Care Beyond Limitations: Lived Experiences of Non-specialized Nurse Practitioners Handling Breast Cancer Patients

Abstract

The increasing prevalence of breast cancer, coupled with the shortage of oncology nurses, places the responsibility of patient care on non-specialized nurse practitioners. Despite limited training and expertise, these nurses strive to address the multifaceted needs of breast cancer patients. This study explores the lived experiences of non-specialized nurse practitioners in providing care for breast cancer patients within various health settings in Malaybalay City, Bukidnon. Employing a qualitative descriptive phenomenological research design, the study used purposive sampling to select seven (7) non-specialized nurse practitioners as participants. Data were collected through in-depth, face-to-face interviews, which were recorded, transcribed, validated, and refined for accuracy. Colaizzi’s descriptive phenomenological method guided the data coding process, while Van Manen’s lifeworld existential framework informed the analysis. Three themes emerged from the findings: (1) caring with caution, (2) caring with grit, and (3) caring with confidence. The results reveal that non-specialized nurse practitioners evolve through their experiences in breast cancer care, overcoming initial limitations and progressively building competence and confidence. Continuous patient interactions serve as a catalyst for professional growth, with experience becoming their greatest teacher. This study underscores the resilience and adaptability of non-specialized nurse practitioners and highlights the importance of providing targeted training and support to enhance their skills and confidence in managing complex cancer care.
Keywords: non-specialized nurses, breast cancer, care services, lived experiences

Author Biography

Carina Joane V. Barroso, Bukidnon State University
College of Nursing, Assistant Professor 3

References

Abdelaziz, S. H., Salem, D., Zaki, H., & Atteya, S. (2015). Nurse’s Role in Early Detection of Breast Cancer through Mammography and Genetic Screening and Its Impact on Patient's Outcome. International Journal of Medical and Health Sciences, 9(2), 155-162.

Ahmed, A.K., Atta, M.H.R., El-Monshed, A.H. et al. The effect of toxic leadership on workplace deviance: the mediating effect of emotional exhaustion, and the moderating effect of organizational cynicism. BMC Nurs 23, 669 (2024).
Alibudbud R. (2023). Addressing the Burnout and Shortage of Nurses in the Philippines. SAGE open nursing, 9, 23779608231195737.

Alipio, J., Florendo, M. G., Montilla, M. G., & Narvaez, R. A. (2023). Compassion Fatigue in Oncology Nurses: An Integrative Review. World Journal of Cancer and Oncology Research, 85-10

Aparicio, M., Centeno, C., Robinson, C., & Arantzamendi, M. (2018). Gratitude between patients and their families and health professionals: A scoping review. Journal of Nursing Management, 27(2), 286–300.

Ariza - Heredia, E. J., & Chemaly, R. F. (2018). Update on infection control practices in cancer hospitals. CA a Cancer Journal for Clinicians, 68(5), 340–355.

Banks, J., Lopez, V., Sahay, A., & Cleary, M. (2023). A Scoping Review of Compassion Fatigue Among Oncology Nurses Caring for Adult Patients. Cancer Nursing, 10-1097.

Bakker, D., Strickland, J., MacDonald, C., Butler, L., Fitch, M., Olson, K., & Cummings, G. (2013). The context of oncology nursing practice: An integrative review. Cancer nursing, 36(1), 72-88.

Berma, A., Mohamed, H., & Nosier, H. (2021). Organizational Silence as a Mediator Factor between Work Place Toxicity and Thriving among Nurses. Assiut Scientific Nursing Journal, 9(26.), 10–20.

Blackburn, L. M., Thompson, K., Frankenfield, R., Harding, A., & Lindsey, A. (2020, January). The THRIVE© Program:

Building Oncology Nurse Resilience Through Self-Care Strategies. In Oncology Nursing forum (Vol. 47, No. 1).

Callis, A. M. B. (2020). Application of the Roy Adaptation Theory to a care program for nurses. Applied Nursing Research, 56, 151340.

Cant, R. P., & Cooper, S. J. (2014). Simulation in the internet age: The place of web-based simulation in nursing education. Collegian, 21(2), 153-158.

Chan, R. J., Teleni, L., McDonald, S., Kelly, J., Mahony, J., Ernst, K., Patford, K., Townsend, J., Singh, M., & Yates, P. (2020). Breast cancer nursing interventions and clinical effectiveness: a systematic review. BMJ supportive & palliative care, 10(3), 276–286.

Charlton, M., Schlichting, J., Chioreso, C., Ward, M., & Vikas, P. (2015). Challenges of rural cancer care in the United States. Oncology (Williston Park), 29(9), 633-640.

Chow, K., & Dahlin, C. (2018, August). Integration of palliative care and oncology nursing. In Seminars in oncology nursing (Vol. 34, No. 3, pp. 192-201). WB Saunders.

Cohen, J., Dempsey, M., & Miller, S. (2016). The role of continuing education in oncology nursing: A qualitative review. Journal of Nursing Education and Practice, 6(3), 45-52.

Converso, D., Loera, B., Viotti, S., & Martini, M. (2015). Do positive relations with patients play a protective role for healthcare employees? Effects of patients’ gratitude and support on nurses’ burnout. Frontiers in Psychology, 6.

