Searching for a professional identity: a qualitative study of the oncology nurses role in a multidisciplinary breast-unit team

Background and aims: Interprofessional collaboration concept in healthcare implies and evoke enhanced nurses’ involvement and role consideration. However, these aspects are often taken for granted by professionals and organizations, while there is not always a mutual awareness of them in interprofessional relationships. Our research aimed to investigate: 1) the impact of nursing within a multidisciplinary team of breast-unit practice; 2) healthcare team and patients’ perceptions of the interprofessional care pathway dimensions (e.g. decision-making process participation, model of care adopted and patients’ centrality). Methods: A qualitative exploratory approach was adopted. Researchers were involved in the activities of the Breast Unit (B.U.): department meetings, review of unit guidelines, observation of professional practice and documents. Moreover, in -depth interviews with 14 patients and a 15 healthcare professionals from the B.U. were conducted. Qualitative content analysis was the approach chosen to infer data from interviews’ transcripts. Results: The analysis’ critical themes showed a very marginal nursing presence and the unfulfilled role of the Case Manager, especially in organizing the patient’s journey and facilitating team communication. Additionally, lack of shared decision-making, team communication problems, and limited interprofessional collaboration could constitute signs of mono-professional B.U. management and potential devaluation of the role of oncology specialist nurses in managing patient care. Conclusion: The supportive roles of cancer nurse and case manager are still struggling within cancer care pathways and the multidisciplinary team, albeit healthcare organizations have been trying to implement and integrate these roles into cancer care programs for several years in Italy. However, our study suggests that the implementation of interprofessional collaboration and a person-centered model of care can also occur through socio-cultural awareness and identification of the role of the specialist nurse.