Macmillan nurses - Clinical Nurse Specialist (2024)

'When I was in hospital, I didn't have to worry about the cancer - my CNS and the team ensured everything went so smoothly that I only had to focus on the next step of the treatment and recovery process.' - Martha, diagnosed with cervical cancer

Some Macmillan nurses are based at the hospital and work as part of a multidisciplinary team (MDT). A clinical nurse specialist (CNS) gives information about cancer, and support during treatment.

A CNS who specialises in the type of cancer you have is usually your main contact at the hospital. They are called your key worker.

They will give you information about:

• the type of cancer you have
• your treatment options
• possible side effects.

They usually co-ordinate your care. They can also give you and your family practical and emotional support and refer you to other services that can help.

You are usually referred to a CNS when you are first going for tests for cancer, or have just been diagnosed with cancer. They will give you a telephone number so you can contact them. But there may not always be a CNS for your type of cancer. You can ask your doctor if there is a nurse specialist you can talk to.

The CNS may be part of a team of clinical nurse specialists. This depends on:

• the type of cancer they specialise in
• how many people they care for.

You may have more than one CNS involved in your care.

A Macmillan CNS may specialise in an area that is not specific to a type of cancer. They may specialise in:

• a cancer treatment such as chemotherapy
• caring for urgent problems caused by cancer or its treatments
• a particular symptom of cancer or side effect of cancer treatment such as lymphoedema.

You may see these nurses as well as your key worker.

‘I still find the most rewarding part of my role is being at the bedside during the last hours/days of a person’s life. I have always found supporting the patient along with the family an experience that is not only requiring but a privilege to do.’ – Steven, Macmillan Palliative Care Nurse

Often, people will say “Macmillan nurse” to mean a nurse who helps manage the symptoms of advanced cancer. Nurses that do this are called specialist palliative care nurses.

Some palliative care nurses are based in hospital. They may be called a palliative care clinical nurse specialist (CNS). They see you if you are in the hospital as an inpatient. They are experts in managing your symptoms and medications. They will work with your key worker and other members of the multidisciplinary team (MDT) to help plan your care in hospital. They may refer you to the palliative care team in the community when you go home.

Other specialist palliative care nurses are based in the community and visit you in your home. They work as part of a community palliative care team and may be connected to a hospice. They may have a different name, which might include the hospice they are attached to.

Community palliative care nurses work with your GP and district nursing care team to give specialist advice on:

• treating symptoms
• medicines
• emotional support
• other support you may need.

All specialist palliative care nurses, even if they are based in different places or are known by different names, have similar skills and knowledge. Their aim is to help you live as well as possible.

They are experts in controlling symptoms such as pain or shortness of breath. They can:

• help manage your medications
• help you plan for your future
• arrange practical care and support if you need it
• offer emotional support to you and the people close to you.

They do not usually give hands-on physical nursing care in the same way as hospital ward nurses or district nurses in the community.

In the video below, Andy talks about his experience of being a Macmillan Palliative Care Clinical Nurse Specialist. We have more information about palliative care and cancer.