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  • COVID-19 and Cancer – The View from the Frontline

COVID-19 and Cancer – The View from the Frontline

When COVID-19 first reared its head in 2020 it changed everything, for everyone. For some, it's been more difficult than others.

Last year we spoke to three of our health specialist and charity contacts to find out how they’d been getting on as the pandemic developed.

Sadly the pressure on the NHS has intensified in 2021, not only through COVID admissions, but also the impact it has on other clinics. There’s a fine balance in making decisions for those living with cancer, where continuing treatment with a weakened immune system could put them at risk of contracting the virus. On the flip side, postponing their treatment risks progression of their cancer. 

To find out what it’s like on the frontline, we spoke to Sarah Berwick, a Macmillan Advanced Lung Cancer Clinical Nurse Specialist for York Teaching Hospital, about her experiences through the ever-changing circumstances of the pandemic.

How have you and your team adapted to offer support virtually?

During the COVID-19 pandemic, the York lung cancer nurse service has had to adapt to many new ways of working and supporting our patients. During the pandemic, what has changed is that instead of a nurse seeing a patient face-to-face in a clinic with a consultant, the patients now receive a call from a respiratory consultant. 

This call discusses the patient’s scan results, the potential diagnosis of a cancer and also assesses the patient’s fitness for treatment. The patients are told that we’ll ring them next day to introduce our service. We also go through what they’ve been told and send them out information and a summary of their results and plan.

How has it felt to work in the profession you do? What has the toughest moment been?

It’s been an incredibly challenging time for everyone working in the NHS. On a daily basis I hear about staff really struggling with the impact of COVID-19. It’s been particularly hard on mental health. There’s a feeling of constant trepidation as we wonder if the NHS can continue to cope with the demand, especially the staff who are exhausted from the second wave of admissions.

As nurses, we’ve shown a great resilience. Even now when we think we can’t take anymore, we all find something to get us through. The hardest part of this pandemic for me is not being able to see the patients at diagnosis. Many of them have been very unwell and unable to have treatment and trying to support them over the phone when they have little to no support in the community is really tough.

What positives have you been able to take away in these challenging times?

I’ve realised more than ever that I work with an amazing team. They’ve adapted to all the challenges without any complaints or compromise and they’ve never stopped trying to improve the service we provide. We’ve coped with whatever has been thrown at us.

What has improved since March 2020 to make things better for patients?

Diagnostics and treatment for lung cancer weren’t stopped unlike some other cancer specialities, but only patients who were deemed fit enough for treatment were put forward to continue with diagnostic tests. The other patients were told over the phone that they would have no further tests or treatment. The only time a patient came to a face-to-face appointment was when they spoke to an oncologist/surgeon before starting their treatment. 

This has now changed a little, patients who are potentially not going to be fit enough for treatment are now seen in a face-to-face appointment. This is really helpful because it’s difficult to assess how well a person is over the phone. This makes a massive difference to patient experience and expectations. Patients did feel abandoned because they’d never met a doctor or nurse and would be told devastating news over the phone. Thankfully this is no longer happening.

Patients who had a low suspicion of cancer also had their scans delayed indefinitely. This is now being managed by our team and the radiology department, where we keep in constant communication with radiology on what CT scans are urgent and which can be delayed for a period of time. It takes a lot of organisation but our coordinators do an outstanding job of keeping on top of it.

Referral rates have been low during the pandemic but this is starting to rise significantly which means that hopefully people feel more confident about approaching their GP when they have symptoms. 

How has the third lockdown impacted what your team does?

The third lockdown has been both easier and harder. We were very well prepared for it, and we didn’t need to change how we worked which was good. Nonetheless we knew that it would cause a lot of anxiety to our patients and generate many questions that are often difficult and sometimes impossible to answer, but most of the questions asked were similar to the ones we had the first and second time so we were more than prepared.

As the amount of COVID-19 patients admitted to hospital escalated, they redeployed a nurse from the team to work on the wards. This time the team was different in that we already had wo members of staff having to work from home and I was covering maternity leave in the team so there was extra pressure on all of us.

Although this time has been particularly difficult, we now see a light at the end of tunnel with the vaccination programme. Hopefully soon we will start seeing life returning to some semblance of normality. 

 

Macmillan nurses do an incredible job supporting people living with cancer, performing an invaluable role in our communities. We’re very proud to support this fantastic charity, who provide emotional, physical and financial support to our clients from the moment they’re diagnosed. 

Find out more about Macmillan and their tireless work on their website.

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