The role of a clinical nurse specialist in oncology varies greatly between healthcare systems, and implementing this healthcare role with its multifaceted and co-existing responsibilities may prove challenging. While already integrated into healthcare systems and services in several European countries, Asia, Canada, and the United States, other countries are just beginning to develop clinical nursing specialties. The current study aims to provide healthcare policymakers with up-to-date evidence that focuses on the diverse modes of oncology clinical nurse specialist role implementation across several healthcare systems and pertinent implementation challenges as described in the literature. A rapid evidence assessment was carried out in order to provide policymakers with a rigorous review in a condensed timescale. Initially, only items in the English language were included, and “grey literature” was excluded. We searched PubMed between 1 January 2022 and 28 February 2022 and two independent scholars reviewed items. Based on 64 papers, both non-scientific and papers that met the initial criteria of the rapid review, we describe the modes of implementation of the oncology clinical nurse specialist in the United States, Canada, United Kingdom, Japan, Brazil and Australia. Barriers to implementation include conflicts around role boundaries, skepticism and lack of organizational support, as well as fears that oncology clinical nurse specialists will “encroach” on doctors’ powers. In contrast, an oncology clinical nurse specialist is found to be universally more accessible to patients and their families and can help physicians deal with difficult workloads, among other advantages. Conclusions: This role offers a myriad of gains for cancer patients, oncology physicians, and the healthcare system. The literature demonstrates that it is a necessary role, albeit one that brings specific implementation challenges.
The purpose of the study was to examine the attitudes of nursing and medical teams about the role of oncology clinical nurse specialists in the healthcare system in Israel, where, unlike many countries in the world, such a role has not yet been developed or professionally defined. We conducted 24 interviews with physicians and nurses between August and October 2021. The interviews were transcribed and analyzed using a thematic analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study. Five main themes emerged from the interviews: (1) contribution to the healthcare system, (2) contribution to the patient, (3) drawing professional boundaries, (4) additional responsibilities and authority for oncology clinical nurse specialists, and (5) the field’s readiness for a new position of oncology clinical nurse specialists. The findings provide evidence about the need to develop the role of clinical nurse specialists in the oncology field due to its potential benefits for nurses, physicians, patients, family members, and the healthcare system. At the same time, an in-depth exploration of the boundaries of the role and its implementation, in full cooperation with the oncologists and relevant professional unions, is needed to prevent unnecessary conflicts in the oncology field. Professional development training programs in nursing must create a platform for open dialogue between key stakeholders, nurses, and physicians, in order to help all involved parties, place the benefits to the patients above any personal or status considerations.
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