Social Interaction and Collaboration among Oncology Nurses.

Collaboration is a complex process influenced by organizational, professional, interpersonal, and personal factors. Research has demonstrated that collaboration may also be influenced by social factors. Nurses spend much of their time working in collaborative teams, yet little is known about how they socially interact in practice. This qualitative case study explored nurse perceptions of social interaction in relation to collaboration. Data were collected using telephone interviews and documentary reviews from fourteen oncology nurses employed at one cancer center in Canada. Thematic analysis revealed two themes: knowing you is trusting you and formal and informal opportunities. Nurses reported that social interaction meant getting to know someone personally as well as professionally. Social interaction was enacted inside of work during breaks/meals and outside of work at planned events. Social interaction was facilitated by having a long-term current and/or previous professional and personal relationship. The barriers to social interaction included a lack of time to get to know each other, workload issues, and poor interpersonal skills. Findings suggest that social interaction is an important factor in the collaborative relationship among oncology nurses. Nurse leaders need to promote social interaction opportunities and facilitate educational sessions to improve social and interpersonal skills.

Oncology nurses' experience of collaboration: A case study.

PURPOSE: Changes in the health system have created new models of healthcare delivery such as nurse-led teams. This has resulted in the increased opportunity for enhanced collaboration among nurses. Oncology nurses have a long history of working together, yet little is known about their perceptions about collaboration in the practice setting. This paper aimed to explore and describe the experiences of collaboration among oncology nurses, and to understand the factors that influenced collaboration. METHOD: Qualitative, case study design was used to study fourteen oncology nurses from one cancer center in Canada. Participants were registered nurses or nurse practitioners, employed full-time or permanent part-time in an oncology nurse role, and working on an in-patient or out-patient unit. Data were collected in 2013 using individual telephone interviews and document reviews. RESULTS: Thematic analysis revealed two themes: Art of dancing together, and the stumbling point. The first theme related to the facilitators of collaboration including having: regular face-to-face interaction, an existing and/or previous relationship, oncology nursing experience, and good interpersonal skills. The second theme related to the barriers to collaboration such as: role ambiguity, organizational leadership, and multi-generational differences. CONCLUSIONS: Collaboration is a complex process that does not occur spontaneously. To improve collaboration nursing leadership needs to support and promote opportunities for nurses to build the relationships required to effectively collaborate. It is equally important that individual nurses be willing to collaborate and possess the interpersonal skills required to build and maintain the collaborative relationship despite differences in age, generation, and clinical experience.

Relational ethics in everyday practice.

Oncology nurses frequently encounter ethical issues in their everyday practice because of the complex needs of patients, which require the expertise of many health care providers. The involvement of various health care providers, as well as of the patient and family means there is the potential for differing views about what is best for the patient. The focus of this paper is to share a case history describing the ethical issues experienced by nurses and to illustrate how relational ethics can offer guidance for nurses caring for patients with cancer.

Collaboration among nurse practitioners and registered nurses in outpatient oncology settings in Canada.

AIM: This article is a report on a case study that described and analysed the collaborative process among nurse practitioners and registered nurses in oncology outpatient settings to understand and improve collaborative practice among nurses. BACKGROUND: Changes in the health system have created new models of care delivery, such as collaborative nursing teams. This has resulted in the increased opportunity for enhanced collaboration among nurse practitioners and registered nurses. The study was guided by Corser's Model of Collaborative Nurse-Physician Interactions (1998). DESIGN: Embedded single case design with multiple units of analysis. METHODS: Qualitative data were collected in 2010 using direct participant observations and individual and joint (nurse dyads) interviews in four outpatient oncology settings at one hospital in Ontario, Canada. FINDINGS: Thematic analysis revealed four themes: (1) Together Time Fosters Collaboration; (2) Basic Skills: The Brickworks of Collaboration; (3) Road Blocks: Obstacles to Collaboration; and (4) Nurses' Attitudes towards their Collaborative Work. CONCLUSION: Collaboration is a complex process that does not occur spontaneously. Collaboration requires nurses to not only work together but also spend time socially interacting away from the clinical setting. While nurses possess the conceptual knowledge of the meaning of collaboration, findings from this study showed that nurses struggle to understand how to collaborate in the practice setting. Strategies for improving nurse-nurse practitioner collaboration should include: the support and promotion of collaborative practice among nurses by hospital leadership and the development of institutional and organizational education programmes that would focus on creating innovative opportunities for nurses to learn about intraprofessional collaboration in the practice setting.

