The Interview with: Jessie Chenery - Breast Care Nurse (Metastatic)

You care for people with metastatic breast cancer – what personal and professional resources do you yourself draw on when a patient is having a particularly bad day?

When a patient is having a bad day, the best resource to draw on is the relationship you have spent time building with them from the get-go. It’s all about relationship building – spending time listening and getting to know them and their lives. And so, for example, when they are having a particularly rough day – you are more likely to know the right advice for them at that moment in time. You’ll probably know which family or friends are beneficial and remind them to reach out for that support. It helps to offer more meaningful strategies such as psychology and social work. Understand the issue providing the resources that best support the patient.

I also know how to draw on the many great, evidence-based resources out there and know which ones to recommend to a patient. The McGrath Foundation, BCNA, the Cancer Council have fantastic resources – and it’s important to have a good knowledge of them because each patient is different and is ready for different types and amounts of information at different times.

I also find the local support groups are a really good resource to recommend to patients. Here in Cairns, we have some great groups including COUCH, Pink in the Tropics, Innisfail Breast Cancer Support Group and Chemo Chicks.

Having that first conversation with a patient who is new to a diagnosis of metastatic breast cancer – what is your advice on how to navigate that conversation?

On that first meeting with a patient, I spend a lot of time listening and trying to get a sense of what type of information and support they are needing in those first weeks. Of course, everyone is different, some want to talk about their fears, others don’t. In that first meeting it’s important to allow a patient the space to talk.

At that first meeting it’s so important to find out what the patient knows, what they want to know and finding any knowledge deficits. It’s also important to get to understand how much information they want at that early stage.

Open listening is such a powerful tool, and also giving them permission or the freedom to express their emotions in a safe and confidential space. It’s very important to give them the space to talk through their emotions – their sadness or their anger.

Follow-up is also very important. Call them 24 or 48 hours after that initial meeting to see how they are going.

It’s also extremely important to do what you said you were going to do. If you said you were going to book a test or talk to a doctor – it’s important you follow through and let them know.

You are working in far north Queensland and based in Cairns. How is being a breast care nurse different to being one in a major metropolitan city? What are the differences and challenges?

The biggest challenge is travel and distance. Being based in Cairns means a lot of our patients are a plane flight away. For example, patients across the Torres Strait or the Cape, down to Mission Beach or across to Croydon, many of our appointments are via Telehealth, which offers different challenges. It also means that when they are in Cairns for appointments, we make the most of that face-to-face time.

We try and align appointments as smoothly as possible, which means more planning. Sometimes patients need to stay in Cairns for treatment sometimes for many weeks. This means they are away from their home and support people for long periods of time. As you can imagine, being away from your home while having treatment is stressful and these patients need a lot of support.

But there are also benefits. We are a small community, and we know each other. We have good connections teams at Cairns Hospital including our surgical, medical and radiation oncologist, the staff on the cancer ward and in the day oncology unit. As McGrath Nurses we also work across the private sector, and we have worked hard to build those relationships within this sector.

What do you love about your job?

I love my patients. They teach me something every day. I feel so lucky to have this role, and I find it a real privilege to be able to support people through the most difficult thing they have to face. But I get so much from them. I learn so much from their strength and how they overcome huge challenges each day. The McGrath Foundation provides me with support through a network of other metastatic breast care nurses and we have extensive learning opportunities which allow us to do our job well. It’s such a supportive environment to work in which helps me enjoy my job and do it well.

What advice would you give to a breast care nurse just starting out?

I’d say it’s all about building relationships and learning from the people around you. The McGrath Foundation provides us nurses with a network to bounce ideas off and draw from others’ experience. This is so important. Look at the McGrath Model of care, it provides clear and helpful direction on being a breast care nurse, how to troubleshoot, and useful resources.

The support of a McGrath Breast Care Nurse is available across Australia to anyone facing breast cancer. The support is free, and a doctor’s referral is not required. To find your nearest nurse, visit mcgrathfoundation.com.au