HEPL

Course of oncology of 3rd GN and course of biophysical radio

Resulting of this, future graduated nurses will have to :

• Ensure the complete care of both the person being treated and his family, and this taking into consideration the know-how, the knowledge-to be and eventually the knowledge-to-become.
• Be able to plan and manage an information and education plan dedicated to the patient and his relatives.

General overview about radiotherapy.

Full care of a patient treated by :

• External radiotherapy
• Brachytherapy
• Curietherapy
• By sealed no sources
• Total body irradiation

Protection and education actions aimed to:

• The family
• The patient
• The team.

PRUDHOMME Ch., JEANMOUGIN Ch., MOREL N., Processus tumoraux, éd Maloine, 2009.

MAZERON J.J., MAUGIS A., BARRET C., MORNEX F., Techniques d'irradiation des cancers, éd. Maloine, 2005

HOERNI B., MORTUREUX A., KANTOR G., Cancérologie - Hémopathies, Nouveaux cahiers de l'infirmière, éd. Masson, 2007.

IFSI, Réussir son Evaluation en Soins Infirmiers en Hématologie et Cancérologie, éd. Estem, 2007.

Medical nursing care ( 2^nd and 3rd years) + pharmacology + solid tumors and hematology (4th Oncology).

To deal globally with patient ( as well at the technical, physical, spiritual, psychological or social level), treated by chemotherapy, immunotherapy, and/or hormonotherapy.

To react correctly when faced to patients in remission, in relapse or cured.

The student will be made sensitive to the approach of the cancer children as some treatments require a hospitalization in the services of adults.

Introduction

Prerequisite and specific additional to the following care :

· Hemoculture

· Bloodletting

· Marrow puncture and marrow biopsy puncture

· Blood taking away by central way

· Blood transfusion

Cytostatics

The care in sterile unit.

The care in daily hospital

Hormonotherapy

Immunotherapy

The unit of rehabilitation

Announcement of the diagnosis, cure, remission, relapse: nursing role

· Nursing care in pediatry ( cancer children)

· The patient with hemopathy, osseous metastases, abdominal metastases, cerebral metastases, cancer of otorhinolaryngology sphere

Nursing diagnoses : tiredness, ineffective assumption of responsability of the therapeutic program, feeling of powerlessness, compromised strategies of ineffective family adaptation, loss of hope, non constructive refusal.

MAROLLA M., GUERIN R., Oncologie et soins infirmiers, Lamarre, 1996.

Guide pour l’administration et la surveillance de la chimiothérapie cytotoxique, Centre REGAUD C., Toulouse.

ZELEK L., KHAYAT D., Guide pratique de cancérologie, Médiguides, 1994.

DALY-SCHVEITZER, Cancérologie clinique, Masson, 1998.

LEBEER G., L’épreuve du cancer, sociologie d’une éthique au quotidien, L’université de Bruxelles, 1998.

GORIN, PHILIP, SYMANN, Manuel pratique d’hémato - oncologie et de chimiothérapie, Frison – Roche, 1998.

HOERNI B., MORTUREUX A., KANTOR G., Nouveaux cahiers de l'infirmière, Cancérologie, Hémopathies, Masson, 2007

VARET B., Le livre de l'interne, Hématologie, Médecine-Sciences, Flammarion, 2007

Exposed clinical cases and visits

None

To inform and make the students sensitive to the concepts and the philosophy of the continuous and palliative care as well as to the organizations and structures giving medical care.

To make sensitive to the global assumption of responsibility of the patients and the close relatives by taking into account their needs and their desires.

To make sensitive to interdisciplinary work .

To make sensitive to the assumption of responsibility of discomfort symptoms.

