Occupational health nurses' personal attitudes toward smoking: A cross-sectional study.

OBJECTIVES: This study aims to investigate if experience in smoking intervention training influences attitudes toward smoking, discuss the role of health management programs of small- and medium-sized enterprises, and analyze the current attitude of occupational health nurses regarding the hazards of smoking and responsibility to smokers to effectively facilitate smoking cessation support programs. METHODS: We conducted an anonymous self-administered cross-sectional survey of 108 nurses employed in occupational health services outsourcing specialized agency in Korea. We assessed the difference in attitude about smoking according to training experience in smoking interventions and perceived competence in counseling smokers using chi-square test and Fisher's exact test. RESULTS: Occupational health nurses with the training experience of smoking interventions tend to perceive the harmful effects of smoking more seriously, compared to occupational health nurses without the training experience (P = .024, Fisher's exact test) and the OHSO nurses with the training experience tend to have professional ethics as health care professionals (P = .017, Fisher's exact test). Occupational health nurses having expertise in smoking cessation counseling tended to have professional ethics (P = .047, Fisher's exact test) and social responsibility as health care professionals (P = .022, Fisher's exact test). CONCLUSION: The occupational health nurses with training experience and expertise in smoking cessation counseling perceive the harmful effects of smoking more strongly and can enhance their professional ethics and social responsibility as health care professionals.

Barriers to end-of-life discussion with advanced cancer patient as perceived by oncologists, certified/specialized nurses in cancer nursing and medical social workers.

OBJECTIVE: The objectives of this study were to identify barriers to end-of-life discussion with advanced cancer patients and their families as perceived by oncologists, certified/specialized nurses in cancer nursing (hereafter, collectively referred to as 'nurses') and medical social workers, as well as to clarify their opinions about effective strategies to facilitate end-of-life discussion. METHODS: A questionnaire survey was distributed to 4354 medical professionals working at 402 designated regional cancer hospitals in Japan. Responses were obtained from 494 oncologists (valid response rate 30.7%), 993 nurses (46.7%) and 387 medical social workers (48.1%). RESULTS: Among the barriers to end-of-life discussion with advanced cancer patients, factors related to patients and families, such as 'Family members' difficulty accepting loved one's poor prognosis', were recognized as the most important issues, which was the common view shared across the three types of medical professionals who participated in this study. Nurses and medical social workers were significantly more likely than oncologists to recognize as important issues 'Health care team disagreement about goals of care' and 'Lack of training to have conversations for end-of-life discussion'. To facilitate end-of-life discussion, 'providing mental and emotional support for the patients and their families after end-of-life discussion' was needed most as perceived by the respondents regardless of their profession. CONCLUSIONS: Barriers impeding end-of-life discussion were factors related to patients and their families, and oncologists' close cooperation with nurses and medical social workers is important in providing emotional support for patients and families. To facilitate end-of-life discussion, it is important to share information on patients' prognosis and goals for treatment among oncologists and other medical professionals, as well as strengthen communication skill of these medical professions.

Factors associated with the job satisfaction of certified nurses and nurse specialists in cancer care in Japan: Analysis based on the Basic Plan to Promote Cancer Control Programs.

BACKGROUND: As the Japanese population ages, the number of cancer patients will likely increase. Therefore, qualified cancer health care providers should be recruited and retained. Nurse job satisfaction is influenced by numerous factors and may affect staff turnover and patient outcomes. OBJECTIVES: To evaluate the job satisfaction of certified nurses and nurse specialists in Japanese cancer care and elucidate factors associated with job satisfaction. METHODS: Participants in this cross-sectional study comprised 200 certified nurse specialists and 1,472 certified nurses working in Japanese cancer care. A chi-square test and logistic regression analysis were conducted to identify job satisfaction factors. RESULTS: Job satisfaction was present in 38.45% and 49.00% of certified nurses and nurse specialists, respectively. Certified nurses associated job satisfaction with cross-departmental activities (OR 2.24, p<0.001), positive evaluation from senior stuff (OR 4.58, p<0.001), appropriate staff allocation (OR 1.75, p<0.001), more than five years certified nurse experience (OR 1.91, p<0.001), and positive evaluation of the development of certified nurses (OR 2.13, p<0.01) and nurse specialists (OR 1.37, p<0.05). Low job satisfaction was associated with working on a ward (OR 0.51, p<0.001) and a capacity of more than 200 beds (OR 0.33, p = 0.00). Certified nurse specialists associated job satisfaction with palliative care team participation (OR 2.64, p<0.05), cross-sectional activities (OR 7.06, p<0.01), positive evaluation from senior stuff (OR 13.15, p<0.001), presence of certified nurses in radiation therapy (OR 2.91, p<0.05), positive certified nurse specialist development evaluation (OR 7.35, p<0.001), medical service fees (OR 3.78, p<0.01), and independent activities (OR 11.34, p<0.01). CONCLUSIONS: We identified factors related to activities, facilities, and the cancer care team associated with job satisfaction of certified nurses and nurse specialists in Japanese cancer care. Suggestions are provided to enhance job satisfaction through Japan's Basic Plan to Promote Cancer Control, which may help hospital administrators retain nursing staff.

