There was another transition to navigate upon leaving the larger centre and reentering the local community in northwestern Ontario. Having negotiated the first transition did not prepare them for the transfer back home. After parents reentered the local hospital environment, staff often seemed somewhat uncomfortable and ill at ease, having little knowledge of what had taken place in terms of the patient’s treatment in the larger centre. Participants recognized the local staffs’ level of discomfort and wondered whether it was a lack of training or simply a matter of not working with young cancer patients on a daily basis. The fourth theme to emerge related to training needs, both for local staff and for parents. In terms of staff, parents recognized that it is more difficult to develop and maintain expertise in centres seeing relatively few patients, but hoped that something could be done to improve the local situation both for the staff involved and for the children. Staff working in smaller local facilities may have the necessary expertise but have not had the opportunity to learn that variations in practice are not only possible but, with some young patients, may be essential. Dreaming of a reliable pharmacy that could give you an opportunity to buy any amounts of prednisone for asthma with no prescription required and spend less money?
“It wasn’t the fact of not trusting what they do here. It’s just that they do it so often in Toronto.”