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Building a Sustainable and Resilient Cancer Nursing Workforce: The Power of Story

Yates, Patsy PhD, RN, FACN, FAAN

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doi: 10.1097/NCC.0000000000001115
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Last week, I was privileged to conduct a series of interviews with 4 leaders in cancer nursing from different parts of the world. The interviews were presented as part of the final session of the virtual International Conference on Cancer Nursing that was hosted by the International Society of Nurses in Cancer Care. The aim of the session was to explore these nurses’ perspectives on the impact of the COVID-19 pandemic on nurses and people affected by cancer, as well as what needs to be done to ensure a sustainable nursing workforce as we face the growing burden of cancer across the globe.

The first interview was with Johan De Munter, nurse manager at the University Hospital Ghent Cancer Center and current president of the European Oncology Nursing Society. A key message from his interview was that cancer nurses’ expertise in areas such as infection prevention and supportive care and our flexibility and adaptability have been important resources for the health system during the pandemic. He commented that these skills enabled nurses to play a key role in accelerating important reforms to our health systems, reforms that should be retained in the future.

The second interview was with Mulugeta Wassie, lecturer of clinical oncology nursing at the University of Gondar, Ethiopia. Mulugeta explained that Ethiopia had a scarcity of resources even before the pandemic and that the pandemic exposed such challenges even further as nurses had limited access to basic personal protective equipment and water in some settings. He explained that the emotional impact of the pandemic on nurses was significant, as they faced high workloads and were sometimes separated from family for months. He also explained that many nurses were stigmatized because they worked in a hospital setting.

The third interview was with Mohammad Asif Hussainyar, a nursing instructor and research coordinator at the Aga Khan University Academic Projects, Afghanistan, and a board member of the Afghanistan Nurses’ Association. Asif explained that not only did nurses in Afghanistan have to deal with a pandemic, they also faced challenges associated with the concurrent collapse of government systems. As a result, he said that nurses’ workloads increased dramatically and that many did not receive salaries for several months.

The final interview was with Howard Catton, chief executive officer of the International Council of Nurses (ICN). Howard similarly emphasized that the pandemic was translating into negative impacts on the health of the nursing workforce. He referred to a recently released ICN report on data that conveyed a deterioration in many indicators of the health of our workforce, such as sickness, absence, retention, intention to stay, and intention to quit. He also described how deficiencies in our health systems, such as lack of equipment and lack of support, where nurses feel they cannot give the care that is needed, can lead nurses to experience moral injury. He argued that the existing and projected future workforce shortages should be considered a global health crisis.

The challenges that all speakers described were substantial and overwhelming. I explored with each of the speakers their perspectives on what we need to do to ensure we had a sustainable and resilient cancer nursing workforce. Their responses provided important insights as we rebuild our health systems following the unprecedented stressors over the past 2 years.

First, a common theme in their responses was that it is critical that we look at the systems in which we work if we are to ensure a sustainable workforce. This means safe and supportive work environments with adequate resources and safe staffing levels. It is simply outrageous that nurses in any work environment today can be exposed to safety risks.

Whereas some of us have access to high-quality nursing education programs, that is not the case for cancer nurses working in many parts of the world. One of the recurring themes throughout the interviews was that cancer nurses have unique skills and expertise that are essential to keep our healthcare systems functioning and our patients safe. Yet nurses in many countries across the world do not have the benefit of education to enable them to fulfill their role to its potential. How can we continue to waste one of the most important resources in our health system?

The power of the collective was another insight shared by the interview panel. National and international nursing associations and alliances with other relevant groups were seen as important vehicles to advocate for a sustainable nursing workforce. Actively participating in and supporting the work of such societies was seen as essential to give nurses a voice at decision making tables.

The power of story was also highlighted by the interview panelists, who encouraged us all to widely share what nurses do and what impact this has on people and communities. In his role as chief executive officer of ICN, Howard Catton described how important it is in our stories to make links between what nurses do and the impact this work has on the health of our communities.

The future of healthcare, especially in the context of our complex cancer care systems, is fundamentally dependent upon a sustainable and resilient nursing workforce. The stories of the 4 nurses I interviewed for the conference is strong evidence of the power of story. Their stories left me feeling inspired and empowered, a great boost as we look to the future following 2 years of this most devastating pandemic.

Notes: For Access to the Virtual Library Sessions from the 2022 International Conference on Cancer Nursing, please go to

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