Helen Francis
Breast Care Nurse Specialist/Breast Advanced Nurse Practitioner
Why did you choose the career you have?
I was passionate about the impact that I thought a nurse specialist could have on a patient’s adjustment and ability to cope with breast cancer. Having worked on a surgical ward from 1986 - 1988 looking after breast cancer patients pre and postoperatively and working in a surgical clinic in 1989, I realised that women and men with breast cancer did not have any formal specialist healthcare support.
I have been in my post as a Breast Care Clinical Nurse Specialist since May 1995 and I have also worked as a breast advanced nurse practitioner since 2014. I incorporated the specialist care of patients with breast cancer into my role as a clinic nurse from 1989 under my own initiative, despite scepticism from others. I attended breast care units and met other breast care nurses in my own time to learn about their role to enable me to create a similar service at UHNM.
Since then I have led the development of a comprehensive breast care nursing service for patients with breast disease in North Staffordshire. The MSc in Clinical Oncology that I completed in 2011 and the health assessment module and breast assessment module that I completed at Masters level in 2013 underpins my skills and experience.
What challenges have you faced getting to where you are now?
In the early days I struggled with the attitudes and beliefs of colleagues and in particular one person who believed that nurses should not specialise and should never get involved in conversations with patients and families regarding diagnosis, choices of treatment, informed consent and coping strategies and mechanisms. I did however have enormous support from other surgical and oncology colleagues who helped me maintain the strength, courage and conviction I needed to establish a gold-standard comprehensive supportive service for women and men with breast cancer.
This made me even more determined and I initiated and ran the service single-handedly until a second person was appointed in 1997 and a further third in 1998, funded by Macmillan Cancer Relief, who then adopted the whole team. A fourth post was created in 2010 to bring us up to full establishment to match caseload. The service has developed over the years in terms of post-holders and skills and there are now two breast advanced nurse practitioners and seven breast care nurses who make up the team at UHNM. I have been at the forefront of developing and improving the service. I have been instrumental in the development of nurse-led clinics which include daily wound assessment/seroma drainage clinics, formal counselling and a monthly nipple and areola micro-pigmentation service to complete breast reconstruction. Now my practitioner role allows me to assess and diagnose patients and support patients on a breast self-managed pathway following treatment for breast cancer.
How does what you do make a difference to other people?
I provide comprehensive, highly specialist advice, support and counselling to meet the complex emotional, physical and psychological needs of women and men who fear they may have or have a diagnosis of breast cancer and those recovering from and surviving breast cancer. I act as a key worker, managing co-ordinated high quality, expert care, advice and support, particularly to patients with highly complex psychological and physical needs. This ensures the best quality of life and care for our client group from pre-diagnosis, along the whole breast cancer journey, through to survivorship, helping patients live well and beyond a diagnosis of breast cancer.
I lead on patient issues including patient satisfaction and patient information. I have led the formation of a comprehensive patient information pack and patient record for all newly diagnosed patients which has been recognised by National Peer and the NHSBSP quality assurance teams review with exemplars. The discharge booklet we developed has now been adopted by the Greater Midlands cancer network as “best practice” and is being used in all trusts within the network.
I worked with a patient to secure a suitable dedicated room within the new Cancer Centre to create a bespoke hair and beauty salon with enough stock and choice to offer a “one stop service” for all patients requiring a wig fitting service. The salon is named “Fresh Hair” Wigs and Beauty and has recently celebrated its 10-year anniversary.
What would you say to other women aspiring to be in a similar field of healthcare and who may have doubts about their ability to achieve their goals?
Never doubt yourself and learn to be resilient. If you are passionate about something there is nothing you can't achieve if you believe in your goal. Remain professional and realistic but always strive for what you think is important. Despite the challenges and scepticism that you may come across always fight for what you believe in and never give up, especially if you know it’s what your patients require and deserve. Work with your patients to help understand what their true needs are and never assume – they will always surprise you. Never stop learning, knowledge is power and underpins everything that we do. Enjoy learning something new every single day and travel to work every day with a smile on your face because you know you are going to make a difference to the people in your care.