Does the Macmillan Cancer Care course for Practice Nurses and the Primary Care Nurse Facilitator role enhance nurse consultations and holistic care for patients and support the implementation of nurse led cancer care reviews in general practice?
Problem
With increasing numbers of people living with and beyond cancer, the role of primary care in the management of cancer patients is evolving. As new and alternative approaches to patient follow up, are being considered practice nurses have been identified as key professionals who could have a vital role in managing cancer as a long-term condition. This research is an evaluation of the Macmillan cancer care course for practice nurses and the associated role of the Primary Care Nurse Facilitator. The research investigates practice nurse’s views on the impact of the course, in particular; perceived benefits, applying new skills and transferring knowledge to clinical practice, increased ability and confidence to administer cancer care reviews, cancer related activity and post course follow up support.
Approach
A mixed methods approach was adopted, involving a survey for practice nurses who completed the course and follow up qualitative interviews. The survey was designed to enable a broad understanding of the impact of the course and contained 20 questions plus 2 questions for open text box responses. The survey was piloted with sub sample of 3 practice nurses. Six semi-structured interviews were conducted, lasting around 20 -30 minutes either face-to-face or by telephone. Topics for the interviews were formed from responses to the survey, aiming for more in depth exploration of key questions. The interviews provided greater depth in understanding the nurses’ experience and the variations in implementation that occurred.
Findings
Twenty-one practice nurses returned a completed survey, ranging in experience from 1-20+ years in a practice nurse role. Survey findings indicate enthusiasm for the course and increase in practice nurse confidence to start a conversation with patients around cancer, care and other issues such as emotional or psychological problems, employment and finances. Skills from the course were used during routine consultations with patients and long-term conditions reviews. These included signposting to local services and referrals to other professionals. The survey findings illustrate some of the challenges of implementing nurse led cancer care reviews in general practice, such as lack of time, administrative support and support from colleagues. Findings from the interviews indicate common facilitating factors for overcoming challenges such as, systems for identifying and recalling patients with cancer, peer support and follow up with the Primary Care Nurse Facilitator.
Consequences
The Macmillan cancer care course and Primary Care Nurse Facilitator role are a valuable educational resource to upskill practice nurses to conduct nurse-led cancer care reviews and provide holistic, supportive care to patients.This research identifies that there is a need for nurses to have time to establish a system for nurse-led cancer care reviews in their general practice and consultation time to conduct reviews with patients. This can be achieved through a policy initiative such as the LES.