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Staff attitudes before and after the inception of a pediatric oncology unit
1Department of Psychology, University of Göteborg, Sweden.
Insights
A new pediatric cancer unit met staff expectations, with improved relationships and care. Initial fears about patient suffering were unfounded, though staffing and space remain concerns.
Area of Science:
- Pediatric Oncology
- Nursing Management
- Healthcare Quality Improvement
Background:
- Establishment of a specialized pediatric unit for cancer patients.
- Varied staff training in pediatric oncology care.
- Initial staff expectations included positive aspects (feeling needed, common goal, results) and negative aspects (fear of patient suffering/death).
Purpose of the Study:
- To evaluate the fulfillment of initial staff expectations after one year of operation.
- To assess changes in staff relationships and organizational structure.
- To identify persistent challenges in the pediatric oncology unit.
Main Methods:
- Qualitative assessment of staff expectations and experiences.
- Follow-up evaluation of the unit after one year.
- Analysis of changes in staff relationships, organization, and perceived care quality.
Main Results:
- Positive expectations were realized; fears of patient suffering were not confirmed.
- Interpersonal relationships among nursing staff improved significantly.
- Organizational improvements were noted, but concerns about insufficient Registered Nurse (RN) staffing and physical space persisted.
- Initial positive views on parental presence evolved, with some negative aspects identified after one year.
Conclusions:
- The pediatric oncology unit successfully met initial positive staff expectations and mitigated initial fears.
- While improvements in relationships and organization were observed, ongoing challenges require attention.
- Sustained focus on adequate RN staffing and physical resources is crucial for optimal patient care and staff well-being.
Abstract:
A special pediatric unit was started for patients with cancer. All staff had experience in caring for chronically ill children, but there were great individual variations in training. Positive expectations of the new unit expressed by staff were (1) feeling needed, (2) having a common goal, and (3) seeing results. Negative expectations expressed were fear of the suffering and dying of the children. One year later the positive expectations were found to be fulfilled. The fears were not found to be confirmed. The existing relationships among the nursing staff were criticized at the opening of the unit. Relationships had improved 1 year later. The prevailing organization at the opening of the unit was criticized. The RNs had too little time for primary nursing of the patients. Conditions had improved 1 year later, but the RN staff was considered too small and more physical space was needed. The parents' presence at the ward was considered positive by all staff when the unit opened. One year later some negative aspects were also pointed out.