Cuthbertson, L., Lauder, W., Steele, M., & Cleary, S. (2020). Emotional resilience in the oncology workforce: An integrative review. Journal of Advanced Nursing, 76(3), 803-815.

Da Mata Tiezzi, M. F. B., de Andrade, J. M., Romão, A. P. M. S., Tiezzi, D. G., Lerri, M. R., Carrara, H. A. H., & Lara, L. A. S. (2017). Quality of life in women with breast cancer treated with or without chemotherapy. Cancer nursing, 40(2), 108-116.

Dixit, N., Burke, N., Rodriguez, G., Sarkar, U., Cicerelli, B., DeVore, J. D., & Nápoles, A. M. (2020). Knowledge and self-efficacy for caring for breast and colon cancer survivors among safety net primary care providers. Supportive Care in Cancer, 28(10), 4923–4931.

Galassi, A., Anwarali, S., & Challinor, J. (2023). Global challenges and initiatives in oncology nursing education. Annals of Palliative Medicine, 12(3), 633–645.

Gill, F., & Duffy, A. (2015). Caring for cancer patients in non-specialist wards. British Journal of Nursing.

Gillman, L., Adams, J., Kovac, R., Kilcullen, A., House, A., & Doyle, C. (2015). Strategies to promote coping and resilience in oncology and palliative care nurses caring for adult patients with malignancy: a comprehensive systematic review. JBI Evidence Synthesis, 13(5), 131-204.

Gillespie, M., Chaboyer, W., & Wallis, M. (2017). Developing confidence in nursing practice through exposure to oncology settings. Journal of Clinical Nursing, 26(1-2), 52-62.

GMA News. (2023, March 27). PRC: Only 59.7% of Philippines’ doctors practicing; nurses, only 53.55%. GMA News Online.

Greta, G., Cummings., Sarah, D., Lee., Kaitlyn, Tate. (2018). The evolution of oncology nursing: Leading the path to change.. 28(4):314-317.

Gyawali, B., Jalink, M., Effing, S. M. A., Dalgarno, N., Kolomitro, K., Thapa, N., ... & Berry, S. (2021). Oncology training programmes for general practitioners: A scoping review. ecancermedicalscience, 15

Han, P., Duan, X., Jiang, J., Zeng, L., Zhang, P., & Zhao, S. (2023). Experience in the development of nurses' personal resilience: A meta - synthesis. Nursing open, 10(5), 2780-2792.

Hines, S., Ramsbotham, J., & Coyer, F. (2015). The lived experiences of non-specialized nurses caring for oncology patients: A phenomenological study. Australian Journal of Cancer Nursing, 16(3), 27-34.

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.

Iheanacho, P. N., Opara, H. C., Ifezulumba, J. C., Omotola, N., Ingwu, J. A., & Anarado, A. N. (2022). Nurses' Perceived Challenges in the Management of Hospitalized Cancer Patients in a Comprehensive Cancer Center in Southeastern Nigeria. Asian Pacific journal of cancer prevention : APJCP, 23(10), 3587–3593.

Iheanacho, P. N., Opara, H. C., Ifezulumba, J. C., Omotola, N., Ingwu, J. A., & Anarado, A. N. (2022). Nurses’ perceived challenges in the management of hospitalized cancer patients in a comprehensive cancer center in Southeastern Nigeria. Asian Pacific Journal of Cancer Prevention, 23(10), 3587–3593. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924352/

Johnson, L.M.,& Davis, K.S. (2018). Journal of Oncology Nursing. University of California. 25(3), 112-125.

Kim, E. Y., & Chang, S. O. (2022). Exploring nurse perceptions and experiences of resilience: a meta-synthesis study. BMC nursing, 21(1), 26.

Lindseth, A., & Norberg, A. (2004). A phenomenological hermeneutical method for researching lived experience. Scandinavian Journal of Caring Sciences, 18(2), 145-153.

Liu, B., Liu, M., Wang, H., Yang, Y., Ma, Y., & Wei, X. (2022). Can patient gratitude expressions boost innovative performance? The role of work meaningfulness and supervisory support. Frontiers in Psychology, 13, 1024211.\

Lubasch, J. S., Lee, S., Kowalski, C., Beckmann, M., Pfaff, H., & Ansmann, L. (2021). Hospital processes and the nurse-patient interaction in breast cancer care: Findings from a cross-sectional study. International Journal of Environmental Research and Public Health, 18(15), 8224.

Kidayi PL, Manhica H, Nakazzi S, Mtuya CC, Aune RE, Serventi F, Mahande MJ, Björling G. (2023) "Caring for Breast Cancer Patients Is a Work That Brings Sorrow": A Qualitative Interview Study with Nurses in Tanzania. National Center for Biotechnology Information.

Malterud, K., Siersma, V. D., & Guassora, A. D. (2016). Sample size in qualitative interview studies. Qualitative Health Research, 26(13), 1753–1760.

Maor, S., Cojocaru, S. (2018). Family as a powerful factor that influences career choice in nursing. Social Research Reports, 10(1), 7-22.

