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Navigating the Toughest Challenges in Hematology Nursing: Insights from HNHCP Leaders · EHA Unplugged

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  The one thing that we pride ourselves is that when we
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  develop any of these materials, it's not just a nurse writing
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  them. It's a multidisciplinary
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  approach. So we have physicians, we have
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  nurses and perhaps uniquely, we usually have a patient voice in
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  in the early stage of planning of every material we do.
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  Welcome to EHA Unplugged, the official podcast channel of the
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  European Hematology Association. EHA.
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  I'm Sarah de Ficher and I'm here today with two very special
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  guests from HNHBC, Maraid and Eric Maraid.
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  Would you mind introducing yourself?
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  Hello, my name is Marini Canela. I am the Vice President of the
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  Hematology, Nurses and Healthcare Professionals Group,
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  otherwise known as HNHCP, and I'm also a bone marrow
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  transplant coordinator in Saint James's Hospital in Dublin,
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  Ireland. Eric.
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  Yeah, my name is Eric Adds. I'm the president of the
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  Hematology Nurses and Healthcare Professionals group, and I'm
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  nurse manager at the hematology department at the University
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  Hospital in Zurich in Switzerland.
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  Many of our audience will not be quite as familiar with HNHCP, so
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  could you tell us a little bit about, you know, what is HNHCP?
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  Where did it come from? How did it start?
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  Yeah, HNHCP was established about 10 years ago and our main
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  focus is educating nurses and Elliott Healthcare care
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  professionals like physiotherapists, nutrition
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  specialists, social workers, etcetera, etcetera, to educate
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  them in the field of hematology. Over the years, I suppose we
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  noticed that there was a a scarcity of education and
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  information for nurses working in general hematology and the
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  areas like bone marrow transplants are very well
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  covered by other organizations, both general nurses working
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  generally at the coalface with patients with myeloma, lymphoma,
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  CLL that never referred for specialist treatments.
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  There wasn't much out there in the lines of educational
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  material or information or even a conference where they could
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  meet and come together and share ideas and get it, learn what was
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  happening in other centres throughout Europe and the world.
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  OK. So man, you've been going for 10
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  years. What are the sorts of things,
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  the activities that you do for that part of the community these
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  days? So important is we are global
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  organization and our main focus is our annual meeting.
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  It's a 2 day hybrid meeting and then the development of
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  educational materials from non malignant and malignant diseases
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  and we develop textbooks and important is for some nurses and
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  other healthcare professionals. The lack of language.
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  We translate our textbook from English in French, Italian,
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  German and Spanish language. And we have AE learning platform
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  where people can educate themselves, can do a test and
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  then we have the E by accreditation.
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  So today's we have developed 7 learning programmes on ITP
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  myeloma, acute leukemias, chronic leukemias, lymphoma, CAR
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  T therapy and bispecific antibody therapy.
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  And our 8th program is in development at the moment and we
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  are looking at hemoglobinopathies and as well
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  as the material textbook. As he said, the the learnings
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  available in only in English, unfortunately, but is there for
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  individuals to access. But also we have collaborated
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  particularly with the likes of the CAR T program, with
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  institutions in the Netherlands and Austria, with translating
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  them locally into their language for use by universities and
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  national societies in those countries so that they can
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  access the material as well. Within the community, umm, how
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  have these activities benefited both the healthcare
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  professionals but also the patients?
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  We think, we would think that there's been a very positive
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  receptionism, but we know from the demand for the information,
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  the fact that it's readily accessible both in print form
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  and downloadable from our website.
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  And we know from tracking the downloads that they're being
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  accessed everywhere in the world.
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  But we know that they're not only being used for the
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  education of nurses, but as we said very keenly for other
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  healthcare professionals and even in some places are being
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  used as an introduction to certain topics where junior
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  doctors may not see a lymphoma patient or a CAR T, but they may
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  be seeing them when they come in sick.
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  That's some way of being able to get themselves up to date with
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  what may be involved. The one thing that we pride
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  ourselves is that when we develop any of these materials,
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  it's not just a nurse writing them.
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  It's a multidisciplinary approach.
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  So we have physicians, we have nurses and perhaps uniquely we
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  usually have a patient voice in in the early stage of planning
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  of every material we do and then they get reviewed of by other
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  physicians and nurses and patient voice that are not
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  involved in the development of the original material.
