Seeking Common Ground: A Grounded Theory of the Nurse-Patient Relationship in Cancer Infusion Care.

BACKGROUND: The nurse-patient relationship represents a valuable connection in cancer care. Largely studied within inpatient settings, the nature and influence of this central relationship in ambulatory settings remain relatively unexamined. The notable shift to ambulatory settings like infusion centers warrants examination of the nurse-patient relationship in this context. OBJECTIVE: The aim of this study was to develop a grounded theory of the nurse-patient relationship in ambulatory cancer infusion care. INTERVENTIONS/METHODS: Using grounded theory methodology, 11 nurses were interviewed using a semistructured interview guide. Data collection continued until data saturation occurred with the primary concepts. RESULTS: The grounded theory, entitled Seeking Common Ground, includes 6 primary concepts. The concepts "we are all human"; "we work in a busy, complex environment"; "we seek common ground with patients"; "we use connections to support meaningful encounters"; "we find meaning in the relationships created"; and "we are governed by the push and pull of time" abstract the nurse-patient relationship from the nurses' perspective, emphasizing fundamental human connections. CONCLUSIONS: The grounded theory Seeking Common Ground depicts the profound connection that nurses form with their patients in the ambulatory infusion setting. Underscoring the value of the nurse-patient relationship as foundational to the nursing profession must be driven through practice, education, and policy. IMPLICATIONS FOR PRACTICE: Consideration of educational aspects within nursing across all levels to influence clinical practice will remain key.

Cancer Screening and Early Detection in Older People: Considerations for Nursing Practice.

OBJECTIVE: To synthesize relevant issues in cancer screening for older people for nursing practice. DATA SOURCES: Published scientific literature, clinical literature, and published cancer screening guidelines from the United States and Canada. CONCLUSION: Nurses are caring for increasing numbers of older patients and, with this demographic shift, face increasing demands to address cancer screening and detection in both primary and specialty practice. IMPLICATIONS FOR NURSING PRACTICE: Ageism, self-stereotyping, cancer fear and fatalism, and cancer survivorship experiences influence cancer screening and generate the need for improved awareness of these issues to advance nursing practice.

The oncology phone: an innovative program for the management of the oncology population in an academic medical center.

The Oncology Nursing Leadership Team at the Hospital of the University of Pennsylvania designed and implemented a phone consultation and intervention service to address increasing needs for specialty oncology nursing consultation and care for patients located on nononcology units. This article describes the planning, implementation, and evaluation of this service, which the team named the oncology phone. The service is available 24 hours per day, seven days per week by members of the Oncology Nursing Leadership Team and designated senior members of the clinical nursing staff. Consultation is initiated by any clinical nurse throughout the hospital who determines the need for oncology nursing expertise. Those needs include support for chemotherapy administration, symptom management, and care coordination. Data are collected from each call as well as subsequent face-to-face consultations and interventions. Evaluation of the data reveals important areas for education. A similar program may be valuable to other inpatient settings in addressing the needs of patients and staff.

Adherence and oral agents with older patients.

OBJECTIVE: Oral antineoplastic agents offer multiple advantages in cancer therapies. Thus, understanding issues of adherence to these agents for older adults becomes critical to successful comprehensive care of the older cancer patient. DATA SOURCES: This analysis of adherence to oral agents among older cancer patients draws on interdisciplinary geriatric and oncologic research reports and clinical reviews. CONCLUSION: Older adults are at increased risk for poor adherence to oral agents. Barriers to adherence are diverse. Problems emerge from age-related physical changes, comorbid conditions, polypharmacy, and drug interactions. Psychosocial barriers include limited insurance coverage and transportation problems to social isolation and inadequate social support. IMPLICATION FOR NURSING PRACTICE: Nurses should lead interdisciplinary, individualized plans of care to mitigate barriers and support adherence to cancer therapy.