The workshop emphasized essential concepts such as effective communication, building trust, interdisciplinary teamwork, and tailoring care to meet individual needs. A key highlight was the DISC personality test, which helped me understand how to adapt my communication and collaboration style with different personality types—including my head nurse and other three staff members who also attended the workshop. The training also stressed the value of incident reporting.

Focusing on breast cancer—a key area of my clinical exposure and interest as a member of a breast cancer institution—it is currently the most common type of cancer in Palestine. According to the Palestinian Ministry of Health, 546 new breast cancer cases were diagnosed in the West Bank in 2023, with a 5.3% annual increase in incidence. Breast cancer arises due to a combination of genetic, hormonal, lifestyle, and environmental factors, such as BRCA1/2 gene mutations, family history, prolonged estrogen exposure, obesity, alcohol use, and radiation exposure.

EEarly detection is vital, using tools like mammography, MRI, ultrasound, biopsy, and clinical examinations. Staging is guided by the TNM system—assessing tumor size (T), lymph node involvement (N), and metastasis (M). Treatments include surgery (e.g., mastectomy), chemotherapy, radiation therapy, and targeted treatments like trastuzumab for HER2-positive cases.

Although rare, breast cancer can affect men as well. Male patients are often diagnosed at later stages due to lower awareness, making education and early detection efforts crucial across genders.

Among the many breast cancer cases I handled, one case stood out deeply. A patient with metastasis to the bone marrow suffered from chronic thrombocytopenia, anemia, and a left hand DVT. She remained hospitalized for over a month and received Gemzar chemotherapy. I supported her in line with the workshop’s patient-centered approach—keeping her family updated with her permission, addressing her emotional needs, encouraging a potential home visit for psychological and physical relief, and simply sitting with her for warm conversations. These experiences reminded me that compassion and trust are as essential as clinical interventions.

This clinical experience strengthened my self-confidence and decision-making skills. I learned how to prioritize tasks, manage time under pressure, and collaborate with different team members. One notable challenge was witnessing and participating in my first CPR and shrouding a deceased patient—an emotionally intense but educational moment.

In addition to medication administration, my daily responsibilities included shift handovers, narcotics checks, ER trolley and stock inspections, vital sign assessments, documentation, attending physician rounds, reviewing medical notes, and preparing treatments—tasks that formed the core routine of the oncology department.

Pain management was another critical area where I applied what I learned in the workshop. We were trained on the RATES pain assessment scale and the WHO pain ladder, both of which I actively implemented during patient care. I learned to determine when to use NSAIDs for mild pain, mild opioids for moderate pain, and strong opioids like morphine for severe cases. I also paid close attention to medication pharmacokinetics, educating patients and families accordingly.

Educating patients on what to expect from their pain medications helped build trust and empower them in managing their symptoms effectively.

Based on both the workshop training and my clinical experience, I strongly recommend adopting a multidisciplinary approach when delivering bad news to patients. Sensitive conversations about a patient’s diagnosis or prognosis should involve a team consisting of a physician, nurse, and social worker. This ensures the information is delivered accurately, respectfully, and with appropriate emotional support. Additionally, giving patients the autonomy to decide whether they want their family involved in these discussions respects their preferences and enhances their dignity.

Despite the rich learning experience, I recognized areas where improvements could significantly enhance patient care and staff well-being. First, implementing regular debriefing sessions for healthcare providers can help manage emotional stress and prevent burnout. Second, organizing ongoing training and updates on chemotherapy protocols, safe administration, and research developments is crucial for keeping staff informed and competent.

Another challenge arises when non-oncology patients are placed in the oncology department due to limited bed space elsewhere. These patients often require different care, and their presence increases infection risk for immunocompromised oncology patients. Addressing this issue is essential for both patient safety and departmental efficiency.

For patients, introducing group therapy sessions that incorporate psychological, emotional, and spiritual support can enhance their well-being. Additionally, early integration of palliative care and active family involvement improve treatment outcomes and overall satisfaction. Finally, due to travel burdens many patients face—especially when medications are delayed or unavailable—a centralized contact system should be established to confirm medication availability before they travel to hospital especially that Beit Jala hospital is the only cancer hospital which covered all the south of the West Bank.