To give food for thought. This course will consist of theoretical talks, of analysis of clinical cases, practical exercises and personal research and reflexions

General points :

• Place of death in social life·
• The history of palliative care·
• Concepts and philosophy of palliative care·
• The quality of life
• Pluridisciplinary team
• Palliative care
• Curative care, continuous care, rehabilitation, palliative care, terminal care
• Structures and organisations
• Associations as regards palliative care

Global assumption

• Patient’s needs
• Comfort

Symptoms

• Pain
• • Chronic pain-global pain

o Fundamental principles of treatment

o Pain assessment

o Morphine : administration, side effects, demystification

o Device and particular techniques

o Transmission of information

• Other symptoms

o Respiratory

o Digestive

o General :dehydration, cachexia, asthenia,…

o Mobility

o Unpleasant smells

o Mouth care and wound care

o Agitation, confusion, anxiety

o Affected self image

• The final stage

o Signs showing end of life

o The dying’s needs

o Five meanings of relational life

The nursing role in the psychosocial assumption : psychologist’s role

The nursing role in relation with philosophical and spiritual needs

The family and closest relatives

o Inform, educate, support

o Guide through accompaniment

o Accompaniment in bereavement

o Support structures

Integration of knowledge in his unit

o Resistance to this kind of approach

o Support of the nursing team

Cancer patients ‘sexuality

o Who do they question ?

o Who answers their questions ?

How can they be supported ?

Clinical cases analysis

Biology and biochemistry of the 1^st year GN.

Revisions of notions of biology

Cancerogenesis

· Physical

· Chemical

· Virological

Cancerology

· Epidemiology

· Prevention

· Detection

· Spreading modes

· Cancerous states

· Diagnosis and extension assessment

· Biological indicators

Paraneoplacic syndromes

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cases analysis

Nutrition and dietetics lessons of 1st and 2^nd year GN..

To transfer theoretical knowledge related to biology, carcinogenesis, pharmacology, cancerous pathologies, treatments practised in the daily assumption of responsability of the concerned patients.

To understand the step of each speaker in order to bring a continuity in the care lavished by these speakers ( speech therapist, physiotherapist, dietician and occupational therapist).

Recall :

· Mode modified in consistency : by probe, liquid, semi-fluid ;

· Hyper-caloric and hyper-protein mode

· Hydration

Loss of weight:

· Anorexia

· Increased needs.

Change of taste

Food of substitution

Mode leukose

Food education of patient for the return to home

Food of the patient in palliative phase

Course of denutrition

Food problems due to the various treatments

Food and prevention of cancerous pathologies.

Les références bibliographiques inhérentes aux différents contenus se trouvent disponibles et actualisées au centre multimédia de la HEPLAV, adresse : 2, quai du Barbou 4020 Liège

self research ; reading of articles.

Notions of human physiology and biochemistry

Course of pharmacology, 2^nd year GN.

Knowledge of the pharmacology and mechanism of action of drugs used in cancer therapy.

Chemotherapeutic agents

Antiemetic agents

Antipyretic agents

Corticosteroids

Hematological growth factors

Antiviral drugs

Antibiotics

Antifungal agents

Classification and mechanisms of action of cytostatic drugs.

Fillet G., Cours d’Oncologie médicale ,1^er doctorat en médecine- ULG

Les références bibliographiques inhérentes aux différents contenus se trouvent disponibles et actualisées au centre multimédia de la HEPLAV, adresse : 2, quai du Barbou 4020 Liège

discussions

Pharmacology and some notions of the course of oncology of 3^rd GN

To transfer theoretical knowledge related to biology, cancerogenis, pharmacology, cancerous pathologies to treatments practised in the daily assumption of responsibility of the patients concerned.

To understand the approach of each speaker in order to bring a continuity in the care lavished by these speakers (speech therapist, kinesitherapist, dietician and occupational therapist).

Pain

· Basic notions

· Definition

· Distinction of pain:

acute pain, chronic pain, neuropathic pain

· Pain estimation

· Pluridimensional model

· Child pain

· Old people pain

Pharmacology and treatment

· Pharmacology of pain

· Antalgics, non morphinic and morphinic, adjuvants

· Non pharmacological treatments : hypnosis

· Invasive treatments: loco-regional blocks, medullary stimulation, pomps

· Characteristics of the assumption of responsibility of pain in palliative care

· Scale of WHO

Clinical cases

Les références bibliographiques inhérentes aux différents contenus se trouvent disponibles et actualisées au centre multimédia de la HEPLAV, adresse : 2, quai du Barbou 4020 Liège

cases analysis

None

To transfer theoretical knowledge related to biology, cancerogenis, pharmacology, cancerous pathologies to treatments practised in the daily assumption of responsibility of the patients concerned.

