T internAtionAl PersPectiVe S UE

210 Volume 25, Issue 2, sprIng 2015 • CanadIan onCology nursIng Journal
reVue CanadIenne de soIns InfIrmIers en onCologIe
FEATURES/RUbRiqUES
internAtionAl PersPectiVe
by Savitri Singh-Carlson
The Oncology Nurses Association of
India (ONAI), formed in November
of 1994, is situated in the Nursing
Department at Tata Memorial Hospital in
Mumbai, India (https://tmc.gov.in/med-
ical/departments/nursing.htm#). The
ONAI organization promotes Professional
Nursing through membership of National
Nurses Association (American Nurses
Association, http://nursingworld.org/)
and the National Oncology Nursing
Association (Oncology Nursing Society
[ONS], https://www.ons.org/). It has an
aliation with International Society of
Nurses in Cancer Care (ISNCC, http://
www.isncc.org/) and Australian Cancer
Nursing Association (Cancer Nurses
Society of Australia [CNSA], https://www.
cnsa.org.au/).
With ve chapters within India, it
has more than 400 active ONAI mem-
bers. The ONAI set the criteria for
starting a chapter as having a min-
imum of 30 members according to
Sulochana Retnamony, Deputy Nursing
Superintendent of Tata Memorial
Nursing and ONAI President. The
vision of ONAI is: Excellence in Service,
Research and Education. Its aims and
objectives include:
a. To render quality patient care;
b. To update the current advances
related to practice and skills;
c. To develop and disseminate evi-
dence-based treatment, and;
d. To provide a link within India and
outside India.
Its activities include yearly or biennial
conferences for oncology nurses in India,
with awards for conference presentations,
and a quarterly newsletter “Oncology
Nursing Newsletter”. ONAI continually
strives to provide timely educational sem-
inars on cancer awareness for upcoming
oncology nurses. This national orga-
nization’s entrepreneurship in raising
Professional Consciousness of Indian oncol-
ogy nurses is applauded for its innova-
tiveness and for providing a forum for
integrity and advocacy of oncology nurs-
ing in India.
As reported in an earlier article, “cur-
ricula taught in nursing schools for edu-
cation of the general nurse, as well as
the standards of practice and guidelines
under which each country prepares
nurses for practice, dier from coun-
try to country” (Singh-Carlson, 2014, p.
109). While this is true for general nurs-
ing education standardized curricula in
most countries, including the Indian
Nursing Council, there is a challenge
when developing practice standards and
competencies for specialized oncology
nurses. This is because a national foun-
dation for professional oncology nurs-
ing standards of care, and a denition
of the roles and the necessary compe-
tencies has not been put in place yet in
India. Without a national foundational
document that outlines guidelines for
practice standards and competencies
for specialized oncology nurses, each
cancer setting (program or centre) has
the task of preparing its own docu-
ments and educational content when
educating their sta nurses to be com-
petent in preparing and delivering che-
motherapy, radiation, and other related
skills for providing quality cancer care.
In January 2015, Akanksha
Dicholkar, Chief Nursing Ocer, Dr.
Vivek Radhakrishnan, Chief Medical
Oncologist of Aster MedCity Oncology
Care in Cochin, Kerala, and I success-
fully conducted a workshop in Oncology
Nursing in India. An interdisciplinary
team presented topics that were relevant
to oncology care with invitations sent to
nurses in neighbouring cancer settings.
Following this successful workshop
and assessment of the nurses’ educa-
tional needs, our next task was to pre-
pare practice standards, competencies
and guidelines for oncology specialized
nurses in preparation for the opening of
the new oncology unit at Aster MedCity.
After reviewing the Canadian Association
of Nursing Oncology (CANO) and ONS
published standards of practice and
competencies, the team created a docu-
ment that ensured appropriate elds of
education for the specialized oncology
nurse and created skills mastery levels to
be utilized as part of the curricula.
In order to ensure this document
covered depth and specicity for qual-
ity patient oncology care and safety stan-
dards for nurses, the team approached
the Regional Cancer Centre (RCC) in
Trivandrum to examine their exist-
ing practice standards, competencies
and curricula. This Kerala state-funded
cancer centre has been in existence for
more than 10 years. I was invited as
a guest lecturer to the RCC and con-
ducted a verbal assessment of the cur-
rent educational level of specialized
oncology nurses. This assessment
revealed a depth of clinical and leader-
ship expertise, which I recognized as a
combination of academic and experi-
ential knowledge comparable to that of
cancer care nurses in most settings.
Most of the oncology nurses at RCC
in Trivandrum had autonomy to make
clinical decisions within their scope
of practice. However, they also desired
Professionalism, Advocacy, and the abil-
ity to collaborate and share evidence from
their practice that would allow change.
And they faced the continuing chal-
lenge that oncology nurse leaders and
educators at each cancer setting prepare
their own documents for practice stan-
dards, competencies and protocols to
train nurses for moving from general
to specialized oncology nurses. Content
for developing these documents was
derived from CANO and ONS, but
mostly from the latter, as the RCC nurse
educator was an ONS member. Credit
was given to both these international
organizations in their curricula.
Nurse leaders at RCC and Aster
MedCity were able to share their knowl-
edge and help to strengthen the devel-
opment of practice standards and
competencies to guide the special-
ized oncology nursing training at Aster
MedCity. Consequently, following the
meeting of oncology nurse leaders
from various centres, the next steps
will be to unite Kerala oncology nurse
leaders from various regional state
and private cancer centres to collabo-
rate on the development of a document
About tHe AutHor
Savitri Singh-Carlson, Associate Professor, California State University, Long Beach, California.
