[The advanced practice nurse in a supportive care department: The missing link?] / L'infirmière en pratique avancée au sein d'un service de soins de support : le chainon manquant ?

INTRODUCTION: Cancer has become a chronic disease thanks to therapeutic evolutions and justifies the early integration of supportive care in the management. The Advanced Practice Nurse (APN) was created to respond to the increase in the number of patients followed in the long term. The objective of this study is to identify the place and expected missions of an APN within a multidisciplinary supportive care team. MATERIAL AND METHOD: A qualitative study by semi-directed interview using a previously developed interview grid was carried out with 14 health professionals (doctors, nurses and health managers) working in a supportive care service in three Cancer Centres. RESULTS: The role expected by the participants is based on the optimisation of patients' follow-up, the integration of supportive care into the care pathway, the improvement of the relationship with the town, and the development of nursing leadership in the establishment. At the same time, the potential arrival of an APN as a change agent in a supportive care service is a source of fears. DISCUSSION: The APN seems to be a real link in the institutional organisations facilitating the link between the professionals of the institution and with the professionals of the territory. The identification of the origins of the fears expressed should enable work to be done to facilitate the integration of the APN into specific support care services, particularly for patients in palliative situations.

[What support for requests to return to the country of origin of migrant patients in a palliative situation?] / Quel accompagnement pour les demandes de retour au pays d'origine des patients migrants en situation palliative ?

Requests for return to the country of origin of palliative patients are not exceptional and cause many difficulties for caregivers. This article provides a narrative review of the literature to examine the practical difficulties in dealing with these requests and to identify ways to overcome them. The return to the country of origin requires a medical assessment of both the conditions of the trip and the coordination with the teams that will take over the care of the patient. Transportation of patients is most often possible but requires preventive and therapeutic measures. The organization of the return journey may require collaboration between the social service, families, associations, or diplomatic representations in order to carry out the administrative procedures or to finance the return project. For patients with a language barrier, this process requires the use of professional interpreters. The return to the country of origin for patients in a palliative situation requires sufficient anticipation to take place under the best conditions. Early integration of palliative care and anticipation of the cessation of specific treatments and the end of life are ways of addressing these issues.