Spring 2019: How do we really treat our younger colleagues?
This is a question I asked myself after attending EONS 1st young cancer nurse (YCN) workshop in Lisbon in January.
Young cancer nurses from all over Europe attended the two-day workshop. We had honest, deep conversations concerning working conditions, educational needs and professional support. As so many times before, it strikes me how incredibly engaged and committed cancer nurses are, and these young colleagues are no exception. However, it was both painful and embarrassing to hear some of their stories, also confirmed by the preliminary results from EONS YCN survey (the final results will be presented later this spring).
For those of you who know me, I often refer to” The Doctor-Nurse game” that was described for the first time in 1967 by Leonard Stein. He explained and showed that the hierarchical relationship between physicians and nurses were problematic, and in fact, a safety risk. However, these YCNs did not tell any doctor-nurse stories. On the contrary, many of these nurses explained how they had good and supportive relationships with the physicians they work with; it was rather senior nurse-junior nurse stories that we were told, but just as problematic.
The YCNs told stories about nurses being moved from their clinical positions by their nurse managers if they were praised by other professions for their clinical skills. Others explained how they met strong resistance by management and more senior colleagues when trying to arrange educational activities or improve practice in other ways. Some of the YCNs described how they repeatedly had been declined to have an active role at national cancer nursing congresses, and/or how their work was ignored and not referred to on national societies’ web pages and in other social media. There were even examples of YCNs achieving external recognition, in the form of awards, and then being actively ignored by colleagues and management.
All this makes me so sad. We should applaud our younger colleagues for the work they do! Most countries in Europe suffer badly from a nurse shortage and we know that many leave the profession after only a few years’ practice. The feeling of hitting the infamous glass ceiling early in your career is devastating and increases the risk of leaving the job.
We discussed these issues at our recent Board meeting in Brussels. Many of the Board members confirmed my concerns and could recall similar experiences. To recognise the YCN group is important for EONS! Each of the four EONS working groups have a YCN representative and we will now make permanent the YCN position on the EONS Board. We are also expanding the YCN network under the leadership of Sara Parreira. We will continue to promote the YCNs at the upcoming EONS12 congress and in a range of EONS Education activities. This is all good, but together we could do more to support our younger colleagues.
I challenge all EONS members to support our younger colleagues and do everything we can to help the YCNs to continue to develop within our profession. We all benefit from a strong workforce where each generation has good career possibilities.
Lena Sharp, EONS President
Winter 2019: Time to reflect, and to look forward
Just over a year ago, I took over as President of EONS. This means it’s more than “half-time” before handing over to our President-Elect, Andreas Charalambous. Over Christmas and New Year, I took some time to reflect on what EONS has achieved during 2018 and where we are now, from my perspective. In this blog, I will share some of my reflections.
Looking back at 2018, a lot happened and EONS organised several successful events. One of the major ones was the meeting in the EU Parliament in May 2018. Here we presented some results from the RECaN project and stressed the importance of the recognition of cancer nursing as a specialty across Europe. The strategic work to achieve this continued after the meeting in May. All four EONS Working Groups are involved and we will continue to play as part in RECaN Phase 3, during 2019. We also launched The EONS Cancer Nursing Education Framework at this event.
Talking about RECaN, more scientific papers are on the way. In 2018 the systematic review was published and recently, a study on the patient safety climate from cancer nurses’ point of view, was submitted. In this, we describe and compare survey data from the four countries included in RECaN Phase 2 (Estonia, Germany, The Netherlands and The United Kingdom). A meta-analysis, presenting more data from RECaN Phase 1 and also a qualitative paper including focus group data from the four countries (RECaN Phase 2) will be submitted very shortly. I am so proud of what we have achieved so far with the RECaN project. Currently, we are working on project phases 1, 2 and 3 simultaneously, and once we have all the planned papers published, we will intensify the lobbying work even more.
During 2018, we also built a stronger collaboration between the four EONS Working Groups (WG). We arranged parallel and joint meetings for all four groups for the first time in 2018, and the feedback was really encouraging. During these meetings, we had some really good discussions around EONS’ strategic work, resulting in a new strategy plan, which both the WGs and the EONS Executive Board have continued to develop since. An updated version will be presented after the Board meeting this February.
