Paediatric ONGOLOGY C.W.M HOSPITAL FIJI Nursing Drawbacks

List of challenges faced by nurses in the unit Family Cultural Barriers Teenage patients Staff Shortages Palliative Care Parent Support Defaulters Follow up care Accommodations Non Compliance of Medication Chemotherapy Schedules

Defaulters Problems are encountered when caregivers do not regard patient reviews Social commitments take priority over the child's follow up

Home visits is preferred Follow up care Home visits is preferred Staff to be specifically assigned to keep track of patients who are still under treatment whilst being discharged or on home leave

Accommodation for distant patient and caregivers Outside Viti Levu zones Patients and Caregivers are mostly affected This leads to the increase in the number of social admissions in the Unit They do not adapt well into relatives homes and usually voice that they feel that they are burdening them more

Non compliance of medication Caregivers are not consistent in ensuring that their child promptly take their medication Patients usually comes back in a worsen state

Chemotherapy schedules There is no proper chemotherapy schedule designed for the unit.

Family cultural barriers The different ethnic groups and religions have different perspective and interpretation of cancer and its treatments which some times contradicts medical interventions making management quite difficult

TEENAGE PATIENTS These age group becomes resistant to some of the medical procedures and most parents allow them to make decision on their own.

Staff shortages One nursing staff / shift Managers in – patients, day cases (reviews blood, chemotherapy) Occasionally do blood transfusion for haematology cases when ward is full Patients needing Barrier Nursing not given due to this issue

Palliative care Pain management

More Involvement from parent support group with difficult cases

Thank you