A J curve of interprofessional change: co-locating non-health partners in an oncology unit.

BACKGROUND: Internationally, clinicians face increased demand, pressure on resources and unmet patient needs. A community social support service was co-located within cancer clinics in Glasgow, Scotland to help address some of these needs. AIM: To analyse the impact of the service on clinical staff and to propose an explanatory theory of change. METHOD: Qualitative exploratory design, using thematic analysis of semistructured interviews with 8 nurse specialists and 2 medical oncologists from lung, breast, head and neck, and gastrointestinal oncology teams in Glasgow in 2018-2019. FINDINGS: Four themes captured this process: 'The conversation', 'A better experience', 'Freedom to focus' and 'Working hand in hand'. CONCLUSION: Together, these four themes explained the process of effective interprofessional working. This process would have been predicted by the J-curve literature on diffusion of innovations. Linking J-curve theory to this successful process provides new understanding that could prove essential for clinical teams who are implementing change within their practice.

Palliative care nurse specialists' reflections on a palliative care educational intervention in long-term care: an inductive content analysis.

BACKGROUND: Older people in long-term care facilities are at a greater risk of receiving care at the end of life that does not adequately meet their needs, yet staff in long-term care are often unprepared to provide palliative care. The objective of the study was to explore palliative care nurse specialists' experiences regarding the benefits of and barriers to the implementation of a palliative care educational intervention, Supportive Hospice Aged Residential Exchange (SHARE) in 20 long-term care facilities. METHODS: Reflective logs (465), recorded over the course of the yearlong SHARE intervention by the three palliative care nurse specialists from two local hospices, who were the on-site mentors, were qualitatively analyzed by two researchers utilizing inductive content analysis. RESULTS: Categories emerging from the logs include the importance of relationships, knowledge exchange, communication, and the challenges of providing palliative care in a long-term care setting. CONCLUSION: Evidence from the logs indicated that sustained relationships between the palliative care nurse specialists and staff (registered nurses, healthcare assistants) as well as reciprocal learning were key factors supporting the implementation of this palliative care educational intervention. Challenges remain however in relation to staffing levels, which further emphasizes the importance of palliative care nurse specialist presence as a point of stability.

Patient safety culture among European cancer nurses-An exploratory, cross-sectional survey comparing data from Estonia, Germany, Netherlands, and United Kingdom.

AIM: To explore the differences in perceived patient safety culture in cancer nurses working in Estonia, Germany, the Netherlands, and the United Kingdom. DESIGN: An exploratory cross-sectional survey. METHODS: In 2018, 393 cancer nurses completed the 12 dimensions of the Hospital Survey on Patient Safety Culture. RESULTS: The mean score for the overall patient safety grade was 61.3. The highest rated dimension was "teamwork within units" while "staffing" was the lowest in all four countries. Nurses in the Netherlands and in the United Kingdom, scored higher on "communication openness", the "frequency of events reported", and "non-punitive response to errors", than nurses from Estonia or Germany. We found statistically significant differences between the countries for the association between five of the 12 dimensions with the overall patient safety grade: overall perception of patient safety, communication openness, staffing, handoffs and transitions and non-punitive response to errors. CONCLUSION: Patient safety culture, as reported by cancer nurses, varies between European countries and contextual factors, such as recognition of the nursing role and education have an impact on it. Cancer nurses' role in promoting patient safety is a key concern and requires better recognition on a European and global level. IMPACT: Cancer Nursing Societies in any country can use these data as an indication on how to improve patient care in their country. Recognition of cancer nursing as a distinct specialty in nursing will help to improve patient safety.

