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Right care for teenagers

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Sam Smith believes teenagers with cancer need different care from adults, so set out to make this happen

Teenagers can be complicated and are often a misunderstood group. What about when a cancer diagnosis is thrown upon a young person?

Sam Smith, head of nursing and quality (north) for UK-based charity Teenage Cancer Trust, has committed herself to supporting teenagers and young adults with cancer.

“Young people are in a development process, and life is hard enough emotionally and physically for a healthy teenager, much less one who has just been diagnosed with cancer.”

Ms Smith, who is also a Florence Nightingale Foundation leadership scholar, has dedicated much of her nursing career to improving the quality of life and care of young people who have been diagnosed with cancer.

Ms Smith started working in acute paediatric medicine and paediatric intensive care then moved to paediatric oncology before developing services for teenagers and young adults with cancer.

During her early time in cancer wards, she saw many young people receiving treatment on adult wards.

“I started to challenge local practice and really put forward the idea that young people require different care from adults,” said Ms Smith. “It was all about challenging culture and winning over hearts and minds.”

Since those early days, Ms Smith has been an advocate for health professionals to continue learning about the best ways to treat these patients. She co-authored the groundbreaking 2012 Blueprint of Care for Teenagers and Young Adults with Cancer guidance, published and funded by Teenage Cancer Trust, in response to the need for shared best practice for treating young people with cancer.

Since young adults are on the cusp of independence, but without adult maturity, Ms Smith says those who nurse young adults should know the best way to interact with them.

“Teenagers push boundaries. Their behaviour can be inconsistent - sometimes dependent, sometimes independent. Nurses need to be able to communicate well and show tolerance and patience when dealing with this age group.”

For a teenager, a cancer diagnosis can be a frightening and isolating experience, says Ms Smith. Aside from obvious medical uncertainties, social issues are at play as well. Often, when they finish treatment, their friends back home have changed social groups and life stage and the readjustment back to “normal” can be as difficult as the treatment itself.

Ms Smith can recall several memorable moments during her work with adolescent cancer care, from treatment breakthroughs to unlikely friendships formed through something as unfortunate as a cancer diagnosis.

“Two young ladies met through an event we held. As it turns out, they had met one another before and are now great friends, supporting each other throughout one another’s treatments,” Ms Smith says.

Ms Smith’s current work is focused on working for Teenage Cancer Trust to pilot a new scheme that aims to reach all young people with cancer in the UK.

“At Teenage Cancer Trust, we were aware that only 50% of young people with cancer in many regions were being notified to the teenager and young adults’ multidisciplinary team based at principal treatment centres,” she says.

“This means that young people may be treated in isolation within adult care. We wanted to address this issue by working with NHS colleagues and providing Teenage Cancer Trust nursing and support wherever the patient is treated.”

The pilot is being formally evaluated by Dr Jane Coad at the Centre for Children and Families Applied Research at Coventry University and has shown favourable early results.

“We’ve formed a network of experienced lead nurses trying to develop solutions,” Ms Smith said. “Most importantly, it’s about taking this charity to these patients wherever they are in the country.”

Rachel Stanback

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