Department of Nursing

Kazuko Nasu

Introduction

The Department of Nursing bears responsibility for team healthcare at the National Cancer Center Hospital (NCCH), the core institution for national cancer treatment and control in Japan. The responsibility of our department is to develop and improve the quality of cancer nursing as well as to contribute to the appropriate management of the hospital. Our department is also expected to foster nursing staff to achieve the best cancer nursing.

Our team and what we do

Based on the philosophy of the Department of Nursing, which is to create and provide the best cancer nursing geared to the needs of patients, we are working to provide safe and reliable nursing in response to advances in medicine with the consciousness and responsibility of a nurse in the NCCH.

We adopted the two-shift nursing system in 15 units, comprising an 8-hour day shift and a 16-hour night shift. Inpatient unit nurses work together more closely than nurses in an outpatient clinic. Moreover, we have strengthened the support for the patient discharge process so that patients can return earlier to their own home or area.

We are accepting and meeting the challenge to provide numerous patient education programs produced by Certified Nurse Specialists and Certified Nurses. We have five patient education programs and consultation services, four outpatient clinics run by nurses, and a support program for patients and their families. Many patients and families have participated in the educational program for their self-care and survivorship in their daily life.

Research activities

We presented 33 studies on nursing at several annual conferences in 2016. We organized the Nursing Research Committee, the members of which must have a master's degree or a doctor's degree. They must also have sufficient experience regarding nursing research activities. They support nurses in their nursing research based on their clinical questions. We are making efforts to improve the quality of nursing research with support from some physicians and statisticians. We expect our nurses from the NCCH to move and develop cancer nursing to even higher levels of proficiency and expertise.

Education

1.Assist and support new nurses

We have worked to reduce the gap between the technical skill level of new nurses and the clinical nursing required for actual cancer care by carrying out practical nursing training. During the first month, we provide training courses on basic nursing skills for new nurses, who learn about clinical nursing practices by shadowing a senior nurse. We ensure that new nurses can work in a favorable, work-related, stress-free environment.

2.Development of knowledge and skills for cancer nursing

To develop the skills associated with cancer nursing, the Department of Nursing is enhancing a system that can bring out individual expertise and an educational system to improve the careers of nurses. In particular, the interaction between large-group training and small-group training was increased to implement the knowledge and techniques acquired from years of continuing education, which resulted in improved patient care.

We have 10 specialized nurse training courses: Cancer chemotherapy nursing I and II; Palliative care nursing I and II; Lymphedema care; Wound and skin care; Dysphagia nursing; Radiation therapy and Interventional Radiology (IVR) nursing; Support for discharge and home care coordination nursing; and nursing research. A total of 219 nurses have participated, all of whom have over four years'nursing experience. Many nurses want to participate in these courses. Through evaluation of the result of these courses this year, the future issue is to improve the educational content for nurses to enable career development.

3.Certified Nurse Specialists and Certified Nurses

Currently, 13 certified nurse specialists and 35 certified nurses are working at the NCCH. They represent the role model for cancer nursing practice in both inpatient and outpatient settings. The number of consultations is increasing, which proves that the use of Certified Nurse Specialists and Certified Nurses is being accepted by the nurses in this hospital. The number of support meetings and consultations for patient's decision making by physician and CNS/CN was 1,342 cases, and the number of support meetings and consultations for psychosocial problems by CNS/CN was 1,012 cases in 2016.

As members of teams where different professionals work together in special areas, such as infection control, palliative care, nutritional support and care of decubitus ulcers, and respiratory support, these Certified Nurses contribute to effective cooperation. The identification of problems and discussions from the point of view of multidisciplinary teams serve as a good model for other nurses and provide an important educational role in the clinical setting.

Certified Nurse Specialists contribute to education and coordination for ethical issues in the clinical setting. They support and empower not only patients and their families, but also nursing staff.

Certified Nurse Specialists and Certified Nurses also engage in educational activities both within and outside the hospital, and contribute to the development of educational programs by giving lectures and practice training for the curricula of Certified Nurse Specialists or Certified Nurses.

Future prospects

The Supportove Care Development Center was established in September 2016 in the NCCH. Nurses of this center are providing various care by nursing consultation, perioperative nursing management, Lymph edematous care clinic, and patient education programs. We are aiming to respond to various needs of cancer patients and their families, build a support system with interdisciplinary team including nurses, and disseminate useful information throughout Japan.