We had quite a few changes in the WGs during 2018. Several members left, as their time was up, and when advertising for new members, many excellent candidates applied. I sincerely want to thank the leaving members for the excellent work they have done for EONS over the years. So much of EONS’ work is done by the WGs and they are really important of the success of EONS’ current and future activities. I also want to congratulate and welcome the new WG members and am looking forward to good collaboration. For applicants who weren’t selected this time, please apply again! We try to select WG members with different competences, backgrounds and countries, which means that sometimes we must, regrettably, turn down really competent candidates.
EONS11 and EONS12
The most important event for EONS during 2018 was, in my view, the EONS11 Conference at the ESMO Congress in Munich. Over 300 cancer nurses attended, and the feedback was very positive. A new Scientific Committee is now formed, and the work has started to create a high-quality, interesting cancer nursing programme for EONS12. Make sure that you save the dates for EONS12 – in Barcelona from 27 September to 1 October. If you have suggestions for topics and/or speakers, please contact the Scientific Committee Chairs: me, email@example.com or Andreas Charalambous firstname.lastname@example.org. We most warmly welcome all kind suggestions and ideas!
The future is bright
Looking to the future, I am confident that we will have great year in 2019. A lot has been planned already and I want to highlight a few activities early in 2019. The first is the dedicated EONS Young Cancer Nurses meeting took place in Lisbon January 16-17. Sara Parreira, Johan de Munter and I lead the two-day meeting, focusing on the specific needs and challenges this group face.
In February, the EONS Board will meet in the new EONS office in Brussels for strategy work and a Board meeting. During March, the Masterclass in Cancer Nursing will take place near Berlin, Germany. EONS’ 6th research proposal workshop will take place in Athens, Greece, June 5-7. The deadline for application is open until 31 January.
In May, EONS will celebrate European Cancer Nursing Day, ECND, for the 3rd time! Save the date: 18 May! This year the theme will be Patient and Occupational Safety. We know that these two safety perspectives are strongly interlinked, and we believe that more focus is needed to address safety issues in cancer care. As part of ECND 2019, we also plan to arrange joint WG meetings and a Board meeting. If you and your national cancer nursing society are interested in hosting these EONS ECND events in your country, please find more information and apply by emailing email@example.com
Hoping to meet you at the EONS events in 2019!
Lena Sharp, EONS President
Autumn 2018: EONS11 is coming!
Many of us have experienced a very dry and hot summer. It was wonderful for people like me, living in the north of Europe who are used to a cooler summer climate, but at the same time worrying that the climate changes are so obvious. Now that the summer is coming to an end I want to mention a few words about EONS activities this autumn.
For the last year, we have worked hard in EONS to complete the programme and to plan for the upcoming EONS11 cancer nursing track at the big ESMO congress in Munich in October. I must say that I am very proud of the final programme! It includes three full days of important and highly relevant cancer nursing topics, such as symptom management, patient safety, research, new cancer nursing roles and leadership. It features an exciting mixture of top quality invited speakers and submitted abstracts. We have also involved patient representatives and colleagues from other professions to support the team approach in modern cancer care.
The programme also includes several very interesting satellite symposia. These will cover the following topics from a cancer nursing point of view: precision oncology, biosimilars, support to patients and carers, nutrition, immunotherapy, targeted therapies, communication, occupational safety and nausea and vomiting.
We also have poster sessions and a special session for young cancer nurses (open for all delegates of course) and we will end the three days with the presentation of this year’s EONS awards.
I truly believe that this conference will be the best event we have ever planned! It is a fantastic and unique opportunity because nurses attending will have access to the whole ESMO programme. We have also managed to negotiate a special, flat conference rate for nurses of just over 400 Euros, which represents amazing value.
I hope you will join us in Munich! Together we can continue to improve the cancer care for patients and their loved ones. This will also be a fantastic opportunity to further improve the recognition of cancer nursing. As the matter of fact, we will for the first time award the EONS RECaN award. This award will be received by a cancer nurse who has contributed in some unique way to increasing the recognition of European cancer nursing.
View the full EONS11 programme here at http://www.cancernurse.eu/documents/EONS11Programme.pdf
NB. You will need your ESMO log in details to register. If you do not have an account, you will need to create one. Please be sure to select the reduced rate for nurses.
Read more at http://www.cancernurse.eu/communication/eons11.html
And last but definitely not least, right now we are doing the final planning for the 1st Eastern European Masterclass in cancer nursing. It will take place in Budapest in September and is slightly different from the other yearly masterclasses we arrange in collaboration with ESO (European School of Oncology). We will for instance have onsite translation in both Hungarian and Romanian to overcome some of the language barriers. The interest from our members has been great and due to high demand we have managed to increase the number of places from the planned 30 to 41! Follow us on social media during September 20-22 for updates on the event:
Lena Sharp, EONS President
May 2018: Do nurses really have a role in cancer prevention?
