A day in the Life of Susan Nagle, Acute Oncology Clinical Nurse Specialist (AOS)

My name is Susan Nagle; I am Acute Oncology Clinical Nurse Specialist in Cancer Services at University Hospital Limerick (UHL). I have worked in various roles in Cancer Services since 2005.

I have two children—a boy and a girl—so life outside work is very busy, but incredibly enjoyable, as we spend a lot of time together, going to their various activities, baking at home, going out for walks together, and going to the cinema.

I took up my post as an Acute Oncology Clinical Nurse Specialist in June 2021. The Acute Oncology Service (AOS) provides telephone triage to cancer patients at home who have issues or concerns while they are under the care of the haematology or oncology teams.

The Acute Oncology CNS role was established nationally, and funded by the National Cancer Control Programme (NCCP) in response to the COVID-19 pandemic. Our Acute Oncology Nursing service aims to keep cancer patients well at home and out of hospital. It also provides the patients with a regular point of contact, and a name they will know—this encourages early intervention, which is very important, given the kinds of side effects some cancer patients can experience from their medications.

I cover the Emergency Department (ED) and patients on the wards, and my day starts before 8am, with a check of the hospital computer system to see how many patients are on wards and in ED. Not all patients can be treated at home and have to attend ED, and so I go to the department to see those patients, take bloods when needed, and provide support and education to nursing staff there. As well as liaising with the haematology and oncology teams and other members of staff on the wards, I will also go to the wards to see specific patients.

Telephone calls from patients start coming in from 8am. I answer these calls and return any that I miss as a matter of priority. The lines are open Monday to Friday, 8am-5pm. In 2023, our service dealt with 2,622 patient calls. Of these, 1,835 patients were dealt with at home with advice and by providing prescriptions to deal with the side-effects of treatment.

A big part of my role is liaising with support services in the community, including palliative care teams, GPs, public health nurses, and the community intervention team. I also see patients who come to us for their first appointments with the oncology consultants, giving them support and education around chemotherapy.

What I enjoy about my job is that every day is different. There is so much variety, whether I am in the Emergency Department; on the phone talking with patients; liaising with the full multidisciplinary team; and overall, acting as an advocate for our patients.

This is such a rewarding job. The connections I make with our patients mean so much, given the difference the service makes to their lives, and the personal as well as the professional growth is incredibly fulfilling.

My favourite part of the job is having the chats with the patients, whether on the phone or in person, and helping to bring a smile to their faces. Observing the positive impact of healthcare expertise on someone’s life is deeply fulfilling and constantly reaffirms my passion for nursing.

A particularly memorable career highlight for me came in 2019 when Cancer Trials Ireland nominated me for the Research Support Staff of the Year Award. I received the nomination for my dedication and compassion to patients and making a meaningful difference to their lives. I was thrilled when I won the award, and very thankful for this recognition of my hard work.

With my focus on helping patients avoid the Emergency Department through early intervention, educating patients on contacting the service early is key. When a patient is critically ill at home or in the ED going through a difficult diagnosis, my reassurance, whether in person or on the phone, gives them support.

Above all, my goal is to provide compassionate care that helps patients not only survive but also thrive.

Seeing patients regain their health and vitality is incredibly satisfying, and gratifying.

Cancer nursing is a specialised area that’s constantly evolving and progressing with new cancer treatments available all the time. Even as I write, we’re working on a brand new project for haematology/oncology patients on Ward 4B, and I’m involved in educating and supporting the nursing staff there. I would encourage nurses to embrace cancer nursing as an option, and provide specialised nursing care to cancer patients. It is an extremely fulfilling area to work in, there is always something new to learn and a kind face to meet. I couldn’t recommend it more enthusiastically as a career.