By Jose Peralta and Anne Chinye

Today’s seniors are not willing to end their last days in a hospital or nursing home. It is our duty as nurses to advocate and respect their wishes. Oncology and cancer care is a significant and important aspect of healthcare that presents its own multiple challenges and complications to patients, family, nursing students, oncology healthcare providers, and the community at large. In the United States, there are more than 1.9 million new cases of cancer, and an estimated number of deaths was 609,360 in 2020. Consumers may still hold misconceptions about hospice and palliative care fearing that participating in these care modalities is in a sense “giving up”. It is important to educate the public and healthcare workers to understand the similarities and differences. Hospice care is end-of-life care in which no possible cure may be available or acceptable to the patient. Palliative care focuses on comfort care and treatment may or may not be available. Both modalities offer a multidisciplinary approach delivered in various locations such as inpatient hospitals, long term care, outpatient palliative/hospice units, and homes. Nursing students assist, participate, and practice along healthcare providers such as oncology and hematology nurses in caring for oncology patients in different stages of their illness trajectory.

Despite the medical advances, innovations, and technological developments in oncology care, cancer is still the most feared health condition around the world. Oncology patients are affected by multiple factors from disease progression, symptom control, quality of care, effective coping, and constrained encountered in the clinical setting. Caring for an oncology patient provides its unique challenges for the oncology team and student nurses are no exception. Studies have suggested that healthcare providers experience some variation of difficulty in providing care to oncology patients in the care units and hospice setting. Similarly, nursing students have demonstrated difficulty in providing effective care due to negative attitudes, behaviors, perceptions, and constrained encounters when caring for oncology patients and thereby risk depriving these patients of support and care needed to maintain effective coping and quality of life.

Student nurses have an important role in caring for oncology patients in any setting and in hospice care. Nursing students need adequate knowledge, education, and understanding of the care trajectory of oncology patients in hospice care. Literature reviewed regarding nursing students’ perception and attitude in caring for oncology patients in hospice care revealed that student nurses are afraid, lack sufficient knowledge, and education needed to care for these patients. Nursing programs need to provide nursing students with accurate nursing information and education on oncology care, provide mentorship programs with positive role models for student nurse to assist and participate in caring for oncology patients in hospice care.

Some of the article states Evidence shows that the more student nurses are prepared in oncology care, the more confidence they have in caring for this population of patients. It is essential for nursing schools to implement curricula that address this problem since it is a major concern. Experienced oncology nurses know the significant burden that cancer diagnosis and care create on patients and caregivers. Furthermore, talking about palliative or hospice care to cancer patients may be stressful because many oncology patients and their families have the perception that when hospice is recommended, patients are at the end stage of their life. Nursing programs should develop a comprehensive oncology education in their ungraduated nursing curriculum that focuses on oncology patient care, treatment modalities, and symptoms control. The curriculum on oncology care must focus on training student nurses on how to form positive relationships and communicate effectively with cancer patients and their families, how to approach emotional problems relating to their condition and care, provide psychosocial support, and how to care for terminally ill patients in hospice care.

Nursing students acquire essential knowledge and skill in caring for patients during their basic nursing training and yet they experience limited exposure in caring for oncology patients in palliative and hospice care during their clinical. Research shows that healthcare professionals including nursing students have a negative perception, attitudes, fear, afraid, anxious, stressed, and lack adequate knowledge and skill to care for oncology patient which affect students’ motivation and care behaviors towards oncology patients in hospice care. Nursing institutions, faculty, and clinical faculty must develop, design, and re-think how nursing education and clinical experience for nursing students must occur throughout the trajectory of health and illness and across a continuum of care for oncology patients and their families.

It is important for nursing programs and practice partners to address this gap and develop interventions and education that prepare students to take care of cancer patients, improve their quality of life of the patients and caregivers, and incorporate hospice care into their clinical rotations. The Benjamin Leon School of Nursing and Vitas Healthcare have created a partnership to immerse and motive students on the importance of caring for a cancer patient, provide more clinical experience to ensure students have adequate knowledge and skill to care for oncology patients in hospice care and have experts participate in lunch and learn opportunities to share hospice and palliative care information,. Scholarships are provided to interested students that provide a wraparound support including tuition, clinical experiences in hospital or palliative care, opportunity to work during their nursing education, and a guaranteed job post-employment.

For more information, Jose Peralta, Director of Nursing Clinical Competencies, Benjamin Leon School of Nursing, Miami Dade College, can be reached at (305) 237-4111 or jperalta@mdc.edu. Dr. Anne Chinye, Associate Professor, can be reached at achinye@mdc.edu or (305) 237-4120.