This may be a leading question but you would be surprised how many people, nurses and others, fail to see our important and unique opportunity in cancer prevention.
A recent report from the American Society for Clinical Oncology states that up to 50% of cancer cases could be prevented! The same report also highlights alcohol among the important risk factors for cancer and that action is needed to raise awareness among both the general public and health care staff.
It is well known that alcohol increase the risk for H&N, liver and pancreatic cancer but the association between colorectal and breast cancer are less well known. Recent studies show that even light and moderate alcohol intake increases the risk for breast cancer. There is also some evidence that alcohol intake increase the risk for complications from cancer treatments and, even more alarming, that 1 of 3 secondary cancers are associated with continued tobacco and/or alcohol use.
In April, I attended an alcohol policy conference in Washington DC (AP 18). The theme for this year’s conference was alcohol and cancer. Having many years’ experience regarding smoking cessation and cancer, I recognise the situation from about 20 years ago. Then we worked hard to raise awareness of the impact of tobacco use during and after cancer treatment.
We are all aware of the tobacco industry’s sometimes brutal marketing methods but to learn that the same strategies are used by the alcohol industry, was an eye opener. I learned a new word here; pinkwashing, which means the promotion of products and services using the pink ribbon associated with breast cancer awareness and fundraising.
In Washington, Lisa Kennedy Sheldon from the American Oncology Nursing Society (ONS), myself and Emma Woodford, EONS COO, were invited to speak about cancer nurses’ role in cancer prevention. Lisa focused on how nurses in clinical settings could intervene. She also stressed that nurses need to particularly intervene among patients that are both smoking and consuming alcohol, since the risks are even greater for this group. I reported on cancer nurses’ involvement in both primary and secondary cancer prevention projects in Stockholm. Emma talked about cancer prevention within the EU and the EU’s code against cancer. Our session went well and ended with an interesting discussion on cancer nurses’ opportunities to tailor lifestyle advice and support, to integrate all known risk factors and to assess when and how to best intervene.
Today, we have strong evidence to support our recommendations to patients to quit smoking and to be physically active during cancer treatment to reduce side effects and to improve the outcome. Even if we don’t have the same evidence concerning alcohol consumption during cancer treatment, some studies show an association between alcohol consumption and complications after cancer surgery.
Cancer prevention, including tobacco and alcohol cessation, is the most cost-effective way to reduce the cancer burden! These interventions will reduce the cancer incidence and also other major health issues. Nurses are the largest group of health care professions and the most trusted profession in many countries. We have a central role to play in cancer care, working closely with patients and their loved ones during the cancer journey, which gives us a unique opportunity to impact both primary and secondary cancer prevention, among patients, their families and also staff. We also have the skills to intervene on lifestyle changes. Integrated and systematic approaches, intervening on all cancer risk factors including alcohol is recommended.
Lena Sharp, EONS President
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November 2017: And so, EONS goes on…
This final week as EONS President has been a busy one. Looking back, I started the week taking part in interview panels for new nursing lecturers at Cardiff University, enjoyed watching a PhD student that I have supervised being awarded her PhD (on men’s perceptions of risk of prostate cancer), completing the edits to two papers for publication and attending the UKONS conference to recruit UK participants to our RECaN project. Next weekend, we are looking forward to the EONS Board meeting, Advisory Council, General Meeting & Leadership Summit – so another busy one is in store. Before that, and back at work in Cardiff this coming week, I will be involved in the selection process for a new Professor of Cancer Nursing with Velindre Cancer Centre in Cardiff. All positive developments and all will bring benefit in the long run hopefully.
As I made my way home to London for a couple of days of relaxation after the UKONS conference, I was reflecting on these events and thinking about how the juggling of so many different tasks is a common feature of the working world for us all – a situation that is also compounded when we volunteer for EONS or other organisations. It is demanding on our time, and it is important to balance such demands with relaxation, reflection and recovery.
I think of time away from such demands as time to ‘heal’, and everybody needs this space to renew their energy and ability to think. I have tried to keep the same advice in my own mind during two very busy and eventful, but hugely enjoyable years as EONS President.
The time went quickly and reflecting on what was achieved helps me to make sense of what happened and where EONS is now.
