Feature story

Healing hands

A first-of-its-kind nursing fellowship programme in Assam is building a cadre of professionals trained to offer high-quality cancer care

Sarah Nasir* visits the Barpeta Onco Care Centre in Assam at least three times a month to seek treatment for breast cancer. The 40-year-old gets some relief from the fact that the centre is just 30 minutes away from her home. Before it opened in December 2020, she had to undergo a gruelling four-five-hour journey, each way, to reach the nearest cancer care facility (in Guwahati).

Ms Nasir is one of an estimated 2.25 million Indians who suffer from cancer. A recent World Health Organization report states, more alarmingly, that one in 10 Indians will develop cancer during their lifetime and one in 15 will die of the disease.

An oncology nurse administers treatment at the State Cancer Institute in Guwahati
An oncology nurse administers treatment at the State Cancer Institute in Guwahati

Emergency priority

The extent and immediacy of the cancer emergency in the country is one big reason the Tata Trusts have made cancer care a priority in their healthcare programmes.

Ms Nasir has benefitted from this commitment. She and many other patients from her state depend on a network of cancer centres set up by the Assam Cancer Care Foundation (ACCF), a partnership between the state government and the Trusts. 

Apart from convenience and the quality of treatment she receives, Ms Nasir says she prefers visiting the Barpeta centre for the nursing care it offers. “I feel I am safe in the hands of the nurses here,” says Ms Nasir. “In addition to being excellent professionals, they are very caring.”

The nurses she is referring to are ‘oncology specialist nurses’ (OSNs), professionals who have undergone intensive training as part of a nursing fellowship programme launched by the Tata Trusts and ACCF. This first-of-its-kind programme equips nurses with specialised knowledge and skills in cancer care and treatment.

The nurses at Barpeta and other ACCF facilities have an enormously difficult, and delicate, responsibility on their hands. “From the clinical perspective, cancer is an extremely challenging ailment to deal with,” says Dr Sanjiv Chopra, chief executive of the Trusts’ cancer care initiative. “It calls for a novel and empathetic approach towards patients.”

OSNs will help ACCF bridge a key human resource gap in the 10 cancer hospitals it is establishing in Assam. “Along every step of the cancer continuum, oncology nurses are integral to the delivery of quality, patient-centric care,” adds Dr Chopra. “We felt it was necessary to train local nursing talent so that they can become champions in the cancer care delivery team.”

The nursing fellowship was launched in July 2020 with 12 registered nurses. The 11-month-long programme includes cancer nursing, treatment modalities, palliative care nursing, communication and counselling, and leadership lessons. Kickstarted in Assam, the programme — through which 18 OSNs have been trained in two batches thus far — will eventually be rolled out in other states.

The teaching is done mainly by in-house master trainers and facilitators from the ACCF team. Lending a hand are the Foundation’s medical oncologists, radiation oncologists and palliative doctors — the backbone of the programme — as also doctors from Guwahati and Mumbai and nursing research experts.

At the end of the course, the freshly minted OSNs get placed as mentors or in relatively more responsible roles at an ACCF centre. While the plan was to incorporate both online and offline elements in the fellowship programme, the Covid pandemic and the subsequent lockdowns led to a digital-only module for some time. This posed challenges for those unfamiliar with online platforms but adaption was quick as the modules were made user friendly and faculty was available at all times to guide the nurses.

Despite the Covid pandemic roadblocks, the programme was rolled out successfully and the quality of the training provided has produced a batch of excellent nursing professionals.

An oncology nurse talks to caregivers of patients at the State Cancer Institute
An oncology nurse talks to caregivers of patients at the State Cancer Institute

High-quality care

“The quality of service provided by the nurses here is very good,” says Gajendra Sharma*, a 39-year-old testicular cancer patient who lives in Dhemaji and gets chemotherapy at an ACCF centre. The nurses also counselled Mr Sharma and his family members about the treatment modalities and the ways in which he could improve his psychological well-being.

“Nurses are the most vital link in the clinical care delivery system,” says Dr Sajal Sen, ACCF’s chief operating officer. “Cancer patients need specialised care and attention due to a variety of reasons. There is also the specific psychosocial needs of patients as well as their immediate caregivers. Our objective is to create a large pool of cancer care nurses in the healthcare system for the larger benefit of patients.”

* Names changed

Oncology nurse Smita Chetri with a patient
Oncology nurse Smita Chetri with a patient

Special skills for special needs

I have been a nurse for 20 years but I did not know much about oncology nursing,” says Sabita Sen, an operating theatre nurse at the Dr Bhubaneswar Borooah Cancer Institute in Guwahati. “Enrolling for the nursing fellowship programme was an eye-opener.”

The 44-year-old Ms Sen joined the programme in January 2021 in order to upgrade her nursing skills. “I was always interested in bone marrow transplants and saw this training as an opportunity to learn the key differences in caring for cancer patients,” she says. “What stood out was the theoretical knowledge: it helped me understand the rationale behind surgeries and has made my work in the operating theatre more interesting and meaningful.”

The enthusiasm is shared by 26-year-old Smita Chetri, who works at the State Cancer Institute in Guwahati. “When I was studying to be a nurse, our syllabus had limited information about oncology nursing,” she explains. “After I joined this programme, I got to explore each and every aspect of the field. Having hands-on practical experience in an oncological set up has made learning fun and realistic.”

The training hasn’t always been smooth sailing, with participants having to juggle on-going duties and learning along with assignments and assessments. Ms Chetri is clear the effort has been worth it. “The needs of cancer patients and the care required are very different from that of other patients,” she says.

Ms Sen is upbeat about the contribution she can make locally. “I have been able to enhance my knowledge through the programme, but what makes me happier is that I will be able provide quality services to the people in my area,” she says.