In celebration of International Nurses Day (12th May) we spoke with a Check4Cancer skin cancer specialist nurse, Rebecca Maxwell, on how and why she got into nursing. Rebecca also explains what a ‘typical day’ looks like for her seeing Check4Cancer clients in clinic.
How did you get into nursing, what was your impetus to become a nurse?
I’m from New Zealand and many years ago I got a job in a care home working in the kitchens, one of the elderly residents became ill and I was asked to help out with providing care for this resident – I wasn’t keen and was quite happy to stay in the kitchens. However, I gave it a go and realised that I loved caring for people. After this personal revelation, I went on to study nursing and carried on working in the care home as I studied. Elderly people are interesting to look after from a nurse’s perspective as they have very complex medical needs and hence it is a challenge and pushes you to your limits as a nurse.
Why did you choose to become a skin cancer specialist nurse?
Whilst I was studying as a nurse in New Zealand, I was sent on placements as part of my training. I really enjoyed the surgical placements and I started to specialise in burns and plastic surgery, realising I had a natural flair for it. When you work in plastic surgery in New Zealand, you care for patients who have reconstructive plastic surgery on areas of the skin after the removal of skin cancers. This led me to focus my studies on Dermatology, working in both medical and surgical dermatology.
I found this work very satisfying, especially when we provided patients with an outcome that improved their lives. In 2009, I took the plunge and moved to the UK and started work with nursing agencies, which led me to specialise as a skin cancer nurse later on.
Can you take us through what a typical day in clinic looks like for you?
I arrive at clinic around 8am and I set up all of the equipment I need to use throughout the day with my clients, I also review all their notes before clinic starts at 9am.
I then see clients, for skin consultations throughout the day. A typical skin cancer screening and mole check appointment with a client lasts around 25 minutes and we cover the following areas:
- I review together with the client their personalised risk assessment, family and personal medical history
- I then conduct a complete skin examination of the client using Dermoscopy* and look out for pre-cancerous as well as cancerous moles or localised changes to the skin
- I give tuition and education to the client on how to check their skin, advice on skin health, and how best to protect their skin
- I take high-quality digital and dermoscopic images of any suspicious skin changes/moles, so these can be reported
*What is Dermoscopy?
Dermoscopy is a non-invasive method to examine your skin. A dermatoscope is a hand-held instrument, a bit like a magnifying glass, which can magnify an area by up to 10 times. The nurse will usually put some lubricant on your skin and then will hold the dermatoscope over your skin so they can examine the area very closely assessing lesions for certain features. This process does not hurt or affect your skin.
After each client, I thoroughly clean all equipment and couch following our strict Covid cleaning procedures, and then clinic normally finishes around 5pm which is when I pack up. After each client, I write up all my notes and upload any images required, which are sent to our consultant for review and any recommendations for further investigation.
What are the most common questions you get asked by clients?
The most common question I get asked is about moles, patients get worried if their moles are soft and squashy as this causes people the most concern. In terms of moles or dark patches on your skin that are flat or slightly raised, these usually will remain harmless all your life. However, moles or localised patches of normal skin that change in size, shape or colour over weeks or months in adult life should be further investigated.
I show clients how to follow the ABCDE melanoma rule (see graphic below):
There are some clear signs that a mole could be a melanoma. You should get your moles checked by your GP or a skin cancer specialist if you notice any of the following skin changes:
- Changing shape, particularly if it has an irregular outline
- Changing colour, getting darker, becoming patchy or multi-shaded
- An existing mole getting bigger or a new mole growing quickly
- If a mole starts to itch or become painful
- If a mole is bleeding, becoming crusty and/or looks inflamed
It is important to regularly check your skin so you know what ‘your normal’ is, this is so you can detect any changes early and get these checked out by a professional if you are worried.
Another common question I get asked is about sunscreen, how to use it, how to apply it, and what factor is best. You can find out about choosing the right sunscreen and understanding UVA protection here.
What is the most rewarding aspect of being a skin cancer specialist nurse?
The most rewarding part of my role is being able to provide my clients with peace of mind. A lot of the patients I see are so relieved to be able to talk to someone about their concerns about their skin health, this for me is the most satisfying part of my job as a nurse.
More information on skin cancer screening and mole checks
If you are concerned about any moles or lesions, Check4Cancer offers SkinCheck – a private skin cancer screening service for anyone who wants a specialist review of the appearance of their skin or moles. You can find out more about SkinCheck here.
Rebecca Maxwell | Check4Cancer Skin Cancer Specialist Nurse
Rebecca is a highly qualified skin cancer nurse specialist, with many years of experience. Rebecca not only has a passion for skin cancer and nursing but is also a very keen sportswoman, playing touch rugby competitively. Rebecca will be representing Check4Cancer at the BDNG conference this year in Harrogate.