Since becoming President in 2015, we have managed a period of considerable change. First, we worked for over a year without a CEO, started the RECaN project with little advanced warning and gradually recruited new members to the EONS team. At the same time, we organised a very successful EONS 10 in Dublin and have been managing our finances very carefully. Then there was Brexit!
It is fair to say that few saw the result to leave the EU coming: 51.9% (of a total turnout of 72%) voted to leave the EU on 23 June 2016. This was hardly a large margin of success for those campaigning to leave, but it was enough to start a process that feels increasingly chaotic, made worse by political incompetence and mediocre politicians who will not have to live with the outcome (as many young people of the UK will). For those who do not yet know the reason for the UK having a Brexit referendum – it was included as part of the Conservative Party manifesto in 2015 to placate those in the party who were skeptical of the European Union. It was seen as a gesture by David Cameron, then the UK Prime Minister, to silence his Eurosceptic critics, and few expected the result to be to leave the EU. The UK was divided, with Scotland and Northern Ireland voting to remain, and England and Wales voting to leave (excluding the major cities, where the remain vote dominated). Those who have analysed the Brexit results since have claimed that it was primarily a protest against job insecurity and the free movement of people into areas where people felt less secure about employment and life chances.
So, we are where we are and we will have to move through the Brexit process. We are told we must make the best of it. Some believe it may still be stopped but this seems unlikely; certainly until more time has passed and some people’s views have mellowed with the benefit of hindsight. There are those who worry that, if we now tried to stop Brexit, there would be civil unrest and cries of anti-democratic meddling. The will of the British people must be seen to endure. However, the will of the people is also shaped by the adequacy of the knowledge about what they were actually voting for when they voted to leave. Most now admit that details were lacking; such as the argument that was put forward about how much money could be saved by leaving the EU.
The impact of Brexit is now being played out in British hospitals, with nurses from other countries worried that they will be sent home. Hospitals, in turn, are making promises and calling for politicians to secure the employment and status of such nurses. This includes cancer nurses and many European nurses who now work in the UK as salaries may be higher than at home and career opportunities more attractive.
The impact of Brexit will continue to play out during the next few years and my two years as past President will see new activities from EONS, new ideas, new team members and new volunteers. This is exactly how it should be and how an organisation such as EONS will survive into the future. There must be change or else there will be stagnation.
At the time that I stood for election I was not sure whether to do so, but a colleague gave me some useful advice – ‘If you don’t, you will never know what could have been.’ Good advice, on reflection.
And so, EONS goes on… I look forward to watching the next phase of EONS’ development and feel very proud to have been the EONS President. It has certainly been a busy and eventful couple of years, and there are two more to go as Past President, but this has been a unique experience that I would not have missed. For those of you who may have the ambition to become President, I would highly recommend it!
With very best wishes to all.
October 2017: Leadership, in action
The EONS leadership summit is coming up in the Netherlands in November. This will be a significant opportunity for cancer nurses to consider their current contribution as leaders, and perhaps more importantly, what more they could do to improve cancer care.
I have been writing about leadership recently for a chapter in a forthcoming book and as part of this task have been summarising different theories and approaches for understanding what is actually quite an elusive concept. Having thought about it, I have come to realise that leadership, above all else, is a way of working with other people to solve problems whilst also building their future potential. What I am not doing is offering a new theory here, but I am putting out a challenge to consider as we approach the EONS leadership summit.
In political terms, the challenges of effective leadership are on display as the UK and the EU negotiate their way through Brexit. The outcomes of this process, however, will actually be played out by countless more people who will have to lead future development to ensure that trade, education, security and many other aspects of modern life move forward within a European and global context regardless of political agreements. Again, it is really only through action that the skills of leadership become apparent.
One of the main problems with the leadership agenda, I suggest, is that anyone can simply assume the title and call themselves a leader. It is a bit like the term ‘expert’. However, leadership, like expertise, only becomes a reality when people find themselves leading others through a situation that might otherwise become unmanageable. In cancer care, this might be apparent on a daily basis when a nurse has to manage the care needs of several patients at the same time, and doing so with skill, compassion and confidence. This is leadership in action. Similarly, a nurse working in senior management has to lobby for nursing resources in a context where financial cuts are being promoted. This is also leadership in action.
Through EONS we seek to advance the recognition of the role of cancer nursing on the European stage through education and support of cancer nurses: this too is leadership in action and is why leadership is the focus of the 2017 summit.
As we look forward to this meeting in November, I would encourage you to consider your own potential and the leadership skills you already possess, as well as those you hope to develop. The leaders of cancer nursing for the next 20 years are already employed and working in the specialty. Our task now is to encourage them to take up the challenge and to shape the future within their own country. By doing so, the cancer nursing voice will gain even more prominence on the national and global stage and a new generation of leaders will be created.
