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EONS, Eusoma, ESSO Training ProgrammeReport from the participantsJan Foubert, EONS representative on this Training Programme.Regular readers of the EONS Newsletter may recall an articlepublished in the Winter 2007 issue which announced the recipientsof a traineeship supported by Eusoma, EONS, and ESSO. Theaim of this educational initiative is to train specialist health careprofessionals to better deal with patients with breast cancer.Following a very successful call for applications for the traineeships,five EONS members were chosen to participate in a one-monthvisitation to a European breast care center. As you will read below,both recipients made the most of the opportunity to learn more aboutnursing care of the patient with breast cancer and to extend theirnetwork of European colleagues.Lara Kaligaric from Slovenia was selected to attend a clinicaltraining programme in the Senology Department, FondazioneSalvatore Maugeri, Pavia, Italy, here follows her impressions of thetraineeship:Although the approach to care was multidisciplinary on this breastunit, most of my traineeship was concentrated on interaction with thenursing staff. I had the opportunity to observe different procedureswhile working on the unit as well as observing procedures in theoperating room. I found the experience of assisting in the operatingroom particularly interesting as I had never before done this type ofnursing.Experiencing the interaction and collaboration between oncologistsand plastic surgeons was new for me as plastic surgeons are not partof the oncology team at my ‘home’ institution. I also gained newknowledge by participating in multidisciplinary sessions where patientcases and treatment options were discussed.Although I am sure that I have developed new competencies throughmy experience, the one-month duration of my traineeship was tooshort for these newly acquired skills to really show themselves. Ihave learned some new aspects of cancer care that I will certainly beable to use in one form or another when I return to my place of work.These are:• The importance of developing a relationship with the patient priorto surgery;• Different patients have different needs: some want to knoweverything about their illness while others just want to have surgeryand get on with their lives;• Sometimes the best nursing care is to just be quiet and listen tothe patient.The training was a good experience however what I observed wasnot so very different from the situation on my ‘home unit’. Beforeundertaking the training I was very motivated to initiate change andstill am! On the unit where I work we care for patients with all typesof cancers so it will be somewhat difficult to implement all of what Iexperienced. I would like to eventually work in an outpatient settingwith women who have different stages of breast cancer undergoingdifferent types of treatment.Marjia Adamovic from Serbia did her traineeship at the CancerInstitute-Antoni van Leeuwenhoek in AmsterdamMy one-month traineeship in a specialized, high-standard institutionlike The Netherlands Cancer Institute-Antoni van Leeuwenhoek(NKI-AVL) in Amsterdam was a great experience for me that widenedmy knowledge. I had an opportunity to visit the operating rooms, theinternal medicine department, the outpatient clinic for chemotherapy,the radiology department and the department for creative therapy.My attendance at the interdisciplinary meetings was especiallyrewarding. Contact with patients really increased my understandingof the role of cancer nurses.Working in the medication preparation room, which was speciallydesigned to protect nurses and pharmacists from contact withhazardous agents, taught me a lot about the proper handling ofchemotherapy agents. That is something we do not have at theInstitute for Oncology and Radiology of Serbia.In everyday work with kind and helpful colleagues, I gained insightinto new protocols to treat breast cancer and other malignancies.I also saw a new generation digital mammography in practice andstereotactic biopsy used as a diagnostic procedure.What I found most intriguing was the organization of the institutewhich is centered around the patient and many procedures, forexample MRI, are performed within one day. I also was surprisedthat breast reconstruction is paid by the social insurance fund. Theaccommodations for patients are spacious and brightly decoratedand there are meditation rooms for both Christians and Muslims.Patients and their families can easily access information which isavailable in leaflets, books, internet and open phone lines.Workshops and creative therapy play a big role in the psychologicalaspect of patient care. I met an elderly lady who was receivingchemotherapy and happily chatting about a necklace she was makingin creative therapy. Concerts are held every month for patients.All these experiences left a big impression on me and I hope that oneday we will have the facilities and resources that I saw at the CancerInstitute-Antoni van Leeuwenhoek at my institute. Although wecannot offer patients the same treatment as offered in Amsterdam,we give our best, we use what we have, and we try to makeeverything easier for them.Elizabeth Vella from Malta went to Burney Breast Unit in WhistonHospital in Prescott Merseyside.My one-month traineeship was positive and an excellent learningexperience. Although I had had an opportunity to attend the course‘Care of the Patient with Breast Cancer’ at the Royal MarsdenHospital in London, actually experiencing first-hand how things aredone and being present as part of the team on the Burney Unit was amuch more enriching experience.Burney Breast Unit is situated within Whiston Hospital and coversa population of 360,000. The breast service is staffed by a team ofdedicated clinicians and specialist nurses. The team detects andtreats over 200 new cases of cancer each year. I had the opportunityto attend a variety of services offered by the clinic, such as rapidaccess, non-urgent, follow-up and clinical trials clinics. I alsoparticipated during surgical procedures, in the chemotherapy unit, atoncology consultations, and during reconstructive/plastic surgeonconsultations.Mr. R Audisio under whose patronage I was entrusted, kindly invitedme to attend clinic sessions. Although my main interest was toobserve, share and work with the specialist breast care nurses,watching surgical procedures which have not yet been introduced inMalta, was interesting.- newsletter fall 200814
