Nurse-physician collaborative practice: the clinical nurse specialist in a radiation oncology private practice

The role of the clinical nurse specialist (CNS) has been established and described in some detail. The majority of these specialists practice in academic centers or large hospitals, often in concert with a group of their peers and with strong administrative support for the advanced practice role. Changes in the healthcare system, particularly the recent trend toward the establishment of freestanding cancer centers, have opened new practice opportunities for advanced nursing practitioners. This article describes the transition of a radiation oncology CNS from a university hospital to a collaborative practice in a private radiation oncology setting. The CNS describes important steps in this process, including negotiation of role functions and benefits, maintenance of professional commitments, and collaborative practice issues. Comments from the radiation oncologist, along with speculation on the future of the practice, also are included.