Alberta Cancer Foundation

Distance Nursing: An Edmonton program equips a world of oncology nurses

For nurses, caring for patients who have cancer can be very different from caring for patients with other diseases or conditions. Training in oncology nursing takes place on the job and it takes time for nurses to learn the ins and outs, even when they are working in a dedicated cancer-care facility. The Oncology Nursing Distance Education Course (ONDEC), offered by Edmonton’s Cross Cancer Institute, is giving nurses across Canada and around the world in-depth training in oncology nursing that’s helping them provide better care and feel more confident in their roles.

The novel course provides a comprehensive and detailed look at oncology. Divided into five sections, it covers cancer biology and epidemiology, cancer treatments, oncologic emergencies, cancer diseases and symptom management and supportive care. Course designers created ONDEC for nurses, but now allied health care professionals such as pharmacists, physiotherapists and physicians can take the course, too. ONDEC students can be found in Pakistan, Australia, Trinidad and Tobago, South Africa, Europe, Malaysia and, of course, Canada.

Students of ONDEC are armed with new skills. The course becomes a foundation of learning.

Erin Taylor is a registered nurse working in the medical day care unit at the Cross Cancer Institute who graduated from the course in April 2012. “For me, the most important topics were basic cell structure, cell biology and how chemo drugs work in the cell cycle,” she says. She wanted to be better able to address questions from people receiving outpatient chemotherapy.
“Patients are really involved in their own care. Although they take a general orientation to chemo, the experience is different for everyone,” says Taylor. “I wanted to be able to answer specific questions and know where to look for information when I don’t have answers.”

The individual nature of responses to cancer treatment combined with the fact that cancer involves multiple disease processes, make patient care more challenging.

“Within cancer care there are 12 different tumour groups and within each of these tumour groups there are various types of cancer that can affect each person,” explains Scott Fielding, executive director, Cross Cancer Institute. “One of the main concerns for a nurse looking after patients receiving chemotherapy or radiation therapy is the interaction of the treatment with the patient because, in some cases, the treatment can be as dangerous to the patients as it is to the cancer cells.”

For Hwei Ling Cheah, who works at the Penang Adventist Hospital Oncology Center in Penang, Malaysia, ONDEC provided her with the rationale behind the treatment, care and education she gives patients. Although she’s been a nurse

for eight years and in oncology for more than three years, the information in the course gave her more confidence. That has translated into greater confidence on the part of patients, increasing the effectiveness of care she provides and improving patient safety.

“As a nurse, when we have the knowledge to back up our practice, we are able to provide teaching and care with rationale,” she says. “When the patient knows that the nurse who takes care of them is knowledgeable, it increases their confidence level, indirectly increasing their compliance with treatment.”

To accommodate nurses’ busy schedules and offer the course to those health-care professionals who would otherwise not have access to it, the Cross Cancer Institute offers ONDEC in two formats. Taylor took the intense, 14-week, on-site course with intake offered twice a year. Students attend class one day a week and undertake about 12 hours per week of reading and study.

“It’s a dual way of learning. Students complete the distance education course plus participate in tours of hospital departments and get to hear from experts who are treating specific cancers as well as people who have had cancer,” says Lori Weber, clinical nurse educator and ONDEC consultant. “They have to eat, sleep and breathe ONDEC, but they love it when they’re done. It becomes a foundation of learning for them.”

Hwei did not travel to Edmonton to take the course so, unlike Taylor, she did not take the immersive version of ONDEC. Like many students, she completed the distance-education version of the course, mainly via email. Participants can take the full course within a certain time period, or take individual sections, working at their own pace to complete them all or just take sections that interest them or apply to their workplace situations. Exams take place by student-designated proctor supervision.

Marie Kemp is a program co-ordinator and tutor for ONDEC. She provides whatever assistance students require, from helping them better understand a concept to reviewing learning activity answers to preparing them for the examinations at the end of each section. Some people never contact her; others email her daily. Nurses don’t have to specialize in oncology to benefit from ONDEC.

“When this course was first developed, I believe the vision was that it would be for oncology nurses. But we are here for cancer patients in a variety of health care settings including large urban hospitals, smaller rural hospitals and nursing homes, and the course can be of benefit to health-care professionals who work in any of these settings,” says Kemp.

ONDEC is the only course of its kind offered in North America. It benefits both new and experienced nurses. Kemp reports that nurses who’ve spent more than two decades in oncology have told her how valuable the information is for them and their patients.

Knowledge On Deck:
The ONDEC course is a comprehensive source of information that is improving the care of people with cancer around the world.