Oncology out-patients nursing: a challenge within the changing face of cancer care.

Eighty to 90% of cancer care is delivered in the out-patient setting, and thus the out-patient nurse's role is pivotal to patient care. A report published in 1990 (NHS Management Executive) suggested that there had been no change in the traditional 'handmaiden' role of the out-patient nurse over the previous 20 years. This study was designed using the conceptual framework of the domains of ambulatory nursing practice developed by Verran (1981). Two self-report questionnaires were developed in order to identify what nurses were actually doing in out-patients and the activities which both nurses and doctors felt should be undertaken by nurses. Questionnaires were distributed to all out-patient nurses, clinical nurse specialists and doctors working within an oncology out-patients department in a London teaching hospital. Results showed that oncology-trained nurses were more involved in areas where specialist skills and knowledge are important for patient care. However, there were still non-nursing aspects of care that could be relinquished. Both nurses and doctors saw the role of the oncology-trained nurse as important in undertaking professional nursing activities within the out-patient department. This study suggests that specialist oncology out-patient nurses are beginning to break away from the traditional 'handmaiden' nurse's role utilizing their knowledge and skills within these departments. However, they still have to develop the role further in order to meet the needs of patients and their families within the out-patient setting.