Assessing nursing problems of importance for the development of nursing care in a radiation therapy department

The challenges to nurses working in the rapidly changing milieu of radiotherapy in cancer care are great. New treatment regimens continually require reexamination of old assumptions about patients' needs and communication between colleagues. In order to continue the development of the nursing care in the radiation therapy department, the purpose of this study was to assess the nursing problems experienced in the care of the cancer patients and the nursing problems experienced in work with other professionals from the nurse's perspective. Eighteen of the 38 nurses in the radiation therapy department were invited to participate in the study. The mean age of the nurses was 39 years (range 25-57 years). The study was carried out by using a three-phase, structured, communication-process method according to the Delphi technique. The nurses reported "poor follow-up of patients who have completed radiation therapy," closely followed by "finding time to document the nursing care" and "finding time to treat the scheduled patients" as the most problematic areas of importance for the development of nursing care. The nursing problems considered to be the most difficult in the work with other professionals were "lack of communication," "lack of knowledge of our work and competence," and "lack of comprehension of each other's professions." With the present trend in the health care system toward smaller financial resources, it is necessary to find new ways of organizing nursing care in order to find time to take care of the patient's problems during and after the radiation therapy. This study constituted the base for organizing a nursing care clinic in the department with sufficient time to assess and monitor side effects, patient education, sexual counselling, and coping assistance.