Understanding Nurses' Role in Systemic Anti-cancer Therapy Day Unit: A Qualitative Study

Internationally systemic anti-cancer therapy (SACT) nurses are facing increasing workload challenges against the backdrop of rising patient numbers, innovations in systemic anti-cancer therapies and continued development of responsive outpatient chemotherapy systems. This raises concerns about the possible effects on the quality of patient care and has implications for workforce outcomes (e.g., wellbeing, staff retention). This study aims to explore in-depth aspects of SACT day unit nurses' work including their roles and responsibilities (e.g., safe chemotherapy administration, symptom assessment, information giving, self-management advice, and psychosocial support).

Qualitative, online, semi-structured interviews with SACT nurses which analysed using thematic analysis.

15 SACT day unit nurses were recruited. Two key themes emerged from the analysis: 'SACT day unit nurses' roles' and 'Factors affecting SACT day unit nurses' roles'. The theme 'SACT day unit nurses' roles' encompassed four distinct sub-themes: the specialist clinical role, informal leadership role, enabling work role and supportive role. The theme 'Factors affecting SACT day unit nurses' encompassed workforce shortages, work overload, treatment delays, and lack of recognition and support.

The themes provided insights into the responsibilities and challenges that impact SACT day unit nurses in fulfilling their roles effectively. By detailing the care provided within the SACT day units, this study addresses the current research gap pertaining to the roles of SACT day unit nurses.

The multifaceted roles of SACT day unit nurses encompasses clinical expertise, leadership capabilities, facilitative roles, and supportive functions within the cancer care pathway. Understanding these roles and the challenges nurses face, such as workforce shortages and treatment delays, is crucial for optimizing patient care and addressing the well-being and retention of nursing staff in this specialized field.