Maree, J. E., & Mulonda, J. K. (2017). Caring for patients with advanced breast cancer: The experiences of Zambian nurses. Asia-Pacific journal of oncology nursing, 4(1), 23-28.

McKenna, L., Mambu, I. R., Sommers, C. L., Reisenhofer, S., & McCaughan, J. (2023). Nurses' and nursing students' reasons for entering the profession: content analysis of open-ended questions. BMC nursing, 22(1), 152.

Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development: A metasynthesis of the literature. Nurse Education Today, 97, 104724.

Nassar, Y. M., Eshah, N., Al-Maqableh, H. O., Nashwan, A. J., Rayan, A., & Alhawajreh, M. J. (2024). Workplace resilience and compassionate care among Jordanian private sector nurses. BMC nursing, 23(1), 634.

National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on the Future of

Nursing 2020–2030; Flaubert JL, Le Menestrel S, Williams DR, et al., editors. The Future of Nursing 2020-2030: Charting a
Path to Achieve Health Equity. Washington (DC): National Academies Press (US); 2021 May 11. 4, The Role of Nurses in Improving Health Care Access and Quality.

Nukpezah, R. N., Khoshnavay, F. F., Hasanpour, M., & Nasrabadi, A. N. (2020). Striving to reduce suffering: A Phenomenological Study of nurses experience in caring for children with cancer in Ghana. Nursing open, 8(1), 473–481.

Nwozichi, C. U., Ojewole, F. O., & Oluwatosin, A. (2017). Understanding the challenges of providing holistic oncology nursing care in Nigeria. Asia-Pacific Journal of Oncology Nursing, 4(1), 18–22.

Nwozichi, C. U., Guino-O, T. A., Madu, A. M., Hormazábal-Salgado, R., Jimoh, M. A., & Arungwa, O. T. (2020). The Troubled Nurse: A Qualitative Study of Psychoemotional Effects of Cancer Care on Nurses in A Nigerian Cancer Care Setting. Asia-Pacific journal of oncology nursing, 7(4), 328–335

Opoku, E. N., Khuabi, L. A. J. N., & Van Niekerk, L. (2021). Exploring the factors that affect the transition from student to health professional: an Integrative review. BMC medical education, 21, 1-12.

Paton, L., McAuliffe, L., & Tullis, R. (2016). Time-dependent learning in healthcare: Supporting novice nurses in critical care units. Journal of Nursing Management, 24(2), 149-158.

Salinda, M. T., Lauro, J. P., Dancil, V. M., Cañete, G. S., & Quijencio, W. D., Jr. (2021). Caring for cancer patients: Lived experiences of oncology nurses. Globus: An International Journal of Medical Science, Engineering & Technology, 10(2), 58–65.

Sexton, M., Pennebaker, J., & Brooker, R. (2019). Managing emotional labor in oncology nursing: Coping with patient loss and burnout. Nursing Inquiry, 26(1), e12320. https://doi.org/10.1111/nin.12320

Shan, J., Lv, S., Li, T., Wang, S., Zhang, C., & Li, J. (2022). Experiences of oncology nurses caring for patients with solid-tumor bone metastasis: A qualitative study. European Journal of Oncology Nursing, 60, 102196. https://doi.org/10.1016/j.ejon.2022.102196

Sherman, D. W., Haber, J., & Friedman, L. (2015). The longitudinal impact of oncology care
on nurse-patient relationships. Cancer Nursing, 38(1), 34–43. https://doi.org/10.1097/NCC.0000000000000154

Shewbridge, A., Meade, E., & Dowling, M. (2024). Treatment and management of the clinical manifestations of advanced breast cancer. Seminars in Oncology Nursing, 40(1), 151549. https://doi.org/10.1016/j.soncn.2023.151549

Shinners, J., Ireland, A., & Golemboski, K. (2016). The journey from novice to expert: Skills acquisition in the clinical setting. Journal of Continuing Education in Nursing, 47(9), 407-412. https://doi.org/10.3928/00220124-20160817-08

Stewart, M., Hughes, M., & Norton, C. (2019). The impact of time on clinical decision-making and critical thinking in nursing practice. Journal of Clinical Nursing, 28(15-16), 2873-2883. https://doi.org/10.1111/jocn.14800

Sun, Y. S., Zhao, Z., Yang, Z. N., Xu, F., Lu, H. J., Zhu, Z. Y., & Zhu, H. P. (2017). Risk factors and preventions of breast cancer. International Journal of Biological Sciences, 13(11), 1387-1397. https://doi.org/10.7150/ijbs.21635

Tsuchihashi, Y., Matsunari, Y., & Kanamaru, Y. (2018). Survey of difficult experiences of nurses caring for patients undergoing radiation therapy: An analysis of factors in difficult cases. Asia-Pacific Journal of Oncology Nursing, 5(1), 91–98. https://doi.org/10.4103/apjon.apjon_60_17

World Health Organization. (2019, November 25). Infection prevention and control global.

World Health Organization. https://www.who.int/infection-prevention/control

Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129-140. https://doi.org/10.1016/j.ijnurstu.2019.02.014
Published
2024-12-30