A Day in the Life of a Lead Cancer Nurse

Caroline Tweedie, Macmillan Lead Cancer Nurse in South Tyneside and Sunderland NHS Foundation Trust provides a detailed look at what a typical day in her nursing role involves.

My day to day

My days look very different now to when I worked in the breast clinic. These days, my mornings often begin by reviewing key updates across our cancer pathways - reviewing service activity, workforce pressures or ongoing quality improvement projects. Much of my work involves collaborating with MDT’s, operational leads and clinical colleagues to ensure services are safe, efficient and aligned with both local and national priorities.

My Role

Before moving into this post, I spent a year working as the Macmillan Lead Practitioner for living with cancer. This gave me confidence to navigate complex systems, building business cases, influencing senior leaders, and developing new models of care

I spent 18 years as a Clinical Nurse Specialist in breast cancer. Those years shaped who I am as a nurse learning to be clinically astute, emotionally strong and connected to my patients. But we were rarely taught how to be leaders: how to write a business case, influence change or understand the politics behind the decisions that affect our patients.

Now, as a Lead Cancer Nurse, I try to bridge that gap. My role is about making sure the voices of patients and frontline nurses are heard at every table. I work closely with operational teams to turn data and feedback into meaningful improvement. I’m deeply involved in Quality Improvement (QI) from pathway redesign to workforce development because every small change can have a significant impact.

As a Professional Nurse Advocate (PNA), I support colleagues to reflect, reset and refocus through restorative clinical supervision. Nursing can be emotionally demanding, and I believe that supporting staff wellbeing is just as vital as supporting patients.

I’m part of the National Institute of Clinical Excellence Breast Cancer Guidance Committee and the Northern Nurse Representative for the Association of Breast Cancer, which has been an incredible opportunity to influence national practice. Being part of these processes reminded me how important it is for nurses to be involved in research and policy development not just as observers but as contributors. I’d encourage every nurse to lean into research wherever possible; it gives our profession a voice, credibility and evidence to drive better care.

Although much of my work is now strategic, I still run a virtual breast cancer wellness clinic and an endocrine support clinic. It keeps me connected to what nursing is about listening, supporting and helping people feel less alone.

My Clinical & Support Duties

• Supporting and mentoring specialist nurses across tumour sites
• Leading and embedding Quality Improvement projects across services
• Using patient experience data to shape decision-making
• Delivering virtual wellness and endocrine support clinics
• Providing restorative supervision as a Professional Nurse Advocate
• Representing nursing on national and regional forums, including NICE

My Reflections

This role is rewarding but not without its challenges. Leadership can be lonely at times balancing strategy, people and politics while trying to hold on to the heart of nursing. But I believe nurses can make powerful change when they’re supported to lead.

I’m passionate about service improvement, staff wellbeing, and research because together, they create the foundations for safe, compassionate and forward-thinking care. Seeing a small idea grow into something that genuinely makes life better for patients and staff is what keeps me going.

And when it all feels a bit much, I lace up my trainers. Fitness is my antidote to stress. It clears my head, restores perspective, and reminds me that we can’t pour from an empty cup.