Campus Review Vol. 29 Issue 3 - March 2019 | Page 19

industry & research campusreview.com.au breast cancer, people affected by pancreatic cancer, and people living with multiple myeloma. So we really are trying to find these groups of patients who we know have suboptimal outcomes in terms of their cancer diagnosis because of the complexity of the disease. There’s a program of work where we’ve been doing core design studies with patients and their family members to say, “Actually, what sort of interventions do you need to help you manage?” It could be the informational challenges of a complex cancer diagnosis, and all of these new novel therapies, or what you need to manage the cognitive decline that comes with the treatments, or the pain that’s associated with some cancer diagnoses. Then there’s a program of work that is looking at developing our skills as nurses, particularly nurses who have cancer knowledge, but developing skills on caring for older adults with cancer. We know we’re an ageing population; we know that’s where the majority of cancer diagnoses are; and yet the challenges facing somebody who may have comorbidities, or may be at risk of frailty because of their cancer, or their cancer treatments, are particularly challenging. So, we’re looking at developing new interventions, and then testing those to see what the impact of that is on the quality of care that is then delivered to these older adults. We’re also working with the older adults themselves on a core design study to say, “What do you need nurses to know about caring for you when you’re older with a diagnosis of cancer?” So we’re really using the experts’ experience to drive our programs and research, and to inform the system changes we need. Then the final program we’re working on is looking at the workforce. We know we have this remarkable workforce of nurses. But we also know that by 2025 we’ll be around 85,000 nurses short in Australia. So how do we profile the impact and importance of specialist cancer nurses to make sure that resource-strapped organisations are investing in these nurses? That we can carry out studies to show the contribution of expert clinical decision-making, of being able to triage complex and less complex patients, so that we’re really directing our expertise to those patients who need us most, but also, who have the greatest capacity to benefit from interaction with specialist nurses. The breadth of programs allows nurses who are interested in many different things to tap into our programs and say, “I’d really like to know more about research, and I’d like to do it in that program of work.” How does it work when a nurse approaches you? Is it run through the university, or through their hospital? There are a couple of different ways. A lot of it is informal. I’m very lucky to have access across the clinical partners, so a lot of it is conversations with nurses on a day- to-day basis. The other way is people may contact me formally through the university website, either through the Department of Nursing, or the Centre for Cancer Research at the University of Melbourne. But very excitingly, we just got a new initiative that’s being funded by the Victorian government, through the VCCC, which is a million-dollar investment for a nurse-led cancer innovation research hub, which will allow us to engage with nurses, both face to face, but also online, and flexibly, so that they can learn research skills. But really, importantly, they can also apply to spend 12 weeks with us in the research hub to learn skills, and to think about how they would use those skills for a project that has been prioritised by their organisation, as something that is really important for the care of people, and in the organisation they come from. The hub also has seed funding for research grants. So we will say to nurses, “If you can pitch an idea that has real resonance with your organisation, and importantly with at least one of the VCCC organisations, we will give you seed funding to kick start that program of research work.” In your time in academia, how have things changed in the way we teach students cancer nursing? I think things are changing really quickly. For a long time we’ve been fairly stable – I’m trying not to say stagnant – in the way we’ve approached teaching cancer nurses. It’s been quite didactic. It’s been heavily classroom-based. What we’re seeing, in lots of organisations, and what we’re investing in at the University of Melbourne at the moment, is taking content that is appropriate and relevant to take online, so that we can begin to bring cancer nurses education that is flexible, that is there for them at point of delivery, when they can get to it, but also allows them to access it in the clinical environment. So they can maybe look at a quick three or four-minute learning module about how to talk to a person about exercise and cancer if they’re not sure how to introduce the conversation. So there’s a shift in mode of delivery, but I think the critical piece is that we’ve seen an enormous shift in two of the big domains, the first being that we actually have to embed the voice of the patient and the consumer in our education. We have to make the experience of having a cancer diagnosis and treatment real for nurses, because the more we can do that, the greater we will hone people skills of empathy, communication and the desire to support people, which we Nurses are quite research naive. There are few of us who have doctoral or postdoctoral studies. know from the data we have mastered is fundamentally important to the quality of care, the people see that experience of care, but also they have constant care. The other piece that, obviously, we’ve seen shift, exponentially, is we have this incredible, remarkable advancement in cancer therapy. So we have immunotherapies, targeted therapies, these new CAR T-cells. We have remarkable technological changes in radiation therapy. We are doing surgery that we could only have dreamed of 5–10 years ago. With that comes a complexity around the patients that we’ve never seen before. We are getting older patients, people who are coming in with far advanced disease, and we’re seeing these people thankfully live much longer. But they live longer with consequences of complex therapy, so we’re having to teach nurses not just the acute care of people with cancer, but survivorship care, complex long-term comorbidity care and, importantly, expert, exquisite end-of-life care and the communications that go with that.  ■ 17