Page 85 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

I make recommendations through orders, medical directives and then for areas where it
is needed for further expansion of the care, then I would collaborate with the physician
and have physician order as well. It has to be with physician order. (P#4)

Another RTN participant depicted consistent inter-professional interactions in the clinical setting

to plan individual patient care:

Nursing is the one who does the primary assessment and make some clinical judgments
and you know we have opinion from the oncologist, 9/10 it’s kind of a combined effort
from nursing and oncologist to decide what’s best treatment for skin care. (P#2)

Another sub-theme is Patient advocacy in relation to wound management. Reinhard,

Grossman, and Piren (2004) aptly describe client-focused advocacy as the participatory process

of enhancing client autonomy and assisting clients in voicing their values by involving clients in

co authorship of their health narrative (p.283). Participants emphasized their role as patient

advocates in their cancer trajectory as illustrated in the following comment of one participant,

“We practice primary nursing so we are very advocative for the patient” (P#1).

A reflection of a patient’s current status and its influence on wound care management is

suggested by the participant, “Compliance from the patient, as well as if there are other factors

like co-morbidities or level of understanding” (P#2). Referral to necessary care and resources

available for the patient undergoing radiotherapy might become part of the Radiation Therapy

Nurses’ role while providing wound care, as explained by this participant:

So if I am seeing them and I see that maybe they are having a psychosocial issue, or
they’re not having nutrition, you call in all those colleagues that need to help that person
through their aspect of care. (P#3)

A participant described wound care as being holistic. The participant provided insight on the

patient factors and interdisciplinary approach in wound management. The focus on patient care

as a whole was explained with this in-depth description:

There’s multiple facets that you have to address; we look at whole patient. We don’t look
at just one aspect of that patient, so even if I’m seeing a patient for wound care