A construção do vínculo das enfermeiras da Estratégia de Saúde da Família com as gestantes HIV positivo / The construction of the nurses bond of the family health strategy with HIV positive pregnant / La construcción del vínculo de las enfermeras de la estrategia de salud de la familia com embarazadas VIH positivo

Objetivo: conhecer a percepção das enfermeiras em relação à construção do vínculo na assistência prestada na Estratégia de Saúde da Família com as gestantes HIV positivo. Método: Para coleta das informações foi utilizada a entrevista semiestruturada com dez voluntárias. A análise das informações foi realizada sob a luz da Razão Sensível. Resultados: Após análise, emergiram duas categorias: 1) O vínculo vivido e pensado como cuidado solidário e humanístico; e 2) A construção do vínculo como elo que favorece o desenvolvimento das ações de saúde. Foi possível apreender que as enfermeiras mantêm o vínculo após encaminhar a gestante ao serviço especializado ou seria este vínculo passível de ser construído mesmo ao encaminhá-las. Conclusão: Nessa relação, a enfermeira visualiza a possibilidade de estar-junto à gestante, proporcionando ações que possibilitem mantê-la em acompanhamento na unidade

Objective: to identify nurses' perceptions regarding the construction of the bond in assisting in the Family Health Strategy with HIVpositive pregnant women. Method: For data collection was used to semi-structured with ten participants. Information analysis was performed under the light of Reason Sensitive. Results: After reviewing, two categories emerged: 1) The bond lived and thought as supportive and humanistic care and, 2) The construction of the link as a link that favors the development of health. It was possible to learn that nurses maintain the bond after forwarding the pregnant woman to the specialized service or this bond is likely to be built right to convey them. Conclusion: In this relationship, the nurse sees the possibility of being-together to pregnant women, providing actions that enable it to keep up on the unit

Objetivo: conocer la percepción de las enfermeras en relación a la construcción del vínculo em la assistência prestada en la Estrategia de Salud de la Familia con embarazadas VIH positivo. Método: Para recoger las informaciones ha sido utilizado una entrevista semiestructurada com diez voluntarias. El análisis de las informaciones ha sido realizado bajo la luz de la Razón Sensible. Resultados: Tras el análisis, surgieron dos categorias: 1) El vínculo vivido y pensado como cuidado solidário y humanístico y; 2) La construcción del vínculo como enlace que favorece el desarollo de las acciones de salud. Ha sido posible absorber que la enfermeiras mantienen el vínculo despues de encaminar la embarazada al servicio especializado o sería este vínculo posible de ser construído incluso tras encaminarlas. Conclusión: En esta relación, la enfermera visualiza la posibilidad de estar junto a la embarazada, proporcionando acciones que posibiliten mantenerla en acompañamiento en la unidad

O estresse no trabalho dos enfermeiros e enfermeiras em oncologia e os danos à saúde / Stress on the work of nurses in oncology and damages to health

O objeto de estudo foi o estresse relacionado ao trabalho e os danos à saúde em enfermeiros que atuavam em oncologia. O objetivo geral foi analisar a associação entre o estresse no trabalho e os danos físicos, sociais e psicológicos em enfermeiros e enfermeiras em oncologia. O pressuposto do estudo o estresse no trabalho em oncologia está associado ao adoecimento físico, social e psicológico dos enfermeiros. Material e Método: Estudo com delineamento transversal e abordagem quantitativa. A coleta de dados ocorreu entre os anos de 2017 e 2018. A amostra foi composta de todos os enfermeiros da equipe de enfermagem dos setores definidos para a coleta de dados no local da pesquisa. Participaram do estudo 212 enfermeiros, equivalendo a 87,96% da população elegível (241). O instrumento de coleta de dados consistiu em um questionário estruturado multidimensional, autopreenchível, que inclui questões referentes aos dados sociodemográficos, laborais e relacionados à saúde; a Escala de Avaliação do Estresse, do Inventário de Estresse em Enfermeiro (IEE) e a Escala de Avaliação de Danos Relacionados ao Trabalho (EADRT) quarta parte do Inventário Sobre Trabalho e Riscos de Adoecimento (ITRA). Os dados foram analisados no programa IBM SPSS Statistics (IBM, versão 23.0). Resultados: na avaliação entre o alto estresse no trabalho (IEE) e as variáveis sociodemográficas, laborais e relacionadas à saúde os resultados mostraram significância nas seguintes variáveis: o tipo de vínculo empregatício (p=0,001); apoio social no trabalho (p<0,001) e queixas de insônia (p=0,001). As dimensões do IEE que apresentaram maior fonte de tensão foram as Relações Interpessoais e Fatores intrínsecos ao Trabalho. A associação entre os danos e as variáveis sociodemográficas mostraram significância entre danos físicos com sexo (p<0,001), apoio social no trabalho (p=0,003); satisfação com a duração do sono (p<0,001) e queixas de insônia (p<0,001); danos sociais com presença de parentes (p=0,003) e pensa em abandonar a enfermagem (p<0,001); danos psicológicos com pensa em (p=0,002); queixas de insônia (p<0,001) e, consome bebida alcoólica (p=0,005) com avaliação mais negativa para Danos Físicos com presença de doença ocupacional. Na associação entre a exposição e o desfecho com base na Razão de Chance (RC) e respectivo intervalo de confiança (IC95%) observou- se forte significância com presença de doença para Danos Físicos (p=0,012) e (RC=4,32; IC95%: 1,38-13,54), Psicológicos (p<0,001) e (RC=7,46; IC95%: 2,42-23,00) e Sociais (p=0,003) e (RC=10,11; IC95%: 2,21-46-31). Conclusões: A hipótese testada para este estudo foi confirmada, uma vez que houve associação significativa entre o estresse no trabalho e os danos à saúde. Os dados obtidos revelaram aspectos importantes dos fatores de estresse a que estão expostos os enfermeiros em oncologia no cotidiano do trabalho e a presença de danos físicos, sociais e psicológicos oferecendo subsídios para a implementação de ações de promoção à saúde do trabalhador.

