SUPPLEMENT CANCER NURSING
Grasping the opportunities Sheila MacBride, Vice-Chair of the RCN Cancer ■ Nursing Society, analyses past trends in cancer care and looks forward to the challenges of the future. They say that opportunity knocks during times of change. Nobody would dispute that the National Health Service is cur rently undergoing great change, but does this present any opportunities for cancer nursing? The development of Trusts, their pur chaser/provider role and community care legislation could easily be seen as divisive in terms of continuity of care for the cancer patient. Liaison and teamwork may be of para mount importance to the cancer patient. First, the often chronic disease may be treated with chemotherapy, radiotherapy or surgery, or a combination of all three, frequently in different places at different times. Second, the rehabilitative needs of the patient may require a change of setting. Third, the individual and his or her family may wish to choose where he or she will be cared for. Last, early discharge from hospital may increase the likelihood of community support being required by the individual and the family. Much of the original work in liaison posts in this area of continuing initiatives was done in the late 1970s, and many of these posts were never evaluated (1). Most of the recent work focuses on the needs of cancer patients, particularly those in the terminal stages of the illness, and is evaluated in terms of its impact on patient and family. As this constitutes an important part of nurses' work, whether in general or specialised hospitals or community-care settings, it presents real opportunities for patients and relatives. Putnam (2) believes that the provision
of an organised system of services is important and necessary for cancer pa tients, and that the nurse is ideally placed to assess family needs and suggest appro priate services. Many voluntary carers are now in volved in providing support for cancer patients. Hinds (3) opens the debate on the lack of support for these people from the professions. Statistics show that nur ses are not always seen by those in the community as accessible (4). In the field of cancer care, however, authors have reported schemes to identify and teach the skills required by such carers (5,6). Many studies have concluded that other specialist nurses, such as health visitors and Macmillan nurses who operate outside hospitals, are ideal co ordinators of care and advisers on the need and availability of services (7,8). These changes do not affect only nursing, but all the professions involved in patient care.
This has recently been the subject of renewed scrutiny by nurses. Doctors have made little attempt to discuss the issue. Yet it is their autonomy which is under threat, not only from nursing but from all the professions allied to medicine who now expect and insist upon open consul tation. The financial implications of present Government policy represent a further threat. The common thread, once again, is nursing's ability to focus on the patient. I am confident that if cancer nursing conti nues to develop the lessons it has learned, and to use the structures it has created and evaluated, it can grasp the oppor tunities presented by the current changes in the National Health Service. Sheila MacBride BSc. KGN. NON. One Cert, is Charge Nurse, Department of Clini cal Oncology, Western General Hospital, Edinburgh and Vice-Chair of the RCN Cancer Nursing Society.
References 1. Dunn A. Sharing some solutions. Nursing Times. 1981. 77, 6, 223. 2. Putnam STe/ al. Home as a place to die. American Journal of Nursing. 1980. 80, 8, 1451. 3. Hinds C. The needs of families who care for patients with cancer at home: are we meeting them? Journal of Advanced Nursing. 1985. 10, 575. 4. Vaughan B, Taylor K. Homeward bound. Nursing Times. 1988. 84, 15, 28-31. 5. Eastrom S, Miller M W. Preparing the family to care for the cancer patient at home: a home-care course. Cancer Nurs ing. 1981. 4, 1, 495. 6. Mudditt H. Home truths. Nursing Times. 1987. 83, 35, 31-33. 7. Gordon H. Liaison: the vital link. Multidisciplinary teams Nursing Mirror. 1983. 157, 5, Com The functioning of multidisciplinary care munity Forum Supplement. teams has also been examined, with 8. CoyleN e/al. A model ofcontinuity of research ranging from interprofessional care for cancer pain and neuro-oncologic boundaries and jealousies to illuminated complications. Cancer Nursing. 1985. 8, examples of role definition. White-house 2, 111-119. (9) says the past 20 years have seen the 9. WhitehouseC R. Conflict or Co-oper rise and fall of the team concept in ation between doctors and nurses in primary care. But medicine still sees primary health care. Nursing Practice. itself as the natural leader of the team 1986. 1, 4, 242. (10) . It is also made clear in the reference 10. Smith L. Doctors rule OK? Nursing material that when co-operation exists, Times. 1987. 13, 30, 49. with the patient placed firmly at the 11. Hahn K. A nursing framework for centre of all deliberations, the result is an multidisciplinary rehabilitation. Reha improved standard of care (11). bilitation Nursing. 1988. 13, 1, 6.
