The Experiences of Specialist Nurses Working Within the Uro-oncology Multidisciplinary Team in the United Kingdom

Abstract

Purpose:United Kingdom prostate cancer nursing care is provided by a variety of urology and uro-oncology nurses. The experience of working in multidisciplinary teams (MDT) was investigated in a national study.Design:The study consisted of a national survey with descriptive statistics and thematic analysis.Methods:A secondary analysis of a data subset from a UK whole population survey was undertaken (n = 285) of the specialist nursing workforce and the services they provide. Data were collected on the experience of working in the MDT.Results:Forty-five percent of the respondents felt that they worked in a functional MDT, 12% felt that they worked in a dysfunctional MDT, and 3.5% found the MDT meeting intimidating. Furthermore, 34% of the nurses felt that they could constructively challenge all members of the MDT in meetings. Themes emerging from open-ended questions were lack of interest in nonmedical concerns by other team members, ability to constructively challenge decisions or views within the meeting, and little opportunity for patients’ wishes to be expressed.Conclusions:Despite expertise and experience, nurses had a variable, often negative, experience of the MDT. It is necessary to ensure that all participants can contribute and are heard and valued. More emphasis should be given to patients’ nonmedical needs.

Barriers to delivering advanced cancer nursing: A workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit

“…These findings may be related to different hospital cultures, such as whether an LCNS chairs the meeting. Similar associations were also found with nurses who felt uncomfortable or intimidated within MDT settings, which highlights an opportunity to improve MDT culture, inclusivity and engagement of all members as integrated care progresses across sectors (Harris et al, 2013, Punshon et al, 2017.…”

Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care

“…Whereas the views on development of individual competence did not differ between physicians and nurses/coordinators, the latter group reported being less involved in the case discussions. An observing rather than an interacting role of nurses in MDT meetings has been reported also by other investigators with reports that the medical perspectives dominate over care perspectives during MDTMs [ 18 , 19 ]. An important aspect of improvement of MDTMs relate to an appropriate skill mix of a multidisciplinary team and development and implementation of MDTM structures and procedures [ 20 ].…”

“…These observations suggest that the roles of nurses and coordinators should be highlighted to improve MDTM function. Responsibilities that could be targeted to nurses include consideration of comorbidity, psychosocial aspects, rehabilitation and supportive care needs, patient preferences and relevant clinical trials [ 19 ]. Cancer care coordinators could take responsibility for all relevant documentation being available prior to the case discussions [ 18 , 20 ].…”

A survey of nursing and multidisciplinary team members' perspectives on the perceived contribution of intellectual disability clinical nurse specialists

“…The CNS capability for decision-making is important in order to enable shared decision-making (Lamb et al, 2011), and it is recognised that the role of the CNS within the MDT is diverse (Ream et al, 2009). However, the CNS is vital to the effective working of the team (Amir, Scully, & Borrill, 2004;Punshon et al, 2017), and despite evidence supporting the development of the role of the CNS within the MDT, barriers exist to CNS taking roles in leadership, clinical decision-making and management within the MDT (Devitt, Philip, & McLachlan, 2010;Kidger, Murdoch, Donovan, & Blazeby, 2009;Lamb et al, 2011;Lamb & Sevdalis, 2010).…”