Review of the 18th Cancer Nursing Society of Australia Winter Congress by Ruth McConigley.
From the 14-16th June 623 cancer nurses converged on the Perth Convention and Exhibition Centre for the 18th CNSA Winter Congress. As befits an 18th birthday, the congress was time to look back at our past and to consider where cancer nursing was heading in the future. A ceremony to honour past presidents of CNSA was held at the welcome reception as we considered our history from our beginnings as a small group of dedicated nurses to the current 1,000 strong membership of an independent organisation.
Sunday saw six workshops take place with a band of very dedicated nurses attending the early Sunday morning sessions. Workshops this year had an emphasis on growing and developing areas of cancer nursing; radiation oncology, care of central venous access devices, advanced nursing practice, research and communication skills. Sunday also gave us a chance to welcome some new friends– for the first time we welcomed the Breast Care Nurses to congress, and they had a chance to attend a workshop that covered an expansive array of topics in this field.
Winter Congress itself challenged those attending to reassess cancer nursing roles and to consider their own journey in cancer nursing. Our keynote speaker, Dr Carrie Tompkins Stricker, Oncology Nurse Practitioner, University of Pennsylvania, Chief Clinical Officer, On Q Health, Inc., from Pennsylvania in the US, challenged us to look at nursing opportunities beyond traditional ‘bedside’ nursing roles. Dr Stricker highlighted the changing face of cancer care, with increasing survival rates and the resultant increased costs of cancer care, along with changing treatment regimens and growing use of technologies requiring a new focus for cancer nurses. Roles well known in the US but still new in Australia were discussed: Nursing Informatics, Nurse Navigators and Nurse Practitioners in areas as diverse as cancer prevention, cancer screening, cancer surgery, radiation oncology, survivorship care and palliative care were all highlighted. Higher education for nurses was also addressed with consideration of Doctor of Nursing Practice degrees, which are becoming more common in the US and offer nurses the chance to acquire advanced practice knowledge with an emphasis on translation of knowledge to practice. DNPs are not seen often in Australia but offer the opportunity for nurses in clinical roles to gain a terminal degree that has relevance in their workplace.
Our second international speaker, Professor Lesley Fallowfield, from the University of Sussex in the UK, challenged us to consider cancer treatments from the patient’s perspective, in her thought provoking paper entitled “Why patient reported outcomes matter in trials”. Professor Fallowfield described the benefits of considering health related quality of life and patient related outcomes when trialling new treatment regimens rather than the more traditional measure of patient survival (with or without disease) and questioned the notion that patients are willing to accept considerable side effects for minimal benefits in terms of survival. Professor Fallowfield also reported many studies showing that health professionals under-report side effects experienced by patients, in many cases rating patients as having no symptoms while patients report very severe issues with treatment. Even severe and obvious symptoms such as vomiting, diarrhoea and constipation were missed or under-reported by health professionals, while less noticeable symptoms such as appetite loss and loss of libido were often completely missed. And yes, sadly there were reports of cancer nurses missing these symptoms – we can’t just lay the blame at the feet of our colleagues. And the solutions? Assess patients using well validated measures of patient reported outcomes – both while conducting clinical trials and also perhaps while providing day to day care.
Professor Alex Molasiotis from Hong Kong Polytechnic University also challenged his audience, promising us that he may not make friends with his presentation about advanced nursing practice. Prof. Molasiotis described the plethora or roles, role descriptions and role titles currently in use and suggested that they were making nursing more confusing for the public and making nursing roles less transparent to all. He suggested that advanced practice and nurse practitioner roles were in fact, based on role definitions, providing care that all nurses working to the full scope of their practice should be doing. He cautioned that stepping into the world of nurse prescribing (as nurse practitioners in Australia are) may in fact be detracting from providing advanced nursing care as nurse prescribers can become perceived as cheaper doctor substitutes in a health care system looking to cut costs. He recommended that advanced practice nurses consider what they can offer to patients that is unique and valuable and measure these outcomes as a way of demonstrating the benefits of advanced practice and to ensure advanced practice nurses are in appropriate positions in the health care system where they can legitimately make a difference.
The three days in Perth certainly challenged cancer nurses to consider just where we can take our practice in the future and some of the roads we may need to take to get there. Next year’s congress in Cairns will see us considering issues of distance, culture, workforce and knowledge with the theme of “Bridging the Gap”.
[hr] Dr Ruth McConigley RN, PhD is a Senior Lecturer at the School of Nursing and Midwifery and Paramedicine, Curtin University and CNSA Winter Congress 2015 Local Organising Committee Chair. Visit the CNSA website for more information.