EONS

Sidsel Dragsbæk Holm

Onkologisk Sengeafsnit, Odense Universitetshospital E-mail: sidsel.holm@rsyd.dk Når man arbejder indenfor kræftområdet vil man højest sandsynligt være stødt på organisationen EONS. Mange dog nok uden rigtig at vide hvad det er. EONS er forkortelsen for European Oncology Nursing Society og er en europæisk medlemsorganisation for kræftsygeplejersker. Der er for nuværende 28.000 medlemmer fra hele Europa.

EONS hovedformål er at få kræftsygepleje anerkendt som en profession med specialiseret uddannelse og kvalifikationer af politiske beslutningstagere på både nationalt og europæisk plan. Dette for at sikre at alle mennesker, ramt af kræft, har adgang til højtuddannede, velinformerede og kompetente kræftsygeplejersker

Derudover danner EONS via forskning og efteruddannelse et overordnet praksisfællesskab på tværs af lande.

Dette kan godt lyde højtsvævende og svært at relatere sig til i den daglige danske praksis, men faktisk har EONS rigtig mange tilbud. Når jeg selv har deltaget i EONS-sammenhænge må jeg ligeledes konstatere at selvom mange af medlemslandene ligger et stykke fra Danmark, både geografisk og kulturelt, så har vi overraskende meget tilfælles.

Et eksempel på dette var sidste års EONS-konference, hvor mange af de emner der var oppe og er noget vi diskuterer og beskæftiger os med i min egen praksis.

For eksempel: • Vigtigheden af opsporing af ernæringsproblemer og interventioner – Herunder diskussion om udarbejdelse af et internationalt ”assesment tool” • Palliation i hæmatologien • Palliation til ikke maligne lidelser, fx

KOL • Mere fokus på den øgede tid mellem kurativ og døende: Palliation i den ”kroniske” fase • Covid og cancer: overlevelse kontra mental sundhed For at få gavn af de mange gode tilbud fra EONS vil jeg opfordre jer til at følge med på deres sociale medier, f.eks. Facebook og Twitter. Og selvom at det kan være svært at gennemskue hvad det enkelte tilbud præcis dækker over, så synes jeg man skal give det chancen. For ofte er emnet helt relevant og helt nede på jorden, tæt på egen praksis

Et godt tilbud er EONS Masterclass, som er et intensivt fem dages kursus med fuld fordybelse i onkologien. Formålet er at forbedre deltagernes kliniske færdigheder og derved patientplejen. De fleste sessioner er sygeplejeorienterede og udforsker blandt andet vurdering, kommunikation, kompleks symptomhåndtering, forskning i sygepleje og psykosociale konsekvenser af kræftbehandling. Derudover er der rig mulighed for at diskutere kræftsygeplejen med de andre deltagere, for eksempel vha. patientcases. Der er også særlige fælles sessioner med lægerne, som har til formål at understøtte behovet for den tværfaglige tilgang til udvalgte emner. Sidst, men bestemt ikke mindst, giver Masterclass i høj grad mulighed for at danne netværk på tværs af Europa. Noget som jeg selv stadig nyder meget godt siden jeg var afsted i 2014.Som alt andet har Masterclass væres udfordret af Covid, men hold øje med de sociale medier.

Jeg bliver ofte spurgt til sprogkunskaber og siger hver gang at hvis man kan klare sig på en ferie kan man også klare sig i EONS. Det kræver noget tilvænning af manøvrere rundt i et nyt sprog med helt nye fagtermer, men det kommer lige så stille og husk at alle er i samme båd.

Under dette skriv ses endnu et par rigtig fine eksempler på at det vi oplever som kræftsygeplejersker her i landet går på tværs af landegrænser, så alt i alt, kan jeg kun opfordre til at man hopper om bord i EONS’ univers og dykker lidt ned i hvad de har at tilbyde. Der er en reel mulighed for at der åbner sig et helt nyt fagligt univers med masser af ildsjæle og faglige åndsfæller.

The emotional evolution of an oncology nurse

Helena McCallig, Ireland

You have completed your training and become a registered nurse. The sense of accomplishment and excitement is thrilling. The world is your oyster, you ask yourself where to now? A range of specialities awaits; emergency medicine, surgery, community nursing or even oncology nursing. Often referred to in more general terms as ‘cancer nursing’, it is not always the chosen pathway for some nurses. However, over the years many more newlyqualified nurses are entering the specialism. An immensely rewarding speciality, the continued kindness, strength and knowledge shown by those who are in it means it is one that is widely admired.

Nurses continue to constitute the largest group of healthcare professionals. Those working within the area where cancer is the focus need specialised skills and knowledge to deliver advanced care. Oncology nursing involves observing patients through their full cycle of care from diagnosis to treatment and sometimes death; intense interaction at numerous intervals takes place between the nurse and the patient. Caregiving is both rewarding and satisfying –helping people in need has been identified as a great source of motivation for nurses. However, leaving the emotional experience unexamined can have cumulative adverse consequences for nurses' physical and psychological health.

