Protocol for Urology Clinical Nurse Specialist and Urology Cancer

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					       Protocol and guidelines for the Urology Clinical Nurse Specialist in the Urology
                                  Cancer Surveillance Clinic

    The Urology Clinic

    The CNS will work alongside the Urology Consultant in out patient clinic and provide
    surveillance and follow up service for patients with a diagnosis of Urological cancer,
    including Kidney, Bladder and Prostate.

    The present clinic model involves the CNS and consultant being in the clinic at the
    same time. There is no provision as yet for a nurse only clinic apart from Flexible
    Cystoscopy where a bladder cancer surveillance clinic will be operational.

    Patient criteria

        1. The patient will have been diagnosed with cancer.
        2. The consultant will triage the patients in clinic and request that the CNS do the
           follow up consultation.
        3. The patient will have completed a course of treatment or be on long term
           treatment or surveillance:

                      Bladder cancer – Cystectomy, Radiotherapy, Intravesical
                       chemotherapy or immunotherapy and be on surveillance programme.
                      Prostate cancer – Radical Prostatectomy, Radiotherapy, Hormone
                       therapy, Active surveillance.
                      Kidney cancer – Nephrectomy, partial nephrectomy

    The Consultation guidelines

            Urology Cancer Surveillance Guidelines for urology Clinical Nurse Specialist

        These guidelines are for the nurse who will see patients in the out patient clinic
        whilst the Urology Consultant runs a simultaneous clinic. The patients seen will
        be decided by the consultant and include those with prostate, bladder and kidney

        Action                                       Rationale
        1. The patients’ case notes, including       1. To familiarise self with the
        the Urology section, results and             patients’ history and latest blood,
        letters will be read prior to the nurse      radiology or histology results.
        seeing the patient.
        2. The nurse will introduce self and         2. To gain patients confidence and
        explain role briefly obtaining verbal        provide reassurance.
        consent for the consultation to
        3. The nurse will systematically             3. To actively monitor the patient’s
        cover all aspects of general health          condition and ensure other health care
        listed in the major cancer follow up         practitioners can follow the patients’
        protocols.                                   progress when reading the case notes.
APPROVED               REFERENCE            DATE              VERSION                REVIEW 1
                          GD                9//04                1                    9/05
       4. The consultation will be accurately    4. To provide accurate records for
       documented in the case notes              medico legal purposes.
       adhering to Trust documentation
       5. Any investigations ordered will be     5. So that other clinicians can quickly
       documented within that clinic entry in    see what investigations have been
       the case notes eg radiological,           performed, providing a trigger to look
       haematology.                              up results or chase up investigation
       6. Opportunity is provided for the        6. To ensure the patient feels they are
       patient to verbalise any concerns or      a central part of the consultation
       ask questions pertaining to their         process and are involved in their own
       urological illness.                       treatment
       7. The nurse will ensure that the         7. Provides the patient with
       patient knows when they will be seen      reassurance that their illness is being
       again in the clinic.                      monitored. Also provides a goal post
                                                 towards which they can aim.
       8. The nurse dictates a letter to the     8. To keep the GP informed of the
       patients GP to reflect accurately what    patients progress and any
       was discussed in the clinic               treatment/investigations ongoing.

APPROVED          REFERENCE              DATE             VERSION              REVIEW 2
                     GD                  9//04               1                  9/05

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