University of Saint-Etienne, Centre Hygée, Institut Presage, CIC-EC Inserm 1408, Saint-Etienne, France.
Soc Sci Med. 2021 May;277:113896. doi: 10.1016/j.socscimed.2021.113896. Epub 2021 Apr 3.
Florence Nightingale lamented that nurses were seen as merely obedient and devoted. Our two previous oncology studies demonstrated the continuum of strictly curative care and paternalistic care practices among healthcare professionals. At a time when France has just formalized the nursing sciences, this article seeks to shed light on the specifics of the nursing role in oncology and the evolution of standard nursing practices in a rapidly changing environment.
We performed a secondary qualitative analysis, on the same dataset, focusing only on the nursing population (n = 20), to answer a question not excavated through the two previous studies. The COREQ guidelines were used to ensure the rigorous reporting of this study.
The data analysis show that the inherent role and application of medical directives characterise the profession of nursing in oncology. The former is essentially an intermediary role, whereby the nurse directs the patient to a professional specialist for a problem identified through clinical nursing expertise. The latter is expressed through the application of various medical instructions. The results highlight a minor evolution in nursing practices, despite an evolving environment. Oncology nurses do not seem to authorise themselves to become agents of change.
Various reforms and studies of the nursing profession, as well as public funding of programmes dedicated to nursing research were designed to facilitate the integration of Evidence Based Practice to encourage the autonomy of nurses in their practices. Education in research is fundamental to awakening critical thinking and considering scientific validity as vital. Continuing education and leadership by advanced practice nurses are two strong levers to acculturate registered nurses to gaining empowerment, improving their ability to question practices, helping them adapt to increasing the quality of care and making oncology nursing care more efficient. For cancer nurses in France, research education is the challenge to be met.
弗洛伦斯·南丁格尔曾感叹护士仅仅被视为顺从和忠诚的人。我们之前的两项肿瘤学研究表明，医护人员在严格的治疗护理和家长式护理实践之间存在连续性。在法国刚刚正式确立护理科学的时候，本文旨在阐明肿瘤学中护理角色的特殊性以及在快速变化的环境中标准护理实践的演变。
我们对同一数据集进行了二次定性分析，仅关注护理人群（n=20），以回答两个先前研究未挖掘到的问题。使用 COREQ 指南确保了本研究的严谨报告。
数据分析表明，医学指令的固有角色和应用是肿瘤学护理专业的特征。前者主要是一种中介角色，护士通过临床护理专业知识识别出问题，将患者转介给专业的专家。后者通过应用各种医学指令来表达。研究结果强调了尽管环境在不断变化，但护理实践的演变很小。肿瘤科护士似乎没有授权自己成为变革的推动者。
各种护理职业改革和研究以及公共资助专门针对护理研究的项目旨在促进循证实践的整合，鼓励护士在实践中自主。研究教育对于培养批判性思维和将科学有效性视为至关重要至关重要。继续教育和高级实践护士的领导力是使注册护士获得赋权、提高他们质疑实践的能力、帮助他们适应提高护理质量以及使肿瘤护理更有效的两个重要手段。对于法国的癌症护士来说，研究教育是需要应对的挑战。
