Pink Hope member Melinda provides an insight into the history and role of Breast Care Nurses in Australia. She interviews a Breast Care Nurse, Judy, who shares the type of support and services that are provided by Breast Care Nurses.
You have been diagnosed with breast cancer. What now? The treatment is multifaceted – who will coordinate it all for you? Who can you turn to for support and information? So many questions arise. Luckily there is someone who can help.
Breast Care Nurses are central to coordinating the care for breast cancer patients in Australia. It was as late as 1998, during the First National Breast Cancer Conference for Women in Canberra, that a movement began to formalise such a service Australia-wide(1). A recent interview with a Breast Care Nurse named Judy, who has several years experience in this role, helped shed light on the role of Breast Care Nurses in our health care system.
Melinda: Are there any formal requirements for Breast Care Nurses aside from a degree in nursing?
Judy: Most Breast Care Nurses either have, or are working towards, a Graduate Diploma in Oncology, a Graduate Certificate, or Diploma or Masters in Breast Care Nursing, and a few have a Masters in Nursing (Nurse Practitioner).
Melinda: What is your role in the health care of women and men (pre- and post- operative)? It obviously extends beyond general nursing practices.
Judy: My main role is really information and support to the patient. Really, what you are trying to do is to give them information about the surgery, and other information they might need in terms of treatments that they have, and give them support. Some of it is a counselling role, although I don’t have any formal counselling qualifications, but clearly if I am worried about someone, then there is a social worker and a psychologist who is part of our team. I refer them to those people if I feel that I can’t manage just normal things.
Judy is part of a multidisciplinary team when treating patients for breast cancer. The team at her centre includes a surgeon, a breast physician, radiologists, pathologists, medical oncology doctors and radiotherapy doctors.
Judy is pivotal in determining what a patient needs throughout the course of their illness and helps to coordinate that care. This is particularly important for country patients in order to reduce the number of visits to city hospitals during the course of their treatment. Judy also ensures that, post-surgery, patients have various supports at home such as cleaning or Meals-on-Wheels, if required.
On average, Judy has eight formal meetings with each breast cancer patient at the hospital. She is not, however, directly involved in the patient’s care once they return home. District nurses provide home patient care, with country patients receiving care from community nurses. Judy is contactable by phone and email. Judy also maintains contact with patients during follow up appointments at the hospital (during the annual mammogram and physical examinations).
Melinda: An online search has found that the push for Breast Care Nurses seems to have taken form around 1998 after the First National Breast Cancer Conference for Women was held in Canberra. What changes have you seen over time as your role as a Breast Care Nurse?
Judy: When I look back at what I used to do 8 years ago, I am a bit more pro-active now about appointments and looking at the bigger picture of the patients. There is a lot more information about the surgical techniques that have changed in that time as well. Clearly in terms of reconstruction, that’s changed quite a bit too. More women these days are asking for reconstruction.
Judy makes mention of the McGrath Foundation and it’s valuable role in generating Breast Care Nurses across Australia. She also comments on the fact there is now better coordination of medical care for patients. In terms of discussing cancer with children, Judy recommends the valuable resources available through Canteen to help children deal with a parent’s cancer and the death of a parent.
Melinda: Who has access to your services? Do you deal predominantly with cancer patients?
Judy: Both men and women, and people without breast cancer as well. I see patients with any kind of breast problem (except for breast feeding). I see anyone that has breast surgery here. I don’t always see the non-breast cancer patients pre-op, I see them post-op to talk about recovery at home, but the bulk of the people that I see are breast cancer patients.
Prophylactic surgery is on the rise. Judy mentions that patients who have a single breast mastectomy will often have their other breast removed just because they want peace of mind. She also mentions that the support base for prophylactic surgery with high-risk individuals is probably not as good as for cancer patients, but the online support is probably beneficial here.
When asked if Judy had any other comments, she emphasized that she is happy to talk to people even if they aren’t patients of hers to answer questions they may have during their treatment process, but stresses that she is not a doctor. Judy gives nursing advice and can refer people on to the appropriate professionals. Some patients require a lot of support, others don’t.
From a personal perspective, it is positive to see how far the care of breast cancer patients has progressed over recent years. Just over 30 years ago, my mother experienced aggressive breast cancers in her late 20’s and early 30’s, with an almost non-existent support network. Thankfully, improvements in the health care system, the advent of online support services and the creation of Breast Care Nurses to coordinate the overall treatment process have helped to guide many people through an extremely difficult time in their lives.
(1)Specialist Breast Nurses: An Evidence-Based Model for Australian Practice (2000), National Breast Cancer Centre Specialist Breast Nurse Project Team
The author would like to thank the Breast Care Nurse Judy for her valuable time.