Developing advanced clinical practice skills in gastrointestinal consequences of cancer treatment

Abstract

This article explores the transition from a clinical nurse specialist (CNS) towards developing advanced clinical practice skills within a gastrointestinal consequences of cancer clinic. It presents data on the first 50 patients assessed by the CNS from a prospective service evaluation, demonstrating how this informed the nurse's future learning. There is high demand for advanced clinical practice skills to address unmet health needs and improve the quality, efficiency, and sustainability of healthcare services. However, a literature review found no literature on developing advanced clinical practice skills in this setting. Emerging themes from the service evaluation focused on barriers and enablers, ongoing support, organisational commitment and working in a multidisciplinary team. Blended learning provided both structured and opportunistic learning, embedding both formal and tacit knowledge, as roles require increasing flexibility. Clinical supervision and reflective practice were key in maintaining professional and peer support.

From healthcare professional to degree apprentice

“…Other factors promote progression through transitionhaving a comprehensive induction, being able to use transferable skills and being accepted by other staff, 19,20 along with having protected training time and there being organisational commitment to the role. 23 Some of these were reported on negatively in our study, specifically a lack of induction and difficulty with finding time for the learning and supported practice of clinical skillsboth themes for Moran and Nairn too. 4 One of the strongest negative influences discussed was the clarity of the transition momentwhen the trainee stopped their previous healthcare role and became a trainee ACP.…”

“…Support focused on transitioning to advanced clinical practice could help with this. Other factors promote progression through transition — having a comprehensive induction, being able to use transferable skills and being accepted by other staff, 19,20 along with having protected training time and there being organisational commitment to the role 23 . Some of these were reported on negatively in our study, specifically a lack of induction and difficulty with finding time for the learning and supported practice of clinical skills — both themes for Moran and Nairn too 4 …”

Developing the Heart Failure Specialist Nurse Competency Framework

“…This was considered as important by the project team as we were keen to acknowledge HFSN would enter this competency framework at different stages based on their knowledge and experience. A fundamental component of this model is the emphasis on reflection in practice and the integration of evidence base to enhance clinical decision making; attributes considered important when considering advanced nursing practice (Gee et al 2018). The ease of transition from one proficiency level to another meant this model of learning and skill acquisition was appealing to the HFSN community plus the model has a degree of familiarity to nurses, important when considering its application to advance clinical practice.…”