Page 78 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

Theme One: The context of wound care practices in radiotherapy. This theme reflected

the environment in which radiation oncology nurses practice. Each participant was from a

different Radiation Oncology Center from various provinces across Canada. Their position or

roles were quite different; however there were commonalities in their practice environment. A

first subtheme, Hierarchy in the model of care, was noted as a participant reflected on wound

care:

Leadership! without a doubt, …yeah we take the lead role for sure… we seem to work in
such a fluid, we seem to be on the same page, but if I were to have a different opinion, I
probably wouldn’t I wouldn’t question it, I probably would let’s say some don’t want to
give someone Flamazine◊, I wouldn’t challenge them. (P#3)

In this excerpt, two different perspectives are being expressed. While the nurse worked in a

fluid, non-hierarchical manner, she also would not challenge a different opinion. In a study by

Whitworth (2008) accommodation followed by avoidance are the two most preferred styles of

conflict management among female registered nurses. It is noteworthy that authority for

individual patient care tended to be attributed to the Radiation Oncologist as a participant

explained, “We can’t do things based on our judgment, it has to be a combined effort from

everyone as well and the final decision is always the oncologist” (P#2). In the context, reference

to Khan’s (2007) statement that the radiation oncologist heads the treatment planning team is

helpful to explain the process.

Another sub theme, Communication with electronic documentation was common to all

participants’ work environment. The electronic virtual communication exemplified the essence

of inter-professional practice in Radiation Oncology Centres in Canada. One of the participants

explained:

All of our documentation is done electronically, so it’s quick access for someone to
follow up with what the other has done. So I think that’s… huge improvement for us as