He encouraged people to be independent thinkers and to have mastery over their own
ideas. His ideas are related to business and organizations.
Wen[1] noted that Senge, in his book, talks about disciplines
in the routes of his learning organization theory:
1. The ability to inspire or aspire;
2. The ability to start reflecting on conversation and
3. The ability to understand complexity.
These ideas can be gathered in a unique way to the
healthcare system in general and to the Israeli BCNs in
particular. Senge’s criteria for a learning organization will
also be presented in relation to the Israeli BCNs.
In 1996, some years after Senge wrote his book, the role
of the BCNs was established in Israel. The Hadassah Ein
Kerem Medical Center is the first to establish this profession,
and Dr. Ilana Kadmon, who was appointed to the BCN role
in 1996, still holds this position to date. At that time, lack
of support had been given to women with breast cancer.
This role was hardly recognized by the health care team
and its importance took some years to attain recognition
from the whole multidisciplinary team. Originally, BCNs
mainly provided practical advice to women. Throughout
the years, BCNs learned to implement more psychosocial
interventions. Since 1996, the BCN role has continued to
develop all over Israel through the support given by the
Israel Cancer Association.[3]
Today, at least 40 BCNs are working in different centers in
Israel. These nurses created a network among themselves.
When a woman is diagnosed at a specific center and decides
to undergo a part of her treatment in a different institution,
BCNs from both centers communicate effectively. An
advertisement about this network was presented at an
international conference in Germany in 2004.[4] Majority
of the hospitals implement the BCN role within their
institution. Some institutions have more than one BCN, such
as in some centers where BCNs provide service throughout
the treatment trajectory, i.e., from diagnosis to rehabilitation
and metastatic stage. In other institutions, some BCNs are
dedicated to follow women at the surgical stage or mainly
at the oncological stage. Some centers also have BCNs with
more specific roles, such as those for genetic carriers or in
coordinating care in the imaging institute.
This unique working group of BCNs meets every few weeks
in the Israel Cancer Association led by the head nurse.
These regular meetings are particularly designed to train
the group, discuss common concerns, enable a forum to
include consultation with each other, develop some new
ideas and facilitate social gatherings. This design is similar
to that of the learning organization described by Senge.