To understand the approach of each speaker in order to bring a continuity in the care lavished by these speakers (speech therapist, kinesitherapist, dietician and occupational therapist).

1st part: rehabilitationt in physiotherapy

Indications of the physiotherapy treatment among patients suffering from cancer

Different types of treatments

· Massage (types + aims)

· Mobility (types + aims)

· Relaxation (aims)

Relation physiotherapist and nurse with patients suffering from cancer

2nd part: rehabilitation in occupational therapy

Definition and status of occupational therapist

Presentation of the C.I.F. to show the importance of multi-field work in oncology.

Process of occupational therapy in oncology, palliative care

3rd part: rehabilitation in speech therapy

Physiology of the voice, of swallowing, of breathing.

Pathology of the voice and swallowing, vocal results and possibilities of food recovery after surgery.

Breathing principles according to the cannulas used.

Principes of rehabilitation of the voice

· Oesophageal

· Tracheo-oesophageal

· After C.H.P. and C.H.E.P.

· Hemi-laryngectomy

· Cordectomy through endoscopy

Primary and secondary wrong ways

Mechanisms and principles of rehabilitation

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Practical activities, lectures and realistic situations.

Surgical pathology ( 2^nd and 3rd years).

Transfer knowledges of tumor biology, pharmacology, cancer genesis, clinical cancer pathology and cancer treatment with special regards to the daily care of the patients.

Principles of oncological surgery

Techniques of loco-regional chemotherapy

Principles of treatment of colorectal cancer

Principles of treatment of oesophageal and gastric cancers

Principles of treatment of liver and pancreas cancers

Principles of the follow-up of abdominal cancers

Principles of treatment of urinary tract and prostate cancers

Principles of treatment of breast and skin cancers

Principles of treatment of superior respiratory and digestive tract cancers

Principles of treatment of central nervous system cancers

Principles of gynecological cancer treatment

Les références bibliographiques inhérentes aux différents contenus se trouvent disponibles et actualisées au centre multimédia de la HEPL, adresse : 2, quai du Barbou 4020 Liège

None

Transfer of theoretical knowledge linked to tumor biology, cancer pathology and radiation therapy into practical daily care of specific patients.

From prognosis to treatment options :

· Importance of histological proof

· Pathological prognosis

· General condition – Coding

· Evaluation of prognosis

· Treatment choice

· Patients and physicians information

Radiation therapy :

· Definition and importance

· Physics

· Biology

· Radiosensitivity and radiocurability

· Radiation safety

· Terminology

· External radiotherapy

· Brachytherapy ( sealed and unsealed sources )

· General indications of radiotherapy

· Practical care: external irradiation

· Peculiar indications of brachytherapy

· Observation during treatment

· Observation at the end of treatment

· Late effects

After treatment :

· Follow-up / recurrence

· Second cancer

Quality of life

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cases analysis

Immunology, Pathology, Anatomy courses of 1^st, 2^nd , 3^rd GN

Transfer knowledges of tumor biology, pharmacology, cancer genesis, clinical cancer pathology and cancer treatment with special regards to the daily care of the patients.

Hormonotherapy

Immunotherapy

Prostate cancer

Breast cancer

Ovarian and testis cancer

Bowel cancer

Skin cancer

Lung cancer

Palliative approach

Child neoplasms

Les références bibliographiques inhérentes aux différents contenus se trouvent disponibles et actualisées au centre multimédia de la HEPL, adresse : 2, quai du Barbou 4020 Liège

Anatomy, Pathology, Pharmacology

Transfer knowledges of tumor biology, pharmacology, cancer genesis, clinical cancer pathology and cancer treatment with special regards to the daily care of the patients.

To understand the approach of each speaker in order to bring a continuity in the care lavished by these speakers (speech therapist, kinesitherapist, dietician and occupational therapist).

