Tihana Gašpert: Being an Oncology Nurse in Croatia: First Hand Experience

In this interview, Tihana Gašpert will introduce her career path in nursing, discuss oncology nurse job in Croatia, and address the challenges and issues in the healthcare system.

Tihana Gašpert, RN, BSc, MSc, PhD (c). Tihana is a dedicated and highly skilled healthcare professional with a specialization in oncology nursing. With a profound interest in oncology nursing, Tihana took on roles that allowed her to make a significant impact in this specialized field. Subsequently, she expanded her horizons by undertaking a specialization in Oncology Nursing at the European College of Cancer Nursing, further enhancing her knowledge and skills in the intricate field of cancer care.

Currently, Tihana is pursuing a Ph.D. at the University of Maribor, Faculty of Health Sciences, solidifying her commitment to advancing knowledge in the field of oncology nursing and psychosocial interventions.

Adrian Pogacian, MS Psychology, licensed clinical psychologist with executive education in Psycho-oncology, considerable time active in the field of Health Security, holding a degree in Global Health Diplomacy from Geneva Graduate Institute.

Currently, an advocate of Psycho-education in the field of oncology, researcher and associate lecturer with focus on Communication in Cancer Care, Coping with Cancer and Fear of Recurrence, working with young people and their caregivers on self-blame and disease acceptance.

Additionally, co-author of the first Romanian Pediatric Oncology and Hematology Guide Book, Founder of INCKA Psycho-oncology Center, ESO (European School of Oncology) Podcast contributor, Writer and Host Content in Psycho-oncology and Beyond the Cancer Diagnosis Interview Series at OncoDaily, IPOS Fear of Cancer Recurrence Special Interest Group (FORwards) member and IPOS Early Career Professionals in Psycho-Oncology board member.

00:00 Introduction
1:37 Why did you choose to become a nurse?
5:10 Role of an oncology nurse
8:08 Qualities needed to be an oncology nurse
10:33 With whom is it harder to communicate?
14:03 Words of appreciation for nurses
15:42 Lack of nurses in oncology
20:34 AI and nurses
25:59 Tihana’s personal journey
28:40 IPOS Conference 2024

Adrian Pogacian: Hello everyone, nice to see you again at a new interview from the series Beyond the Cancer Diagnosis. Today our guest is Tihana Gaspert, she’s a lead nurse at a nursing home in Croatia and PhD student at the University of Maribor. Tihana thank you very much for accepting our invitation, how are you, how are things going?

Tihana Gaspert: Hello Adrian, nice to see you, thank you for the invitation, I’m really honoured to be a part of your interviews at OncoDaily, I’m really doing good today.

Adrian Pogacian: I’m great, I will start the interview with maybe a common question that I’m asking to all my invitates. Nowadays the oncological medical staff become more and more let’s say diversified, the team is multidisciplinary and the role of the oncology nurses increases a lot nowadays and the question is how or why did you choose to become a nurse in general and oncology nurse in particular?

Tihana Gaspert: Well to answer the question in the most simple way, I never wanted to be a nurse, I didn’t even know what it meant to be a nurse. When I finished my high school I originally applied, put my application for medical school and for my second space I put nursing school because I thought that it is basically the same thing but without the responsibility and the tables turned that way that I wasn’t accepted to medical school and I was accepted to nursing school,

I was really unsatisfied with that, I couldn’t bear myself being in a nursing school and I decided that I’m going to take the first year of nursing school to see what it’s going to be and then take the exams for the medical school again.

But I liked it, I liked it and I never applied for the medical school again, I mean from what I felt was that I’ve always been driven by a desire to help others and to make meaningful impact on their lives but the tables turned that I got into the nursing school and not into medical school and I wouldn’t change it any other way.

