Having your treatment in the Ambulatory Care Unit (ACU)

Ambulatory care Unit (ACU) contact numbers

If you need help or advice at any time please call:

When the ACU is closed please call:

What is Ambulatory Care (AC)?

Ambulatory Care allows you to have a variety of treatments, including high dose chemotherapy, without having to stay in hospital overnight.

If you are fit enough, rather than staying in hospital as an inpatient for your treatment, you will have your treatment on the Ambulatory Care Unit (ACU), on Level 3. At night you will either stay at home, or in the hospital hotel on Level 8, Bexley Wing.

Can I stay at home during my treatment?

Many of our AC patients are able to sleep at their home for the night. This depends on the type of treatment you will be having and your consultant must also agree and consent you to this.

To stay at home you must:

• live within a 30 min travel time to St James’s Hospital (according to AA route planner);
• have a relative or friend who is able to drive you to the hospital at anytime, day or night if you are unable to do so;
• have a mobile phone so we can contact you at any time, or you contact us.

What advantages does Ambulatory Care offer me?

• You will continue to have and receive full access to nursing and medical care. Staying at home or in the hotel offers you a comfortable environment in between your daily treatment.

• We hope staying at home will give you more privacy, independence and help you continue with a more normal homelife.
• Your partner or relative may stay with you in the hotel throughout your treatment, there are twin beds available.
• You will receive the same treatment as on an inpatient ward, except that it is will be given between the hours of 8.00am and 7.30pm.
• If having chemotherapy, your treatment may be given through a small portable pump called a CADD pump, which you carry in a specially designed rucksack or bumbag. This will allow you to continue daily life away from the hospital.

Car Parking

When you are coming for treatment your car parking is free.

• On entering the car park take a ticket and park as usual (disabled parking spaces are on Level 0).
• When exiting use the left hand lane next to the ticket office. Take your parking ticket and appointment card to the attendant. They will process your ticket so that when you insert it at the barrier no charge will be made.

If you require assistance or are unable to leave your car please press the button on the barrier.

There is a drop off zone available on the Plaza in front of the main entrance in the event of an emergency, or you are unwell.

Your first visit to ACU

Your first visit to the ACU will involve a pre-assessment day with a nurse. This will last approximately an hour and a half. This will make sure you fully understand how your treatment is given, side-effects of treatment and what to do if you become unwell. We will also explain to you how the chemotherapy pump works and give you information about it. This is an opportunity for you to ask any questions and make sure you are happy with the arrangements.

We will also discuss where you will stay during your treatment, either at home or at the hotel. If you wish to stay in the hotel we will be able to arrange the booking for you throughout your treatment.

What happens during ACU opening hours (daytime)?

A ‘typical day’ in Ambulatory Care:

• You will be given treatment appointment times to attend each day.
• You will be assessed daily by a nurse; the assessment will include your temperature, pulse, blood pressure, weight and a physical assessment.
• Please tell your nurse if you have any of the following symptoms; nausea (feeling sick), vomiting (being sick), diarrhoea and fatigue (tiredness).
• You may also have a daily blood test.
• Other investigations may be carried out.
• You will have your prescribed chemotherapy treatment and additional intravenous fluids, blood or platelet transfusions if required.

• You will be seen by a nurse or doctor each day.
• A sandwich or soup will be offered to you at lunchtime while you are on the unit. You will also be offered tea/coffee, cold drinks during the day.
• If you have any specific dietary needs please tell the nursing staff, or if you need any supplement drinks.

What happens during ACU out of hours (night-time and at weekends)?

Every evening once the unit closes your medical and nursing notes will be transferred to the Oncology assessment area to allow access by the Oncology Bleepholder if required.

If you phone from your hotel room or home, the nursing and medical team have access to your records:

• The Oncology Bleep is held by a senior nurse overnight (from 8.00pm – 8.00am).
• This provides a quick and direct way to speak to a member of the nursing team, and if required they will arrange for you to be assessed or admitted.