The aim of the study was stress related to the work and damages to health in nurses that worked in oncology. The general aim was to analyze the association between stress at work and physical, social and psychological harm in nurses in oncology. The study hypotesis was that stress at work in oncology is associated to physical, social and psychological harm in nurses. Material and method: Cross-sectional study with quantitative approach. Data collection happened between the years of 2017 and 2018. Sample was composed by all nurses in the nursing staff of defined sectors to data collection where the study took place. 212 nurses participated in the study, equivalent to 87,96% of the elegible population(241). The data collection instrument consisted in a structured multidimensional self-priming questionnaire that included work and health related sociodemographic data. Beyond that, it includes the Stress Evaluation Scale, Stress Inventory in Nursing (IEE) and Evaluation scale of harm related to work, the forth part of Inventory about work and risk to sickening. Data were analyzed in the software IBM SPSS Statistics (IBM, version 23.0). Results: in evaluation of stress and work and work and health related sociodemographic variables, results showed significance in the folowing variables: type of employment relationship (p=0,001); social support at work (p<0,001) and complaints about insomnia (p=0,001). The dymations of IEE that presented a great source of tension were Interpersonal Relationships and Intrinsic factors to work. The association between harms and the sociodemographic variables showed significance between physical damage with sex (p<0,001), social support at work (p=0,003); satisfaction with sleep duration (p<0,001) and complaints of insomnia (p<0,001); social harm with presence of relatives (p=0,003) and thinks about abandoning nursing (p<0,001); psychological damage with thinks about abandoning nursing (p<0,001), satisfaction with sleep duration (p=0,002); complaints of insomnia (p<0,001) and, drinking alcohol (p=0,005) with negative evaluation to Physical Harm with presence of occupational disease. On association between exposure and outcome based on Odds Ratio (OR) and respective confidence interval (IC95%) it was observed a strong significance with presence of disease for Physical Harm (p=0,012) e (OR=4,32; IC95%:1,38-13,54), Psychological Harm (p<0,001) e (OR=7,46; IC95%:2,42-23,00) and Social Harm (p=0,003) e (OR=10,11; IC95%:2,21-46-31). Conclusions: The hypothesis tested for this study was confirmed, since there was a significant association between stress at work and damage to health. The data obtained revealed important aspects of the stress factors to which nurses are exposed in oncology in the daily life of the work and the presence of physical, social and psychological damages offering subsidies for the implementation of actions to promote occupational health.

