What Is A Macmillan Nurse?

“My very first ward experience was on a women’s medical ward. It was run by a very strict sister who scared the life out of me. All her Nurses were expected to know each patient and what was wrong with them - all 24 of them!”

Christine takes us through what life is like as a MacMillan Nurse and gives you the knowledge you need when starting your journey.

Topics covered in this article

My Journey To Becoming A Macmillan Nurse

What Is A Macmillan Nurse?

What Skills Are Needed To Be A Macmillan Nurse?

What Does A Macmillan Nurse Do?

What Are The Settings Macmillan Nurses Work In?

Where Does The Macmillan Nurse Fit Into The Process Of Patient Care?

How Does Macmillan Cancer Support Work With Other Health Organisations?

What Are The Career Opportunities In Macmillan Cancer Support For Nurses?

A Brief History Of The Role Of The Macmillan Nurse

Brief Outline Of A Day In The Life Of A Macmillan Nurse

My Journey To Becoming A Macmillan Nurse

I left school at 16 with a few CSEs and went to college to train to be a children’s nanny.

I spent the first year after my training looking after children in private homes in London.

I lived in Coventry so when my Mum had to have minor surgery, I went home to help.

There was a massive shortage of nanny jobs outside of London.

My mum suggested Nursing and I thought this seemed a reasonable idea.

I didn’t want to do the 3 year course and opted instead to do the more practical 2 year SEN training.

My very first ward experience was on a women’s medical ward. It was run by a very strict sister who scared the life out of me.

All her Nurses were expected to know each patient and what was wrong with them - all 24 of them!

From that first ward, my love of Nursing grew.

I especially liked the human contact, talking to the patients as I attended to their needs.

I was not very fond of the ‘machinery side’ such as theatre and ITU.

When I completed my training, I worked on various wards before my children came along.

Then, I started to work nights.

I settled into a role working nights on a geriatric ward (as it was called then).

It was on this ward that I started looking at why every patient admitted was automatically prescribed sleeping tablets.

I felt that this disorientated many of them and added to their night incontinence. I researched and read articles, asked questions and eventually got my voice heard.

This led to me being presented with an award for being innovative and caring. After that, I started doing training courses and learning as much as I could on top of my basic Nursing skills.

I wanted to expand my career.

I decided that my goal was to become a Macmillan nurse!

I enrolled on one of the first Nurse conversion courses and I became a registered nurse in 1989.

I applied for a post in the local Hospice and from there, I set out my stall to achieve my goal.

I read articles, went out with the local Macmillan nurses, applied for courses and managed to get myself a place at Birmingham university to study for a Palliative care degree.

With the degree under my belt, I started to apply for Macmillan posts.

What Is A Macmillan Nurse?

A Macmillan Nurse is a Nurse who specialises in palliative care.

The aim of palliative care is to focus on the needs and comfort of individuals and their families who have been diagnosed with a life limiting illness.

He or she provides leadership, innovation and expertise when patients have highly complex care needs.

They provide direct care to the patient and support and guide other medical practitioners and carers.

Education and teaching are large parts of a Macmillan Nurse role.

Both in enhancing the Nurses own role and teaching others in a wide range of settings.

The Macmillan Nurse is a registered Nurse who has been educated to first degree level and has completed, or is working towards post graduate qualifications.

The skills needed to become a Macmillan Nurse are ever changing, depending on the type of role applied for and the employing health authority.

Above all, you will need excellent communication skills and be able to work as part of a team.

Though there is no age limit, the maturity that comes with life experience is a massive asset in helping to cope with the emotional burden that this role carries.

Most weeks will see a lot of sadness, tears and death and it is very easy to allow the role to ‘get to you’.

It is important to learn how to switch of and take care of yourself.

Just securing a post as Macmillan Nurse doesn’t mean you immediately ‘become’ a Macmillan Nurse.

It can take many weeks and months to fit into this challenging role.

What Skills Are Needed To Be A Macmillan Nurse?

I worked so hard to achieve ‘my dream’ and it was not easy.

I dreaded the teaching aspect and used to spend hours fretting about having to speak in front of people.

I took on far to much emotional baggage and ended up ‘burnt out’ for a while. Sometimes it would have been easier to give up, but I am so glad I didn’t.

Being a Macmillan Nurse truly enriched my whole life.

Now, I easily teach and lecture others without qualm.

I have taught myself that I am not invincible.

I have a life outside of my role.

I do get emotionally involved because I care, but I know when to let go.

I always said to myself that the day I don’t feel the emotion is the day I need to give up.

So, I would say to anyone who really wants to break into this area of Nursing, get as much Nursing and life experience as you can.

