EONS at ECCO 2017 – Current challenges, future opportunities in cancer nursing
The ECCO Congress 2017 got off to a dynamic start on Day 1 with a special programme of talks and presentations specifically selected for EONS members.
EONS President Danny Kelly welcomed a packed room of oncology nurses who had travelled from all over Europe to attend this important event, introducing them to an imaginative and interesting programme.
Danny told the audience that ‘nursing is both a science and an art’ and he highlighted that ‘the human element’ must always be the key to the care and support that oncology nurses give. He explained that for 1 in 3 of us, cancer would be a reality in our lives.
There were certainly challenges ahead for oncology nurses, the EONS President acknowledged – many were global and there were definitely more similarities than differences. However, despite the fact that there is never enough time or enough nurses, he told the audience that they should be very proud of the work that they do and of what they achieve.
Danny went on to praise the work of ECCO, and in particular the importance of its multidisciplinary approach, and introduced ECCO President Peter Naredi.
ECCO President Peter Naredi entitled his talk, ‘Valuing cancer nursing’. He explained that ECCO’s vision was
- To promote the concept and practice of multidisciplinarity across all areas of cancer
- To be the united voice of European cancer professionals to address common policy issues
He put multidisciplinarity at the heart of ECCO’s work, it was: ‘The united voice of European cancer professionals’. He also stressed the importance of patients at the heart of care. Peter then turned to the vital contribution of nurses. He made three main key points:
- The central contribution to all cancer patients made by nurses
- That nurses should be integral to effective multidisciplinary team working
- That specialised cancer nursing lacks uniform regulation, or recognition, across Europe.
Peter said that for the patients themselves, the specialist role of cancer nurses is acknowledged. They value the fact that nurses:
- Co-ordinate care across the patient pathway
- Promote the values of collaboration, creativity, care and commitment
- Promote continuity of care and manage transitions between services
- Respond effectively to patients’ complex needs by person-centred approaches to care
- Develop and lead innovative supportive care services
- Ensure quality and safety of care.
However, in the wider healthcare policy world this is still not adequately recognised and this, Peter explained, was where the RECaN project, led by EONS and ECCO together was so key. It would:
- Systematically review and consolidate the evidence available on the added value of specialised cancer nurses undertaking nurse-led interventions
- Gather case studies in some contrasting European countries
- Illustrate the full potential of specialised cancer nursing as part of the multidisciplinary team.
Through the RECAN project, ECCO intends to support the key recommendations that:
- Cancer nurses are core members of the multidisciplinary team
- Cancer nursing should be a recognised speciality everywhere in Europe based on a mutually agreed educational curriculum
- Education for specialist cancer nurses should be available
- Enhanced free movement of cancer nurses across Europe should be promoted and facilitated to help address rising demand.
He went on to describe how nurses make a central contribution to all cancer patients’ experiences and how they are integral to effective care, and he talked about the way in which the personal aspect is so key to treatment: touching hands and talking with patients.
Peter also pointed out that nurses ‘are the bridge between patients and other professionals’. In the confusion that patients often face, nurses are central to the ‘coordination of care across the patient pathway’. He concluded that cancer nurses could in fact lead the way, he called upon nurses to: ‘Be the model for other disciplines in the cancer care community.’
Daniel Kelly – The current situation of cancer nursing in Europe
The EONS President then returned to the podium to speak about the importance of recognising ‘When things go wrong’ – a subject about which Danny has written in a chapter of the same name in the recent publication, ‘Understanding Sociology in Nursing’.
He referred to what he termed ‘a tangle of tyranny and trust’ and spoke honestly and directly about the danger of cynicism in the health profession. He described how work patterns are central to this and highlighted the safety issues that attend these issues. He cited findings of the Shipman Inquiry, set up by a British governmental investigation into the activities of general practitioner and serial killer Harold Shipman, and the important lessons around safety that this contained.
To operate well in a world where we are constantly being asked to do things ‘faster, better, cheaper’ (NASA 1986), Danny explained that we need to be aware of hugely different workplace cultures and health systems across Europe, and of all the psycho-social aspects of patient and employee safety, including issues around absenteeism. ‘Well rested nurses work better,’ Danny concluded, and he referred to patient safety studies that prove this.
Finally, Danny, like Peter Naredi, drew attention to the very important work EONS is doing in the RECaN project on recognising the value of cancer nursing and, as President of EONS, he encouraged participants to find out more about this vital work to increase the status of oncology nursing throughout Europe.
Judith Shamian – The impact of nurses on the health of the global population
Judith Shamian, President of the International Council of Nurses, outlined how important it is for nurses to be able to raise their status in the healthcare world by showing that they enable a strong economic return on investment; that they bring both clinical and social benefits. This pragmatic approach was the way for nurses to get their voices heard where it matters.
She asked a tough question: ‘Do we have an impact on the big decisions that can improve health outcomes?’
