There has been a growing international interest in extending nursing practice beyond the level acquired at initial registration (East et al., 2015) to advanced nursing roles. The role of the nurse has steadily evolved over the previous two decades due to influencing factors such as developments in healthcare delivery, financial restraints and increasing service user expectations (Furlong & Smith, 2005). One commonly identified category of Advanced Practice Nursing is the Clinical Nurse Specialist (CNS) role (East et al., 2015; International Council of Nurses, 2020) which has been evolving over the past 20 years (Balsdon & Wilkinson, 2014

It is estimated that 60% of patients diagnosed with head and neck cancer will receive radiotherapy at some stage in their disease trajectory. The aim of this literature review was to find and analyse papers pertaining to the lived experiences of patients with head and neck cancer receiving radiotherapy. The review identified a limited number of high-quality research papers focusing on this topic, with only 10 papers fitting the inclusion/exclusion criteria. The majority of the investigative studies were not generalisable owing to small sample sizes and many of them being conducted in only one centre. However, the findings do highlight and contribute to the understanding of the lived experiences of this patient group and provide some insight into the unique physical, social, and psychological difficulties they encounter as a result of their treatment. There appears to be a need for further high-level research into these patients, particularly focusing on the provision of support and information prior to, during, and following radiotherapy. Further attention needs to be paid to preparing patients for the slow recovery following radiotherapy. Interventional studies are also required to develop clinical guidelines and protocols that can assist health professionals in meeting the holistic needs of this patient group.

Background Clinical cancer research trials may offer little or no direct clinical benefit to participants where a cure is no longer possible. As such, the decision-making and consent process for patient participation is often challenging. Aim To gain understanding of how patients make decisions regarding clinical trial participation, from the perspective of both the patient and healthcare professionals involved. Methods In-depth, face to face interviews using a grounded theory approach. This study was conducted in a regional Cancer Centre in the United Kingdom. Of the 36 interviews, 16 were conducted with patients with cancer that had non-curative intent and 18 with healthcare professionals involved in the consent process. Results ‘Nothing to lose’ was identified as the core category that underpinned all other data within the study. This highlighted the desperation articulated by participants, who asserted trial participation was the ‘only hope in the room’. The decision regarding participation was taken within a ‘trusting relationship’ that was important to both patients and professionals. Both were united in their ‘fight against cancer’. These two categories are critical in understanding the decision-making/consent process and are supported by other themes presented in the theoretical model. Conclusion This study presents an important insight into the complex and ethically contentious situation of consent in clinical trials that have non-curative intent. It confirms that patients with limited options trust their doctor and frequently hold unrealistic hopes for personal benefit. It highlights a need for further research to develop a more robust and context appropriate consent process.

Student evaluation of teaching is routinely completed as modules and programmes of study at higher education institutions conclude. The evaluations are often focused on the educational value and experience. For programmes with healthcare professionals as students, the impact of the learning on patient care and clinical practice is not routinely captured in these student evaluations. These insights are crucial as the definitive impact of learning for many educational programmes of study for healthcare professionals is to enhance patient outcomes. The aim of this qualitative research study was to capture the impact of a post-registration Specialist Practice in cancer pathway for registered nurses in the context of Northern Ireland following completion of the programme. Eleven participants engaged in interviews in 2021 who had completed the education programme from 2013 to 2021. Two themes inductively emerged from the data which provided insights into the specific impact of the education programme on patient care and clinical practice. Theme one identified patient outcomes improved, and was related to five sub themes; development of nurse’s clinical knowledge; enhanced awareness of the holistic impact of cancer; greater understanding of patient services available; development of clinical networks; and greater decision-making ability. Theme two related to the impact of the qualification on clinical practice through an increase in their professional credibility within the multidisciplinary team in cancer services. The debate on how to capture the impact of education on patient care and clinical practice in cancer care, should consider how to routinely capture this data.

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