July 2017: Do we work in a death-denying culture?
In the late 1980s, I was working at St Columba’s Hospice in Edinburgh, Scotland. I had recently completed the oncology nursing course at The Royal Marsden, in London, UK, and had returned to Scotland to a post as the senior nurse in charge on nights. One of my fondest memories of that summer was watching the sun rising over the Firth of Forth while the patients slept and before the city was fully awake. There is a unique sense of quiet at that time that is one of the perks of working such unsocial hours. I would then cycle home to bed as everyone else made their way to work. (I later decided that one year working at night was enough and I then moved to a new role in AIDS care.)
Apart from the sunrises, I also remember the work that we did and the nursing staff that I worked with at that time, many of whom were older women who worked part-time. They cared for the patients so well and I learned much about palliative nursing from them. I also recall some of the patients and remember them arriving, often exhausted and apprehensive, from the acute oncology hospital nearby (I was later to work there also in a charge nurse role). These patients had been through whatever cancer treatments had then been available, usually a combination of chemotherapy with surgery and radiotherapy. The pursuit of cure was intense, until this phase was over, and patients either returned to their lives or were referred to the hospice for end-of-life care or symptom management. For the acute oncology unit staff, their job was primarily curative and end-of-life care was best delivered elsewhere (although we also cared for many dying patients in the acute oncology centre, and we did so very well). The hospice was saved for those with more complex needs, or with symptoms that were best managed in a setting with the time to focus on their relief.
At the first meeting, people were often terrified of what a hospice actually was. In the acute cancer setting the focus had been on their cancer and its changing dimensions and degree of threat. Inevitably, with this focus on cure, it was difficult to also acknowledge the fact that, despite the best efforts, death was always a possibility in the end. However, it was always there in the background, like an unwelcome smell.
Having experience in acute cancer care, and reflecting on changing attitudes, it seems that we still struggle to deal with dying in acute settings. It is still difficult to manage conversations about death when we lack the time, or the training, or the will and courage to do so. The risk is that we inadvertently perpetuate a death-denying culture in a specialty where its avoidance can only add to a cancer patient’s already present sense of isolation. Whilst many people will now enjoy cure, others will eventually succumb to their cancer. I am not suggesting that we should emphasise the risk of dying, rather we need to consider how the culture of modern cancer care allows us to manage this outcome, or encourages us more often to simply avoid it.
In the hospice, death was an inevitable companion but it was not the sole topic of attention. Instead, time seemed to slow and comfort became the focus. Those who worked in the hospice certainly dealt with death on an everyday (and every night) basis, but my recollection was that the value was placed on living.
St Columba’s Hospice celebrates its 40th anniversary this year; when I worked there it was marking its first decade. I went back recently to look at the new and expanded buildings and hoped that the sunrises were still visible to those nurses still working there at night.
May 2017: Celebrating cancer nursing
On 18 May, EONS will be launching the first European Cancer Nursing Day (ECND). We have a dedicated ECND website www.europeancancernursingday.com and will be hosting a new ECCO position statement on Specialist Cancer Nursing. We are also busy with our flagship RECaN project; with the first phase almost complete and the second already well underway.
This important activity is thanks to the hard work of the people involved in making it all happen, and our multi-disciplinary colleagues on the ECCO Board and Oncopolicy Committee who have put their faith in demonstrating the value of cancer nursing. With all this going on, especially the countdown to ECND, it is an incredibly busy time but we are also aware of the many benefits that these projects can bring to help raise the profile of cancer nursing.
When I see what is being achieved already, I feel really proud of all our EONS volunteers and I know that it will prove to be a great success.
On 18 May, EONS will be in Estonia with cancer nurses working in that country. We will be launching ECND with Estonian colleagues and will be tweeting all about the activities from @cancernurseEU; and you can join in by using the hashtag #ECND2017 to show what you and your colleagues are doing to celebrate the day. There’ll also be updates on EONS Facebook for you to follow.
You don’t need to wait until 18 May to find out more about what’s going on though - you can visit our special ECND website now. There’s lots of really interesting material there, including clinical nurses talking about their role in caring for cancer patients.