Side effects of chemotherapy

Chronic myeloproliferative syndromes

Acute leukemia

Grafts

Lymphoms

Chronic lymphoproliferative syndromes

Hemato-oncological urgencies

Les références bibliographiques inhérentes aux différents contenus se trouvent disponibles et actualisées au centre multimédia de la HEPL, adresse : 2, quai du Barbou 4020 Liège

Lectures of previous years.

The general purpose of this lecture is to provide to the students the legal bases which will enable them, in their professional life, to assist the patient and his family to understand the legal and social aspects  linkend to the disease.

1. The civil and criminal liability.
2. The professional secrecy.
3. The disease and the labour contract.
4. The disease and the social security(wage earner worker and independent worker).
5. Differents leaves which the sickperson and his circle of family are entitled to apply for,in particular the leave for palliative.
6. The disease and the legal capacity.

General psychology course of 1^st, 2^nd and 3^rd GN; Courses of help relationship and communication.

Observe, listen and help the patient and his family. Identify and be able to express his personal emotions concerning illness and patients.

Listening, communication and ethic questions

The cancer, the patient and his family

· Psychological aspects of illness

· Anxiety ( about illness and death)

· Psychological factors to “fight” against cancer

· Effects of illness on patient and family life

The helping relation

· With the patient

· With the family

· With the children

· The active listening

· The language of body and non-verbal communication

Death

· Ethic questions in oncology

· Accompanying the patient at the end of his life

· The process to protect himself from illness and death

· Palliative care

· Bereavement

Stress and pain of nurses

· Nurses in front of illness, pain and death

· The process to protect oneself

Team working

Discussions. Cases study.

None

To acquire notions of sociology in direct relation with the professional practice : the social representations associated to cancer, the social inequalities faced with health, the cultural dimension of health behaviors, the funeral rituals, ...

To nurture a reflection on social behaviors in order to better understand mechanims that underlie our society.

The social representations associated to cancer

The social inequalities faced with health

Ways of life and prevention of cancer

The hospital facing the cultural diversity

The funeral rituals

No main reference book; but a lot of book abstracts, articles, feature articles, ...

Clinical experience and 1st, 2^nd and 3rd year courses of GN.

Integrate theoretical theories necessary to take on adult and child (only sterile department) patients whatever the stage of the cancer

Placement in departments of

· Surgery

· Radiotherapy

· Palliative care

· Day hospital

· Sterile department

Hemato-oncology department

reports

Poisson, Mémoire de fin d’études infirmier, Maloine, 1998

courses of principles of care (4 oncology)

courses of pathologies (4 oncology)

On base of a fictitious clinical case, to analyze, to interpret and to draw up the plan of care of a patient presenting an oncological pathology.

any

any

Course of anatomy, physiology, general nursing care and general pathology

To apply theoretical knowledge of physics, radiobiology and protection against radiation in the patients care in order to ensure good quality X-rays examinations.

General information: definition, goals, organisation, hazards and contraindications of medical imagery

specific nursing role relative to the type of imagery and examination, especially patient preparation and surveillance

JOFFRE et GIRON, Guide du manipulateur en imagerie médicale. Ed Axone, 1989

To review to the various techniques of medical imaging

1^st part :physics and quality control

• Radiotherapy, simulation
• X-rays imaging
• Quality control of machines and treatments
• Dosimetric units of ionising radiations

2nd part: legislation and protection against radiation

• Definition and legal framework of radioprotection
• Basic principles of radioprotection
• Radioprotection measures towards the patient and the nurse

Course of deontology of 1st and 3rd year

The future professional will be faced to the care of a cancer patient and his family. This will lead him (her) to face situations requesting both ethical and deontological reflection. To educate the future professionals in these situations and allow them to make a reflexion.

Deontology, ethical or moral.

Concept of quality of life.

The nurse and the die with dignity

The prolonging life by technological means

The living will

Euthanasia

Cancer patient’s rights

The specific ethical problems related to cancer

The ethics commitees.

The clinical research / data manager

The spiritual distress.

