SIOG 2013

Training programmes for new oncology nurses

Sylvie Perrin - Centre Léon Bérard, France

I am an expert oncology geriatric nurse; I’ve been in this medical specialisation for six years and I’m working in Lyon in a cancer institute called Centre Léon Bérard. We have twenty institutes in all of my country so my job is to bring the geriatric culture inside cancer institutes everywhere – hospital made oncology. So I have two big jobs to do training and, as I am one of the oldest nurses in geriatric oncology, I’m a leader in my country and I’m working for the National Institute of Caner. We have 24 co-ordination units of geriatric oncology and I’m working in one of them, I think it is the oldest in France, since the 90s, and I make a lot of training for care-givers everywhere I can.

In my area we have 39 hospitals with oncology so I have organised a lot of training for nurses working in oncology and now I do some new training for nurses working in geriatrics because sometimes we have an elderly patient, after treatment, who must go into a geriatric hospital or area and they don’t know the cancer treatment and so on. So it is to average all the knowledge of nurses; it’s a very big job and I think it’s a way to change, maybe, the mentality of some doctors, oncologists, because some of them think they don’t need geriatricians. If nurses in the future, their knowledge is higher and higher in geriatrics sometimes they don’t understand all the consequences of the treatment and they say they are old and sometimes it appears something like stupid to do it in this way. Nurses, more and more, their knowledge average, they will be able to ask the oncologists, ‘Why are you doing it in this way? We need geriatricians because of the nutrition, because they fall down and so on and a lot of consequences.’

So, for me, I prepare maybe the future for all elderly people in France to average all the knowledge. I go everywhere because the new expert nurses in geriatric oncology are here since maybe six months, one year, so they don’t know how to do it. I try to show them the way to train and I go to the schools of nursing because all the teachers in such schools in France don’t teach geriatric oncology. It’s new in France and when I see the teachers they don’t know how to do it. So I say, ‘This is the way to do it.’ For example, they have old ideas like cancer growing up very slowly because they are elderly. I say, ‘No, it’s stupid because cancer grows up at the speed it wants, it depends on the histology, not on the age.’ This is one of the things like that. In France we have screening, for example, for breast cancer but it stops at 74 years old but after there is about 25% of elderly women in all breast cancer who have a cancer appear and they are astonished – 80, 90 years old - ‘Oh, I can have a cancer at this age.’ I realised that care-givers think the same, all care givers in other hospitals. I think if care-givers don’t know these sort of things, how the population, French population, can know these sort of things.

So I bring a lot of information; I have made a public meeting last year for what we call in France Pink October to say to old women; I say to her, ‘You can have a breast cancer when you are 80; you have one chance, if we can call it chance, to have a cancer in ten women.’ In my age it’s about one for fifty women so the impact is very important because in oncology elderly women, for instance, I say in breast cancer because it’s the first cancer for elderly women, we saw too many elderly women with cancer still metastatic because we have the information when the cancer makes noises because they don’t suffer when they have nothing, they suffer when they have metastatic bones and so on.

So it’s to average all the knowledge for care-givers and for all the population. We think all expert nurses in geriatric oncology for next year to do a national action to say to elderly women, ‘Be careful, you can still have cancer after the national screening.’ So things are like that but it’s a very, very big job and so interesting.