What is the role of the children's community nurse in childhood cancer care?
To highlight the experiences of children's community nurses (CCNs) within cancer care and to identify their day-to-day roles and responsibilities.
Questionnaires were completed by 12 CCNs and oncology specialist nurses within London, these were analysed using a coding software.
Children and their families perceive CCNs as knowledgeable, happy and friendly professionals, essential in reducing hospital admissions and who have a positive impact on a child and their family's well-being. The CCN has a varied role in cancer care, however, currently in the UK there is no framework specific to caring for a child at home with cancer. In response to the findings, one has been written to identify care needs and to emphasise service expectations.
Specific training for caring for a child with cancer should be prioritised for all staff working within a CCN team and to ensure best practice, the framework should be implemented once reviewed and services re-evaluated.
In the United Kingdom, cancer affects one in every 500 children under the age of 15 (Office for National Statistics, 2020), the most common types being leukaemia and brain tumours. Children's community nurses (CCNs) are a group of professionals working together alongside principal treatment centres (PTC) and local shared care units to provide care. The CCNs aim is to reduce hospital visits, reduce infections and try where possible to help the child to live as normal a life as possible (The Queen's Nursing Institute, 2018). Episodes of care often included administering intravenous antibiotics and chemotherapy, wound management, phlebotomy and enteral feeding. However, at present there is no framework for CCN teams, particularly in relation to cancer care, therefore CCN services throughout the UK vary.
There are many advantages of receiving care in the community, be that in an educational setting or at home (Green, 2019). Children undergoing cancer treatment and families want to feel a sense of normality by attending school and seeing friends, and parents want to continue working (Hansson et al, 2012; Darcy et al, 2019). Both parents and children may at times feel isolated and lonely, as a result of attending multiple appointments and having long admissions for treatment, or due to complications (Bjork et al, 2009; Gibson et al, 2010; Darcy et al, 2019). Support from CCN teams can have a positive impact on the child and family's quality of life, children were able to be seen at a time suitable for them and their family (Castor et al, 2017). Support from a CCN team can reduce pressures on the family, both emotionally and financially (Green, 2019).
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