Khayelitsha Breast Course for Nurses

Our recent Breast Course for Nurses was held at Khayelitsha District Hospital (KDH). The participants were mostly nurses working in the primary clinics that refer to KDH. Although all the
courses we have run are different, there were a number of administrative changes to this course.

We have partnered with the African Cancer Institute, based at Stellenbosch University. The partnership will allow us to be more effective nationally and also quantify the impact our course is having. Prof Sewram opened the course and spoke about the importance of local research into breast cancer. Without data and effective research, we are unable to advocate for the change needed to see more access to care.

The lectures on the first day were given by a variety of speakers: myself, Dr Austin Goliath (surgeon working at KDH) and Dr Britta Dedekind. The afternoons lymphoedema session was run by Jen Dunn from the Lymphatic Therapy Centre in Durbanville and Linda Greeff who once again brought all her energy and knowledge to the course.

We started the second day with an "assessment".  Instead of assessing individual nurses, we looked at the clinic knowledge. One of the aims of the BCN (and the PEP foundation) is to promote understanding about breast changes and management of breast problems to all who work in a clinic and not focus on an individual health care worker.  We plan to run annual BCN in KDH and so assess the clinics each year to see what impact our course has had. Dr Anne Gudgeon (a breast cancer expert and breast cancer survivor) was our "patient". In the evening, we were discussing the day and she made comment to me that she felt "cared for" by all the nurses who examined her. An ongoing challenge of the course is to make it more realistic. For the first time, we had inpatients who were bought from the ward by Dr Goliath.

Many thanks to them for being so accomodating. All of us found it sobering to be reminded about why we were there.

Sr Correia (a wound care expert and the first sister to teach on the BCN) facilitated a discussion about wound care and practical ways of dealing with locally advanced breast cancer. The excellent palliative care session was run by Dr Margie Venter and 4 members of her palliative care team. (A big thank you). The afternoon session was run by Carol and Corneli from Lancet Laboratories. It was a practical session and the participants had a chance to understand the challenges of FNABs and core biopsies.

On the last day, we had 2 new sessions: an excellent talk on down staging breast cancer given by Dr Karin Baatjes and a session on communication given by Elna Sutherland. What I learnt from her session is that LISTENING is not WAITING TO SPEAK!
For most of us working in the public sector, one of our major battles is making the patient journey more efficient and shorter.  We took this opportunity to use all the expertise in the room and finished the day with a discussion about referral pathways.  I hope we will soon have some new initiatives to help make the process faster and more seamless.

Once again, many thanks to all the people involved in making it such a successful course. The course was sponsored by The African Cancer Institute (ACI), Lancet Laboratories and Bard. In particular, our thanks to Dr Austin Goliath, Sr Milanie Bennett and Alecia Louw from KDH, Dr Phillips and Cheryl Steyn (KESS), Prof Sewram, Shane and Claudia (ACI), Carol (Lancet Laboratories) and Dr Germarie Fouche (Family Practitioner at Michael Mapongwana Community Health Centre).

Last but not least: the biggest thanks go to Sr Lieske, who, as usual, had everything and everyone organised!

BCN Khayelitsha Group

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