El objeto de estudio fue el estrés relacionado al trabajo y los daños a la salud en enfermeros que actuaban en oncología. El objetivo general fue analizar la asociación entre el estrés en el trabajo y los daños físicos, sociales y psicológicos en enfermeros y enfermeras en oncología. La hipótesis del estudio fue que el estrés en el trabajo en oncología está asociado a las enfermedades físicas, sociales y psicológicas de los enfermeros. Material y Método: Estudio con diseño transversal y abordaje cuantitativo. La coleta de datos ocurrió entre los años 2017 y 2018. La amuestra fue compuesta de todos los enfermeros de la equipa de enfermería de los sectores definidos para la coleta de datos en el hogar de la investigación. Participaron del estudio 212 enfermeros equivaliendo 87,96 de la población escogida (241). El instrumento de coleta de datos consistió en un cuestionario estructurado multidimensional, auto administrado, que incluyó cuestiones referentes a los datos sociodemográficos, laborales y relacionados a la salud. Además, incluyó la Escala de Evaluación del Estrés, Inventario del Estrés en Enfermero (IEE) y la Escala y Evaluación de Daños Relacionados al Trabajo (EDRT) cuarta parte del Inventario sobre Trabajo y Riesgos de Enfermedad (ITRE). Los datos fueran analizados en le programa IBM SPSS Statistics (IBM, versión 23.0). Resultados: en la evaluación entre el alto estrés en el trabajo (IEE) y las variables sociodemográficas laborales y relacionados a la salud los resultados demostraron significancia en las siguientes variables: l tipo de vinculación en el empleo (p=0,001); apoyo social en el trabajo (p=0,001) y quejas de insomnio. Las dimensiones del IEE que presentaron mayor fuente de tensión fueron las Relaciones Interpersonales y Factores Intrínsecos al Trabajo. La asociación entre los daños y las variables sociodemográficas demostraron significancia entre daños físicos y sexo (p=0,001), apoyo social en el trabajo (p=0,001), satisfacción con la duración del sueño (p=0,002), quejas de insomnio (p=0,001) y consume bebida alcohólica (p=0,005) con evaluación más negativa para Daños Físicos con presencia de enfermedad ocupacional. En la asociación entre la exposición y el desfecho con base en la Razón de Chance (RC) y respectivo intervalo de confianza (IC95%) se observó fuerte significancia con presencia de en enfermedad para Daños Físicos (p=0,012) e (RC=4,32; IC95%: 1,38-13,54), Psicológicos (p<0,001) e (RC=7,46; IC95%: 2,42-23,00) y Sociales (p=0,003) e (RC=10,11; IC95%: 2,21-46-31). Conclusiones: La hipótesis testada para este estudio fue confirmada una vez que hubo asociación significativa entre el estrés en el trabajo y los daños a la salud. Los datos obtenidos revelaron aspectos importantes de los factores de estrés a que están expuestos a los enfermeros en oncología en el cotidiano de trabajo y la presencia de daños físicos, sociales y psicológicos ofreciendo subsidios para la implementación de acciones de promoción de salud del trabajador.

The Role of the Specialist Nurse in Gynaecological Cancer.

PURPOSE OF REVIEW: To explore the role of the specialist nurse within gynaecological cancer. RECENT FINDINGS: There are many different job titles associated with the role of the specialist nurse. Nursing roles are evolving not only to meet the increasing demands on services but also within the ever changing landscape of cancer treatments and improvement in survival. Women and their families need specialist nurses to guide and support them on their cancer journey, along the treatment trajectory and into survivorship. This paper explores specialist nurse roles generally, and within our service which have been adapted to meet service and patient needs within a gynaecological cancer centre. Irrelevant of title, specialist nurses are best suited to meet the patients' needs. The fundamental ethos of the care should always remain having the patients' best interest at heart, acting as their advocate - in essence giving them a voice when they need it.

Experiences of gynecological cancer patients receiving care from specialist nurses: a qualitative systematic review.

