Sarah Liptrott^​1 and Elaine Lennan^​2

¹European Institute of Oncology, Milan, 20141, Italy

²University Hospital Southampton, Hampshire SO16 6YD, United Kingdom

The field of oncology nursing represents a continuous challenge for numerous reasons. Cancer prevention, diagnostic methods, treatments, side effects and their management as well as living life after cancer are all changing. It is necessary to have a nursing workforce that has the appropriate knowledge and skills in order to be able to provide such complex care. The advancement of knowledge is identified as a key theme within the strategic planning of some of the main oncology nursing societies [1]-[3], by way of education and research. Research is said to be a fundamental component of the educational process and an aid to promote excellence in nursing care [4]. Irrespective of host country or health service delivery model the fundamental issues remain the same.

Outcomes from treatments have improved over the past decade with the availability of additional lines of treatment including targeted therapies. Many countries are experiencing the impact of increased patient survival and management of chronic cancer or treatment related conditions and streamlined services are a clear necessity. Increased capacity has not kept pace with increased demand and for many organisations financial constraints are ever present.   To combat this there has more recently been a shift towards empowerment of patients via educational programmes aimed at self management of cancer and its treatments [5].

There is a real need to promote evidence based practice in nursing and there are multiple opportunities such as complexity of care, symptom assessment and management, education initiatives, communication strategies, and pathway coordination.

With this in mind, this special issue is aimed at the promotion of research and education in the cancer nursing field. The articles presented here come from a variety of fields within oncology nursing practice. They provide illustrations of exemplary practice, nurse led research and educational initiatives in order to inform clinical practice. The papers cross the patient pathway spectrum.

The special issue includes an article by Elaine Lennan reviewing the extended role of the nurse in chemotherapy prescribing and how a multidisciplinary team evaluation strategy is used to ensure effectiveness of implementation into the clinical setting. This is an example of team effectiveness in delivering care. Not all countries have prescriptive authority for nurses but we believe this will be of interest to all areas and perhaps inspire others to lobby their own organisations for change.

Two nurse led research studies have highlighted clinical practice issues relating to haematopoietic stem cell transplantation. One article, by Gargiulo et al, relates to hemorrhagic cystitis – a well recognized side effect of high dose cyclophosphamide conditioning regimen used in bone marrow transplant.  This devastating condition is a side effect of treatment not the cancer and needs careful consideration. Prevention is key but should it occur cystectomy is the poorest outcome. This paper examines prevalence and management strategies and will be of interest to all nurses.  The other paper, by Gori et al, looks at the variation in microbial sampling practices compared with established evidence based literature. This is an important consideration given the recent strategies to decrease misuse of antibiotics whilst at the same time protecting vulnerable groups.  High standards of practice in this area are fundamental.

An example of another contribution of research methods is the literature review. This is represented in a paper by Gilani et al examining chemotherapy handling in pregnancy. Hospitals should have clear polices in this regard but how many are based on evidence?  This paper offers a review of the current evidence and offers recommendations.  We would urge nurses to use this information to cross reference their local guidelines. Given the predominant female workforce this is a pertinent concern for oncology nurses both in the administration of drugs and in the after care of patients who have received chemotherapy.  In additional some of the concepts translated could be of use to the patient and family members.

Oncology nurses are in a prime position to observe and guide the patient pathway. They have direct access to the patient and are involved not only as practitioners, but as patient advocates, promoting and facilitating a streamlined service for patients. A service improvement initiative is outlined in a paper by Helen Roe regarding patients’ perceptions of a trastuzumab service. Insight into logistical difficulties for patients and the need for safe practice have led the specialist nurse to demonstrate how a local issue has been overcome. This paper offers clear nursing leadership in recognising a problem, gauging the stakeholder view and developing and implementing change.

Following treatment, the term survivorship has been used to describe living with and beyond a cancer diagnosis. Much emphasis is put onto the diagnostic and treatment phase of the pathway but given that many more patients are cured or surviving longer a shift in preparing patients better beyond treatment has been apparent in recent years. This is an important paradigm for the future as estimates for 2030 is that one in two people will develop a cancer though all will not die from the cancer [6]. Strategies to guide practitioners and patients through survivorship are discussed in an article by Henry et al looking at the development and implementation of a multi module educational package. This focuses on holistic needs assessment and care planning within an oncology setting. This is an important step in individualising patient needs and tailoring care appropriately.

Sharing experience and information by means of research and publication can aid in the development of nursing both individually and as a profession. It is hoped that the articles within this special issue provide a stimulus to others in the performance and dissemination of research and sharing of novel nursing activities.

We hope you enjoy the variety of practice shared.

 
References

[1] Davies NJ and Batehup L (2011) Towards a personalised approach to aftercare: a review of cancer follow-up in the UK J Cancer Survivorship 5 142–51
[2] European Oncology Nursing Society (2014) EONS Strategic plan  http://www.cancernurse.eu/about_eons/strategy.html accessed 04/04/14
[3] International Society of Nurses in Cancer Care (2013) Strategic Plan 2014-2017 http://commondatastorage.googleapis.com/isncc-core-documents/ISNCCStrategicPlan-2014-2017 FINAL.pdf accessed 04/04/14
[4] Oncology Nursing Society (2013) ONS Strategic Plan http://www2.ons.org/about/StrategicPlant accessed 04/04/14
[5] Tingen MS, Burnett AH, Murchison EB and Zhu H (2009) The importance of nursing research J Nursing Edu 48 (3) 167–70.
[6] www.macmillan.org accessed 04/04/14