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10.5 Advanced Practitioner Case Study 3

Advanced Practice Radiographer in Gynaecological Oncology at CUH

I have worked as an Advanced Practice Radiographer at Cambridge University Hospital since 2005. Prior to this I undertook a number of diverse roles, including Clinical Lecturer and Clinical Trials Radiographer. I have embraced every role with a passion but have found my niche as an Advanced Practice Radiographer in Gynaecological Oncology, developing a special interest in cervix brachytherapy.

My role as an Advanced Practice Radiographer in Gynaecological Oncology facilitates the provision of specialist information regarding disease, treatment and side effects from the point of diagnosis for patients, relatives and carers.  

Role extension, supported with a competency led training program has enabled me to assume a number of responsibilities, traditionally undertaken by the consultant oncologist. For example, I provide a radiographer led ‘on treatment’ review clinic for patients undergoing pelvic radiotherapy, following an agreed departmental protocol, which involves reviewing the patient on a weekly basis and assessing their general well being; identifying side effects and recording possible toxicity from radiotherapy/chemotherapy.  

I undertake sizing and insertion of brachytherapy equipment for patients undergoing vaginal vault brachytherapy. This involves performing a vaginal examination prior to sizing, in order to exclude possible recurrence. I am also involved during the surgical procedure required for cervix brachytherapy; undertaking independent removal of the brachytherapy applicator following treatment.

Delivery of the brachytherapy pathway, fast becoming increasingly complex, is a daunting experience for many patients. Involvement of the Advance Practice Radiographer facilitates provision of effective information and support throughout the patient pathway, ensuring patients receive a high standard of care and the pathway remains, at all times focussed around the patient needs.   

My role has significantly developed and evolved over the years and in fact continues to do so. I have developed additional clinical expertise, skills and attributes within my defined area of practice, underpinned with evidence based knowledge, allowing me to practice at an advanced level securely.  

This involves studying at M level (level 7) in appropriate academic subjects; ultimately achieving the award of MSc Advanced Practice in Radiotherapy and Oncology.  

Finding a balance between studying, my clinical responsibilities (and home life!) has represented a challenge. It is hard work but definitely manageable; in fact it eventually becomes second nature (and if I dare say, enjoyable!).

The role has presented me with many more challenges over the years. In 2009 Cambridge University Hospital became the first hospital in the United Kingdom to introduce Image Guided Brachytherapy. I was an integral member of a team responsible for its successful implementation; inspiring, motivating and collaborating to facilitate improvements in service delivery; offering appropriate advice to professional colleagues on care practices, delivery and service development.   

Indeed, one of the most significant (and daunting) challenges to date was when I was invited to present at the CRUK, Cambridge. Around 100 radiographers, physicists and oncologists gathered for a progress meeting on the subject of implementation of IGBT for cervix cancer in the UK.  The meeting provided me with the opportunity to inspire; describing how the role of the Advance Practice Radiographer is instrumental during service redesign and within the delivery of Image Guided Brachytherapy.

I feel extremely privileged to work as an Advance Practice Radiographer. No day is the same! The role enables me to demonstrate my expert knowledge and skills, interacting with the multidisciplinary team, identifying where service improvements can be achieved and ultimately delivering the highest standard of care to all patients.

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