Oncology
Style of Care
Play Therapy
There is one play therapist working in Camperdown ward who works with children 2-17 years of age. Each week priorities have to be made to cater for the varying needs of children who come into the ward. Referrals are taken from the nursing staff and other members of the team.
The Play therapy program works towards minimising the stress and anxiety felt by many children when they have to stay in the hospital. Children's normal development can be delayed due to a serious illness because they are missing out on school and other experiences that are pertinent to a child's global development. Play therapy can assist with children by providing opportunities to gain a sense of mastery, play, learning, self-expression, family involvement and peer interaction.
Team work with nursing staff:
- Supporting nurses with distraction equipment/resources (bubbles, videos, games etc, relaxation music) for procedures.
- Making reward charts/systems to help them to encourage children to take medicine etc.
- Answering their referrals when they feel a child needs some support
Passing on play therapy/child development information for nursing assignments.
I encourage nurses to participate in play therapy with the children in Camperdown ward as much as possible. I am also very in interested to form a small committee with nurses interested in medical play and play therapy to work on a few projects together. This includes working on joint journal articles and developing an education program/book for children coming into Camperdown ward (to learn about their time in hospital , their illness, medical procedures, ways to help further with fear and anxiety associated with being in hospital etc).
Dietician
Adequate nutrition is very important to decrease morbidity and mortality in oncology patients.
The role of the dietician who covers Oncology and Bone Marrow Transplantation at CHW includes:
- Identifying patients at risk of malnutrition or who are already malnourished by conducting individual nutritional assessments.
- Nutritional education and counselling for patients and their families (for issues such as failure to thrive, enteral feeding, nutritional management of oncology treatment side effects such as mucositis, diarrhoea, constipation, steroid induced obesity).
- Monitoring nutritional rehabilitation and growth.
- Educating staff about nutritional therapy.
The dietician participates in daily ward rounds as a means of liaising with other oncology staff. The dietician and nursing staff work closely together to monitor oral intake, monitor tolerance of nutritional support (oral, enteral or parenteral), perform anthropometric measurements, initiate and grade up enteral nutrition support and review compliance to nutritional therapy.
Social Work
 There are 5 social workers working in Oncology. We have chosen to work in this area because although it is demanding work, it is also satisfying. We work closely within the multidisciplinary team to provide a complete service and to support one another. Each social worker is 'buddied up' with a staff specialist in Oncology.
All children are linked to a social worker at the time of diagnosis and that social worker is available to assist them throughout their treatment and beyond. Our aim is to minimise the impact of the illness and hospitalisation on the child and family. We offer counselling to individuals and families, and run groups (for example, Soulmates, our support group for bereaved families, and our Siblings Day programs). We advocate on behalf of our families, provide psychosocial education and make referrals to, and liaise with, community services and resources. Social workers attend and contribute to the weekly Multi Disciplinary meeting. We participate in case conferences contributing psychosocial information relevant to case planning or management.
We believe that the multidisciplinary team roles complement each other. Working as a team ensures a high standard of service delivery and also enables mutual support among team members. We appreciate the expertise of nurses and feel that our expertise is acknowledged in return. In working together we can discuss mutual concerns about children or families. As nurses have 24 hour contact with patients and families we appreciate being informed about changes in family circumstances or about specific issues which can be distressing to families. Social workers are available to provide in-service lectures about psychosocial issues and about our work with patients and families.
As part of Oncology Allied health, social workers work together with other Allied Health members. We meet with other Oncology Allied Health staff regularly for case discussion and support.
Psychologists
I am a clinical psychologist working in oncology since 1989. I often receive referrals from nurses in the ward and clinic and we discuss patients/families from time to time. Last year I attended a couple of nursing hand-over meetings at the request of the NM or other senior nurses, to facilitate discussion of deaths on the ward. I think providing non-judgmental support to one another and an opportunity to talk about reactions to patients and families is important. I also did the critical incident training and plan to attend the meetings that are held twice a month to review incident reports. I offer help with anxious and depressed patients and parents, conduct assessments and therapy, (including what I like to call 'therapeutic conversations'). My office is in the clinic and I see people referred as soon as I can. I am facilitating a parent/carer discussion and support group that meets weekly in school term. Nurses remind parents about the meeting and encourage them to attend.
Occupational Therapy
Occupational therapy aims to enhance the overall performance of children who are limited by the effects and treatment of cancers and hospitalisation. The therapists review how oncology treatments affect mobility, productivity, play and rest. The therapists aim to help patients adjust and adapt to everyday tasks, including the use of adaptive aids; to review pain management; to develop concentration and other tools to help learning and development; through play to express themselves and their feelings and use relaxation techniques to gain a greater sense of calm and well being.
Integrated Clinical Services
When the various teams who provide patient care work closely, communicate well, share leadership and respect each other's expertise and contribution, patient care is better. This is why it is important to further integrate our clinical services.
The Hospital has embarked upon a project looking at Integrated Clinical Services in our environment and ways we can improve.
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