To develop a model of care for nursing patients in Australia with a diagnosis of breast cancer

Health and Medicine
To develop a model of care for nursing patients in Australia with a diagnosis of breast cancer featured image
Prior to 1999, the breast care nurse (BCN) rolewas not recognised as a ‘stand alone’ role within the Australian health care landscape. The duties of care coordination and the supply of prosthesis and bras post operatively for breast cancer patients were absorbed by registered nurses employed within surgical or oncology units.  The first BCN conference was held in Canberra in 1998 and solidified the need for the BCN role to be an independent role whose focus was to care for people following a breast cancer diagnosis.  In the early 2000s, the National Breast Cancer Centre (now Cancer Australia) released a suite of publications relating to breast cancer clinical care along with the BCN model of care and competency standards. During this time the diagnosis rate for breast cancer was one in twelve women, with 10,000 cases per year with little to no mention of male breast cancer or metastatic breast cancer. This model of care (MoC) demonstrated that the BCN provides patient support, information and care over five planned visits within a twelve week timeframe from diagnosis to the post operative phase.  The role of the BCN is extending and expanding and the McGrath Foundation have now placed over 130 BCN in communities across Australia. Independent evaluations of the McGrath Foundation BCN initiative supports the view that McGrath BCNs (MBCNs) are a complementary service that provides a valued role within cancer care teams, and delivers an improved patient experience. A new MoC is required to define the delivery of breast cancer services in Australia. The current diagnosis rate in one in seven women and there is a growing recognition of male breast cancer and metastatic breast cancer. The guiding principles of a new MoC are that it is patient centric, has localised flexibility and considers equity of access, supports integrated care, supports efficient utilisation of resources, supports staff, quality care for patients, has a robust and standardised set of outcome measures and evaluation processes, is innovative and considers new ways of organising and delivering care and sets the vision for services in the future.  Attending breast cancer clinics with BCNs and Nurse Navigators in Canada and the US allowed me to observe key points for discussion with patients, especially key points for discussion, such as advanced care planning, diagnosis and prognosis discussions, emerging treatments and wellness and survivorship. An added benefit of attending other Cancer Centres was seeing the collaborative approach they employ across the entire multidisciplinary team and empowering patients to use resources and make contact as required. Keywords: Breast cancer, model of care, Australia, best practice, nursing, McGrath Foundation, Breast Care Nurses, multidisciplinary team, patients, communication, care coordination, diagnosis, cancer treatments, Nurse Navigators  Awards and Honours 2017 awarded Public Service Medal for outstanding public service to community health in the Australian Capital Territory. 


Kerryn Ernst

Kerryn Ernst


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