The Global Power of Oncology Nursing (GPON) conference is held annually as part of London Global Cancer Week, showcasing the nursing contribution to tackling the global burden of cancer. Nurses share their stories, engage in debates, and celebrate their achievements with colleagues from around the world. Most nurse presenters live and work in low- and middle-income countries (LMIC) and focus on solutions to improve cancer care in a world where universal health coverage is far from a reality. Nurses can and do make a huge impact on the burden of cancer, often being the first and only point of care in their communities. However, there is a huge shortage of trained oncology nursing workforce, affecting both the work nurses can do and patient care.
This theme for GPON 2021 is “Celebrating Oncology Nursing: Compassion, Innovation and Strength” and is being held virtually. The conference is split over three days, being held at different times of the day to enable nurses from a range of time zones to participate.
As she opened the conference, Prof Annie Young, co-chair of the conference with Prof Julia Downing and Dr Julia Challinor, welcomed everyone. She noted that “Coming together strengths an emotional bond between us around the globe at this difficult time. We will hear this year about the turmoil and challenges experienced. Have over 300 participants registered from >30 countries. Since GPON 2020 it has been another year of extraordinary – triple jeopardy – cancer, covid plus weak public health structure mark experiences of health care. Throughout the conference we are focusing on nurses from the global south, and hearing how they have risen to the challenge of caring for individuals – adults and children – with cancer. The pandemic has taught us that we need to work together – only as we work together can we strengthen the care that we provide. It has also highlighted the need to care for ourselves, as resilience has turned to burnout.”
Elizabeth Iro, Chief Nursing Officer for the World Health Organization shared a welcome message to all delegates. She shared that WHO has established a global community of practice for nurses around the world which will bring nurses together from around the world and bring together experience and insight of nurses at all levels of their careers and bring together nurses to learn from each other. We have an opportunity to turn influence into…. And the time to do this is now.” Howard Catton the Chief Executive Officer of ICN also shared with participants. He noted how nurses have been at the forefront of the pandemic but at a cost – estimated 115,000 health care workers have died from Covid-19, at that is thought to be an underestimate. Around the world there are hundreds and thousands of nurses still waiting for the first dose of their vaccine – such inequalities around the world. Hence the need for the Global Strategic Directions for nursing and midwifery and the need to strengthen education, leadership, jobs and service delivery.
The day covered a range of issues connected to the work of the oncology nursing workforce throughout Covid-19. Nikolina Dodlek from Croatia, EONS Board member and co-chair of the young cancer nurses group started by discussing the perspective of oncology nurses in the Czech Republic during the pandemic.
Throughout the world there have been big challenges for nursing teams, with the need for PPE and a new way of working. In her oncology department they operated with reduced category, in two teams and they had their own triage entrance for the oncology department. It was really challenging – the fear of the unknown, reorganisation of work, coming early for triage, working with PPE, more phone calls, and the stress and social isolation. Importantly they didn’t stop treatment and care continued throughout where possible, however there was a shortage of palliative care beds and patients were socially isolated. Shi Qian then discussed the psychological impact on the medical team at Tianjin Medical University Cancer Institute and Hospital in Wuhan. She shared the experience of the oncology nursing team who were supporting the covid response discussing their feare, anxieties, the challenges of PPE, etc and yet the need to communicate well, appearing calm and relaxed, despite not feeling so inside.
We then head about the experience of paediatric oncology nurses in The Cameroon from Glen Mbah Afungchwi, the Childhood Cancer Programme Co-ordinator at Mbingo Baptist Hospital. About 50% of their children and families need palliative care services, with 70% from poor families living in remote rural settings – thus an outreach PC service was developed and he shared their challenges as well as lessons learnt. Shenila Anwarali also shared about the challenges for paediatrics, within paediatric oncology from Indus Hospital in Karachi. Like many services they had to reduce their services due to the pandemic where a shortage of trained paediatric oncology nurses became even worse as individuals were mobilised to work with covid-19 patients and do the numbers decreased even further, thus compromising care. Mauricia Arias Rpjas from Universidad de Antioquia in Columbia then looked at similar issues within adult oncology, highlighting similar issues – with nurses being redeployed, overworked, stressed due to fears and anxieties and separated from families and friends, yet determined to provide the best care possible for patients and their families.
Leadership during the pandemic is key, and this was discussed by Prof Myrna Doumit from Lebanon who has recently been give the Heroine of Health Award. She shared her experiences from working in Lebanon throughout the pandemic and following the Beirut blast. Key to that was looking forward and looking for new ideas and new ways of doing thing, without being afraid of challenges, going to the Parliament etc to defend their patients and nurses rights, asking their partners to stand with them, and learning to shed off old habits, letting things go. They were therefore able to identify stakeholders to help them, create strategic alliances, communicate with media, looked at both sides of the issues, listening and learning, bouncing back from challenging issues and not taking ‘No’ as an answer, partnering with different like-minded partners and engaging the public and stakeholders.
Sherily Pereira-Morales from Puerto Rico then brought the issue of climate change to our attention and the impact on the oncology nursing agenda. She discussed the direct effect of Hurricane Maria on the provision of cancer care in Puerto Rico. Treatment was disrupted and delayed and in some cases prevented entirely – particularly in rural and remote regions of the island. Resilience was the most positive impact of the hurricane as it motivated nurse leaders and educators on the island to create new structures to manage emergencies associated with climate change.
There were two round table discussions held in the afternoon. The first was on the universality of grief, dying and death during the pandemic and was based around a case study from the Teenage Cancer Unit at the Royal Marsden Hospital about a 17-year-old living in Cyprus who was referred to them for treatment. The discussion was led by Anne Keen, a nurse and politician. As a nurse of over 40 years she said she had never faced the challenges that nurses are facing around the world at this time. Joining the discussion alongside Glenn were Rima Saad from Lebanon, Yangden from Bhutan, Alison Turner and Heather Jones from the UK, and Reginald Anang from Ghana. The second discussion was around personal experiences during the pandemic – asking the presenters what it was like for them. Mohammed Aqaddid from Palestine started with his experience working with the Augusta Victoria Hospital Palliative Care Team in Jerusalem, followed by Matt Fowler, an Advanced Clinical Practitioner in the UK, Florence Nalutaaya, from the Palliative care Education and Research Consortium in Kampala, Uganda and Sandra Campbell from UKONS in Scotland.
The conference continues on the 17th and 18th November and more information and for free registration go to the GPON website. After only day 1, oncology nurses are rising to unprecedented challenges, leading the way, in a time of post traumatic growth.
The conference has been endorsed by a range of organisations including host organisations UKONS, The Royal Marsden School, along with ICPCN, SIOP, AORTIC, ISNCC, CNMF, AONS, ecancer, Macmillan Cancer Support, UKSACC and the Teenage Cancer Trust. There are also a range of sponsors including Roche, Leo, Merck Serono, Paxman, Rosemont, Takeda, Incyte and Braun.