Sister Jayne Knight
Clinical Nurse Specialist Breast Reconstruction
Founder, Breast Reconstruction Awareness

Why am I Proud to Work in Healthcare?

“BRA was the first thing since I began my journey that made me think, you can do this.” – BRA Meeting patient

It is a good sign that you have looked after your patient well when they offer to come back to hospital to help others who are facing the same difficulties they had to.

Sister Jayne Knight has had this experience many times. The Breast Reconstruction Awareness (BRA) meetings that Jayne and a colleague started in 2004 are still held every fortnight, and allow women who have recently been diagnosed with breast cancer to talk to recovered patients and see the results of breast reconstruction. In their twelve years they have helped more than 3,400 patients and relatives.

50 to 60% of Jayne’s patients who undergo mastectomies also have breast reconstructive surgery, either in the same operation or after further courses of treatment. Reconstructions can use silicone implants or the patient’s own tissue, usually taken from the tummy, leg or back. Tissue reconstructions are the most common reconstructions carried out at St Andrews.

The meetings show them that…there are patients around who are happy to show others their reconstructions. Because that’s what people want to know.

Jayne has been a nurse for 40 years, spending 38 of them working in plastic surgery and the last 12 years as a specialist in breast reconstruction. She worked at the St. Andrews Centre for Plastic Surgery and Burns in Billericay, having moved with it to its current site at Broomfield Hospital in Chelmsford in 1998. The St. Andrews Centre is a global leader in plastic surgery and Jayne has performed many roles in her time there. She now runs clinics that help patients before and after breast reconstruction, providing counselling, wound care and advice.

On Tuesdays after clinic hours, Jayne and her colleagues run BRA meetings for new patients who are soon to undergo mastectomy and reconstruction. Jayne explains the admission process and offers practical advice for their stay in hospital, such as what to bring into hospital with them. Former patients come to the meetings as well to talk about their own experiences, how it feels post-surgery, and when the hardest parts are. They also show the new patients the results of their surgery, so they can see for themselves what reconstructions look like.

“We have a big database of women we have cared for in the past,” Jayne says. “When we have a new patient, their consultant tells them about BRA meetings and recommends they go to the next one with a friend or family member. We know who is coming and the type of reconstruction that they are considering, and we arrange for a previous patient who had the same surgery to come and meet them. Our previous patients call these sessions ‘Show and Tells’!

“Some of the women we meet just want us to get on with the procedure and not tell them anything about it, but we find that those who do want the information and understand what it involves make a much better recovery. The meetings show them that this does happen to other people and there are patients around who are happy to show others their reconstructions. Because that’s what people want to know; they want to know what it will look like, how will it feel, how will it affect my life, my body image?

The Show and Tells were a development of the original meetings that Jayne held with two of her colleagues, which offered the same friendly support and advice but no returning patients. “It was the ladies’ suggestion to come back to future meetings to talk to new patients,” says Jayne.

I love how my job makes me feel about what I do for other people.

But it is not just women with breast cancer who undergo mastectomies. Some women are considered to have a high chance of developing breast cancer, often because they have a family history of the disease or particular forms of certain genes, such as BRCA. For these women, risk reducing mastectomy surgery could take their chance of developing breast cancer from around 85% to virtually nil. Despite the clear advantages this is a very difficult decision to make. Many women in this position are only in their twenties or thirties and face the prospect of life-changing surgery without actually being ill.

For high-risk patients, a multidisciplinary team (MDT) decides whether or not a mastectomy is recommended. These MDT meetings are sponsored by the BRA charity, who have also raised funds to provide specialist equipment, such as post-reconstruction bras. BRA also holds charity balls every few years – 2016’s was the third.

Jayne is very modest about the success of BRA meetings, but their popularity with patients and the fact that the format has been replicated in several other hospital trusts are evidence of the good that they have done.

And she is proud of her work, not just with BRA but also as a nurse. “I love how my job makes me feel about what I do for other people – I think we provide a really good service. Mid Essex Hospital Trust is a great trust to work for and I think it’s our duty to make the public realise that the NHS is an amazing thing.”