Experiences and perspectives of patients and clinicians in nurse-led clinics in an oncological setting: A sequential multi-methods study.

Abstract

The aim is to explore patient satisfaction with nurse-led consultations and the health care professionals' experiences on the expanded scope of nursing practice. A sequential multi-methods study is comprised of a study-specific questionnaire to patients with gynecological- or breast cancer followed by a survey among the involved physicians. Finally, two focus group interviews explored the perspectives of clinical nurse specialists. Study participants were patients (n=109), physicians (n=12) and clinical nurse specialists (n=10). Patients expressed that their concerns and questions were addressed, and even sensitive and very personal issues were discussed. They reported that they were able to follow self-management strategies to cope with side effects (89.8%) and emotional reactions (68.8%). The clinical nurse specialists described how they sought to embrace a person-centred approach in the consultations. The expanded scope of nursing practice resulted in enhanced feelings of professionalism. The physicians appreciated the clinical nurse specialists' skills and competencies and were comfortable referring patients to nurse-led consultations. Nurse-led consultations are in a pivotal position to establish a culture for person-centred nursing practice. We recommend developing a strategy for implementation of nurse-led consultations and to clarify and align expectations between the involved. Nurse-led consultations have the potential to offer quality-of-care and increase clinical nurse specialists' professional identity and job satisfaction.