One of these nurses, a very experienced colleague, explains the importance of nursing skills and for patients to have confidence in their nurse. He gives the example of a patient leaving home in the morning who might be feeling nervous about whether their nurse will be able to find a vein to deliver their chemotherapy. This may seem a small thing, but to the patient this anxiety can overshadow their whole day and lead to other worries and fears about their cancer and their future. This nurse, to me, captured the essence of cancer nursing: paying attention to the person and what their present needs really are.
This is what we will be celebrating on 18 May and we hope everyone will help us to spread the message that it’s time to recognise and to feel proud of the work that nurses do to make cancer more bearable.
March 2017: Turning away
I was travelling home on a train in London recently on a rainy night and was sitting next to an older woman reading a newspaper. We were getting off at the same station and when she got up to leave she left the newspaper on the seat. I asked her if she had forgotten it but she said no, smiled and asked if I wanted it myself. As we waited for the train to stop we chatted about the bad weather and what the day had been like for each of us. I said I had been to Cardiff and she told me she had been to a concert. Saying goodnight to her I thought no more about it.
As it had been a long day and was raining, I decided to get a cab for the final part of the journey and spotted her again from where I was standing in a shop doorway nearby. She was looking rather lost and approached a younger woman who was standing in another doorway smoking a cigarette. The older woman was asking her the way back to the previous station. (Our train had not stopped there as expected.) She seemed to be struggling to remember the name of this station and I then realised that she seemed to be confused and starting to panic.
The younger woman answered her at the same time as I did and together we mentioned the name of the stop. The older woman then turned to me and asked me which direction this was in. As she did so, the younger woman looked at her and then turned away and walked off into the night without engaging in any further conversation. She did not offer any assistance and did not seem to want to get any more involved. I showed the older woman to the ticket office and she said she would take the next train back. This event stayed in my mind and later made me think about the younger woman’s lack of engagement.
What had led her to do this? Was it just one thing too many? Was she seeing a potential problem that she wanted to avoid? It made me think of the choices we make to engage with people who need something from us, even just some advice on directions. In cancer practice, such demands occur all the time and, if managed well, we can usually help address an immediate need whilst also knowing what is beyond our own limitations at that time. To think about such situations is to reflect on how we live and how we act. We may not always get these things right but to those of you who do choose to help, it’s time to take a bow and be counted.
Modern cancer care, with all its pressures, needs nurses like you.
January 2017: A very happy, healthy and successful new year to everyone
I began writing the first part of this message on a train returning to work after the Christmas break. After the bright lights of the Christmas season we witnessed the turning of the year and more very short days (at least in northern Europe!) but also the promise of spring just around the corner. Already there are bulbs coming up in my London garden and they always remind me that a new year offers us all new opportunities. However, here in the UK we also face uncertainty over Brexit and what this will mean for our everyday lives. We also look ahead to the new American President. The amount of change and uncertainty that we face at the opening of this new year makes it difficult to predict what lies ahead, and many of us will be looking forward with a combination of hope but also perhaps some concern.
Whatever 2017 brings, I know that EONS will continue to support cancer nurses across Europe (and beyond). As an organisation, EONS is also facing its own challenges but we are facing up to them with optimism. I know that EONS has excellent prospects and we are excited about taking part in ECCO17 in Amsterdam very shortly. A new format has been introduced for the congress this year and we look forward to taking our place at the heart of this unique multi-disciplinary forum. Do join us if you can.
We have our own Society Day on Friday 27 January with an excellent array of speakers, and a joint session with the Oncology Nursing Society (ONS) and pharmaceutical companies on Sunday 29th to explore the changing role of oncology nursing. There is also a discussion session on multi-disciplinarity in a forum that includes the EU Health Commissioner. Importantly, we will be presenting early findings from the first phase of the RECaN study. Over the next year, we will be continuing with the second phase, consisting of case studies in four European countries; I am looking forward to discovering how cancer nursing is developing in each.
We will also be publishing the protocol and results of our systematic review from phase 1 of RECaN during 2017. I know that this has already identified a wide range of trial-level evidence of interventions carried out by nurses. ECCO will also be continuing to develop quality statements for a different range of cancers and we will be inviting colleagues to represent EONS in this process. We were closely involved in the statements produced on colorectal cancer and sarcoma that were produced during 2016.
My first trip this year was to Bethlehem University where I was teaching a module on cancer as a chronic condition. This is part of a new diploma in cancer nursing that has been established by Dr Jaqualyn Moore of King’s College London and the University. A number of other colleagues will also be teaching this course over the coming year. I am really pleased to have the opportunity to be visiting Palestine and to meet the members of the Cancer Nursing Society there. Myself and Matt Fowler from the Heart of England NHS Foundation Trust, Birmingham, UK (and recipient of the EONS travel award in 2015) flew out on January 17. This feels like a positive start to a year that is likely to be both challenging and intriguing.
