Collaboration Is Key to Cancer Care
The Oncology Nursing Society (ONS) just concluded our 32nd Annual Congress. It was energizing to participate in a forum of over 6,000 oncology professionals discussing the role for nursing and ONS in the future of cancer care. The call for collaboration to solve the work force shortages and meet the challenge of coordinating care for the growing number of cancer survivors was heard throughout our congress. Oncology nurses represent a vital component of quality cancer treatment across the spectrum of care. The shrinking nurse work force ultimately will result in fewer nurses who choose oncology nursing as a specialty. The conceivable result is a negative impact on access to quality cancer care beginning with prevention and early detection and extending through treatment to survivorship.
The physician and nurse work force shortage has been documented and acknowledged. Simultaneously, the population is aging, and cancer incidence and prevalence will follow these age trends since cancer disproportionately occurs during and after the sixth decade. It is not just the patients who are aging. The aging of physicians and nurses, as well as the work force shortages, promise to create barriers in access to care that extend beyond those we already face. In her 2005 Guest Commentary, Karen Stanley, ONS immediate past president, described a "perfect storm" of an aging population, the correlation of aging and increased cancer risk, and increased demand for health care. Clearly, the work force shortage adds to the perfect storm and requires a multifaceted, transdisciplinary approach because no one intervention or profession can remedy these circumstances.
A recent survey by the American Society of Clinical Oncology (ASCO) acknowledges and describes how traditional approaches to the physician shortage do not offer viable solutions. NCI was able to generate specific projections of cancer prevalence, and the demand for oncology services through 2020 using data from SEER and the SEER Medicare Linked Databases. The ASCO study suggests that, from their perspective, several potential solutions to this crisis exist. One scenario discusses the increased use of nurse practitioners (NPs), thus offering an opportunity to improve practice efficiency and efficacy. In this study, it was reported that approximately 50 percent of oncologists currently work with NPs (or physician assistants) and report higher productivity, improved patient care, and professional satisfaction.
Increasing and improving collaborative practice among oncologists and advanced practice oncology nurses offers a unique opportunity to meet the increase in professional demands while intercepting the potential for increased barriers to quality cancer care.
ONS and ASCO's Clinical Practice Committee have met, and we will continue our dialog to identify interventions that address the work force shortage and to explore and develop collaborative models of care based on a team approach.Those diagnosed with cancer seek and are entitled to the most current information from a variety of sources during their care and after completion of treatment. Access to care and accurate information are critical to their journey. They expect a team of professionals to work collaboratively to provide optimal care. Quality cancer care provided by a transdisciplinary team of oncology experts should be a human right.