What is the Role of the Oncology Nurse in Fertility Preservation Counseling and Education for Young Patients?

Abstract

Oncology nurses are uniquely positioned to offer fertility preservation counseling and education for cancer patients of reproductive age, yet there is a dearth of research that focuses on current practice and perceptions of nursing role. In 2013, the American Society of Clinical Oncology extended the duties of fertility preservation counseling among patients of reproductive age undergoing cancer treatment to include registered nurses and other allied health professionals as active partners in the counseling and education process. This study used a cross-sectional descriptive survey to assess current practices, role perceptions, and barriers to fertility preservation counseling among registered nurses working in an academic care setting with outpatient and inpatient services. There were significant gaps in current practices and perceptions of roles regarding fertility preservation counseling. Many nurses expressed the perception that fertility preservation counseling was important, but it was outside the scope of their practice to perform this education. This preliminary work defined need for an interdisciplinary fertility preservation team, communication surrounding educational practice norms, and designated oncofertility navigator.

Oncofertility to Evidence‐Based Practice: Changes in Fertility Intention and Symptom Burden in Reproductive‐Age Women With Breast Cancer

“…To satisfy the fertility need in reproductive‐age women with breast cancer, we suggest that several improvements must be made regarding the patients’ information, nurses’ awareness, and care coordination. Although the duty of oncofertility was extended to registered nurses by the American Society of Clinical Oncology in 2013, a survey showed the oncology nurses could not perform the necessary education about fertility preservation because it was outside the scope of their oncological practice (Keim‐Malpass et al., ). A gap between the attitudes and practices of communicating possible cancer risk to assisted reproduction technology existed among the nurses (Kadmon, Goldin, Bdolah, Farhat, & Liebergall‐Wischnitzer, ).…”

Barriers and Facilitators to Fertility-Related Discussions with Teenagers and Young Adults with Cancer: Nurses' Experiences

“…[35][36][37][38][39] Research reflective of nurse practices in the United States and Netherlands also indicates role confusion; while some nurses view fertility discussion as their responsibility, 36,40 others believe it is outside their scope of practice. 41 Alternatively, some nurses view it as a joint doctor/nurse role. 35 Similarly, no clear consensus exists among oncologists regarding responsibility for discussion.…”

“…36,39,40,[43][44][45][46][47] Given the international consensus indicating the imperative of retaining reproductive potential for TYAs following cancer and the negative effects of not doing so, it is important to further explore factors that influence nurses in undertaking fertility discussions. Research suggests that by virtue of their primary and extended contact, nurses are generally more available to patients than doctors, 48 are in an optimal position to have FP discussions, 38,41,49,50 and play a pivotal role in addressing fertility concerns. 51 Consequently, a more comprehensive understanding from the nurse's perspective on this important topic is vital to better support TYAs with fertility concerns.…”

Evidenced‐based practice of decision‐making process in oncofertility care among registered nurses: A qualitative study

“…Healthcare professionals involved in oncofertility have gradually accepted and designed a model for prioritizing oncofertility service development in reproductive‐age women with cancer (Anazodo et al., 2019; Wang et al., 2020). Nurses are expected to offer fertility preservation counselling and education for reproductive‐age patients with cancer, but there were significant gaps in current practices and perceptions of roles about fertility preservation counselling among Registered Nurses (Hendershot et al., 2016; Keim‐Malpass et al., 2018).…”

“…In the Netherlands, one‐third of oncology nurses had sufficient knowledge of fertility preservation and more than one‐fourth of oncology nurses never discussed it with patients (Krouwel et al., 2017). Although Dutch clinical nurses mentioned fertility preservation was important for young women with cancer, it was outside the scope of their practice to provide this education (Keim‐Malpass et al., 2018). In addition to a lack of knowledge and training in fertility preservation, a poor prognosis and lack of time were the reasons for not discussing fertility preservation (Goossens et al., 2014; Krouwel et al., 2017).…”