Perhaps a quote is a good way to end this first blog of 2017. I can offer the words of an inspirational American woman, Eleanor Roosevelt, who suggests the best way to approach challenging times:
‘It is better to light a candle than curse the darkness.’
A very happy, healthy and successful new year to everyone!
December 2016: Thanks to all cancer nurses
I admit to sometimes feeling envious of colleagues still working in practice. I miss cancer care practice and I miss the contact I used to have with cancer patients. After a difficult day, a reward always came from the contact and help that was given to patients and families. For non-nurses this is perhaps difficult to understand. When nurses like myself move into other roles, such as teaching or management, there is often a broader remit but less opportunity for direct patient contact. When I left practice I left something very special behind, though now I enjoy the opportunities to visit colleagues and speak to nurses who are real experts in what they do. I must also say, however, that nursing expertise really needs to be recognised and rewarded and the many facets of nursing understood. This is one of the aims of the RECaN project that will continue over the next year.
There was a powerful short film produced by the RCN in 2012 that captured the roles of UK nurses as they went about their daily work, and it helps remind us of the range of skills that we all, as nurses, possess.
As the Christmas and New Year season approaches, I want to celebrate the many cancer nurses across Europe who will leave the warmth and comfort of their homes to care for patients. You deserve the greatest of respect and I know the families and loved ones of those you care for really appreciate the care you will be giving this holiday season.
Myself and the whole EONS team send our best wishes to all cancer nurses, wherever you will be working this holiday season, and whatever role you will be playing, and hope you will join us in our activities in 2017 to help you develop the very special contribution that cancer nursing makes.
November 2016: Reflecting on conferences
Having just returned from our EONS-10 in Dublin, I was soon off again to the AIOM (Italian Association of Medical Oncologists) congress in Rome and thinking about the way that cancer professionals travel around the world to meet up at all these different conferences. Rising at silly hours to catch trains or flights made me wonder whether they really a good use of our time (and money) or could we do just as well without them?
I’m not sure whether anyone has done research into the impact of conferences but they probably should, given the amount of time and effort involved. They certainly are big business and can attract people from all over the world and all sections of the healthcare profession, as well as industry. But they are much more than business events in my view.
There is nothing quite like meeting people face to face to get a feel for their opinions and concerns. Visits to different countries also allow social events to take place, including the sharing of meals and talk, trading jokes (that may or may not work in translation!), and the opportunity to hear about the everyday lives that people are living. The members of the EONS Board always supply interesting anecdotes at such times and I am happy to listen and ponder on all our lives, as different Board members have come and gone over the years.
This is what also fascinates me about conferences - the way that a sense of shared purpose quickly develops and, just for a few days, people feel a sense of connection as they meet friends old and new. I enjoyed walking around EONS-10 last month and intentionally striking up conversations with people I had not met before. It’s an interesting thing to do and it’s amazing what you learn!
In the sessions themselves, I was struck by the high quality of the research and how colleagues put their work across in such a professional way. There was also a wide range of posters that captured the full range of concerns that cancer nurses assist people with. I enjoyed acting as the discussant in a session on symptom assessment and I could see connections between the meaning of symptoms and nurses’ drive to manage them better. This was also an example to me of showcasing strong science that demonstrates just how much the evidence-base of our discipline has developed.
Our next big event is coming up in Amsterdam in late January 2017, when we take our place as part of the large, multi-disciplinary congress that is ECCO17. I think this will be a very interesting one as we will have our own EONS one-day programme and thereafter nursing is included throughout the rest of the programme too. There is even a discounted rate available for EONS members to tempt you to venture out in January… Find out more at http://www.eccocongress.org/Registration
Come and give it a try and let’s talk - I can’t promise what you will learn but it might be more than you expect!
September 2016: Nurse leadership through a pan-European lens
As events around Brexit have shown, nothing should be taken for granted in politics. I argued last time that the same is true for life. Over the past few weeks, I have been reminded by events that Europe is far from being a homogenous mass of attitudes and identities. In fact, things that we take for granted in one country (in my case the UK) do not apply elsewhere and we are reminded of this when colleagues from different countries come together.
The term ‘multidisciplinarity’ is a case in point. This idea (or ideal) goes to the heart of the ECCO organisation and is used as a catch-all term to capture the diverse perspectives of the organisations that, together, comprise ECCO. EONS was a founder member of ECCO and has, therefore, been at the table since its formation in the early 1980s.
