assistance in the most effective manner. As most of our patients are living a long distance away from a transplant centre, a good knowledge of an individual patient circumstances allows me co-ordinate their care safely. For some patients it means cancelling their appointment safely, for others organising prescription via GP, and for some a lengthy telephone conversation explaining why they must attend that week. I communicate in a language that the patient understands, and it helps in building effective working relationships.
The importance of reliable information
I am very keen for patients to have access to safe information regarding their treatments and treatment side effects. Very often patients or their family turn to the Internet for more information. The Internet can be a “minefield” so I guide them towards safe websites and Bloodwise is one of them. It has all relevant booklets available online and inspiring patient blogs. It is like a support group easily accessible from the comfort of home. I feel reassured that if I have missed any information patients can easily access it from a safe website.
If you have a story to share or would like to tell us how you make an impact on patients, please get in touch on firstname.lastname@example.org!