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Balance in a parallel world

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A cancer diagnosis means a reappraisal of life, and Jane Winter and her team focus on providing holistic care to patients

Jane Winter says she is not an easy person to live with. As the team leader of the gastrointestinal (GI) cancer nursing team in the Macmillan unit at the University of Southampton, Ms Winter has developed a “live for today” attitude. This isn’t always easy for those around her.

Ms Winter, who has earned her PhD from Southampton, attributes her carpe diem outlook on life to a single mother of young children she met years ago. The woman had terminal cancer. Her goal was for her family to remember her living, not dying.

“You don’t wait for tomorrow,” says Ms Winter. “You live for today. Sometimes you see a complete change in people when you enable them to do that. Patients inspire me, and not in a cheesy way - they make me think differently. Some people can be really liberated by what’s happening to them.”

Ms Winter says while many still face terminal cancer, a cancer diagnosis has become much less of a death sentence, so post-treatment care is vital.

She and her team provide this through patient-triggered follow-up techniques, for which she was honoured with the Macmillan Innovation Excellence Award 2012. These techniques give patients rapid access to a clinic after they’ve finished treatment, so they can address concerns as they arise.

Through regular visits, Ms Winter and her team focus on patients’ holistic needs. Her continuing research on care after cancer treatment shows Ms Winter how those needs change, based on the patient.

During consultations, patients fill out a holistic needs assessment, which tells nurses how to personalise their treatment by prioritising needs or concerns on a scale.

Besides running clinics for patients with iron deficiency anaemia or colorectal cancer and follow-up clinics, Ms Winter conducts post-doctoral research on how to maximize quality of life after cancer.

“You never stop learning. That’s why I’m so passionate about research. Nursing research is about how it feels for patients to be doing what they are doing and working with where they are in their treatment.”

Ms Winter works in a team of specialists, including two lower-GI clinical nurse specialists, and two lower-GI nurse practitioners.

“You’re only as big as the team you’re a part of,” she says. “The challenge is to be very clear about what you’re doing, why you’re doing it and who’s going to benefit from it. You have to be very patient oriented to do that. Working with a team ensures that we can achieve that goal.”

One of these challenges, Ms Winter says, comes with the flexibility of her role as a consultant nurse as it relates directly to patient care. Her consultant appointments with patients enables her to view them from a personal level.

“People find it quite hard to understand that cancer nurse specialists don’t have hard boundaries,” she says. “You go wherever the patients are, depending on their needs. You’re not there to be a friend to patients, but you’re there to be a support and help them to structure their adjustment to their diagnosis - it’s fundamentally about caring. That’s why we came into nursing in the first place.”

Ms Winter says her work as a consultant nurse in a GI team has helped her to realise her passions for patient care and developing the supportive relationships she values as a professional. This relationship, she says, was difficult to attain in management, which involves little patient contact.

“The thing about nursing is you can fundamentally take two pathways,” says Ms Winter. “You can work on the managerial side of things, affecting care on a strategic level alone, or you can work with patients in a clinical setting. You increasingly get further from the patients the higher up in nursing you get.”

Despite the many responsibilities that come with her work as a nurse consultant, Ms Winter says it is vital to ensure her patients feel a sense of normalcy throughout their treatment.

“When you’re diagnosed with cancer, you’ve got a parallel world going on while everyone else is living,” she says. “My team and I are here to help patients learn how to cope with their lives, their families and children while they balance those two worlds.”

Hilary Weaver

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