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What makes an expert cancer nurse?

Photo: What makes an expert cancer nurse?
People affected by cancer hold nurses in high regard. Not only do they provide information, manage complex cancer symptoms and treatment side-effects, but they support people emotionally through their understanding, encouragement and respect.

But what makes an expert cancer nurse and how can you define these qualities?

Professor Meinir Krishnasamy is Chair of Cancer Nursing at the University of Melbourne Centre for Cancer Research and Peter MacCallum Cancer Centre.

Professor Krishnasamy and a group of 24 cancer nurses identified seven key themes, recently published in Cancer Nursing, which can help to improve patient outcomes and inform and support professional development for cancer nurses.

“For the first time, this study has captured the characteristics of cancer nursing expertise,” Professor Krishnasamy says.
“This means that healthcare administrators, multidisciplinary oncology staff and, critically, patients and family can now recognise this expertise and advocate for it, as a component of their care and treatment.”

A thirst for learning

The first characteristic identified by the study looked at training, highlighting that formal studies in oncology nursing would be combined with on-the-job experience and lifelong learning.

Yvonne Panek-Hudson, a nurse practitioner at Peter Mac, said that expert cancer nurses see knowledge as an infinite building block that requires active commitment and participation.

“Expert cancer nurses are driven by a passion for knowledge in order to participate in clinical decision making, nurse-led research, leadership and education,” she says.

“They understand that knowledge can be gained from formal academic learning and through building relationships, communication, and spending time with patients, families and colleagues.”

Inspiring the next generation

Expert cancer nurses were identified as trusted role models – influencing and inspiring colleagues to do their best, and providing support, encouragement, and constructive criticism.

These nurses face highly emotional situations every day, and lead by example when it comes to self-care and emotional wellbeing.

Nadine Borschmann, a nurse unit manager at Peter Mac, said that “cancer nurses recognise that through the act of attending to your own physical and emotional wellbeing you are supporting enhanced patient care and teamwork.”

Ready for anything

The third characteristic the study identified was adaptability and resourcefulness – an important quality due to the complexity and quality of contemporary cancer care which changes at an incredible pace.

They apply their self-initiated learning, skills and leadership capabilities to new situations, and call on other experts around them to workshop problems.

Diane Davey, a clinical nurse specialist at Peter Mac, said that the start of the COVID19 pandemic illustrated the adaptability of expert cancer nurses.

"Expert nurses quickly adjusted practices to ensure patient and staff safety while delivering quality care, using technology such as videoconferencing to support patients and share information with colleagues near and far."

Compassionate and tailored communication

Expert cancer nurses understand the impact of being diagnosed with a life-threatening disease and potential treatment outcomes. No patient or family will be the same, so they are able to compassionately adapt this information for the individuals they are talking to.

They also effectively communicate with other members of the health care team, translating information – such as what social supports a patient has – to enable the team to build wholistic and effective treatment programs.

“Compassionate care and therapeutic communication are two core foundations of cancer nurses that enable deeper therapeutic connection and care of patients and their loved ones,” said Nadine Borschmann.

Motivated to do their best for their patients

The driving motivation of expert cancer nurses identified in the study was a passion to provide the best care for their patients. They want to engage in research and incorporate evidence-based practice into their work.

The passion, knowledge and commitment of expert cancer nurses inspires and motivates other nurses around them.

Yvonne Panek-Hudson says that expert cancer nurses provide optimal care for a diverse group of patients.

"Cancer patients range from those newly diagnosed with cancer, in survivorship follow up and patients receiving end of life care, and all required tailored care," she says.

The patient comes first

“A nurse simply cannot be considered an expert if they are not deeply driven by providing and enabling patient-centred care,” says Diane Davey.

The study identified that expert cancer nurses have the knowledge, confidence and capability to speak up and advocate for their patients.

They have a compassionate and wholistic approach to care, and consider factors including human response to fear and uncertainty. Experts don’t shy away from death, and allow patients to express themselves in what can be an emotional and reflective time.

Creating a positive and supportive cultures

The last factor the study identified was working culture, noting that expert cancer nurses create supportive environments that value multidisciplinary teams, with nurses and other clinicians trusting, supporting and lifting each other up.

Organisational support and mentorship are an important part of their practice, and they influence a culture that values learning and recognition of success.

“A positive and nurturing learning environment with role models for cancer nurses to strive towards enables our workforce to be inspired and flourish,” says Nadine Borschmann.

So, what’s next?

“These qualities of knowledge, commitment to learning, patient advocacy, adaptability, mentorship, communication and evidence-based practice are being used to establish national consensus on cancer nursing expertise among Australian cancer nurses,” said Professor Krishnasamy.

“The next step will be to observe nurses displaying these characteristics in practice and to evaluate relationships between expertise and patient and health system-level outcomes, achieving what all expert cancer nurses want – the best for the patient.”

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