Why I became an oncology nurse? Well in Croatia we actually don’t get to choose where are we going to work, they usually ask us where do we want to work, in which clinic or on which ward but during my college I was doing my clinical practice in oncology for a week and I had beautiful supervisors there who basically made me fall in love into oncology, they really showed me all of the benefits or all the things that that can be done in oncology

And I knew when I finished that clinical practice that one day when I get a job that I want to ask for oncology and when I get my first job I ask for oncology the interviewers were a little bit surprised because nobody wants oncology as their first opinion

And I really wanted it and I got it because the oncology nursing is really a place where you can make an impact on patients lives and their families lives during their most challenging times of their lives and also the field of oncology is now constantly evolving with new both treatments and research which keeps me intellectually simulated and allows me to grow as a healthcare professional.

Adrian Pogacian: I want to turn a little bit back on the your answer on becoming a nurse in general, I don’t know in Croatia but in Romania we have now since few years a faculty of nurses which is four years and the medical school is six years so it’s quite not the same but it’s something very serious treated.

In Romania I saw now that in Croatia and I guess all over Eastern Europe as regarding the oncology nursing we are talking about the multidisciplinary teams that especially in the development countries or we can see it more often the nurses has an important part and it’s like a liand or core to facilitate the dialogue and collaboration among healthcare providers

And it’s like something that unite the team to work together toward a common goal which is to help the cancer patients. From this perspective I will want to ask you what duties has to have an oncology nurses or what that she needs to do in particular?

Tihana Gaspert: Yeah for being a nurse an oncology nurse first of all it is the base is the same as being a nurse in general which is providing direct patient care. When we talk about specialties that are going in oncology and in oncology nursing that is administering chemotherapy and other treatments, managing symptoms and side effects.

A very important thing is offering emotional support and as well education patients and their families about the disease and treatment options. As you said oncology nurses play a crucial role in coordinating care among different healthcare providers ensuring that communication is clear and she has a vital role in the most multidisciplinary teams where they are working towards a common goal.

Also they are really there for patient in terms of advocating their needs and preferences contributing for a more personalized and patient-centered approach to care.

Adrian Pogacian: As you speak I’m thinking and I imagine that it is a lot of pressure in the hospital dealing with the caregivers especially in the operating room a lot of stress and therefore which qualities do you need to have to be an oncology nurses other than let’s say not regular nurse but oncology nurse?

Tihana Gaspert: I would say that the oncology nurse has a really unique role within the healthcare system because we have patients who are we going to get to know. Those are the patients who are constantly returning to either day hospital or wards so we do get that unique opportunity to really get to know the patient. Each patient and their families and I think that is a huge blessing for each oncology nurse and within that the nurse of course has to have some kind of qualities that may be different from the other nurses in other wards.

So in the terms I would really focus on compassion and empathy because patients often face significant emotional and physical challenges. Then the nurse has to have strong communication skills which are crucial for explaining a lot of complex medical information and providing emotional support and the other qualities are critical thinking and problem-solving abilities to manage the complexities of cancer care and treatment.

And last but not least nurses who work in oncology setting they’re often faced by looking of a lot of side effects and a lot of deaths unfortunately and she has to think of herself and I think that the other another skill is resilience and ability to handle stress giving the emotional and physical demands of the job.

Adrian Pogacian: After all these qualities which are not like for everyone you have to be born with them because they are not qualities that you can acquire in time. I would like to ask you because you mentioned communication skills and the communication in cancer care which today it is a huge problem and there are different ideas different point of views how we should do by who that it should be done

And I want to ask you with whom it’s harder to communicate within the medical team or with patients or with their caregivers because it’s not the same communication but you are the same person and sometimes yeah things are changing.

Tihana Gaspert: Yeah things are changing I would say communication is definitely really important it can be sometimes challenging to handle communication inside of the healthcare team because nowadays nursing is really evolving but we’ve known that for the last I would say decade or two decades the nurses were doctors assistants and we didn’t have a lot of things to say we couldn’t say a lot of things

But now things are changing and nurses are really an official members of multidisciplinary team we have our voice inside of a team and our opinion matter and I would say it can be challenging but I think that we can we can overcome these challenging challenges because we do have a set of skills competencies and we do educate ourselves on a daily basis when it comes to communication with patients and their families it requires patience empathy and communication skills

