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EDITORIAL |
President, Oncology Nursing Society
Imagine being asked to speak to a group of colleagues in a profession other than your own on a topic that is within your professional realm of expertise. You have significant information to share with this group that would improve their knowledge and practice in a specific area of cancer care. But, they find out you are not "one of their own" and decline to have you speak. In the 21st century one might question such a limited point of view. Unfortunately, it is present every day. I experienced just such an occurrence when a group of oncology physicians decided they did not want to have a nurse practitioner speak to them. What could I possibly teach them?
Most of us experience very positive relationships with the colleagues we work with on a daily basis. For me, this represents other nurses, physicians, dietitians, social workers, and physical therapists. The care of the patient with cancer is exceptionally complex and requires the skills of multiple health care professionals to achieve the best outcomes. Each profession has a unique body of knowledge and expertise that, when combined with others, ultimately benefits the patient. There is much we can learn from each other. As discussions of what constitutes quality cancer care within this ever-changing health care system occur, I have noticed an interesting phenomenon. When physicians speak of multidisciplinary care, they generally are thinking of medical oncologists, surgical oncologists, and radiation oncologists. When nurses speak of multidisciplinary care we generally are referring to physicians, nurses, physical therapists, and so on. As professional associations, national policy boards, and the government attempt to define what quality cancer care should be or who should provide it, I maintain that an all-inclusive definition of multidisciplinary care be our guide.
There are numerous ways we can make this vision a reality. Who is sitting at the table as national health policy panels or work groups within your health care setting are formed? Are there a variety of perspectives, including those of the consumer that will guide and balance the work? If a nurse was included, was it because the perspective was genuinely valued? In developing research projects, are the people involved in the project included in the planning process and publications? Oncology nurses have significant expertise in arenas of quality of life, psychosocial issues and symptom management. For example, the Oncology Nursing Society Foundation has funded over $870,000 for research related to fatigue and quality of life that has yielded improved tools for assessing fatigue in both the adult and pediatric populations, and for exercise interventions to relieve fatigue. Would you read an article or a book published by a nurse or be open to learning from a colleague who is not a physician? Have you considered using a multidisciplinary panel for presentations at annual conferences? As the largest oncology health care professional organization in the world, the Oncology Nursing Society is beginning to use the multidisciplinary approach in selected sessions we present at our annual convention. As professionals, nurses included, we tend to publish only within journals dedicated to our own profession. We must challenge each other to consider expanding such views. Who is involved in the care of the patient population being discussed? Which other professionals might also learn from our research, knowledge, or expertise to improve cancer care? Who might we partner with to produce a paper or a study that is broader in scope?
As an oncology nurse for over 20 years, I have had the good fortune to work with and to be mentored by many wonderful physicians who have helped me to grow professionally. I believe that they have learned from me as well. It is my sincere hope that as oncology professionals committed to the care of patients with cancer, we can all see the value of what our colleagues have to offer in achieving quality care and what it is we can indeed learn from them. As you reflect on your practice, I hope you will commit to finding ways to make it truly more interdisciplinary.
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