Being in various clinics once or twice a week for a month’s time gaveme the opportunity to follow patients through the first part of their‘cancer journey’. The breast care nurse is present when the patientis diagnosed, when she is being prepared for surgery when histologyresults are discussed and again when the oncologist explainstreatment options. The breast care nurse is a constant companionthrough the cancer journey, providing support, counselling andinformation for both patient and family.My learning experience was enhanced by the time I spent shadowingthe breast cancer nurses. I learned a lot from their gentle butcomprehensive and diligent approach toward patients. We are stillin contact and I feel this is one of the most important outcomes ofthe traineeship: meeting with professionals who work in the samearea and learning from each other’s experiences in order to provide abetter service for our patients.Attending the oncology clinics was one of the highlights of thetraineeship. The oncologist explains in a comprehensive and detailedmanner the treatment options and their side effects. Patients arethen given written information and are asked to ‘think about it’ and tocome back the following week with a list of questions. This enablespatients to make informed treatment decisions. Unfortunatelyour oncology clinics are not so well equipped. We have only twooncologists in Malta who see all the patients diagnosed with anycancer in the whole of the island. Ideally we should have a specialistbreast oncologist as a member of the multidisciplinary team.I’ve had discussions with my colleagues in Malta regarding somechanges in our service. We are considering to each have an individualpatient load and to maintain better nursing records. It has beendifficult for us to provide this specialist care since we have nosupport or clerical staff on our team and we spend much of our timepreparing for clinics and meetings.Vesna Kodzopeljic from Serbia attended the University Clinic inAachen, Germany. Her visit to this breast centre has been extremelyuseful and helped her to justify previous knowledge and skills. Shenoticed that all activities at the clinic are standardized. She hadthe opportunity to take part in obtaining lab specimens, changingdressings, working with the surgical team, assisting during biopsyprocedures and observing other medical and surgical procedures.This training has great influenced Vesna and will stimulate here tomake some changes in her daily practice.The first thing that Vesna is going to apply to her work environmentis the multidisciplinary approach toward patient care including thecollaboration of a psycho-oncologist which she believes will improvethe care provided to patients and their families.10 th World Congress of Psycho-OncologyInternational Psycho-oncology Society (IPOS)Report by Sara Faithfull, EONS presidentThe theme of this conference was: “Advancing culturally diverseapproaches in psycho-oncology and palliative care. Psychologists,clinicians and nurses were represented at this conference thatpresented overviews and recent research in the field of psychology.Symposiums covered how suffering and pain are related examiningthe relationship between symptoms and psychological distress. MartaSchroder and Debra Koatz (1L-2 2008) in a study of Spanish cancerpatients needs found that few of the 25 reviewed hospitals providedpsychological or emotional care services. They also found thatpatients who had unmet psychological patients need later developeddistress. They concluded that a greater appreciation of psychologicalneed early in the treatment trajectory could lead to better care.Screening for distress was a common theme in that we are all awareof the association between anxiety and distress.The EONS symposium (16) explored crossing boundaries: Etechnology and patient care. The idea of this symposium was to lookat work in progress on communication support provided throughtechnology to enhance patient‘s care experiences. Paz Fernandez-Ortega from Spain opened the session with some of the future careissues in assessing patients remotely and the need for new modelsof care. Roma Maguire from Stirling Scotland described existingresearch work on the ASyMS study on remote monitoring and itssuccessful use in patients receiving chemotherapy. Sara Faithfullfrom England presented work on the role of the workforce andattitudes in implementing telehealth systems and Nynke de Jong fromthe Netherlands described pain symptom management technologysystem that are being utilised and evaluated in clinical practiceto reduce cancer patient distress. The symposium was a greatsuccess with discussion of the role of technology in providing remotesupportive care.It was a common theme in many of the papers that there continuesto be a need for greater education and training in communicationskills and guidelines for assessment and management ofpsychological problems as a result of cancer.newsletter fall 2008 -15
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Page 43: 23-25 April 2009SARAJEVO, BOSNIAAND

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