P28.03 An Autoethnographic Study Exploring the Role of the Lung Cancer Nurse Specialist in the National Optimal Lung Cancer Pathway

Abstract

Background: The National Optimal Lung Cancer Pathway (NOLCP) is a pathway hospitals in the UK are expected to follow which advocates a standardised care pathway. The pathway is aimed at improving lung cancer care to enable time to treatment within 49 days. The Lung Cancer Nurse Specialist is a core member of the Multidisciplinary Team providing expert knowledge, specialist assessment and advanced communication. They also act as an advocate for patients on the NOLCP. The aim of study was to explore the role of Lung Cancer Nurse Specialist in the NOLCP and the Lung Cancer Specialist Nurse's experience of the “meet the Lung CNS “ aspect of the NOLCP. An autoethnographic study of 16 practicing Lung Cancer Nurse Specialist’s from different centres across the country who reflected on the first meeting with two patients on the NOLCP. Written reflections were subjected to thematic analysis and Gibbs reflective model was used to complete the reflections. Four key themes were identified: 1. Co-ordination of complex care. This is delivering care in accordance with the NOLCP, avoiding delays and ensuring right care, right time in the right place. 2. Relationship building and advanced communication. Utilising specialised knowledge along woth advanced listening and communication skills. Being accessible and providing accurate information and advice 3. Specialist patient assessment and management. This involves the undertaking of specialist holistic assessments to support the treatment and management of lung cancer and its symptoms. 4. Support and management of emotions and expectations. Providing emotional support and management of unrealistic expectations for patients and relatives, as well as themselves and the wider healthcare community These four themes were underpinned by a fifth cross-cutting theme which was effective utilisation of resources. Lung Cancer Nurse Specilaists are pivotal in the delivery of high quality lung cancer care. Through the provision of specialist and expert nursing care, Lung Cancer Nurse Specialists co-ordinate complex care, undertake holistic patient assessment and support and management expectations. This is achieved through successful relationship building and advanced communication skills and appropriate and effective utilisation of resources. Recommendations Clarification of the Lung Cancer Nurse Specialist role is required both locally & nationally. Implementation of the NOLCP will add increased demand on Lung Cancer Nurse Specialist services which are already under-resourced. Adequate provision must be made to meet this requirement.