Population trends toward increasing cardiovascular risk factors in Canadian adolescents.

OBJECTIVE: To determine prevalence and cross-sectional trends over time for cardiovascular risk factors in Canadian adolescents. STUDY DESIGN: Cross-sectional trends in cardiovascular risk and lifestyle factors were gathered annually in 14- to 15-year-old students in the Niagara region, Ontario, Canada. RESULTS: A total of 20 719 adolescents were screened between 2002 and 2008. The proportion of obese adolescents (>95th percentile for body mass index [BMI]) increased significantly, by +0.34%/year (P = .002). The proportions of adolescents with borderline high cholesterol (4.4-5.1 mmol/L) (+0.57%/year; P <.001) and with high cholesterol (≥5.2 mmol/L) (+0.43%/year; P <.001) both increased significantly over time. The proportion of adolescents with prehypertension decreased by -0.23%/year (P = .02), whereas the proportion of those with stage I hypertension (5%-6%) or stage II hypertension (2%-4%) remained constant. The proportion of adolescents classified as being at high cardiovascular risk increased by +0.67%/year (P <.001). Family history, low levels of physical activity, sedentary behaviors, poor nutrition, and lower socioeconomic status were all independently and negatively associated with all aspects of cardiovascular risk. CONCLUSIONS: A significant proportion of 14- to 15-year-old Canadian adolescents have at least one cardiovascular risk factor, and the cross-sectional trends worsened during the period 2002-2008.

Adolescent cardiovascular risk factors: A follow-up study.

PURPOSE: To assess the outcomes of a school nurse referral to a family physician for adolescents identified with elevated cholesterol or blood pressure risk factors. METHOD: Telephone survey interviews were used to collect quantitative and qualitative data. FINDINGS: Data were collected on 178 adolescents through parent and adolescent interviews over a 3-month period. The main theme reported for not complying with the follow-up referral was that respondents did not perceive it as necessary or urgent. Of the approximately 60% who reportedly went to the physician, 58% had further tests, 10% were referred to specialists, and 3% were prescribed medications. Eating and exercise changes were reported by those who went for follow-up. CONCLUSION: Adolescent health-seeking behaviors can be influenced positively by school programs that involve families in discussion, nurses in risk identification, and referrals to physicians for follow-up.

Prevalence of cardiovascular risk factors in grade nine students.

BACKGROUND: The Niagara Schools' Healthy Heart Program (NSHHP) is a health education and intervention program offered to students enrolled in a grade nine physical education course. The program involves completion of a family history and a self-report lifestyle survey, measurements of height, weight, blood pressure, and random total cholesterol levels, a heart education class, and CPR training. PURPOSE: The purpose of this study was to report the prevalence of cardiovascular risk for adolescents enrolled in the program. METHODS: A secondary analysis was conducted using data collected by the NSHHP staff to determine the prevalence of cardiovascular risk factors in grade nine students for the school year 2006. Specific risk factors studied were smoking, body mass index, total cholesterol level and blood pressure. RESULTS: A total of 3,639 students from 30 schools participated. Almost 14% of students had at least one cardiovascular risk factor. Body mass index was found to be the highest risk factor (13.7%) and total random cholesterol level (5%) was found to be the lowest risk factor in this sample. There were differences in prevalence rates between male and female students for all risk factors except elevated blood pressure. Five per cent of the students were referred to a family physician for follow-up, mostly for high cholesterol readings. CONCLUSIONS: The findings suggest that adolescents do have cardiovascular risk factors and prevention could be targeted to this population. These risk factors were already established by the time the students reached adolescence. The findings support conducting early prevention with younger children and adolescents.