The Paediatric oncology outreach and palliative care team at Great Ormond Street Hospital (GOSH) meet all new families of children with cancer and leukaemia soon after diagnosis.
They aim to help the family come to terms with the diagnosis and maintain normal family life as much as possible.
This involves visiting the child's school to explain the disease and treatment plan to the staff to make it easier for the children to attend school when they are well enough.
They work with Primary Care Teams to provide palliative care for children whose treatment is unsuccessful.
Naomi Hitchin, Clinical Nurse Specialist (CNS), Band 7
Naomi has worked as a clinical nurse specialist at GOSH since 2007. She took up her Band 7 role after completing a two-year training post in paediatric oncology outreach in February this year. Naomi enjoys camping and says her favourite place is Cornwall, where she can surf and eat at Jamie Oliver’s restaurant Fifteen.
What do the Paediatric Oncology Outreach and Palliative Care team do?
On the oncology outreach side, we offer support to all families given an oncology diagnosis. This includes visiting schools to advise teachers and offering support to community nursing teams who will help treat the patient. The palliative care team support families and patients who are given a terminal diagnosis.
What does your job involve on a day-to-day basis?
Every day is different. We do lots of home and school visits. We might also spend time on the ward checking on patients and their families, or attending meetings with the Psychosocial team to discuss each individual patient's care.
Does it take it out of you meeting families whose children have been diagnosed with cancer or leukaemia?
No it doesn't. If we ever feel overwhelmed by things we can discuss these issues with colleagues who are really supportive. We can always ask for help, so never feel on our own or burdened.
What types of personality would this job suit?
You need to be a great listener because listening to families and deciding the best ways to support them is a huge part of the job. You need to be friendly and approachable because families should be able to pick up the phone to you as and when they need to. You also need to be a strong character with good advocacy skills as we often have to be the 'voice' of the family.
What do you find most rewarding about your job?
I love school visits - seeing a patient just playing with their friends and being able to do the things their peers are doing is great. They might be undergoing really intensive treatment so it is wonderful to see them in a normal environment.
What do you find most challenging?
It is really challenging to support families who have found a prognosis difficult to accept. We work very closely with the Psychosocial team to think about what we can do for these families. We work at the family's pace, listening to their concerns and making sure they have all the information they need at any given time.
What do you think about the appointment of a Professor of Paediatric Palliative Care?
I think it's a very exciting development, especially as palliative care has only really come to be regarded as a speciality in the last few years. We know what we do is effective from practice, so it will be good to use opportunities to undertake research that allows us to prove this and might improve practices more broadly.
Did you ever think twice about coming to work for GOSH?
I previously worked in London at Guy's and St Thomas' on the intensive care ward. I have to admit I hated living in London at that time - I found it a really daunting place and felt that working shifts made it difficult to build a good social circle. After 18 months at Birmingham Children's Hospital I came across the training post here and decided to give London another chance. The role was so right for me at the time, and with all the training opportunities it provided, it was too good to miss.
Did you always want to work in palliative care?
I always had an interest in the field but because it is quite specialist, and there aren't many paediatric palliative care teams in the country, I wasn't sure how to get into it. I'm very glad I have though.
Would you ever go back to working on the wards?
No. I do shifts on Lion Ward and Elephant Ward when they need extra staff so I don't feel like I am missing out. Part of my initial training involved working one shift a month on the ward to maintain my clinical skills.
Tell us something people might not know about the Paediatric Oncology Outreach and Palliative Care team.
That it's a great place to work and despite the difficult situations we are often required to deal with, we do have fun and we all get on. It's great to be part of a close team where everyone is incredibly supportive of one another.