Registed Nurses' Association of Ontario

Development of Education Workshop for Specialized Oncology Nurses to Address the Information and Support Care Needs of Head and Neck Cancer Patients: An Initiative to Improve Ambulatory Patient Experience

Ai Tanimizu
Princess Margaret Cancer Centre

The Wharton Head and Neck Centre (WHNC) of the Princess Margaret Cancer Centre (PM) at the University Health Network (UHN) is Canada’s leading multidisciplinary centre devoted to research, diagnosis, prevention, and treatment of Head and Neck Cancer (HNC). PMCC Head and Neck Survivorship Program (HNSP) has been recently launched to address the survivorship needs of patients and families living with, through, and beyond HNC treatment. The medical complexity of a cancer diagnosis and the uniqueness of every patient’s cancer experience make the cancer journey quite complex and fragmented. Psychological morbidity is common in patients and their caregivers who have received a diagnosis of cancer and who are undergoing treatments for their cancer, particularly with the head and neck cancer (HNC) population (Gold, 2012).

The HNSP has partnered with the Cancer Survivorship Program (CSP) at PM to build a comprehensive approach to meeting the information and supportive care needs of patients undergoing treatment for and living with HNC. This group of patients' has unique needs in terms of the physical and functional sequelae of treatment (Fisher, 2006; Semple, Dunwoody, Kernohan, McCaughan, & Sullivan, 2008), and is often a marginalized group with limited access to resources. The CSP employs an interdisciplinary team with extensive expertise in the design and evaluation of educational programs and resources that provide users with the information, resources, and supports they need.

The overall purpose of this Advanced Clinical Practice Fellowship in the education leadership stream was to develop, deliver, and evaluate a workshop for staff nurses working at the WHNC to address the information and the support care needs of the HNC patients. This was an excellent and unique learning opportunity for the fellow to develop expert knowledge and skills in designing, delivering, and evaluating staff education. The fellow was guided by a group of mentors comprised of nursing clinicians, educators, and leaders with recognized expertise in their fields from the HNSP and CSP at PMCC, Collaborative Academic Practice Office (CAP) at UHN, and the School of Nursing at McGill University.

The proposed fellowship impacted the HNC patients and the nurses at the WHNC. The fellowship enables patients attending the WHNC to have access to high quality information, support, resources, and services that will help them better navigate their cancer journey and have access to a more coordinated continuum of care to help them through their experience at the PMCC. Specialized Oncology Nurses at the WHNC have been supported to implement patient education and supportive care strategies in their daily practice to fully enact in the role of specialized oncology nurses as outlined by CANO.

As part of the learning activities, the fellow completed in the Nurse Educator certificate program offered by Health Leadership Network Learning at York University which offered the theoretical foundation and enhanced fellow’s knowledge of theories and provided tools that could be used to inform the development, delivery, and evaluation of educational programs. The certificate course that she took at York University helped her prepare for the workshop that she designed and delivered. Attendance at the annual Canadian Association of Nurses in Oncology (CANO) conference allowed the fellow to learn innovative ideas implemented in oncology settings and cancer centres. At the event, the fellow was able to network with other nursing leaders in oncology locally, provincially, nationally, and internationally. Moreover, the fellow was able to enhance her knowledge dissemination skills by sharing the earlier developed innovative paper-based navigational tool as an oral presentation (Eliminating “I never knew that was available!”: Development of My Survivorship Map Initiative).

From the fellow’s perspective, the fellowship experience was something valuable in her career that she truly believes every passionate nurse should take advantage of the opportunity. The fellow has grown in nursing leadership throughout the fellowship through the application process, fellowship activities, and mentorship experience.

In the application package for this fellowship, there were some questions the fellow struggled to answer but she was able to reach out to her mentors for assistance. It was also a practice for applying to research grants since those tend to be very competitive as well. Fellow also felt that she was able to learn and refine her writing skills to build a business proposal when one wants to implement an initiative in practice. These skills are not always learned in school and in front-line nursing practice and she believes it would only help her in the future throughout her career and appreciates the experience. In terms of fellowship activities, attending the CANO conference was one of the conferences she wanted attend and present. At this conference she met nursing leaders in oncology and had the opportunity to network with some. This experience motivated her to get more involved in this organization from now on.

During the fellowship period, the fellow was also able to collaborate with the Patient Care Coordinator of the Head and Neck clinic to work on rearranging the clinic resources. The clinic resources were rearranged in a way that is listed in the My Survivorship Map, a patient navigational tool developed by the fellow. By reorganizing the resources it creates a patient education clinical pathway for HNC journey. The reorganization of the resources was also aligned with the workshop that was delivered to the Head & Neck site nurses. With the workshop, the fellow was able to explain new resources available to H&N cancer patients and where to find information to hand out to patients.

Through the RNAO Fellowship, the fellow was able to participate in mentorship experience. She felt they all contributed to her learning in different ways. With the mentorship, she felt that she was supported throughout the way and when she came across stumbling blocks, there were people that she could rely on to provide her with advice. In conclusion, this fellowship was an invaluable learning opportunity for the fellow who had the chance to focus on building on the education pillar of nursing leadership. She cherishes the time spent working on the fellowship project because she was able to focus on certain skills that she would not be able to during her regular nursing practice. She finds that she has grown as a nurse leader in the twenty weeks she was able to contribute to what she is passionate about.

Fisher, P.S. (2006). Survivorship. Clinical Journal of Oncology Nursing, 10(1), 93-98.
Gold, D. (2012). The psychosocial care needs of patients with HPV-related head and neck cancer.
Otolaryngologic Clinics of North America, 45, 879-897.
Semple, C.J., Dunwoody, L., Kernohan, W.G., McCaughan, E., & Sullivan, K. (2008). Changes and
challenges to patients’ lifestyle patterns following treatment for head and neck cancer. Journal of
Advanced Nursing, 63(1), 85-93.

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