EONS President Johan de Munter explains the issues around this year’s European Cancer Nursing Day.
This year’s European Cancer Nursing Day (ECND22) takes place on 18 May. It is organised by the European Oncology Nursing Society (EONS), of which I am proud to be President. This year, EONS has chosen the theme: ‘Supporting cancer nurses in caring for themselves and their patients’.
Why this emphasis on the care of the cancer nurse? During the pandemic, existing issues related to burnout, stress and resilience increased, resulting in many either leaving the profession or expressing an intention to do so. It is for this reason that ECND22 focuses on the importance of self-care and well-being for cancer nurses, on occupational health, and on retention and recruitment – all of which, in turn, impact on the overall quality of patient care. Under the increasing care demands of the pandemic, the workload pressures on cancer nurses multiplied and this, together with continuing challenges in nursing, all serve to exacerbate the situation.
Let us look at the issues in a little more detail. Cancer nurses’ safety impacts patient safety. We have known this for a very long time and yet, based on the EONS European Cancer Nursing Index, cancer nurses in 14 EU member states report no formal education on handling cytotoxic drugs. In these countries, after a few shifts side by side with a colleague, cancer nurses administer chemo and other cancer drugs.
It is estimated that more than 120 000 people in Europe annually get cancer because of occupational exposure to carcinogens, with cancer being the leading cause of work-related deaths. Nurse-led research has associated workplace exposures to hazardous drugs with both acute and chronic health issues. EONS Cancer Nursing Index 2020 found major risks related to both patient and occupational safety. Among the most serious risks reported by cancer nurses across Europe were lack of training and guidelines for handling cytotoxic drugs and, nurses in many countries reporting exposure to these drugs during pregnancy and breast feeding (with many nurses reporting risks of negative consequences if asking for alternative duty at this time in their lives).
EONS, with the support of the European Federation of Public Service Unions (EPSU) and the European Trade Union Confederation (ETUC), called on the European Institutions to utilise the Precautionary Principle by including hazardous medical products and reprotoxic substances in Annex 1 of the CMD4 Directive. We were, then, extremely proud to announce earlier this year that, thanks to a long-running campaign, the EU ‘Protection of workers from the risks related to exposure to carcinogens or mutagens at work Directive’ (CMD4) introduced binding occupational limit values for 11 substances in its annex and broadened its scope with the inclusion of reprotoxic substances.
This is a huge success not only for EU policy makers but also for healthcare workers handling hazardous medical products (HMPs) which, if fully implemented, will strengthen occupational safety and prevent thousands of cases of adverse health effects and even deaths in Europe. But, guidelines on management of hazardous drugs must be fully implemented and the latest evidence-based occupational safety best practice and advice adhered to in order to keep patients and nurses safe.
This is the ‘hard-edged’ side to safety, but strengthening cancer nurses’ well-being also improves occupational and patient safety and needs to be given similar priority. Burnout and stress is a danger both to the health of nurses and to the safety of their patients – errors occur more frequently when people are tired – and nurses must be supported to take care of themselves so that they can take care of others.
Many nurses – by some estimates as many as 66% – say the pandemic has made them consider leaving the profession. High-quality cancer care depends on retaining and supporting a high-quality workforce, and recognition of cancer nursing as a specialism, better levels of reward and appropriate rest and leisure time, are key to addressing the shortage of cancer nurses and avoiding stress and burnout. Resilience in cancer nursing is essential for the management of psychosocial distress among patients and their families; but work-life balance is also important for the caregiver to be able provide compassion and empathy, thus improving cancer care.
Cancer nurses must be supported to maintain their physical and mental health and safety in the workplace by an appreciative management culture that values them as individuals, and, promotes a supportive culture that also encourages learning, personal, and career development. Personal and professional growth and physical and mental wellbeing go hand in hand and should not be seen as ‘add-ons’ – they are essential elements that will strengthen cancer nurses’ capacity to provide high-quality and safe evidence-based cancer care for all affected by cancer.
*A powerful social media campaign – #ECND22Go4SelfCare – will bring Europe-wide attention to these major issues. Follow us on Twitter @cancernurseEU .
Find out more about ECND22 and EONS at https://cancernurse.eu/ecnd2022/