What if I become unwell during my treatment?

It is essential that you speak to a nurse if you develop any of the following symptoms whilst on the ACU, in the hotel or at home:

• ‘shivers’ or ‘hot flushes’;
• temperatures close to or above 38 degrees;
• persistent episodes of vomiting and / or diarrhoea;
• shortness of breath or difficulties with your breathing;
• redness and pain around your central line.

If you need to be admitted to hospital, the ACU nurses will arrange this for you.

If you are unwell during ACU out of hours:

• Phone the Oncology Bleep Holder – please see page two for telephone number.
• Explain you are receiving treatment in Ambulatory Care
• Explain any specific symptoms you are having or any problems with the pump to the nurse
• You will receive prompt medical and nursing advice.
• If necessary, they will ask you to make your way to a specific ward for assessment.

Important

If you experience any of the following symptoms e.g. runny nose/sneezing, persistent diarrhoea or vomiting, you must telephone and inform us before coming to the Unit. We will advise you where to go for your assessment, as it is important that you do not mix with other patients.

What should I do in an Emergency?

An ‘emergency’ is any urgent situation where you require immediate medical and nursing assistance.

If you require urgent medical attention:

• Call ‘999’ immediately (this is also when staying in the patient hotel).
• State your symptoms and location.
• If you have a carer/companion staying with you, they should call the Oncology Bleep Holder, or if within opening hours of the ACU, please call them.

Accommodation

You will either be able to stay at home or at the Hotel on Level 8 in the Bexley Wing, at St James’s Hospital. If you want to stay in the hotel the Clinical Nurse Specialist team and clerical staff are able to book this for you in the ACU.

Checking into the hotel

• Check in is available after 2pm.
• Your room has two single beds, ensuite bathroom and tea / coffee making facilities.
• There is a fridge to store any food.

Checking out of the hotel

• Check out is at 10am.
• If you are admitted to hospital during your stay in AC, you or your carer must ‘check out’ at the hotel reception.
• If you are unable to do this, please inform the nursing staff who will be happy to do this on your behalf.
• If you are admitted to hospital after 4pm your carer may stay in the hotel overnight (if there is a room available), but must ‘check out’ after breakfast the following morning.

What do I need to bring?

• a thermometer, to check your temperature when not in ACU;
• a mobile phone and a charger;
• light luggage that can be easily transported to the hospital by you or your carer.
• you can bring some snacks/drinks with you as there is a small fridge provided in the hotel.

Being admitted to hospital

It may be necessary to admit you into hospital at certain points as part of your treatment plan which your medical team will discuss with you. This is to ensure you are monitored more closely and receive the necessary treatments such as fluids or antibiotics that cannot be managed within the ambulatory setting.

Leeds Cancer Support

Leeds Cancer Support complements care provided by your clinical team. We offer access to information and a wide range of support, in a welcoming environment for you, your family and friends. We can be found in the information lounges in Bexley Wing and also in the purpose built Sir Robert Ogden Macmillan Centre.

The Sir Robert Ogden Macmillan Centre is on the St James’s Hospital site and offers a variety of support services including counselling, support groups and complementary therapies. These therapies include Reiki, natural healing and relaxation, hand and foot massage relaxation and visualisation and many others. You can just drop in for a coffee and a chat anytime. Open from 10am – 4pm Monday to Friday.

You can email all the above services on:

[email protected]

Maggie’s Centre

If you or someone you love has cancer you may have lots of questions. Maggie’s is a warm, welcoming place where you can meet people who are experiencing similar things to you.

You may also be able to find support groups specific to your needs and get advice and information from their professional staff.

You don’t need an appointment and all support is free.

Open Monday to Friday 9.00 am – 5.00pm. Tel: (0113) 427 8364

Address: St James’s Hospital (next to the multi storey car park), Alma Street, Leeds LS9 7BE

Email: [email protected]

Website: maggiescentres.org