May 11, 2020 By Erika R. Whitehead

National Nurses Week: A Day in the Life of a Lung Cancer & Mesothelioma Nurse

It’s 8 a.m. in London and there’s a brisk chill in the springtime air. Rachel Thomas, a lung cancer and mesothelioma clinical nurse specialist at Guy’s Hospital, is just pulling into the employee parking lot of the hospital where she has worked for the past 11 years. She gathers her things from the car and heads into the building to begin her shift. 

She’ll have about 10 to 15 minutes of downtime to run through new emails for the day, before heading out onto the floor to begin working with her patients. As the morning continues, she’ll respond to dozens of phone calls from lung cancer and mesothelioma patients who are curious about everything from symptom control to treatment options. It’s Thomas’s job to have an answer for each concerned patient or to direct them to the appropriate resources to find the answers they need. Like an expert, she juggles the increasing phone calls with one of three weekly clinics during the day.

A small break in her afternoon schedule allows her a moment to grab a quick bite to eat. Before long, Thomas steps back into the fast-flowing pace of the hospital, visiting with lung cancer and mesothelioma patients, explaining information to their loved ones, and coordinating treatment plans with her colleagues. The juggling act continues seamlessly as more tasks are added to the mix. Eventually, the afternoon fades casually into evening.

The city is now winding down for the night. Exhausted from a long shift, Thomas sits in front of her computer glancing through her emails one last time for the day. She reads the last few patient emails intently, before responding with her answers. As she logs off of her computer, she reflects on the steady stream of events during the day. Exhausted though she is, she’s accomplished a great deal during her shift.

Thomas has been a nurse for over 20 years, and her journey began in 2000 with a specialization in HIV nursing. At the time, research was still developing on how to effectively treat the virus, and the virus almost always ended in a terminal diagnosis. “I initially specialized in HIV at a time when many patients were still dying, but there were exciting advances in treatment and there was great hope for a community who had suffered extreme stigmatization,” says Thomas.

Once treatments evolved to dramatically improve diagnoses, Thomas ventured out in search of a new challenge. This prompted a change in specialization. For Thomas, the similarities between being an HIV nurse and a lung cancer clinical nurse specialist were extensive. Both HIV patients and lung cancer patients have experienced stigma and limited treatment options. As a result of both factors, sobering prognoses usually followed. “Many patients were reluctant to seek out services and support due to the misconception that in some way they were to blame for their lung cancer, especially if they had smoked,” says Thomas. “This was exactly the same for HIV patients in the early days.”

Thomas’s time as an HIV nurse equipped her to make the transition into lung cancer and mesothelioma because of her understanding of the science behind mutations and targeted treatments. She also learned how to support patients to adhere to treatment regimens, advocate for patients to ensure that they have access to clinical trials and treatment, and ensure that patients receive good palliative support and end of life care.

Regardless of her specialty, the focus for Thomas is on her connection to each of her patients. As she searches for new ways to improve their experiences, she draws on the skills she has learned so far. “Caring for patients who have a very poor prognosis or who are reaching the end of life draws on all your skills and experience in communication,” Thomas shares. “You don’t always get it right but you can learn from each scenario. This is how you learn and build up a foundation of skills and knowledge.” Relying on compassion, understanding her limitations, seeking help from senior colleagues, and prioritizing her patients, aids in her ability to provide her patients with the expert care they need.

With over 20 years of experience in nursing, Thomas still looks forward to witnessing the advancement of treatment options for lung cancer and mesothelioma patients. To her, it is her favorite aspect of her job and the most exciting. “We have so many more treatments to offer patients now,” says Thomas. “We are also now understanding the genetic make-up of lung cancer and that there are many variations. Seeing patients surviving longer due to new treatment options is brilliant.” Thomas has witnessed an increase in patient advocacy, as lung cancer and mesothelioma patients are becoming more informed and empowered regarding their prognoses. Demands for more research and better treatment options are a common occurrence and can lead to prolonged life for patients. 

Thomas’s experiences have been inspiring and unexpected, like when she met Chris Draft, a former NFL linebacker whose wife died of lung cancer. Draft created the Chris Draft Family Foundation in 2006 and has been a significant advocate for lung cancer patients since his wife’s diagnosis and death. “He is an inspiration and phenomenal advocate for lung cancer patients,” says Thomas. “He always fills my soul with joy and makes me more determined to fight for lung cancer patients in the UK.”

Although her experiences as a mesothelioma and lung cancer clinical nurse specialist have been fulfilling, Thomas has had to redefine the role of being a nurse for those who only saw her as nothing more than a supportive figure next to doctors. It was a common misconception that she and other nurses have worked hard to combat over time. By completing annual review reports that clearly detail and demonstrate her ability as a nurse in the field, she and her nursing colleagues have been able to change the perception. “It has taken quite a lot of hard work but has really paid off,” Thomas shares. “I find that challenging misconceptions is good for my own development as a nurse and has helped me to become more of an expert in the field of lung cancer and mesothelioma.”

Beyond working as a mesothelioma and lung cancer clinical nurse specialist, Thomas serves as a nursing representative in multiple organizations like the National Lung Cancer Forum for Nurses and Mesothelioma UK. Thomas represents Guy’s and St. Thomas’ NHS Foundation Trust and lung cancer patients as a member of the Asbestos Sub-Committee at Parliament. She also runs a mesothelioma support group at Guy’s Hospital that has grown to feature expert presentations, fundraising opportunities, and community events. For Thomas, her involvement in the support group has impacted her life immeasurably. “It has made me realize the value and importance of having a specialist nurse involved in patient care,” says Thomas. “Many patients report stories of feeling without hope when they are first diagnosed. Attending the support group has enabled them to meet other patients who have been diagnosed with mesothelioma and share experiences.”

Thomas’s purpose in nursing is about bringing together the experiences of her patients and the knowledge in her field to create better treatment options and prognoses for her patients. Furthermore, Thomas has been gifted the opportunity to serve her fellow nursing colleagues by sharing their stories and advocating for them as well. Every day, Thomas strives to become a better nurse, offer better care to her patients, and improve the representation of nurses in her field. It is an active choice that she makes to immerse herself in her specialty and keep moving forward progressively.

In honor of National Nurses Week, we would like to celebrate Thomas’s work and achievements. She embodies the best elements of what it means to care for others and to be an active member of a team. For Thomas, these principles are fundamental aspects of the job she loves. Her goal is to be able to continue to add positivity into the lives of others for as long as she can. “My drive and motivation continues to be that I give the very best holistic care to all patients at their point of need, and that for the short moment in their life that I am their nurse, I can bring relief from their symptoms,” says Thomas. “Being a nurse continues to be one of the most rewarding careers. It can often be hard and tiring, but I just can’t imagine doing anything else.”

Vogelzang Law would like to express its gratitude and appreciation to nurses across the globe who dedicate their lives to helping their patients. Especially now during the COVID-19 pandemic, we understand that the profession can be incredibly tough. The self-sacrifice of nurses is invaluable and does not go unnoticed. We would like to encourage all nurses to continue to remain strong and know that you have our support.