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WOUND CARE

1) patient voices would be further represented as nurses advocate for them; 2) more quality

improvement projects would be initiated as nurses identify practice needs; 3) there would be

increased nursing autonomy leading to enhanced job satisfaction; and 4) the role of the RTN

would evolve as an essential member in treatment planning, as well. In order to employ and

maintain the culture of shared governance, the attributes of inter-professional collaboration,

continuous support and education are necessary. In the realm of wound management in radiation

oncology, standardizing practices would help to validate and evaluate ‘best practice’. Expert M.

McQuestion suggests:

I have read that changing practice and moving evidence into practice can take 17 years.
We need strategies to address personal perceptions and responses to the evidence to
support the uptake of evidence and for nurses to be at the tables when decisions are being
made by purchasing about which products are brought into an organization, so the
evidence can be used rather than decisions based solely on cost. (personal
communication, August 30, 2013)

This excerpt indicates the process involved in health care systems resource allocation that might

not have all the stakeholders involved in decision-making. Eventually, the drivers of resource

management (radiation therapy nurses in this study) are required to decide best practice. A

connection between both the resource allocation and resource management is imperative to the

care processes and environment.

The effect of power hierarchies in the inter-professional context versus the need for

collaboration is nuanced with promoting power equality among professionals which in turn is

crucial to including the client in the health care process (Marshall, Medves, Docherty, &

Paterson, 2011, p. 453). These authors reiterate that resistance to collaboration should be

resolved through research, education and leadership because use of collaboration may change

the way professionals and patients consider the health care encounter (p. 453). Careau, Vincent,