Ethica Clinica, pertinence et piege de l'éthique, décembre 2004

Ethique et santé,2004, Masson, Paris

Jouranl européen des soins palliatifs, 2005; 12(3)

HERON ( J.F.),Cancérologie générale, Caen, septembre 2006

ROUGERON ( C.), résumé du cours du jeudi 1 mars 2001

KIIBLER- ROSS, " rencontre avec les mourants, Laennec 1974, p10

Références d' ABIVEN M., de JOMAIN C., AURENCHE S

Différents textes de loi. Articles divers. Symposiums...

http://www.adm.be

Cases analysis

Hygiene 1st year

Global understanding of :

- the different specific treatments of cancer patients;

- the infectious risk;

- the different responsible agents;

the details related to their prevention.

The infectious risk in oncology

The infectious details in oncology

The protocols, specific procedures

The specific isolations.

GORIN NC, PHILIPT ., SYMANN M., Manuel pratique d’hémato cancérologie et de chimiothérapie, Frison Roche, 1996.

Revues : La Presse Médicale, Hygiène en milieu hospitalier…

Interactive expositions

Health education of hte 2^nd and 3rd year GN

To know the prevention interventions of cancer.To develop a critical mind towards advertising and information conveyed by the media

Introduction :

• Implication of the nurse in the prevention of cancers: educational role
• Recommendations of WHO as regards health and prevention of cancer.
• Implication of Belgium in the programmes of health promotion.
• Concept of preventive medicine.

Primary prevention:

• Definition.
• Concepts of epidemiology
• Factors favouring cancer
• European Code of cancer
• Encountered problems.

Secondary prevention:

• Definition.
• Organised mass detection.
• Chance detection
• Encountered problems.

Tertiary prevention

• Definition.
• Early diagnosis
• Encountered problems.

Charte de promotion de la santé d’Ottawa, OMS, 1986.

Programmes nationaux de lutte contre le cancer, OMS, 1996.

Brochures de l’Association contre le cancer : Environnement et cancer, 1997 ; Alimentation et cancer, 1998 ; Mieux comprendre le cancer, 1998 ; 100 réponses à vos questions sur le cancer, 1993; Livre blanc de la lutte contre le cancer en Belgique, tome 1, bilan et perspectives, 1994.

Cahier de l’Institut Royal de Gestion des Ressources Naturelles et des Technologies propres, Cancer et environnement, 1998.

Experts talks.

Course of imagery of 2^nd year

To acquire new theoretical knowledge as regards diagnosis of the most frequent cancers in order to optimize its functions:

• of communication (target information)
• technical (attendance to medical performance)
• of organization and management (planning of the examinations and coordination interservices)
• of applied research (case study).

Common examination for the diagnosis of :

· Brain cancer

· Breast cancer

· Womb cancer

· Ovary cancer

· Digestive tract cancer

· Lung cancer

· Kidney cancer

· Bladder cancer

· Prostate cancer

· Testis cancer

Nursing role :

· In the physical and psychological preparation

· During the examination

· During the supervision

· During the announcement of results

Meeting xith the female committee

Visit of the mammobile and prostamobile

MAROLLA M., GUERIN R., Oncologie et soins infirmiers, tome 3, Lamarre, 1996.

ZELEK L., KHAYAT D., Guide pratique de cancérologie, Médiguides, 1994.

Guide du cancer, brochure de l’ A.C.C., 1992.

Registre national du cancer.

Visiting

Nursing care of 1st, 2^nd, 3rd GN

Resulting of this, future graduated nurse will have to :

• Ensure the complete care of both the person being treated and his family, and this taking into consideration the know-how, the knowledge-to be and eventually the knowledge-to-become.
• Be able to plan and manage an information and education plan dedicated to the patient and his relatives.

Introduction : various types of surgery

The surgery diagnosis: biopsies, endoscopies, radioscopies

Oncologic wounds : problems specific to the cicatrization, odors and treatments

The pain: “invasive” techniques

Treatment by hyperthermia

Surgery by specialities: centre, gynaecological, urologic, digestive, otorhinolaryngologic,...

Processus tumoraux, PRUDHOMME Ch., JEANMOUGIN Ch., MOREL N., éd Maloine, 2009.

Les Nouveaux Cahiers de l’Infirmière : Cancérologie - Hémopathies, Ed. Masson, 2007.

Module pratique Cancérologie, Coll. Dr D. Mallay, Ed. Estem, 2001.

cases analysis