50 Nursing Standard July 17/Volume 5/Number 43 1991 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 26, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
Grasping the opportunities Sheila MacBride, Vice-Chair of the RCN Cancer ■ Nursing Society, analyses past trends in cancer care and looks forward to the challenges of the future. They say that opportunity knocks during times of change. Nobody would dispute that the National Health Service is cur rently undergoing great change, but does this present any opportunities for cancer nursing? The development of Trusts, their pur chaser/provider role and community care legislation could easily be seen as divisive in terms of continuity of care for the cancer patient. Liaison and teamwork may be of para mount importance to the cancer patient. First, the often chronic disease may be treated with chemotherapy, radiotherapy or surgery, or a combination of all three, frequently in different places at different times. Second, the rehabilitative needs of the patient may require a change of setting. Third, the individual and his or her family may wish to choose where he or she will be cared for. Last, early discharge from hospital may increase the likelihood of community support being required by the individual and the family. Much of the original work in liaison posts in this area of continuing initiatives was done in the late 1970s, and many of these posts were never evaluated (1). Most of the recent work focuses on the needs of cancer patients, particularly those in the terminal stages of the illness, and is evaluated in terms of its impact on patient and family. As this constitutes an important part of nurses' work, whether in general or specialised hospitals or community-care settings, it presents real opportunities for patients and relatives. Putnam (2) believes that the provision
of an organised system of services is important and necessary for cancer pa tients, and that the nurse is ideally placed to assess family needs and suggest appro priate services. Many voluntary carers are now in volved in providing support for cancer patients. Hinds (3) opens the debate on the lack of support for these people from the professions. Statistics show that nur ses are not always seen by those in the community as accessible (4). In the field of cancer care, however, authors have reported schemes to identify and teach the skills required by such carers (5,6). Many studies have concluded that other specialist nurses, such as health visitors and Macmillan nurses who operate outside hospitals, are ideal co ordinators of care and advisers on the need and availability of services (7,8). These changes do not affect only nursing, but all the professions involved in patient care.
This has recently been the subject of renewed scrutiny by nurses. Doctors have made little attempt to discuss the issue. Yet it is their autonomy which is under threat, not only from nursing but from all the professions allied to medicine who now expect and insist upon open consul tation. The financial implications of present Government policy represent a further threat. The common thread, once again, is nursing's ability to focus on the patient. I am confident that if cancer nursing conti nues to develop the lessons it has learned, and to use the structures it has created and evaluated, it can grasp the oppor tunities presented by the current changes in the National Health Service. Sheila MacBride BSc. KGN. NON. One Cert, is Charge Nurse, Department of Clini cal Oncology, Western General Hospital, Edinburgh and Vice-Chair of the RCN Cancer Nursing Society.
References 1. Dunn A. Sharing some solutions. Nursing Times. 1981. 77, 6, 223. 2. Putnam STe/ al. Home as a place to die. American Journal of Nursing. 1980. 80, 8, 1451. 3. Hinds C. The needs of families who care for patients with cancer at home: are we meeting them? Journal of Advanced Nursing. 1985. 10, 575. 4. Vaughan B, Taylor K. Homeward bound. Nursing Times. 1988. 84, 15, 28-31. 5. Eastrom S, Miller M W. Preparing the family to care for the cancer patient at home: a home-care course. Cancer Nurs ing. 1981. 4, 1, 495. 6. Mudditt H. Home truths. Nursing Times. 1987. 83, 35, 31-33. 7. Gordon H. Liaison: the vital link. Multidisciplinary teams Nursing Mirror. 1983. 157, 5, Com The functioning of multidisciplinary care munity Forum Supplement. teams has also been examined, with 8. CoyleN e/al. A model ofcontinuity of research ranging from interprofessional care for cancer pain and neuro-oncologic boundaries and jealousies to illuminated complications. Cancer Nursing. 1985. 8, examples of role definition. White-house 2, 111-119. (9) says the past 20 years have seen the 9. WhitehouseC R. Conflict or Co-oper rise and fall of the team concept in ation between doctors and nurses in primary care. But medicine still sees primary health care. Nursing Practice. itself as the natural leader of the team 1986. 1, 4, 242. (10) . It is also made clear in the reference 10. Smith L. Doctors rule OK? Nursing material that when co-operation exists, Times. 1987. 13, 30, 49. with the patient placed firmly at the 11. Hahn K. A nursing framework for centre of all deliberations, the result is an multidisciplinary rehabilitation. Reha improved standard of care (11). bilitation Nursing. 1988. 13, 1, 6.
50 Nursing Standard July 17/Volume 5/Number 43 1991 Downloaded from RCNi.com by ${individualUser.displayName} on Nov 26, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
