The European Oncology Nursing Society

1. The European Oncology Nursing Society The role of Nursing in Palliative Care in Cancer. Jan Foubert President EONS

2. Cancer nursing in Europe • Cancer nurses are the largest group of healthcare providers in the oncology setting in Europe • Involved in the prevention and early detection of cancer and provision of care at different stages of the cancer journey • Strengthening cancer nursing will bring about improvements in care for the millions of European citizens who get cancer each year

3. European Oncology Nursing Society (EONS) • Established in 1984 • Promotes practice of cancer nursing • Involved in educational, research and practice-based initiatives • 32 national societies • 300 individual nurses • 17 institutions and agencies

4. EONS mission statement • The mission of the European Oncology Nursing Society (EONS) is to add value to the work of its individual members and societies in delivering care to patients with cancer. It aims to assist in the promotion of developing healthy communities through influencing, research and education.

5. EONS strategic plan • Context of Strategic Plan • EONS is a European citizen. • It exists within many communities across Europe and not in isolation. • It’s strength lies in co-operation and collaboration with a range of multi-professional organisations.

6. EONS’s partners • MASCC • ISNCC • ONS • ESO • FECS • PCN • Industry

7. Diversity in Cancer Nursing in Europe • Cancer Nursing is not recognised as a speciality in most European countries • Postgraduate Cancer Nursing Programmes are available in most European countries • most of them have used the EONS core curriculum • Evidence demonstrating the impact of cancer nurse education on cancer care is lacking

8. Diversity in Cancer Nursing in Europe • Most European countries have a national oncology Nursing Society • many have existed for more than 20 years • membership numbers vary significantly between countries (5500-100) • Most European countries have a nursing shortage • Nursing, exists as a part-time profession in many countries

9. Future challenges in Cancer Care • Ageing population, living with chronic, debilitating and life-threatening illness • Nature of the advanced cancer journey will change dramatically as a result of integrated molecular diagnosis and therapy • increased awareness and information about cancer amongst the general public • More informed choice • Increased patient activism

10. Future trends in cancer treatment and care • Optimised surgery, chemotherapy and radiotherapy • Increasing array of supportive pharmacology • Personalised healthcare • Different models for follow-up and new focus on survival • Interest in effective approaches to supportive and palliative care

11. EONS is responding to these challenges through education and promoting advances in clinical practice • EONS will develop and implement, in collaboration with members, post basic education and continuing education designed to improve knowledge and competence in agreed areas of cancer nursing. • Examples: TITAN, NOEP, TARGET, Speak Up, Bisphosponates. • Accreditation, Core curriculum Cancer and Cancer in the elderly.

12. EONS Policy on Education • Education is vital as oncology moves forward • EONS provides framework based on learning needs assessment • Education can only be done in collaboration with the local Oncology Nursing Society (ONS) • Impact is shown by dissemination plans and by regular follow up from EONS and NONS • Education mainly focussed on nurses who routinely provide care for patients with cancer.

13. Palliative Care Nursing • Palliative care is both a general approach to patient care that should be routinely integrated with disease modifying therapies, and a growing practice speciality for appropriately trained nurses. • Palliative care is provided by an interdisciplinary team, including the nurse.

14. Palliative Care in different Treatment settings • Cancer nurses, in the routine course of providing care, are expected to provide basic elements of palliative care (e.g. pain and symptom assessment and management) • Palliative care specialist, providing care for patients with cancer, require training in oncology to provide good care.

15. Palliative care: Role of the Advanced Practice Nurse • Presenting bad news in a context of choices • Broaching end-of-life discussions an suggesting possibilities for choices • Managing physical care and emotional needs • Description of specific strategies to address care needs • Facilitating care services and systems • Choreographing the systems and logistic aspects.

16. EONS Activities in relation to palliative care • Collaboration with ESMO between 1998 and 2001 on courses Palliative Cancer Care in Estonia, Budapest and Cyprus. • Accreditation of post-graduate courses • “Palliative Versorgung” in Germany • Short course “ESO German Branch” entitled “Weiterbildungslehrgang Palliative Care fur Fortgeschrittene Plegende”.

17. EONS’s Interest in Palliative Care • Patient population through the different member societies of EONS • Focus on patient and family centred care as a core element in EONS strategy • Comprehensive care as a core element in EONS education strategy • Interdisciplinary team since EONS has interdisciplinary contacts • Communication skills as element in major education projects

18. Important issues for nurses • Previous patient experiences • Patient’s preferences • Health care quality standards • Codes of ethics • Peer-defined guidelines • Specialty care • Continuing professional education

19. Conclusion • Diversity presents a key challenge in developing cancer nursing in Europe • Europe is growing and a lot of countries haven’t been reached • EONS can help palliative care nurses in providing a network and forum. • EONS can help empower nurses • Leadership and power has biggest impact on local level