BACKGROUND: The care needs of women with gynecological cancer are complex and change over the course of their cancer journey. Specialist nurses are well positioned to play a role in meeting the needs of women with gynecological cancer although their role and scope of practice have not been well defined. As patients are a key stakeholder, understanding their experience of care is an important step in better defining the role and scope of practice of specialist nurses in gynecological oncology in Australia and New Zealand. OBJECTIVES: This review sought to consider gynecological cancer patients' experiences of specialist nursing care. Exploring the patient's experience of care by a specialist nurse is one step in the process of better defining the role and scope of practice of specialist gynecological-oncology nurses in Australia and New Zealand. INCLUSION CRITERIA TYPES OF PARTICIPANTS: This review included studies with a focus on women with gynecological cancer who had been cared for by a specialist nurse. Studies of women with gynecological cancer at any point on the continuum of care from pre-diagnosis to survivorship or end of life, including those with a recurrence of the disease, were included, with no limit to the duration of care received for inclusion in the review. PHENOMENA OF INTEREST: Studies that explored how women with gynecological cancer experience the care and interventions of specialist nurses were included. TYPES OF STUDIES: Qualitative studies including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for review. This review also considered the qualitative components of mixed method studies. CONTEXT: Research conducted in any country was considered for inclusion in this review providing that the study was reported in English. Studies conducted in any setting including, but not limited to, acute hospitals, outpatient/ambulatory clinics, chemotherapy or radiotherapy units, support groups, palliative care units or the patient's home were included. SEARCH STRATEGY: A three-step search strategy was utilized in this review. An initial limited search of MEDLINE and CINAHL was undertaken followed by a comprehensive search using all identified keywords and index terms across all included databases. The reference lists of all identified reports and articles were hand searched for additional studies. METHODOLOGICAL QUALITY: Each paper was independently assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal instrument from the Joanna Briggs Institute the Qualitative Assessment and Review Instrument. When disagreement arose between the reviewers, the given paper was independently appraised by a third reviewer. DATA EXTRACTION: Data were extracted from papers included in the review using the standardized data extraction tool from Joanna Briggs Institute the Qualitative Assessment and Review Instrument. Data extraction was completed independently by two reviewers. DATA SYNTHESIS: Extracted findings from seven included papers were grouped according to similarity in meaning from which 11 categories were developed. These categories were then subjected to a meta-synthesis that produced a set of three synthesized findings. RESULTS: Key findings were extracted from six included papers and classified as unequivocal (U) or credible (C). A total of 30 findings were extracted and aggregated into 11 categories based on similarity in meaning. From the 11 categories, three synthesized findings were developed: i) Tailored care: specialist nurses play a role in understanding and meeting the individual needs of women with gynecological cancer; ii) Accessible care: specialist nurses guide women with gynecological cancer along the continuum of care and are an easily accessed source of knowledge and support; iii) Dependable expertise: women with gynecological cancer express trust and reassurance in the experience and expertise of the specialist nurse. CONCLUSIONS: This systematic review synthesized the findings of seven studies that captured the experiences of women with gynecological cancer who received care from a specialist nurse. The specialist nurse offers tailored, accessible and expert care to women with gynecological cancer. From the synthesis it is recommended that women with gynecological cancer have access to the services of a specialist nurse at key points on the continuum of care, that specialist nurses provide information to patients on their disease and treatment in the form preferred by the patient and ensure that this information has been understood, and that specialist nurses are afforded time to spend with patients to enable greater exploration and identification of patient needs and the provision of personalized care. Further study that considers other key stakeholders in the specialist nurse role in gynecological oncology is recommended in order to gain a full understanding of specialist nurses' contribution to the care of women with gynecological cancer. Additionally, it is recommended that further studies be conducted to seek the perspectives of women with gynecological cancer from culturally and linguistically diverse backgrounds and Indigenous populations on specialist nursing care as they appear to be under-represented in current research.

The implementation and evaluation of a communication skills training program for oncology nurses.

Many nurses express difficulty in communicating with their patients, especially in oncology settings where there are numerous challenges and high-stake decisions during the course of diagnosis and treatment. Providing specific training in communication skills is one way to enhance the communication between nurses and their patients. We developed and implemented a communication skills training program for nurses, consisting of three teaching modules: responding empathically to patients; discussing death, dying, and end-of-life goals of care; and responding to challenging interactions with families. Training included didactic and experiential small group role plays. This paper presents results on program evaluation, self-efficacy, and behavioral demonstration of learned communication skills. Three hundred forty-two inpatient oncology nurses participated in a 1-day communication skills training program and completed course evaluations, self-reports, and pre- and post-standardized patient assessments. Participants rated the training favorably, and they reported significant gains in self-efficacy in their ability to communicate with patients in various contexts. Participants also demonstrated significant improvement in several empathic skills, as well as in clarifying skill. Our work demonstrates that implementation of a nurse communication skills training program at a major cancer center is feasible and acceptable and has a significant impact on participants' self-efficacy and uptake of communication skills.

'My band 8 role keeps me close to patients'.

A charity-funded nursing post may be fulfilling, but is it a dead end for your career progression?

Leadership and Management in Aesthetic Medicine.

The aesthetic provider is obligated to leverage their leadership, management, and teamwork skills on a daily basis in order to deliver optimum aesthetic outcomes for their clients. This article discusses leadership and motivational theories, leadership and management traits, complexity theory, Gardner's tasks of leadership, and the role of emotional intelligence in leading, managing, and following, so the aesthetic provider can identify and align with a particular leadership and management style that suits their practice philosophy.