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  So it has it has that unique perspective that it kind of
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  covers all remits and facets of the patient journey, which is
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  really important to us. I mean, that sounds very, I mean
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  not just admirable, but I'm very impressed by the amount of work
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  that must go into that. What are the some of the
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  challenges that you are finding in sort of meeting the demands
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  of the community from, you know, from your standpoint?
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  I think one of the demands is that you can never produce
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  enough material and produce it quickly enough.
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  And there's also some of the programs need to be updated
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  frequently, but others probably not as frequently, but we really
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  wanted that the material is updated in a timely manner so
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  that it's something that is there and accessible and has
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  developments for nurses that are not able to get to meetings and
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  like the likes of E ha that we're being at this week is
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  wonderful and fantastic. Resources for nurses are limited
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  and there's not necessarily the funding for them to get to
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  things with the likes of our online meeting.
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  For people in low and middle income countries and also for
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  Africa and places like that, we offer them free registration to
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  the online meeting so that they can at least access the
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  education. And at board of these, we are
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  not only focusing on advanced nurses, but also newcomers.
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  So new nurses, new other healthcare professionals coming
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  in the field of hematology because there's a big, big need
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  for hematological education because in a lot of countries
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  hematology is only a very small piece in the general education.
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  Also, due to the expanding field of hematology, it's so important
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  that nurses get a proper education because our philosophy
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  is when nurses are not well trained, well educated, they
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  can't inform patients and relatives properly.
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  It's very, very, very true. You're saying the the sort of
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  rapidly developing field of hematology and the the European
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  Hematology Association has also been working on this and has,
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  you know, concerns about what's this going to look like in the
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  future. What do you think that sort of
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  the role of our collaboration should look like in order to
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  facilitate that? I think it's having an awareness
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  of the needs that are out there, being able to collaborate as we
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  do nicely even in the likes of this podcast, to say that we
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  exist, that there is a resource out there.
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  We rely the same way that we advertise and say that there is
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  resources available with EHA on our website.
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  That collaboration to be able to bring it to the attention of
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  physicians and scientists in other organizations that they
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  can go and spread that news to their nurses that there is
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  something that they can use and that they can access readily and
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  easily without a huge cost. And the other thing is, is that
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  even the importance of nurses in hematology needs to be
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  recognised. In some countries still, you
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  know, hematology nursing is not fully recognised as a
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  speciality. And and there are places where
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  maybe oncology nurses are having to take on some of that burden
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  so that they can too have access to information and education and
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  hopefully develop an interest in the area.
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  Hematology nursing is more than just looking after somebody with
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  leukemia. It's the hemoglobinopathies,
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  it's hemophilia, it's thrombosis, it's the Itps, it's
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  the elderly patient who may suddenly be diagnosed with CLL
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  or myeloma on top of other comorbidities.
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  And how do you manage that? And that's why in some of the
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  materials that we do, we look at special populations like nursing
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  the person who's elderly, so that the nurse that's looking,
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  working within care of the elderly can access the material
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  and say this is a hematology patient, what do they need?
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  What can we do? What do you think are the the
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  sort of the challenges that nurses are going to be facing in
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  the coming years within hematology, but maybe
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  potentially also in general? I think hematology is the rapid
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  evolvement of hematology. All the opportunities in most
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  countries patients have to make decisions for their therapies.
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  I think that's that's one of the the biggest challenges for the
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  future. And on the other hand, in
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  general, I think very important item at this moment is talking
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  about staff shortages in in a lot of centres in a lot of
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  countries. So we also as HNHUP, we are
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  trying to motivate colleagues to stay in the field, to educate
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  them probably. So there we see also a role and
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  also together with associations like EHA of course, who bring
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  our forces together. I think another challenge too
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  is, and it's a challenge for EHA as well.
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  And we've established ourselves in a way as the experts of the
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  people that can deliver treatments like CAR T,
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  bispecific antibody therapy and antibody conjugates safely.
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  But now these treatments are expanding out to other diseases.
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  And there's a huge challenge for both medical and nursing because
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  these are going to go on to other areas and we're going to
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  have to lead the education of people in other diseases like
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  rheumatology, dermatology, even solid tumors.
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  And that's a huge challenge and there's a huge implication both
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  on resources and time, because we still have to educate our own
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  staff. We still have to have the
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  expertise and the education there.
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  And so that's going to be very difficult.
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  There's also a little bit about the role of nursing and
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  transferability of education across countries.