Do your homework.

Keep up to date with documents such as The Nice Guidance; Gold Standard framework; The World Health Organisation, etc.

Be familiar with the policies in your own area.

Talk to others in this role and don't be too picky about applying and attending interviews.

Every application and interview helps to develop confidence and interview skills.

What Does A Macmillan Nurse Do?

Macmillan Nurses either work in hospital settings or the community.

Many hospital Macmillan Nurses have ‘site specific’ roles meaning they specialise in certain cancers, such as breast cancer; head and neck; ovarian; prostate.

What Are The Settings Macmillan Nurses Work In?

These specialist Nurses work alongside the consultants and the chemotherapy and radiotherapy departments.

Other hospital based Macmillan Nurses visit patients on the wards and help to support the Nurses and other members of staff by helping with complex symptoms.

Community Macmillan Nurses visit patients and their families in their own homes.

They work very closely with other community Nurses such as District Nurses and Hospice at Home.

Where Does The Macmillan Nurse Fit Into The Process Of Patient Care?

Although the Macmillan service is historically linked with cancer, Macmillan Nurses now help patients who are suffering from a wide range of other life limiting diseases, such as heart disease; dementia; motor neurone disease.

Again, historically, the Macmillan Nurse generally followed her patients through to death.

Now, she or he only gets involved with complex care issues whereby the usual carers such as the district Nurse and/or GP require further specialist help.

How Does Macmillan Cancer Support Work With Other Health Organisations?

Macmillan charity supports the position of a wide range of new Macmillan posts by ‘pump prime’ funding.

This typically funds the post for the initial 3 years before the employing health authority takes over the role.

Once this happens, though many do retain the ‘Macmillan’ title, the post can be renamed such as ‘palliative clinical Nurse specialist’ meaning anyone can refer a patient into the service.

It is then up to the specialist whether they accept the referral or not.

If the patient does not appear to need specialist complex care, the Macmillan Nurse will make sure that the referee is directed to more appropriate help.

What Are The Career Opportunities In Macmillan Cancer Support For Nurses?

There are career opportunities though a Macmillan post generally holds a high band at the start.

Many Macmillan Nurses remain in their roles until retirement, as I did.

There are opportunities to move into managerial posts; site specific roles; teaching roles; hospital and community posts.

A Brief History Of The Role Of The Macmillan Nurse

In 1911, a man named Douglas Macmillan watched his father die of cancer.

At that time there was no NHS, and nurses were not specially trained.

His father’s illness and subsequent death had a profound effect on Douglas Macmillan and he decided he needed to to do something to help others.

He wanted to see homes for cancer patients throughout the land, (later known as Hospices) where attention would be provided freely or at low cost, and nurses who would attend to cancer patients in their own homes.

The following year, despite having no medical background himself, he set up the Society for the Prevention and Relief of Cancer, with a donation of £10.

The aim was to establish what caused cancer and how best to treat it.

The organisation he founded has since flourished and is today known as Macmillan Cancer Support.

Today, there are over 4,700 Macmillan Nurses and other specialist professionals working in the health and social care system across the UK today.

Brief Outline Of A Day In The Life Of A Macmillan Nurse

There are many different Macmillan roles so each will have a different ‘day’.

Initially, most Macmillan posts were 9-5 Monday to Friday, no weekends or bank holidays.

Eventually, more and more posts have extended their hours to cover weekends and bank holidays with the Nurses working on a rota.

The site specific role nurses spend much of there time in the outpatient clinics with the consultants.

The hospital Macmillan Nurses take referrals from the ward staff and see patients on the wards.

My role as a community Macmillan started at 09.00 in the office.

This may be a room in a hospice, or a room attached to a community clinic.

We used to take messages on the answerphone system.

Most services now get their messages directly from a single point of access hub via email.

Many services also have secretarial support.

Telephone calls are a big part of the role, arranging first assessment visits; arranging follow up visits; phoning to see how someone is; giving advice over the phone; calling GPs or the oncology service; bereavement follow up.

Team meetings usually happen weekly to discuss referrals and other issues. Visiting patients in their home then occupies the middle of the day.

Depending on the type of visit, length of time and number of visits vary. Usually somewhere between 2 and 5 visits daily.

First assessments generally take a good hour, with follow-ups often being much shorter.

However, as with any community Nurse job, you never know what you will find behind the door.

At any time during the day, your mobile is likely to ring with a problem. Most Macmillan Nurses are now expected to be Nurse prescribers.

Writing prescriptions and syringe driver charts are important parts of the role.

After visits, it is back to the office to write up the notes and make any calls that are needed, before the day finishes at 17.00.