Safari Daycare

Safari Outpatient Daycare Unit at Great Ormond Street Hospital (GOSH) is a daycare and outpatient clinic for children undergoing treatment for cancer, those pre- and post-blood and marrow transplant, children with immunological and haematological conditions and those with infectious diseases.

The team is responsible for the administration of chemotherapy and immunoglobulin therapy, cannulation, post-operative care and liaising with shared care hospitals.

Rochelle is from New Zealand, where she trained in general nursing. In 1995 she decided to spend two years travelling around Europe, which brought her to London – a city she loved because it's "busy with lots going on". Rochelle joined GOSH in 2000 and is a Band 7 Clinical Nurse Specialist (CNS) for leukaemia.

We treat all sorts of patients including haematology/oncology, blood and marrow transplant (BMT) and immunology cases. Our leukaemia patients tend to require between two and three years of treatment, which they receive both here at GOSH and at their local hospital. We provide the more intensive treatment they require; at their local hospital, they'll receive less intensive chemotherapy and blood product infusions, for example.

My role as a CNS involves acting as a co-ordinator between the two hospitals involved in the patient's care (GOSH and their local hospital). I make sure everyone knows what is going on, on both sides, and spend lots of time giving advice to the local hospitals about suitable treatments. I spend time with families ensuring they understand their treatment and act as a source of information for both nursing and medical staff.

As a nurse practitioner, I run my own clinic once a month, where we see patients who have completed their treatment and are in remission. This is a nurse-led clinic.

For someone coming into a CNS/nurse practitioner role, there are lots of opportunities for professional development. We have hugely supportive nursing managers and consultants so are able to take on roles that might traditionally be considered those of a doctor. Because of the advanced levels of training we receive, and the support we have, we are empowered to take these on. This makes a big difference to our patients as we are able to offer them continuity of care, which we know is what they want.

I thoroughly enjoy and relish the levels of responsibility we are given here. It is really motivating to spend each day working alongside medical experts, who might even be running trials for a treatment covering the whole of the UK. These people are real decision-makers in their field and it allows us to work at the leading edge of medicine.

Quite a big challenge is that other hospitals sometimes work to a more traditional model. The nursing staff there might not be so empowered and experienced, so can find it hard to accept that we make the decisions and give the advice that we do. Again, that's one of the great things about working here - that we have these opportunities to improve our knowledge and skillset.

Treatment for leukaemia is very successful nowadays and the vast majority of children will survive and go on to lead normal lives. But, a small number of patients will suffer long-term effects of their treatment, and some don't survive, so there are difficult days and difficult conversations to be had at times. Making a difference and helping these families through these situations is very rewarding.

A CNS/nurse practitioner role is incredibly busy so you need to be able to prioritise your workload and understand exactly what your clinical priorities are. You need to be someone who can take responsibility and think independently. It goes without saying you need to have good knowledge about your clinical area.
The hours and shifts are fairly flexible and regular - they don't cover evenings and weekends for example.

I remember the mum of a patient who had been diagnosed with leukaemia by his GP. Because the boy didn't look sick, she couldn't believe he needed treatment and found the diagnosis very difficult to accept. I spent a long time just talking to her, understanding her concerns, and working with her to find ways to overcome them. In the end, the patient had the treatment he required and is now in remission.

This is an example of why continuity of care is so important - by talking to families you build relationships and trust. If you know someone, you know how you need to talk to them about things.

Definitely - I feel like we are particularly well supported here, and given great levels of encouragement from our colleagues.

I like working at a paediatric-focused trust. It helps having all the different specialties under one roof; it makes things far more convenient for our patients because they can get what they need when they need it.