Every patient is individual and we must think about that and we also have to have that in mind every time that we communicate with with patient because we must be adept to listening to patient concerns and providing clear and concise informations of course we are going to face patients who are sometimes hostile who are in denial but what we have to think is that we have to stay calm to provide support and we have to build trust

Because if our patient don’t trust us as a professional we are not going to get anywhere and we have to understand the patient perspective always because we are people all of us have different perspectives and different views of everything and that also includes the patient care and we have to bear in mind the patient perspective and we find have to find common ground which can help them in guiding them throughout their treatment journey

Adrian Pogacian: You mentioned empathy and you mentioned trust these are like human qualities I had an interview with a survivor Camille Moses her name and she’s 12 years now a survivor of pancreatic cancer stage four wow this is a performance and she has such a force to fight and during the interview she wanted to thank the nurses and all the team of nurses because they were the person who gave her the power to move on

Because she saw the doctor once twice a month but each day she was working with nurses and she was a very let’s say she said that all her life she will remember the persons and now they are friends and they are doing things together and I guess there is nothing more satisfactory than a feeling like this but you love your job, you love what you are doing

I’m a psycho-oncologist in Romania, I’m loving what I’m doing but now we are in the face like a paradox that there is an increased demand for nurses as you mentioned with a liberty or a freedom or an area of let’s say management higher than before but there are no candidates or there are not enough person who wants to be a nurse

Even though today there is a unique opportunity for some of them what do you think it’s it’s happening this or where is this paradox come from? about the lower number of the nursing and decreasing number of person who wants to be nurse

Tihana Gaspert: Yeah I think it’s a challenging question um we’ve seen and they’re beautiful examples how nursing can be seen and what are the position for nurses inside of medicine and healthcare in general the good examples of it is United States, United Kingdom and I would say Australia and we can see that there are positive changes and there that there are amazing opportunities for nurses however when we think for example if we look at Europe we are looking at the decreasing number of people entering the nursing profession which can be concerning

I think that there are solutions the first thing that I think that nurses are really thinking about is how other people can value us because sometimes we can see that nurses don’t value themselves and if we don’t as a profession value ourselves how can we expect others to value us so I think that the crucial step is to create an opportunities for nurses not to be just at the direct patient care at the bedside

But also to have a position for education for mentoring for supervision even to be on the board of hospitals and universities to be a part of to have their job as part of you know managing just a clinical trial or just a research area

I think that we need to create unique positions for nurse because for example in Croatia there is a situation you can be just I would say just a nurse but when you get into the job you’re being employed as a nurse and that could mean a variety of things but basically you’re doing 90% of your job at the bedside and the other 10% is whatever else you manage but basically you educate people you’re having lectures research you have to do that on your free time

But if we can incorporate those things into the work I would say that the nurses would feel more appreciated and more valued because we’ve seen the reports report is from America but we’ve seen that nurses when they make a hierarchy of their demands at the job the salary is not the number one it is about the working condition it is about what can you do effectively to at that job and how you can contribute to that job and what how are you going to go afterwards

Adrian Pogacian: Yeah what you can give back to the community where you come from and also from my experience as a psychologist I saw that somehow the the problem it’s in the middle between the let’s say the infrastructure as you mentioned to offer you not only a simple position of nurse and also from the other side of the person

Because if you don’t have confidence in yourself if you don’t have charm empathy and if you don’t have resilience you don’t it’s better not to go and now comes the questions about artificial intelligence that everybody’s talking about e-health telehealth artificial intelligence that I don’t know in the next few years it will replace persons and etc

I don’t believe this because never artificial intelligence can replace empathy or sympathy or charm but it’s also a danger of artificial intelligence that maybe a part of the nurse job can be replaced by artificial intelligence so what do you think about let’s say the next five years in these fields of nurses nursing oncology regarding artificial intelligence

Tihana Gaspert: I would personally like more of artificial intelligence in nursing and I will tell you why because for example artificial intelligence can be great in data analysis in administrative tasks because if you ask I think any of the nurse she would say that she would love to spend more time by her patient side than by the computer and if we can get the AI to replace us in those administrative tasks in data analysis diagnostic support and data-driven insights

