ICCN 17

Current challenges facing the oncology nursing community

Birgitte Grube – President of the European Oncology Nursing Society




What challenges do you see for cancer organisations?

I do see that, of course all cancer organisations, we see that we have challenges in that the aging population is increasing and we can see that the non-communicable diseases are increasing, the diseases that cancer is among. It’s chronic diseases like diabetes and heart and lung failure and also WHO and ICN, the International Council of Nurses, are talking about this to be a threat to us. So there is both the increase in survival of cancer patients and also the patients with voices that we have to listen to and also that nurses do have to stand up and speak for themselves in this area, political area, as well. One of the things that I see as the main is that we work together because there are a lot of organisations and a lot of societies, not only in nursing but also in physicians, there are a lot of societies and organisations as well, so we as non-government organisations do work together, make policy statements for the politicians and also with the patient groups, they have also organised in societies and organisations. So if we could build up, for instance, in this area as nurses to say, so that we have a specific role in the non-communicable diseases, where cancer is one of them, because we have the holistic approach to the patients and therefore we should be the one leading and co-ordinating this care of patients.

A lot of the patients are also outside of the hospital now because we have such specialised treatment and therefore the home care nursing is also a very specific area to them to have the right skills and knowledge. So we have a responsibility there also, as a society, to build up educational programmes, training programmes and always make sure that people understand the language barriers. When you are an international society, or European, you’re also international in that way, it’s the language is always the barrier for people so how do we train the trainer? This is also one part of our challenge is to make sure that we don’t just develop but also make sure that it is implemented and used so it can make a difference because this is something you always see that people, they do research, they do training programmes but do they really work out there in the clinic? Do the nurses use it? Is it an impact for the patients and the outcomes for the patients and their relatives? Because that’s why we are there. We must never forget why we are here and why we have these societies, it’s for the patients.

What policy statements do you have?

I can mention that we have, for the European Oncology Nursing Society, we have built up a policy statement in personalised medicine because this is an area that patients are very concerned about, this very targeted treatment. Also the patients sometimes do have to make choices but they don’t really have the knowledge to know how to make the right choices and so in that area we have built a partnership, an alliance with the European Cancer Patient Coalition and also with physicians and pharmacists and the pharmaceutical companies and also the regulators, together to build up an alliance that is in four sections. There’s one about how do we understand personalised medicine, it’s also about personalised care. Then there are sections about how do we communicate the personalised medicines and how do we make sure that the patients do understand the same things that we do so they can make the right choice? How do we educate the nurses and the healthcare professionals? Also about the cost of it because some countries can’t afford to give this very targeted therapy because it’s so expensive, so how can we as partners, this is in Europe but it could be done in the world also, make sure that it is very diverse.

What future challenges do you see for nurses?

In the education area I see that it’s a challenge that we make sure that the nurses have the right skills, the right education to have the right skills and knowledge to deliver this high quality care that is provided in the future. This very complicated treatment that patients often have in the cancer area, often they have three or four treatments in different wards and then there’s the home care as well because they’re home a lot of the time. We must make sure that it is the right level and the right education and help the countries that don’t recognise it as a specialty because a lot of countries don’t have cancer nursing education, they only have the basic nursing education and then it’s up to the ward or the hospital to build up minor education training programmes but we must make sure that it is specialised. I think that this is a key thing that the role of the nurses is recognised in this cancer area.

Tell us about EONS educational guidelines.

We have a basic curriculum guideline that is used in Europe and has been translated also into different languages. We always make sure that it is updated, we do that every second year, we update it. So this is a basic curriculum for cancer nurses to be used but we would like to see it also be known for politicians because one thing is that the cancer nurse knows it and that the national societies think they will use it but if it’s not recognised by our colleagues, physicians, and by the leaders at the hospitals and furthermore the politicians, it’s there I see the cancer organisations, the international organisations, have a role to approach the politicians and say, “This is the need and this is the level of education we should go for.”

Do you believe that with recognition, nurses would have access to funding?

I hope so because some of the things that we have now in Denmark, where I come from, one of the things we made sure was that it was in the National Cancer Plan that it was needed to have high quality care for the patients. There was a need for a specialised education for the nurses and it has to have a level of ECTS, the European Credit Transfer System so you know a kind of level for that. That was in the cancer plan, it was the third cancer plan that it was in, but this is the kind of work that the recognition of it, because this is a whole lot of people sitting there making the cancer plans, a lot of them are physicians and a lot of them are politicians and a small number are nurses but it took some time but I hope that other countries could do the same, to have it in these plans that you have to follow and that’s it’s a recognition and also then the funds for it because now it’s in the finance plan for the education of cancer nurses. But I know it’s difficult in the financial crisis.

How useful is a conference like this in reaching other areas?

I think it’s really important but I also think that it’s difficult for nurses to attend these conferences. We have seen over the years that less and less do attend these conferences because they can’t afford it or they can’t spare them in their day job so I do think this is important to meet and meet in person and discuss and also interact and connect and share. I do think that’s really important to be here but I think we should also make sure that then it goes back again and we do maybe smaller stuff, educational conferences at sites that we move around, maybe not that big, maybe smaller ones. We’ve talked about that in EONS, that we would like to do that for the future, maybe have it at a school of nursing, a university or university college, whatever you have in that country, and then just base it on educational clinical stuff and maybe have 200 nurses or something. Maybe that will enable them to go because we have to make new decisions and go around if people are not able to come due to lack of staff and financial crisis.