Working Together - Breast Reconstruction

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Working Together - Breast Reconstruction
Karen Bell Clinical Nurse Specialist
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Working Together
HCPs should work in partnership to support and
facilitate integrated working and the development
of teams who work together to ensure that
patients are getting the service that was
planned for them with Calman Hine. (NCN 2002)
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The National Health Service (NHS) Executive
(1996a) recommended that the possibility of
reconstruction both immediate and delayed should
be discussed with all women considering a
mastectomy.
Reconstructive surgery can offer positive and
rewarding outcomes for some women, but can be
upsetting and traumatic for others. (Harcourt
and Rumsey 2001)
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Background
Previous experience in plastic surgery Amount of
information provided to patients in breast
reconsruction clinics Total patient care
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Aims
To facilitate an understanding of the
reconstruction process and to offer
comprehensive support to women enabling them to

• Become appropriately informed
• Promote realistic expectations
• Assist with complex and difficult decision making

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Women with high expectations and hopes
pinned upon the outcome of reconstructive surgery
may be especially vulnerable to severe distress
and disappointment if complications occur,
thereby compounding the psychological trauma of
mastectomy (Harcourt and Rumsey 2001)
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Reconstructive Meetings
Held at Newcastle Nuffield Hospital 6-8
weekly Initially for private patients Referrals
from CNS - Various hospitals GPs Patients
Family History Clinic (NHS) Now accessible to
private and NHS patients
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Attended by
Ladies considering reconstruction Ladies who
have undergone reconstruction carried out by
various plastic surgeons
Various reconstructive options Usually prior to
seeing plastic surgeon
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What happens?
Reconstruction technique/procedure explained by
CNS Diagrams to assist explanation Patients
share their experiences and will show
results good, and not so good. Questions and
discussion encouraged Numbers 4 - 50 Can
arrange one to one
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Feedback from attendees
Its nice to hear how it really is after surgery
and it gave a much better insight into what you
can expect.
It is useful to see that not all procedures work
100 for everyone and I felt that this gave a
realistic balance.
It was informative and very reassuring to see
the results. Also the confidence the ladies have
regained since the operations. No amount of
photographs could have made me feel as informed
as I do now.
It was very heartening and informative to see at
first hand some of the results of the alternative
approaches adopted for reconstruction by
different surgeons and this will enable me to
make an informed decision as to which procedure
I shall opt for in the very near future.
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Feedback from attendees
The meeting gave me a lot to hope for after I
complete my treatment. Everybody in the room had
gone through similar experiences as I was
currently going through and their enthusiasm left
me with confidence for the future not only as a
breast cancer survivor but as a woman.
This type of meeting must be very rare but much
needed by ladies who have had to go through the
trauma of mastectomy. It gives you hope of
normality for the future along with information.