Then, Judith set out seven priorities of the global agenda for health:
- Universal health coverage
- Sustainable development goals
- People-centred care
- Non-communicable diseases (NCD)
- Healthcare financing
- Human resources for health
- Health system strengthening
She asked, ‘Where is our impact here? Are nurses shaping the vision and strategy for the future?’ She concluded that the answer was ‘no’, and she argued that this was ‘the essence of our problem’.
Judith explained that ‘nurses are at the bedside most of the time’ but asked, ‘Are we in the boardroom? Can you find us in global organisations?’ This leap might seem like a daunting prospect, but Judith was optimistic – ‘It’s not that difficult,’ she declared, ‘you just have to build the relationships’.
Despite the reality that many pages are written by nurses doing great research, Judith continued, we have to ask ourselves if others in the multidisciplinary team, such as the surgeons, actually read them.
To build the optimal future, there was a lot of work to be done. Nurses would have to ensure that they have a policy impact and this would take full engagement where they can and should have influence.
She ended her talk on a positive and rallying note: ‘We have to unleash nurses’ full potential. Grab a seat at the table! If you don’t have a seat at the table, bring a chair!’
Jacqueline Broekhuizen – Work environment and strategies to improve work satisfaction
Jacqueline Broekhuizen, from the Netherlands Cancer Institute, addressed the question of how to improve nurse job satisfaction and decrease turnover rates. In short, by:
- creating better support services
- a work environment that supports autonomous nursing practice
- more educational opportunities.
She explained that current times, when nurses are ‘caring in a crisis’, many in the EU are working harder than before and are asked to provide more for less. In fact, nurses are unequally and hardest hit, and a lack of equipment, reduced supplies and inadequate staffing are placing patients’ lives in danger and are a risk to patient outcomes.
She went on to point to research that shows that when nursing staffing cuts are made to save money this badly effects patients; and also, that increasing bachelor education for nurses could reduce hospital deaths! Thus, it is key that nurses have the opportunity to specialise in oncology, are properly involved in the multidisciplinary team and are able to be proud of the work they do (Linda Aiken, The Lancet).
Jacqueline described the main features of a ‘Project Taskforce Nurses’ that started at her hospital (Antoni van Leeuwenhoek, Netherlands) in 2016. This involved the following approaches to achieving nurse satisfaction at work:
- Terms of employment
- Financial bonus monthly (for one year)
- Personal development budget for education
- Evidence-based practice
- Focus on development
- Programme for education
- Digital learning including accreditation
- Skills lab
- Job market campaign -> nurses as ambassadors
- fit@work programme
- Involvement of nurses
- Nurse advisory board.
What were the results of this? The creation of:
- A great place to work
- Satisfaction among employees
- Decrease in turnover rates
- A positive effect on patient outcomes
In conclusion, an organisation where employees have trust in the direction, are proud of what they do, and enjoy working with their colleagues, will be an organisation where the goals will be executed, with employees who give the best of themselves and cooperate as a team in an environment of trust.
And finally, what would Jacqueline’s simple wish for the future be? That such an approach would result in… No shortage of oncology nurses and nurses who are proud of their important work!
Johan Lambregts – Influencing national politics: the way to succeed
Johan Lambregts, CEO of Bureau Lambregts, in the Netherlands, argued that in order to make change happen, nurses needed to ask themselves ‘Who do I need to influence in my country? Who holds the power?’ This might be health insurance companies, politicians, employers etc. He explained the importance of identifying who would be sensitive to your issues and choosing the right media. ‘Be original and creative!’ he exhorted his audience.
In an engaging presentation, Johan, highlighted the importance of choosing what instruments to use to reach your goals, of identifying what was the message and what was the evidence behind it. He reminded everyone that social media, as well as the mainstream media, was a key tool now and should be used to good effect.
Using the example of a campaign to address the potential loss of community nurses in one area of the Netherlands, Johan pointed to the technique of using role models, pioneers and ambassadors to get the message across. Where they did not exist they had to be raised. This had been a vital part of winning this campaign.
The characteristics these people needed were:
- Ambition to be a leader
- Be able to inspire, convince
- Be a role model
- Able to confront criticism
- Guts and creativity
- On the lookout for chances and possibilities
- Prepared to invest time and effort.
The campaign was carefully planned with goals, a strategy and timelines established early on. Once it got underway there needed to be powerful lobbying, good communication and motivation of those involved.
A combination of all these skills and a lot of energy and enthusiasm won the day, taking this particular campaign to the very top and gaining the notice of politicians and media outlets. In the end, the community nurses were saved! Johan concluded that this should be an inspiration to us all and proved what could be done when nurses, and the community, work together to achieve change.
Anita Margulies – Lifetime Achievement Award
Another highlight of the day was the presentation of the EONS Lifetime Achievement Award to Anita Margulies, for her huge contribution to EONS over many years and her outstanding work in the cancer nursing field.
An in-depth interview with Anita will appear in a future issue of EONS Magazine.
>Read on in this issue for more news and reports on the ECCO Congress in Amsterdam.