Email: [email protected]

211
Canadian OnCOlOgy nursing JOurnal • VOlume 25, issue 2, spring 2015
reVue Canadienne de sOins infirmiers en OnCOlOgie
FEATURES/RUbRiqUES
PersPectiVe internAtionAle
par Savitri Singh-Carlson
Fondée en novembre 1994, l’Oncology
Nurses Association of India (ONAI)
est située dans le Service de Soins inr-
miers du Tata Memorial Hospital à
Mumbai en Inde (https://tmc.gov.in/
medical/departments/nursing.htm#).
L’ONAI préconise des soins inrmiers pro-
fessionnels à travers son appartenance à la
National Nurses Association (American
Nurses Association, http://nursingworld.
org/) et à la National Oncology Nursing
Association (Oncology Nursing Society
[ONS], https://www.ons.org/). Elle
est aliée à l’International Society of
Nurses in Cancer Care (ISNCC, http://
www.isncc.org/) et à l’Australian Cancer
Nursing Association (Cancer Nurses
Society of Australia [CNSA], https://www.
cnsa.org.au/).
Avec cinq sections régionales en Inde,
l’ONAI compte plus de 400 membres
actifs. Selon M
me
Sulochana Retnamony,
surintendante adjointe des soins inr-
miers de Tata Memorial Nursing et prési-
dente de l’ONAI, l’organisme a xé comme
critère un minimum de 30membres pour
établir une section régionale. La vision de
l’ONAI est la suivante : l’excellence dans
les services, dans la recherche et dans l’en-
seignement. Elle a les objectifssuivants :
a. Orir aux patients des soins de
qualité;
b. Adopter les progrès actuels en matière
de pratique et de compétences;
c. Développer et diuser des traite-
ments fondés sur des preuves;
d. Établir un lien au sein et à l’extérieur
de l’Inde.
Parmi ses activés, l’ONAI organise
des conférences annuelles ou bien-
nales pour les inrmières en oncolo-
gie de l’Inde, au cours desquelles elle
remet des prix pour les présentations, et
publie un bulletin trimestriel, Oncology
Nursing Newsletter. Elle s’eorce conti-
nuellement d’orir des séminaires
éducatifs de sensibilisation au cancer
pour les inrmières et inrmiers en
oncologie débutants. L’initiative de cet
organisme national cherchant à déve-
lopper la conscience professionnelle des
inrmières et inrmiers en oncologie
indiens a été applaudie pour son inno-
vation et pour avoir établi un forum de
discussion sur l’intégrité et la promo-
tion des soins inrmiers en oncologie
en Inde.
Comme signalé dans un article pré-
cédent, « Les programmes d’études
enseignés dans les écoles de sciences
inrmières pour la formation des inr-
mières généralistes, ainsi que les lignes
directrices et les normes de pratique en
vertu desquelles chaque pays assure la
formation de ses inrmières, dièrent
d’un pays à l’autre. » (Singh-Carlson,
2014, p.113). C’est sans doute vrai en ce
qui concerne les programmes éducatifs
normalisés en soins inrmiers géné-
raux, y compris ceux de l’India Nursing
Council. Cependant, c’est un dé que
d’élaborer les normes de pratique et les
compétences pour les inrmières et
inrmiers spécialisés en oncologie. Cela
est dû au fait que des normes profes-
sionnelles de soins inrmiers en onco-
logie, ainsi qu’une dénition des rôles et
des compétences nécessaires, n’ont pas
encore été établies en Inde. En l’absence
d’un document de base national décri-
vant les lignes directrices des normes
de pratique et des compétences néces-
saires aux inrmières et inrmiers spé-
cialisés en oncologie, chaque milieu de
that describes practice standards and
competencies and will guide special-
ized oncology nursing practice at the
state level. There will be several proce-
dural steps to undertake and organiza-
tions with whom to engage. However,
their mission is to promote Excellence
in Oncology Nursing that enhances the
quality of cancer care for patients and
their families. Their aim is to develop
a strategic plan that will promote profes-
sionalism, innovation, autonomy, advocacy,
collaboration, research, and continued edu-
cation. The ultimate goal is to gather
evidence that will inform policy changes
at the national ONAI level for the stan-
dardization of curricula and to develop
an advanced practice nurse role as an
oncology clinical nurse specialist.
Is this a lofty goal? We don’t think
so. This goal is in sync with the ISNCC
World Cancer Day 2015 statement
on The Role of Cancer Nurses in the
World: “Internationally, the contribu-
tion of cancer nurses must be valued
at all levels of the health care and polit-
ical system; failure to do so will have a
detrimental impact globally” (ISNCC).
In order to deliver quality cancer care,
oncology nurses require proper educa-
tion if they are to gain knowledge, be
skilful, and master competencies that
are unique to cancer care. ISNCC fur-
ther states that cancer nursing educa-
tion must be: “based on standardized,
evidence-based curricula, adapted to
meet each country’s needs and based on
lifelong learning” (ISNCC, n.d.) http://
www.isncc.org/?page=WCD2015. We
will report on the ongoing success of
this goal in future reports.
reFerences
International Society of Nurses in Cancer
Care (ISNCC). World Cancer Day
2015. Retreived from http://www.isncc.
org/?page=WCD2015
Singh-Carlson, S. (2014). Cancer nursing in
low-middle income countries. Canadian
Association of Nursing Oncology, 4(2),
109–112.
Au suJet De l’Auteure
Savitri Singh-Carlson, Professeure agrégée, California State University, Long Beach, Californie.
Email: [email protected]