It will be amazing that will mean that me as a nurse would have more time to be next to the patient and do the job that I learned how to do instead of spending most of my time next to the computer entering some kind of data and collecting things and not seeing patient in person

Because those tasks by the computer takes most of our time so in that terms great do I think that the AI will replace nurses or doctors or psychologists I don’t think so we need human qualities in in health care because we need to have patients to be comfortable because they are all facing

No matter if they do have oncology diagnosis or any diagnosis when they enter the hospital setting they’re stressed and they need someone to be by their side and giving them that psychological support to being by themselves that is also great benefit to their treatment we have a lot of studies who confirms that so I don’t think that AI is going to replace us but it can definitely help us in those tasks that are to be quite honest boring

Adrian Pogacian: Yeah because this is the main idea of of the let’s say the health care trust and hope because the medical staff should give every patient hope you enter the on the door of the hospital you can find hope you can find trust you can find somebody that really cares about you and from my opinion as far as I saw in working also in the hospital with patients there is another problem with nurses in general oncology nursing in particular you you can’t have time how how to put it to evolve with the patient disease because the number of patient is very very it’s increasing

Tihana Gaspert: Yes it is

Adrian Pogacian: And all the time you are starting your job from zero you know you don’t have a patient from day one until he leaves the hospital and I guess this is very very frustrating because you can’t observe him and maybe he have trust in you and you can’t offer him what you are meant to offer and I guess this is the the main problem

And I agree with you that artificial intelligence in the part of administrative and data science and so on it it is a very very good instrument and it will it will be very useful but you can never replace human quality you can say we are not robots we have feelings so this makes the difference especially in cancer care now that we don’t have too much on our interview

I will like to talk about you and your personal let’s say or professional projects because I know that you are now co-chair of the new special interest group of IPOS which it’s called early career professionals in psychoncology can you develop a little bit or tell us what is this CIG about?

Tihana Gašpert: Yeah okay yes definitely I am in the last few months I have been given the opportunity to be the co-chair of the early career professionals in psychoncology and as a co-chair along with my chair Amanda Belakurski

Our goal is basically to advance the field of psychoncology by supporting the early career professionals in their development that will include creating opportunities for education for mentorship and networking what are we going to try to do is to promote research and innovation in psychoncology with addressing psychological and emotional aspects of cancer care

Also what we wanted to do is organizing webinars and to have our part in the IPOS yearly conference to share knowledge and best practices as well as advocating for policies that support the integration of psycho-oncological care into the standard oncology practice and by fostering a supportive community

Because we do have a great I would say committee who is created from members from all over the world and we do have a huge community and by fostering that community we hope to improve the patient outcomes and hence the well-being of both patients and healthcare providers.

Adrian Pogacian: Wow so very interesting projects and yes and hopefully and I hope that they can be put in practice of course there is a lot of things to manage to do and as the last question you or your co-chair you’ll be present at the IPOS conference in Maastricht this year in order to promote the SIG.

Tihana Gašpert: Yes yes of course at least one of us is going to be present there and we are already discussing the possibilities of having a face-to-face meeting there so that we can meet each other I mean it’s always challenging thing to get in one place people from all over the world so we think that the opportunities to be present at the IPOS meeting in Maastricht would be an amazing thing not only to listen to the knowledge of other more experienced people than us but also to get to know each other and to create future projects.

Adrian Pogacian: Yeah because as we talked earlier about artificial intelligence e-health and webinars are very good but I always prefer face-to-face meetings because we talk about human qualities and you can feel the warm or the goodwill of your partner and this is very important in creating a stable and strong partnership during the time.

Great very very interesting discussion with you Tihana today thank you very much and I hope we’ll see each other in the future maybe after six months or one year of SIG activities to see the results I guess it will be it will be interesting. Thank you very much and I hope you enjoy being with us today. Yeah thank you.

Tihana Gašpert: Thank you.