The experience of clinical nurse specialists in oncology with reference to psychological support: an IPA study

Introduction: The presence of psychological distress following a diagnosis of cancer is well evidenced. To meet this need, the role of oncology clinical nurse specialists (CNSs) has expanded in line with national guidance to include the provision of psychological support to patients and their families. Skills training and supervision has been provided by clinical psychologists. However, there has been little research focusing on the role and experience of the CNS doing this work. This present study researched the experience of CNSs working with patients with cancer and their families in order to understand more fully their experiences.
Method: Eight CNSs from four NHS trusts were interviewed about their experience of their role, including the recent expectation of offering psychological support. These interviews were transcribed and individually analysed using Interpretative Phenomenological Analysis, before conducting a group analysis to identify overall themes.
Results: Four key themes and fourteen sub-themes emerged through this analysis. The first theme ‘The everyday experience’ captured the experiences and demands of participants in their day-to-day work. ‘The impact of working with patients’ captured a range of experiences of the emotional and existential impact that doing this work involves. ‘Understanding and working out the role’ illustrated the way in which participants must work out their role and identity within their organisational context. Finally, participants experienced ‘Needing recognition and support’ as they carry out this vital role. Two overarching phenomenological themes were also identified as ‘ambivalence’ and ‘uncertainty’ and these run throughout the experiences of all the participants.
Discussion: The findings were examined in relation to existing literature. The strengths and limitations of the study were presented and future research suggested. Finally, the clinical implications of this research were identified which included suggestions for training, the use of supervision and greater role clarity.