Vision for Cancer Nursing – EONS President Johan de Munter

EONS President Johan de Munter

At the close of the EONS14 Conference on 22 September 2021, EONS President Johan de Munter set out his Vision for Cancer Nursing

As we come to the end of this successful EONS14 conference, we look forward to the  future.

It is clear that the cancer nursing workforce is essential for achieving sustainable cancer care and health coverage across Europe.

The challenges
Unfortunately, challenges to a future sustainable cancer nursing workforce currently include general nursing shortages, recruitment barriers (nursing is a demanding specialty with complex care and hazardous work environments), ongoing lack of nursing recognition, difficult cancer nursing movability across borders due a lack of parity in cancer nursing training and education across Europe and, last but not least, the increased risk of burnout and dropout due to high physical and psychological stress.

It’s clear we need an urgent action on these growing barriers. Innovative education and training, continuing education programmes, occupational safety measures, leadership programmes, resilience training and burnout prevention interventions, and increased recognition of the cancer nursing workforce across Europe are already documented solutions to build a sustainable future and secure the cancer nursing workforce.

The changing role of cancer nurses
It is already clear that the role of cancer nurses also will continue evolve, as cancer care research expands, cancer treatment options change, therapies and their administration moves to different forms, and care delivery changes overnight from hospital-based to home-based. Furthermore, the cancer pathway continuously expands from prevention to treatment far into survivorship and end of life care.

The COVID19 pandemic brought an extra burden upon cancer nurses nursing, and, the long-term effect of COVID-19 on cancer nursing is still unknown, but discontinued screening, delayed diagnosis, therapy interruptions, workforce consequences, and threats to standard cancer nursing practice have already been identified.

While it is important to examine the history and impact of the global pandemic on cancer nursing, we must also consider where the future of cancer nursing is headed.

The future
The future of cancer care will be influenced by an aging population, increasing numbers of patients diagnosed with cancer, and pharmaceutical and technical advancements. Some have already been accelerated by the impact of global pandemic, like the use of E-health platforms and telemedicine.

These advancements will lead to more insights on prevention, development of clinical trials, access to screening, diagnosis and treatment, more advanced therapies, and treatment decisions based on a set of different patient, disease and care variables. They will bring new possibilities on the delivery of cure and care information and education by advanced technical support and interventions.

Cancer nurses at the forefront of change
Therefore, cancer nursing must stay current with the ever-changing landscape of cancer care delivery and developing science. This way, cancer nursing will influence the delivery of higher quality of care, develop more cost-efficient care delivery models, and increase patient satisfaction.

Already recognised as the most trusted healthcare professionals, in the world of interprofessional practice, cancer nurses are using relationships and organisational skills to coordinate cancer care across healthcare disciplines, departments, systems and care pathways. They also serve as expert for patients and their families, and for a variety of community stakeholders.

To consolidate their important role, there is a need for increased specialisation and advancement of cancer nurse education and training, including an increased equal recognition of cancer nursing across the European continent.

Precision health
The emerging health sciences’ model of precision health uses big data and patients’ individual variables to create and apply a programme of prevention, detection and intervention that is tailored to an individual. Cancer nurses can play a key role in exploring the possibilities of precision health to improve the treatment for cancer patients and reduce the cancer burden.

Embracing precision health in combination with person-centred care will allow cancer nursing to provide more individualised tailored care, and will also bring better education and support for patient health literacy, self-management and decision-making. Understanding the frameworks around precision health, in combination with existing cancer nursing expertise and leadership in patient-centred holistic cancer care, will be crucial for high quality cancer care in the future.

The challenges and opportunities of change
It’s clear that the roles and responsibilities of cancer nurses have been transformed over the past century, from cancer nurses providing bedside care with few technological advances, to advanced, expert cancer nurses and leaders responsible for everything in the cancer pathway from screening to survivorship and end of life care.

In this ever developing cancer care environment, cancer nurses will be facing many future challenges. In a world of innovative therapies, new technologies and care delivery pathways, it will be crucial to design future approaches to support cancer nurses in their physically and psychologically taxing work if we are to minimise compassion fatigue, burnout and the drop-out of highly skilled cancer nurses across Europe.

Education and aspirations
Education and training, recruitment and retention of the experienced cancer nursing workforce will be crucial for future cancer control, cancer care and cancer survivorship models in Europe. Future challenges must be addressed alongside the appropriate recognition of cancer nursing, particularly in resource-constrained countries with few cancer nursing staff, in order to address the migration of a well-educated and trained cancer nursing workforce across Europe. Only this will ensure sustainable, equal and accessible high quality cancer care everywhere.

Developing roles
As cancer care continues to evolve, cancer nurses will play a key part in an increasing variety of roles: whether as specialised cancer nurses providing clinical care, as cancer nurse researchers spearheading ground-breaking cancer care research, as cancer nurse educators providing the best possible training and education and as leaders and managers structuring current and future cancer nursing.   

Working together
As the cancer burden increases, it will be critical for cancer nursing organisations to engage with all professional and community cancer care stakeholders to identify the future needs of patients with cancer and the way in which cancer care will be delivered.

Most importantly, the future needs of the cancer nursing workforce needs to be reflected in the voice of national and international cancer nursing societies to ensure that there is investment in higher levels of education and research and that cancer nurse play powerful role in leadership, advocacy and policy making. These bodies must assume responsibility for creating opportunities for young and late-career cancer nurses if we are to achieve the European goals for cancer control and care laid out in current and future European ‘beating cancer’ plans.

Most important of all, I invite policymakers, politicians, European leaders and European institutions to include the cancer nursing voice. The future of cancer nursing and of achievable, sustainable cancer care is one that will only be secured by working together.