Gavin Maynard-Wyatt, Teenage and Young Adult Lead Cancer Nurse at Guy’s Hospital, London shares a day in his life...

Sitting on the 7:47am Horsham to London Bridge train, coffee with hot skimmed milk, bleary eyed as I am not a morning person.

First job of the week is to text the 200+ young people currently stored in my BlackBerry – “Hello, how are you? Is there something I can help you with?” On a good response day, 75 will respond throughout the day; less good response day 35+.

Great way to communicate with young people. They don’t want to be bothered with calls that interrupt their day.

Multi-disciplinary team discusses newly diagnosed

I sit in my office and start trawling through emails.  So many MDT lists to search for newly diagnosed young people. At Guy’s we are a growing team - nurse, doctor, psychologist, dietitian, social worker, community youth worker and a fertility expert.

We have a monthly business meeting where we can all come together to discuss newly diagnosed teenage and young adults, current patients with ongoing issues, and how we can keep our service growing and strengthening.

Weekly clinic for young people with cancer

We now have a weekly TYA clinic so I tend to use Monday morning to start preparing for it. Seeing how many new patients are coming, and who are on follow ups. At this point, I text those due to be seen - this reminds them of the appointment and also helps reduce DNA (did not attend) rates (for if they did forget we can re-book them a new date).

We see all our TYAs from diagnosis, end of treatment, then at 3 months and 6-month intervals post treatment. We try and see six patients per clinic. I know compared to other clinics this does seem rather small, however, we try and give each person we see about 20-30mins.

They see each member of the team (as mentioned above) as they work themselves around the clinic so are with us for about 2 hours. We have just started a patient experience questionnaire, which is looking at our clinic, text messaging, Facebook and activities that we run.

Important use of social media

In 2011 I set up a Facebook page for online peer support. I thought it was going to be an easy thing to do, however, that wasn’t the case. I had to go to clinical governance to explain why I wanted the page. To IT to get access to Facebook and then I had to write an operational policy.

With this done, I became the first member of TYAC to have this type of page that allowed TYAs to talk to each other and share their worries and concerns and also their experience. With this page in place, part of my day is spent checking the page to ensure everyone is behaving and being respectful of each other. This is a significant commitment, but a necessary part of my role.

One-to-one support for TYAs

I offer all my TYAs 1:1 support which happens away from the weekly clinic. Not everyone needs to be seen by a psychologist, as they might just need someone to listen to them away from family and friends. This is the part of the job that I enjoy the most. It’s an honour for me to be able to provide this kind of service - to know that a young person trusts you with their story, experience, worries, and concerns.

To know that once the hour is up, they tend to walk away feeling happier and that someone cares about them and their journey. In my experience, TYAs cope reasonably well with diagnosis and treatment, so it is often once treatment has ended and six months have gone by that they finally look back and think ‘OMG! What happened to me?’

Inpatient visits

As I cover three main hospitals I get the chance to spend some of my day visiting those TYAs who are inpatients. Being in isolation (which most of my TYAs would be if admitted) can be a lonely part of the treatment.

I like to see them and spend time talking. This is a great opportunity to find out how they are really coping with their diagnosis and how it has affected their friendship circles.

So often we hear that once diagnosed they lose friends. This can add to their isolation so talking about it, can help them realise that it is nothing they did and that it is a common issue.

My typical day usually ends with re-checking emails, catching up with clinic letters, answering text messages and sorting out wish days. 

Author:  Gavin Maynard-Wyatt