The International Society of Nurses in Cancer Care: Position Statements Can Aid Nurses to Think Globally and Act Locally
The number of new cases of cancer is expected to rise by about 70% during the next two decades, and people living in low- and middle-income countries will experience a disproportionate burden of this increase. Oncology nurses are positioned to take the lead in addressing this looming health crisis. Such efforts will gain momentum and have a greater impact if nurses around the world collaborate. The purpose of this article is to describe the role of the International Society of Nurses in Cancer Care in leading this effort, with a particular focus on three specific position statements that nursing societies and nurse leaders can use to advance cancer prevention and control in their own institution or country.
The number of new cases of cancer is expected to rise by about 70% during the next two decades, and people living in low- and middle-income countries will experience a disproportionate burden of this increase (Stewart & Wild, 2014). Oncology nurses are positioned to take the lead in addressing this looming health crisis. Such efforts will gain momentum and have a greater impact if nurses around the world collaborate. The purpose of this article is to describe the role of the International Society of Nurses in Cancer Care (ISNCC) in leading this effort, with a particular focus on three specific position statements that nursing societies and nurse leaders can use to advance cancer prevention and control in their own institution or country.
For more than 30 years, the ISNCC has provided the infrastructure for oncology nurses around the globe to work together to maximize the influence of nursing to reduce the global burden of cancer. ISNCC encourages its members to actively participate in the work and leadership of the Society. Members are welcome to join ISNCC committees and task forces that are engaged in efforts to advance oncology nursing education, knowledge dissemination, patient care, and policy.
ISNCC members represent more than 50 countries worldwide, and, as of December 2015, ISNCC had 45 full-member organizations, 68 association members, and more than 1,000 individual members (H. Kwong, personal communication, December 4, 2015). Full members include national cancer nursing societies, such as the Oncology Nursing Society; regional cancer nursing societies, such as the European Oncology Nursing Society; and oncology institutions, such as cancer centers and hospitals. ISNCC also provides an opportunity for individual cancer nurse clinicians, researchers, and educators to become part of an international network of professionals in the field of cancer nursing by joining as individuals. Membership fees are reduced for nurses in low- and middle-income countries. Globally, ISNCC members represent more than 60,000 cancer nurses.
ISNCC has continued to work to build and sustain stakeholder relationships and to ensure the ongoing success of these relationships in work internationally. Critical to the success of ISNCC are strategic partnerships. ISNCC is a member of the Union for International Cancer Control and a specialty member of the International Council of Nurses. ISNCC has formal memorandum of understanding agreements with the Oncology Nursing Society, the European Oncology Nursing Society, the Asian Oncology Nursing Society, the Multinational Association of Supportive Care in Cancer, and the International Psycho-Oncology Society.
ISNCC also has formal international liaisons with the African Organization for Research and Training in Cancer and the Lymphoma Coalition, and is a member of the Global Non-Communicable Disease Alliance.
ISNCC is engaged in various international initiatives with a focus on advancing and applying knowledge and influencing health policy. ISNCC facilitates this work through the development and engagement of cancer nurse leaders and via its international network of professionals in the field of cancer nursing. To achieve its mission, ISNCC (2015c) is working to advance four strategic goals: (a) building and sustaining stakeholder relationships, (b) influencing health policy, (c) advancing and applying knowledge, and (d) developing and engaging cancer nurse leaders. The work of ISNCC is organized by six portfolio committees; the leaders of each portfolio serve on the Board of Directors. Although all committees collaborate to achieve the strategic mission of ISNCC, two committees take the lead in developing position statements: the Knowledge Development and Dissemination Committee and the Policy and Advocacy Committee.
Position statements are consensus documents that provide a summary and analysis of a current issue or problem with recommendations that oncology nurses can use to address the problem directly or through advocacy. Statements are developed (or updated) by an appointed task force of oncology nurse experts who are called to volunteer through ISNCC’s membership communication. The draft statements are officially reviewed by the committees and formally endorsed by the Board of Directors and, if applicable, partnering organizations. Specific criteria are used to evaluate whether a statement is reflective of the global burden of cancer and based on current best practice. Position statements are intended to be applicable, culturally and ethically acceptable, and achievable in multiple contexts, including low-, middle-, and high-resource countries and among marginalized and low-literacy populations within those countries; hospital and community care settings; and urban and rural settings. Reviewers also assess whether any potential barriers to the acceptance of the statement in the wider cancer nursing community exist. In the past two years, three important statements have been released.