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  I know we have been doing an awful lot of work with like
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  medical passports and things like that to have a
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  standardization. It's not going to work quite the
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  same way for nursing. If there could be some way of
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  harmonizing things, that would be great because it wouldn't
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  increase potentially work flow and enable maybe retention of
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  staff if they thought that they can then use their
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  qualifications and skills elsewhere if they wanted to,
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  that there's an easy way of doing it without having to go
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  through jump through an awful lot of hoops with transferring
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  registrations, etcetera. And other challenges in the in
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  the field of hematology is the collaboration between the
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  several multidisciplinary disciplines.
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  So to bring all those stakeholders together in this
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  expanding field of hematology, it's a huge challenge for all
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  the organizations. But I think there's an
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  opportunity for a good collaboration between EHA&HNHUP.
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  So I'm going to play The Time Machine game.
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  If we could get into a time machine and transport 50 years
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  in the future, what would your ideal situation be?
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  At the annual meeting of EHA should be nurses involved in
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  terms of joint sessions. Again, this multidisciplinarity
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  between physicians and other disciplines and nurses, I think
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  will be in the future more and more important.
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  I think a lot very much along line of what Eric says, a truly
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  collaborative holistic approach to patient care that involves
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  the multidisciplinary team, the patient, their carers and and
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  the wider support networks. And a recognition that OK, there
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  are other things out there that will also feed in and help
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  deliver treatment to patients that is accessible, affordable
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  and near to their home. Now I'm not saying that it means
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  that everybody has their treatment at home, but being
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  able to provide that care in a holistic, appropriate, patient
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  centred fashion. That sounds like a great
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  feature. It would be wonderful.
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  Well, the other game is the magic wand.
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  What would you use to fix it? I think a lot of the challenges
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  that we're facing at the moment are to do with staffing and
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  resources and retention of staff and trying to reduce the burnout
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  rate, the rate of people leaving to do other, to go to other
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  professions because they don't see nursing as being attractive
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  in keeping with this work life balance that we all like to
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  have. And I think that if you could
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  have a magic wand to make nursing a more attractive
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  proposition and to be able to develop ways of keeping people's
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  interests and career pathways. But I also think there's a
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  challenge that the role of nurses at the bedside is valued
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  as much as the role of an advanced nurse practitioner.
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  So I absolutely agree. I think we should educate every
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  nurse and nurse assistants SO and other disciplines and, and
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  also not not only inpatient nurses, but also so due to
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  future developments in hematology, outpatients setting
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  will be more and more and more important.
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  Yeah. Yeah, the role of community
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  delivered therapies is going to become paramount to what we're
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  doing and to what is there for patients.
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  So being able to to do that safely and effectively is really
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  important. So maybe before we finish, what
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  drives both of you to be so actively championing the nurse
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  and the allied healthcare professional within hematology?
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  What is it that gives you joy? So my drive is and I'm working
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  now almost 35 years in hematology.
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  Is that to motivate nurses and other healthcare professionals
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  and educate them probably to to optimize the care for our
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  patients and don't forget the relatives that that's my drive
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  in this field. I think similarly to Eric, he
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  unfortunately reminded me yesterday that I'm about 35
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  years in the field also. But it is the reward you get
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  when you know that you've been able to improve the working life
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  of a nurse, or they're what they're able to deliver to their
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  patients locally. That you're able to impact the
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  care that somebody is giving to patients, that you're giving
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  them the resources and the knowledge and ultimately helping
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  them develop the skills to care for patients and their families
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  and, and hopefully enhancing the patient's quality of life by
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  doing that and. Another important item is here
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  in the western part of Europe, we have a lot of opportunities,
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  but we also focus on the eastern part of of Europe, on African
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  countries, on countries in South America where nurses have often
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  less opportunities also to involve them and to educate them
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  properly. That's also a huge drive and
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  opportunity and challenge for the future.
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  I think both of you are doing an admirable job and I would like
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  to thank both of you for coming to talk to us today.
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  It's been a very insightful conversation and I hope to see
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  more of these conversations in the future.
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  And we'd also like to say thank you for the opportunity to
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  highlight and and promote nursing and the
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  multidisciplinary team within the setting.
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  It's really nice to know that it's valued and that and the
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  collaboration we have with EHA, with the patient groups that
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  that we're able to collaborate to develop and to move the field
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  of hematology forward. Thank you to our listeners for
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  tuning into this episode of EHA Unplugged.
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  Uh, follow the podcast channels and we look forward to you
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  listening to the next one.