Role of the breast care Clinical Nurse Specialist in facilitating decision-making for treatment choice: a practice profile

Abstract

Recently, the Breast Care Clinical Nurse Specialist (CNS) role has incorporated facilitating decision-making for breast cancer patients. Contemporary breast cancer is experienced as a complex paradigm of choice involving multiple options and a variety of possible outcomes of substantial uncertainty.This project, using a practice profile approach, endeavours to highlight that the Breast Care CNS's role in providing this decisional support must be developed and evaluated. A practice profile allows examination of an area of practice in some depth. In this case, the methodology used adopted a qualitative, descriptive approach using interviews, observations and a demographic questionnaire.The profile indicates that 40% of the role is spent on this area.The profile suggests that facilitation occurs in different stages, that structural/contextual factors may influence this and that Breast Care CNSs generally find this area of care stressful in terms of striving for a neutral role and ascertaining what the patient really wants. Implications and recommendations are highlighted that emphasize the importance of developing this role; a role which will become more challenging as treatment choice becomes more complex.