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Julie Smith CNS Haematology Southland

Our CNS roles are so varied, this is the first in a series of profiles of a CNS

Julie has worked for the SDHB for the past 34 years in a variety of roles. She graduated in 1985 and spent twenty years working in neonatal and post-natal care before moving to the Oncology department to cover maternity leave. From there Julie has developed her passion for haematology nursing, and has covered a variety of roles on her time. Haematology is a complicated and high acuity area of care. Julie developed her passion for haematology early on by focusing on the haematology clinics for visiting specialists which lead to her becoming the resource and liaison nurse for the unit. Julie also worked as the palliative care advisory service nurse covering maternity leave and then went on to become the Clinical Nurse Specialist for haematology.

Julie started her post graduate education journey in 2015 and has just submitted her dissertation for her Masters of Nursing on “healthcare providers’ perceptions of early palliative care and how it applies to haematology and oncology patients”. Other core papers were long term conditions, advanced health assessment, pharmacology and research methodology. Julie is also an RN prescriber which has made a significant change to her practice as there is no onsite prescriber in the oncology service. She is able to provide appropriate and equitable care in supportive medication, prescribing mainly anti emetics, antibiotics, anti-virals and bowel support.

Julie works within the regional Southern Blood and Cancer Service where all haematologists and oncologists are based in Dunedin and visit Invercargill for clinics – these occur weekly. There are no medical staff attached to the Oncology/Haematology day unit which is consequently, very much a nurse-led service. Many patients need to visit Dunedin for their first specialist appointment and for first or all chemotherapy treatments and procedures, including radiotherapy.

Christchurch take care of our stem cell transplant patients who often are there for several weeks to months - thus there are significant psychosocial stressors impacting on treatment journeys. The Southland service includes all of Southland and up to Queenstown. Dunedin looks after the rest of Central Otago and through to Oamaru.

The CNS haematology role involves holding nurse led clinics for treatment patients, long term follow up for non-malignant and malignant haematology cancers, patients due for chemotherapy in Southland and clinic over flow. Julie also provides input to patients coming back to Southland post treatment and meets with new patients prior to going to Dunedin for treatment. Julie has oversight of these patients and will liaise with any issues with Dunedin haematologists.

Julie collaborates with many services across the Southern region including hospice, internal

medicine, Gps, nursing homes, the emergency department and other CNS in roles like palliative care, oncology and the cancer nurse coordinator. These services all play a vital role in delivering care to patients through our region and Julie works as part of this team to coordinate and establish care.

Julie encourages her colleagues to be self-directed and critical thinkers and aims to advance nursing in this area.

Julie is aiming to become a Nurse Practitioner (NP) and is keen to broaden her focus in primary health and other areas of care. Julie sees an area in which she could develop is providing care for monitoring patients with low grade haematological conditions in the community. Not all patients can be seen by a haematologist and so many are cared for in the community by their GPs. This has been reiterated by Gps that this is an area in which there could be more support at the Haematology evenings Julie has run locally in recent years. Also an area in which she could make a difference is from findings from her dissertation with patients who have an incurable malignancy but don’t metthe criteria for specialist palliative care input.

Julie is a member of the Clinical Nurse Specialist Society of NZ (CNSSNZ) and was instrumental in the successful biennial CNSSNZ conference held in 2019. Julie is also an active member of the Southland CNS group and she is valued for her role as a resource for the oncology department at Southland hospital. Julies also provides mentorship to a colleague currently completing post graduate qualifications.

In Julie’s spare time she is a very involved grandmother and is a fabulous singer (as anyone who attended the CNSSNZ biennial conference in Invercargill in 2019) will confirm and has been involved with musical theatre in Invercargill in the past.

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