As a Macmillan nurse, Alison Keen has helped patients through her care and leadership skills
The realisation that she wanted to do something that mattered was a lightbulb moment for Alison Keen, head of cancer nursing at University Hospital Southampton Foundation Trust. The desire prompted her to leave her accountancy training with the NHS and instead train to be a nurse - and it is one that has continued to resonate throughout her 30-year nursing career.
“Like most nurses, most of my learning has come through patients,” says Ms Keen. It was one such lesson while working on a surgical ward that started her on the path to becoming an oncology specialist nurse.
“A patient whom I had cared for on two occasions, was told her cancer was not treatable,” Ms Keen recalls. “I went home that evening feeling sorry for myself. I felt personally upset. When I came in the next day, she clearly and sternly told me that it was she who had cancer and would die; it was her and her family’s grief; not mine.”
Ms Keen realised that what her patients really needed from her was her professional support and compassion, not her sympathy. She wanted to be able to explain what patients can expect after diagnosis and support them by being equipped to answer their questions.
Ms Keen has achieved this and more for individual patients, but her impact on oncology nursing is far more wide reaching. After returning to the surgical ward as ward sister equipped with an ENB in oncology nursing, she continued to seek out opportunities to positively impact on the experiences of patients with cancer.
“I was fortunate that two new Macmillan posts were being advertised within the trust as oncology support nurses,” she explains. “We were the first clinical nurse specialists, apart from breast and stoma care specialists, and we were the prototype for the CNS role now.”
Although the role meant she was able to do exactly what she’d come into nursing to do, it was not without its challenges. “We had to know a little about a lot so weren’t able to be experts in any one area. We decided to ‘divide and conquer’ and split the specialisms between us - but even that was too many.”
Macmillan soon identified that the CNS oncology role had to be broken down further, and nurses given the opportunity to become “site specific”. Ms Keen was thrilled when a gynaecology oncology CNS post came up, an area in which she had a particular interest.
But her desire to continue to improve cancer nursing didn’t stop there. She was frustrated at not being able to find a complete one-stop-shop resource that covered everything relating to this area of oncology: “There’s plenty of literature out there on cancer and treatment, but nothing told the whole story.”
She turned her frustration into action and in 2011 a textbook that she and a colleague, Dr Elaine Lennan, edited on gynaecological oncology was published.
“There were surgical textbooks with diagrams and general oncology textbooks, but nothing told the whole story from the impact of treatment on sexual health to the effects of chemotherapy, radiotherapy and surgical treatments,” Ms Keen explains. “So when Elaine approached me with this idea, I was easily persuaded.”
On being encouraged to apply for promotion, she recalled her original reasons for becoming a nurse and was concerned that being head of cancer nursing would take her away from direct patient care.
“Nurses are nurses because they get so much back from giving to individual patients,” she explains. “When you’re not doing that and you’re working more towards political successes, you don’t get the same gratification.”
But after two years in post and over 20 years with Macmillan, Ms Keen knows she made the right decision. “Even when I feel I didn’t enjoy that day, I know it’s another piece of the jigsaw and part of making significant changes to benefit patients more widely.”
Ms Keen’s career is marked by her ability to make things happen and Macmillan has been the perfect partner: “Macmillan has been hugely influential in developing cancer care,” she explains. “Without Macmillan, cancer services globally would be immeasurably different.”