|  |  |  | | | | NURSING YOUNG PEOPLE - THE TEENAGERS CANCER UNIT | | | | |
| |  | |  Kylee Shipp, clinical nurse specialist
Release Date: 15 October 2006
Teenager cancer units have established themselves as a force to be reckoned with in upholding young peoples’ needs in the hospital setting. One nurse who has been part of that drive is Kylee Shipp, clinical nurse specialist in adolescent haematology, who helped to set up the teenage cancer unit at University College Hospital, London.
Working with teenagers requires specialist care and skills not immediately found in other areas in adult or paediatric care. Kylee Shipp is a clinical nurse specialist in adolescent haematology at University College London. The unit was opened earlier this year to cater for the specific challenges that teenagers face when they have a diagnosis of cancer.
Teenage cancers are probably one of the hardest challenges in cancer care. Young adult cancer has increased by 40 per cent in 50 years. Not only are young people going through a time of change, but they are faced with a serious illness like leukaemia which can affect their whole future.
Kylee refers to a range of skills, if as a nurse, you find yourself choosing a career with this age group, and said:'Teenagers have specific needs that are different from children and adults. We need to have nurses that are trained in that area and are willing to work and be adaptable. You can have the best will in the world and have a plan of care for young people, but to take it to a teenager who may be moody puts another stance on things. Teenagers are probably more intimidated by us, it’s just that they act cool. You have to be adaptable and flexible, but also have to set boundaries with them as well.'
One of the dilemmas for teenagers when they are admitted to hospital is that they may be nursed on a paediatric or an adult medical ward — neither of which takes on the specific needs of young people. This is made harder if a young person has a haematological cancer like AML where they can spend large amounts of time in hospital or even Non-Hodgkins Lymphoma where they can spend months at a time as an in-patient with only a couple of days out.
Kylee said: 'These specialist units make a huge difference. If a patient comes along with a diagnosis of cancer, especially it seems to be with the haematological cancer, they would spend lots of time away from their friends. On the teenage unit adolescents are nursed with their peers, so they have other young people around.'
The unit which is funded by the Teenage Cancer Trust (TCT), is one of the newest units, Kylee added: 'If you ask the teenagers who have been nursed on adult or paediatric wards, they can’t believe this unit exists and they wish they could have come here when they were first diagnosed because there is a huge difference from being sixty and ninety years old. Those patients say that they are the only young person on other wards.'
For your patients, their lives can change dramatically when they are diagnosed with haematological malignancy. They are taken out of their normal school life and away from their friends. Physically, they lose their hair, lose weight, their whole self esteem is affected. As Kylee points out teenagers feel cut off from their peers, and said: 'By having units like this where it’s okay to go round with no hair, where no one is going to say anything to you. It’s reassuring to be with other young people who have gone through similar circumstances.'
The major blood cancers for teenagers that the unit sees are ALL, Hodgkins, Non-Hodgkins, and lesser so AML, also aplastic anaemia, MDS. Since the unit opened combining haematology and oncology they have had a lot more referrals and most of the time they are full.
The unit consists of a four bedded single sex unit and nine single rooms. The single rooms are for teenagers who are neutropenic. They require isolation for the risk of infection or query infection which sometimes occurs during chemo therapy and patients may suffer from diarrhoea, but the cause might not be established. Kylee said that they will be isolated straight away — so that the infection can be contained. Young patients who are undergoing bone marrow transplants go to the adult transplant ward upstairs — but that is changing they are slowly being transferred to the unit. Presently, the bigger ones going upstairs; but the smaller ones are happening here.
'They are able to talk to other young people who are going through the same sort of things. They have others things they can do while they are in hospital as apposed to home, but not just sitting there. There are people that can talk to them about hair loss, a Hickman line and going on school camp. These sorts of things are a lot different from an adult going through similar things. Young people are going through a specific altered body image and their hormones are going beserk, and suddenly you’ve got cancer. If their in hospital for six months, then they can’t go to school and they get behind with their education, she said.'
The unit is fitted for a teenage environment and lifestyle. The main lounge has a big plasma screen TV, play station, game boys, dance mats, DVD nights, internet, web cam, and computers. Management of patients and their families, includes a range of services from the standard eg dieticians, physio and occupational therapist; to the complimentary including a complimentary therapist — who offers healing like Reiki and use aromatherapy oils. The provision is also offered to mums, dads and nurses to.
'The task of adolescence is to find your identity, to live a happy life. When you have cancer at a young age, if you’re taken out of your environment then it’s so isolating. Kids do experiment, they push the boundaries and see how that fits and if they don’t like it they move onto something else,' Kylee added.
At present there are 12 teenage cancer units funded by the Teenage Cancer Trust in the country and no further ones planned. Alternative ways of managing young patients are being addressed — virtual care being one approach of grasping teenager needs in hospital. Adolescent nursing has begun to evolve into a much more formal structure, but it is still on the road to recognition.
As Kylee said: 'I love working with young people and have to try and remember what it is like to be a young person. As nurses we need to say adolescent nursing is different and unique. That’s not just in oncology and haematology it’s in all care. There are other TCT units which are over the UK and therefore serve other regions. Nurses can do an adolescent pathway when they do a degree at some universities. But you still don’t come out as an adolescent nurse; you’re either still a paediatric or adult nurse. We are getting there eventually. We need to have a recognised certificate because there is much more awareness now among adolescent issues.'
Source: Livvy Fernandes, Nursing Leukaemia Co-ordinator, Leukaemia Research
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