Role of Cancer Nurses in the World Joint Position Statement
Several oncology nursing societies collaborated to develop a joint statement for World Cancer Day 2015. Using the tagline “not beyond us,” World Cancer Day 2015 took a positive and proactive approach to the fight against cancer, highlighting that solutions exist across the continuum of cancer that are within reach. The Asian Oncology Nursing Society, the Canadian Association of Nurses in Oncology, the Cancer Nurses Society of Australia, the European Oncology Nursing Society, ISNCC, and the Oncology Nursing Society jointly developed a position statement on the role of cancer nurses in the world. The statement notes the following:
The growing demand for cancer care, from prevention to palliative care, along with rapidly changing healthcare systems provides opportunities for cancer nurses to play a pivotal and increasingly important role in delivering high quality, safe, effective and efficient healthcare to people affected by, or at risk for, cancer. As the largest group of healthcare providers globally, in most countries around the world nurses are the backbone of the health care delivery system. (ISNCC, 2015b, para. 2)
High quality care across the cancer continuum requires nurses be properly educated to gain knowledge, skills, and competencies unique to cancer care. Cancer content needs to be integral to basic curriculum, along with opportunities for specialization at various post-graduate levels. In a rapidly changing healthcare environment, opportunities for continuing education will ensure that nurses remain current in best evidence-based practices. It is pivotal to include education and research in cancer nursing as a political agenda priority. (ISNCC, 2015b, para. 3)
Tobacco Position Statement
In July 2014, the ISNCC released a revised tobacco position statement. The tobacco task force reviewed and updated the previous position statement, originally released in 2009. The Knowledge Development and Dissemination Committee provided review and comment.
The statement reviews the significant impact of tobacco use on health. The statement notes that “by 2030 more than 8 million people will die annually because of tobacco use; 80% in developing countries” (ISNCC, 2014, para. 2).
Nurses are essential to delivering evidence-based interventions to reduce tobacco use. Nurses must also continue to assume leadership in influencing tobacco control policies in their communities and countries. An important addition to the statement addressed increase in the marketing and availability of electronic nicotine-delivery devices, also known as electronic cigarettes or electronic hookahs. ISNCC integrated recommendations from the World Health Organization that nurses should advise consumers to not use these products until additional data are available. It has been endorsed by the Oncology Nursing Society and the Cancer Nurses Society of Australia.
The tobacco position statement led to a joint press release on World Tobacco Day 2015 that focused on highlighting the important role of nurses in combating the tobacco epidemic. The press release was cosigned by several ISNCC member organizations.
Position Statement on Palliative Care
In October 2015, ISNCC released its first position statement on palliative care. Palliative care was identified as a priority topic for oncology nurses internationally at a focus group held in conjunction with the International Conference on Cancer Nursing in Panama in September 2014. The Health Policy and Advocacy Committee developed the statement. The Knowledge Development and Dissemination Committee provided a review and comment before the statement was reviewed, revised, and endorsed by the ISNCC Board of Directors. The statement was released on October 10, 2015, to coincide with World Hospice and Palliative Care Day, which celebrates and supports hospice and palliative care around the world. The theme for 2015 focused on patients who live in unique conditions and often struggle with access to palliative care. The aims of the statement included the following:
• “To integrate a palliative approach into the comprehensive care of cancer patients, in accordance with need.
• “To acknowledge and recognize the unique and critical role of the cancer nurse in assessing and addressing cancer patients’ and their caregivers’ palliative care needs.
• “To support cancer nurses to adopt an evidence-based, palliative approach to support cancer patients and their caregivers across the entire trajectory of illness” (ISNCC, 2015a, para. 1).
These position statements have served to provide oncology nurses with a united voice at important times for advocacy on cancer prevention and control issues, but the potential use of these statements is much greater. All ISNCC member organizations and individual oncology nurses should consider endorsing, adopting, and implementing the recommendations embedded in these statements for educational and advocacy use in their own country, region, or organization.
International Society of Nurses in Cancer Care. (2014). ISNCC tobacco position statement. Retrieved from http://bit.ly/1UOmf6O
International Society of Nurses in Cancer Care. (2015a). ISNCC palliative care position statement. Retrieved from http://bit.ly/23KNe9A
International Society of Nurses in Cancer Care. (2015b). Position statement: The role of cancer nurses in the world. Retrieved from http://bit.ly/1uVJY7t
International Society of Nurses in Cancer Care. (2015c). Strategic planning. Retrieved from http://www.isncc.org/?page=StratPlan
Stewart, B.W., & Wild, C.P. (Eds.). (2014). World Cancer Report 2014. Lyon, France: International Agency for Research on Cancer.
About the Author(s)
Beck is a professor and Robert S. and Beth M. Carter Endowed Chair in the College of Nursing at the University of Utah in Salt Lake City and a member of the International Society of Nurses in Cancer Care (ISNCC) Board of Directors; Bialous is an associate professor in residence in the School of Nursing at the University of California, San Francisco and the president of ISNCC; and Ben-Gal is a pediatric palliative care services coordinator in the Schneider Children’s Medical Center of Israel in Tel Aviv and a member of the ISNCC Board of Directors. No financial relationships to disclose. Beck can be reached at firstname.lastname@example.org, with copy to editor at ONFEditor@ons.org.