Realising the potential of cancer nursing – the need for agreement on appropriate levels of education and professional recognition
At present, cancer nursing is not a regulated profession in all European countries. Lack of uniform recognition represents a barrier to the free movement of the concerned professionals and their ability to contribute positively to patient outcomes across Europe.
There are currently differences in variables such as nurses’ training curricula, presence or nature of specialisation requirements (e.g. training and/or experience), corresponding roles and responsibilities, and salary levels. These factors may serve to further hinder the mobility of formally specialised cancer nurses due to the reluctance to forgo benefits linked to their specialisation in the home country. Conversely, for non-specialised cancer nurses who wish to travel to another EU state, there are barriers to enter the profession in countries where cancer nursing is already a regulated specialism.
The central consideration remains the nurse’s ability to provide the highest possible quality of care to the cancer patient, as part of the multi-disciplinary team, which may also be influenced by the variability of specialisation requirements, such as requisite and available levels of education, between European countries.
Thus there is a clear need to consider working towards specialisation of cancer nursing based on an agreed educational curriculum and a formal system of recognition enabling consistent practice across Europe.At a cancer centre level there are examples of accreditation systems that include questions about the nursing workforce and specialisation. For example, in the Organisation of European Cancer Institutes (OECI) system, the provision of training programmes for nurses, the number of nurses enrolled in specialist training, the total full-time nurses certified in oncology and the institution´s plans for further development of this area, are already outcome measures in the accreditation process. (OECI 2015)
In the international and regulatory context, the RECaN project can be framed by the EU Directive 2013/55/EU on the recognition of professional qualifications as well as by previous agreements such as the Bologna Declaration (1999) and the Munich Declaration (2000).
The Professional Qualifications Directive 2005/36/EC established a system of automatic recognition across Europe for seven professions including doctors - generalists and specialists - and nurses in general practice. The amending Directive 2013/55/EU aims to further facilitate and enhance the mobility of professionals and help alleviate staff shortages across Europe. Specifically, it introduces the European Professional Card (EPF) for professions where:
- (a) there is significant mobility or potential for significant mobility in the profession concerned;
- (b) there is sufficient interest expressed by the relevant stakeholders;
- (c) the profession or the education and training geared to the pursuit of the profession is regulated in a significant number of member states.
Whilst the European Professional Card is now available to general nurses it does not yet cover specialist nurses.
Given this situation, there as an obvious need to promote increased availability of education that promotes a specialist nursing role.
The Bologna Declaration by European Ministers of Education4 aims at, among others, adopting a system of easily readable and comparable degrees as well as promotion of mobility and integrated programmes of study, training and research.
The Munich Declaration by European Ministers of Health5 focuses specifically on Nurses and Midwifes in terms of personnel policies on gender, status, and on ensuring more co-operative and interdisciplinary working in the interests of better patient care.
The RECaN project builds on these initiatives by demonstrating the added value of cancer nursing interventions and can be considered in relation to increased professional mobility, the increasing need for comparable educational curricula, and career advancement for those wishing to specialise in cancer care within a multidisciplinary setting.
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