Specialist Oncology Nurse, Sweden

I´m on my way to the inpatient ward. I have been a cancer nurse for more than 25 years. I dare say that I am “super-skilled”, and I love my work. Today feels just like any other day in the ward, but yesterday they said that we must manage more patients per nurse, and I feel anxiety in my stomach.

Yesterday a younger colleague asked for help, and I felt such hopelessness and despair for her. When I am not there, they have no one who can teach them or that they can look to as a role model. The most critically ill cancer patients in our ward are now cared for by some of the most inexperienced nurses.

We are constantly told that we must work more efficiently. But that won't turn this situation around. Five newly graduated nurses are not the same as five experienced specialist nurses. And we also hear that there won’t be enough new ones in the future. Nurses like me have advanced tasks, with independent referral, follow-up, and more responsibility. I am not a “mini physician”. I am a highly specialized nurse. We have no legal or regulated mandate to work as advanced practitioners, and now due to the workforce crisis, it is unlikely we will be able to advance our careers.

The workforce crisis is not limited to nurses, but since we are the largest group of cancer care professionals it is crucial to attract the younger generation and to retain those already in the profession.

Cancer care is not the same as it once was. For example, I used to have patients mostly in follow up, but now the majority receive adjuvant immunotherapy and we as specialist nurses have a larger workload, despite the same number of patients.

I think we need to be brave and continue as we started during the pandemic; use digital tools, be precise in assessing patient needs and follow-up, and choosing the appropriate treatment. We need to be precise in choosing who should have treatment and when to stop. From my perspective, we learned a lot from the pandemic but not enough to ease the burdens on me and my colleagues, burdens we feel intensely.