Which channels should counselling services use in order to best reach patients?
The Cancer Society of Finland has dual counselling system. The national service is at the head office in Helsinki. But Cancer Society is an umbrella organisation with 12 regional and 5 national patient organisations. Altogether about 50 nurses specialising in counselling are at the service of cancer patients or anyone wanting to make contact.
Nurses meet patients and their families face to face, in group meetings or they give advice via telephone, e-mail or via chat.
Five oncology nurses work for the national cancer information services in Helsinki. The team is led by a medical oncologist. They keep in close contact with their colleagues in regional societies and have during the last years developed standardised procedures in their services across the country. The regional societies started to give psycho-social support in the 1970s. The national helpline started in 1992.
There are services that go across the counselling structure. For instance counselling about familial cancer starts first with drawing a family tree. This meeting is a session where the nurse needs to meet the customer personally.
While telephone is still the most popular channel (75% of contacts), patients are reaching out for new ways. This is why the national counselling service started its chat service in 2009. It was a new way of counselling and required new skills. The counselling nurses had to learn how to fast find information on the web while steering a group discussion online.
“It was very hard at first and we needed a learning process. We are still developing our services and try to listen what the patients and their closed-ones really need”, says the head of counselling services, oncology nurse Taina Häkkinen.
Group chat was especially challenging. The counselling services have done some promotion but it has been quite modest. Leaflets and notepads at the health care centers, pharmacies and hospitals have advertised the service. It might be that for the group chat Facebook is a competitor. People meet at the hospital and form a closed informal Facebook group. It is very easy and patients do not think about security issues.
Personal chat with a nurse can be booked in advance. These have been more popular than group chats.
Now the national counselling nurses are preparing for a new challenge: an instant chat with web visitors. They know that while the Internet offers a lot of information, it is not enough. People can´t always find what is essential in their situation from the vast pool of facts online. The basic need of sound advice from a professional is still the most valuable service that non-profit Cancer Society can offer.
Taina Häkkinen emphasises professional competences:
“We are updating our medical knowledge about cancer as a part of professional counselling. In the same way we should update our knowledge about channels which we are using to give advice. Many services in Finland are nowadays web based, for instance bank services. People are used to using them and they want to have service also via web channels.”
“Chatting is interesting and fun. You get feedback right away and it is rewarding”, says head nurse Taina Häkkinen with 6 years´ experience in chatting.
Finnish experiences about chatting:
- Chat times are offered daily and during different times
- Most popular times are in the morning around 9 o´clock and in the afternoon around 1 PM
- If working in open space offices, people find chatting more convenient than telephoning
- People stay anonymous when reserving the chat time and logging in with secured connection
- All nurses are chatting – it is a part of their professional portfolio
- Nurses received training in how to write chat texts (2 training sessions) and how to find information from the web (2 training sessions)
- Give links only in the last mail, otherwise people get distracted while following the links during conversation
- Cancelling chat reservation is quite frequent
- Many Finns working abroad after getting cancer diagnosis want to discuss it with their mother tongue
Satu Lipponen, director, communications and foresight and Taina Häkkinen, head nurse, counselling services, Cancer Society of Finland