Fast forward to 2016 and a discussion among a group of nurses from across Europe on multidisciplinarity and quality of care. A nurse from one country speaks of the value of holistic needs assessment in everyday practice. A colleague from another country and another discipline cuts in and challenges the need for nurses to assess patients in this way, arguing that this is the job of the doctor and nurses in their country ‘do not bother themselves with such things.’ This view was put in what might be called a ‘forceful’ way, and the first nurse responds by clarifying their role, their skills and the benefits brought to the patient.
So, we have an example of how different attitudes really are, despite the united front that we all like to promote. But what to do about this gulf? My view is that we continue to take our place at the table, to promote the value of nursing and to demonstrate the way that advanced roles can bring benefit rather than threaten the status of anyone else.
A second example is more positive and involved a meeting of nurses from across Europe involved in leading - or seeking ways to lead - services for AYAs (adolescents and young adult) cancer patients. Part of the programme focussed on coaching these colleagues to develop insight into their own personalities and to understand why others coming from a different perspective may fail to connect in situations when conflict or disagreements arise. Whilst differences across European countries certainly do exist in terms of AYA service provision, the importance of communication, assertiveness and clarification of one’s opinion were common traits in effective leaders.
Whether conflict arises in the clinic or in the meeting room, there is a need to speak confidently and to have our voices heard. Sharing these examples will hopefully demonstrate the types of challenges that remain, but also the opportunities that exist, for cancer nurses seeking to lead innovations across Europe.
A fine example of multidisciplinary working is our EONS Masterclass where, in joint clinical sessions, nurses together with physicians update their clinical knowledge about the latest issues for the management of various cancers, with an international faculty of experts. Why not try it out next year?
August 2016: A key lesson in life: be ready for the unexpected!
I took up the Presidency of EONS in Vienna last September, the fourth British nurse to be elected in the society’s 32-year history. Looking ahead for the next two years, I had identified priorities which were to focus on raising awareness of the needs of younger people with cancer, and promoting leadership for the nursing workforce.
At the opening ceremony of the ECCO (aka The European CanCer Organisation) congress in Vienna, where the EONS Presidency is passed on, it was announced that the main priority adopted by the ECCO policy committee over the next two years would be the recognition of cancer nursing in Europe. This came as a surprise to all the nurses in the room - but it was also an incredibly positive opportunity. EONS has since taken this challenge up and we have launched the RECaN (Recognising Cancer Nursing) project. This will be carried out in three phases, the first of which is already under way. We have started with a systematic review of the impact of cancer nursing interventions.
The first year of the EONS Presidency goes quickly and it is important to think about what can be achieved in the time available. The business of EONS is carried out not only by the board but also the four working groups and our many volunteers and staff. The RECaN project is taking place alongside the normal work of EONS, so it takes extra time to set up each phase and manage the work. All is going well and we are on track to make a real impact with this project.
Like many in the UK, I was rather complacent about the EU referendum result. I thought we would vote to stay and things would continue as before.
Then came Brexit!
Working closely with so many European colleagues I felt a real sense of disappointment and surprise at the referendum result. However, since 24 June I have had messages of support from across Europe confirming the EONS approach to collaboration and mutual support. We have also been sent reassurance from ECCO and other European cancer nursing societies.
Time alone will tell what the true impact of the United Kingdom voting to leave the EU will be. For the remaining period of my Presidency, however, I will use the time to complete the next phase of the RECaN project and ensure that the strong bonds across European cancer nursing societies will continue to grow.
The last few months have been a period of great change but to keep me focussed on the benefits of EONS I recall an Estonian cancer nurse telling us at the ESO Masterclass how they work 24-hour shifts and have one registered nurse to 15 acute cancer patients. To help support colleagues in Estonia we will be holding one of our board meetings there in 2017, and will include them in phase 2 of RECaN - a series of case studies in countries where cancer nursing is, or is not, well developed and recognised.
So, despite the unexpected, I am looking forward to another successful year for EONS and to our forthcoming EONS 10 meeting in Dublin in October. This is in conjunction with the International Psycho-Oncology Society (IPOS), the Irish Cancer Society and the Irish Association for Nurses in Oncology (IANO) - so we are continuing to look outwards, to collaborate and to work together to take cancer nursing forward.
From the last few months I have also learned that expecting the unexpected is perhaps the best philosophy for life!