11 August 2022
When the first TYA unit opened in 1990, I was at school and didn’t know I wanted to be a nurse let alone that TYA would be my passion as a nurse. I haven’t always worked with this age group (13-25th birthday). I began my career in adult general medicine and gastro as a grade D staff nurse. We cared for alcoholics either detoxing or admitted with GI bleeds. Being naive and junior, I always believed them when we had patched them up and they said they were going to stop drinking. Unfortunately, after two years of readmissions and some deaths, I was thinking of leaving nursing. But I have been very lucky in my career as I have met many people who have championed me and I met Matt, a lung cancer CNS, who said that I should give cancer nursing a chance before I left nursing. And there began a lifelong love of cancer nursing. From there I have had multiple roles; staff nurse, ward sister, CNS, ANP, lead nurse, nurse consultant. In multiple specialities, gynae-oncology, skin cancer, day-care, prostate cancer, AOS and finally TYA. I chose to be an adult nurse; children’s nursing is not something I considered doing. Though TYA isn’t really the same as working with children. This is the beauty of TYA nursing, it is the bridge between children’s services and adult services. TYA helps to deal with all those grey areas which we have in the NHS, and which can seem daunting.
So what is TYA? I would say working in TYA is the best because it brings all those things I have done together. You don’t look after just one type of cancer which can be difficult. I have limited haem-oncology experience and it feels like listening to someone speak a foreign language at times. Sometimes it doesn’t feel like you are at work in a hospital at all. The TYA units are bright and spacious… for the NHS. I remember the first time I walked into a TYA unit as a skin cancer CNS, it felt bizarre. The unit was very bright, green to be exact. Very quiet and dark. What I learnt was that most TYA units don’t turn the lights on until after 10am as the teens don’t get up until mid-morning. Now as a nurse this felt like bliss; there’s none of the crazy, rush out of handover, do the drug round, give out breakfast, make beds, and do washes that you have on the adult wards. It’s a great way to start your working day!
There are difficult days but the great thing about TYA is that there is a really big team to help you. Most unit have TYA lead nurses/ nurse consultants like me; we are great resources and even though we may look like we just sit in an office, we are really busy making sure that TYA’s get the support and services they deserve. We have amazing youth support coordinators (YSC) who really engage with the patient as a young person rather than as a cancer patient. Young Lives v Cancer provide social care which is invaluable and something the NHS struggles to provide. Then there is psychology; we all know the importance of psychological support but for me the key with young people is getting them connected with this service early, before there is a problem which needs intervention.
I often wonder how I would have coped at that age with a cancer diagnosis. I’m not sure I would have, and let’s face it, we didn’t have these services when I was that age! Going from childhood to adulthood with the trauma of a cancer diagnosis and treatment isn’t easy but with a dedicated team to help you, it can be done. When I engage with a young person, I don’t even mention the cancer diagnosis when I first meet them. I find out what’s important to them and connect with them. I remember one feisty 20 year old, who had been causing mayhem in the adult day unit. I met her and her mother in outpatients. The patient loved dogs, as do I, so we spent the first hour talking about dogs. She showed me photos of her dog, and this fantastic app which makes your pet talk. We used photos of her dog and sang songs using this app, all in the waiting area. We connected. And she really trusted me, even at the end of life, she and her family trusted that I would ensure she got the best care. Not necessarily the best treatment but the best care. And that is why I work in TYA; to help young people be young people during cancer treatment.
I’m going to finish with the story of a young patient. I’m going to call him Harry. Harry had stem call transplant as a child and was under follow up with the TYA team as a late teen. Unfortunately, Harry had awful gut GvHD (graft v’s host disease) which sometimes prevented him from eating and necessitated a PEG tube. He was under gastro and dieticians. Physio saw him to help with exercises as he really wanted to bulk up. Staff were becoming exasperated and as sometimes we do, they started to say it was psychological and there was nothing physically wrong with him. He was taken under the wing of the YSC, music therapist from Nordoff Robbins and the TYA physio. These three individuals worked with him over the summer of 2019. By the time we got to November and the time for Teenage Cancer Trust’s Find Your Sense of Tumour residential event, Harry was in a much better place and came with us to the event. The first evening we were all having supper together, Harry had a cup of tea but that was all. The patients and staff didn’t make a big deal of it and carried on with our meal. This was Friday. The weekend was a blast, everyone had a fantastic time. Harry even got on stage with the music therapist, who had come along with us, and sang ‘my way’. On Sunday, we stopped at services for burgers on our way home. Harry joined us and had a burger with the other patients. Maybe it was psychological, and maybe he felt safe and cared for by people who did not judge him. Since then, Harry has gone from strength to strength, reconnecting with friends, going out and just moving forward.
If you would like to talk about a career in TYA, please feel free to contact me on nkumaralingam@nhs.net. Below is a list of current TYA jobs in a variety of NHS organisations:
Band 6/7 Teenage Cancer Trust Nurse Specialist for Teenagers and Young Adults
Royal Victoria Infirmary, Newcastle upon Tyne
Contact: karen.hamlen@nhs.net
https://careers.nuth.nhs.uk/vacancies?tab=2
Band 7 TYA Ward Sister
The Royal Marsden hospital, Sutton
Contact: Emma.Thistlethwayte@rmh.nhs.uk
http://jobs.royalmarsden.nhs.uk/job/v4403312
Band 6 TYA CNS (opening in September 2022)
The Christie hospital, Manchester
Contact: hanna.simpson@nhs.net
Band 6 Senior Staff Nurse
University College London Hospitals, London
Contact: lauren.jordan@nhs.net
http://uclh.healthjobsuk.com/vacancy/4425793
University College London Hospitals, London
Multiple opportunities for band 5 and 6 nurses in the following areas:
Contact: eleanor.tyrrell1@nhs.net