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WOUND CARE

consultants’ recommended further research, starting with the measurement of bolus effect when

dressings are left in place, by collaborating with the physics department.

Inter-professional relationships. During the qualitative interviews, nurse participants

were invited to describe how inter-professional relationships may affect collaborative practice.

All participants articulated teamwork through team meetings, interdisciplinary co-ordination,

patient allocation and patient flow in the ambulatory care setting. Participants described their

role as patient advocates in their cancer trajectory. One participant in particular described

wound care as being holistic by addressing the whole person and their needs. Wound care was

described to have an interdisciplinary approach, involving different members of the team and

thereby integrating all available resources for best outcomes.

Though the descriptive data show that it is unclear as to whose decision it is to remove or

radiate through dressings, it is noted that the registered nurse is not the sole decision maker in

this aspect of patient care. Nurses value the direction provided by the interdisciplinary team.

One finding in this study was the hierarchy in the model of care that was particularly gleaned

from the interviews with staff nurses, referred to as “subordinated role” (A. Hughes, personal

communication, August 29, 2013). The perception of a subordinate role may impact RTNs

clinical decision-making. However, Advanced Practice Nurses (APN) in the study tended to

present clinical decision-making as more of a collaborative process. Nurse scholars note that

because the treatment complexity of patients undergoing radiotherapy has changed, the evolving

role of Advanced Practice Nurses varies from performing consultations, managing symptoms, to

following patients for recurrence and late side effects and participating in research (Haas, 2010).

The expanded role of the APN offers considerable potential to radiotherapy nursing for