Setting boundaries

Research has shown oncology nurses are exposed to a significant amount of suffering and loss with findings suggesting novice oncology nurses are unprepared for the emotional ordeal of being an oncology nurse. The first few patients for whom novice oncology nurses primarily care can create an increased risk for secondary traumatic memories as healthy boundary setting is often limited. Setting a healthy boundary as a novice nurse can be difficult at times. At some point during our careers, every nurse has probably found it hard to leave work at work. Oncology nurses are even more vulnerable, with rates of compassion fatigue and burnout on the rise due to increased emotional labour and unpredictable workloads.

A supportive environment

How do you positively cope outside of work? Do you spend time with family and friends or have a general conversation about the hardship of the work with your colleagues? I know from experience that being an oncology nurse has both immense highs and lows. Where does work stop and time off begin? This can be a hard balance to achieve, emotional baggage is not easy to just shake off. Giving time and space to open discussions surrounding the impact on the personal consequences of caring for cancer patients needs to be shared. This could help shift the culture in the work environment to value the mental health of its practitioners as there has been a longstanding history of silence. Oncology nurses should not be overcome by deteriorating psychological health. Nursing management should strive to encourage openness and create a supportive professional environment. A valuable investment of resources including education and support programmes for oncology nurses highlighting prevention strategies for compassion fatigue and burnout could be the first step to providing sufficient support to all of us who work in oncology.

It would be next to impossible to look after someone else if we do not look after ourselves.

Look out for Kathell’s blog next month on promoting a balanced lifestyle in oncology nursing, and remember, EONS is always here to support you!

KILDE

https://cancernurse.eu/ycn-blog/

More mental health in oncology

When we talk about health and mental illness there is a tendency for people to withdraw. Stigma, fear, prejudice and stereotypes keep people away from talking about mental health, from seeking help, from taking on a health problem. There is no health without mental health. In order to feel good about ourselves and reach our maximum professional and personal potential, we must have a satisfactory level of well-being.

We know that cancer disease brings suffering to the patient and family. It affects the quality of life as, in addition to the physical symptoms, the confrontation with the idea of death and a threat to the individual’s integrity becomes imminent.

We also know that oncology professionals are more likely to develop compassion fatigue and burnout.

If we know all this, why do we still have difficulties in talking about mental health? Why do we have low mental health literacy levels? We ourselves have to acknowledge that being a cancer nurse is difficult! It's difficult because we work in shifts, affecting our family and social life, because we take care of people in the final stage of life, because of the relentless pace of work required to take care of everyone, for various reasons. But because it is difficult, we sometimes need psychological support. In order to take care of others, we have to first take care of ourselves. We have to be the ones to make our managers see that we need to be taken care of – to be able to play our role more effectively. So…

Let's make Mental Health First Aid as common as CPR.

We therefore need to have programmes in place in our workplaces for training courses in Mental Health First Aid, which allow us to recognise signs and symptoms of psychological distress and/or mental illness. In this way, we will be able to provide first aid to people in psychological distress.

We must think about it both in terms of the patient and family and in the healthcare team. Incorporating this course makes people more available to talk about mental health, encouraging early intervention, reducing stigma around mental health issues, and creating a more positive workplace culture.

There are even a few ways to start a conversation about mental health that might be helpful:

1. Don’t wait to find the perfect moment The moment we idealise may not spontaneously occur, so we have to create it. Sometimes it's easier to talk about our thoughts and feelings if we're doing something relaxed like a lunch break or drinking coffee in the middle of the shift.

2. Ask twice We know that people often say they’re fine when they’re not. So asking twice is an important way of starting conversations about mental health and letting people know that you really are interested. Sometimes we feel uncomfortable opening up if someone asks, “how are you?” because we think they’re just being polite. But if that person says, “no, really, is everything OK?” we know that they’re not just going through the motions. Even if someone doesn’t feel like talking at that moment, they know you’ll be there to listen when they’re ready.

3. Talk about yourself If we want someone to feel free to talk to us, we must give space and share our feelings and concerns. The other person will feel they have space to speak freely and without judgement.

4. Approach the elephant in the room If you think someone has been acting differently you can mention that too in a kind way. “You’ve seemed a bit quiet recently, is everything alright? I’m here if you want to talk.” This shows that you care and opens the door for them to chat about things when they’re ready. If someone took some time off work recently you can ask: “How are things now?” or “Are you back at work?” shows that person that they have nothing to feel awkward about and they can talk with you.

5. It doesn’t have to be face to face If you have difficulty talking about this subject you can always send a text message or Whatsapp. Just remember to open the door so they can feel comfortable if they want to talk.

Remember, there is no health without mental health

KILDE

https://cancernurse.eu/ycn-blog/