Karen A. Skalla

This article describes the concept and function of the blended role advanced practice nurse as a unique synthesis of the clinical nurse specialist and the nurse practitioner. The blended role advanced practice nurse is viewed as a distinct new role that does not replace either critical nurse specialist or nurse practitioner. A short discussion of this role is followed by two clinical examples. A patient scenario describes how the blended role advanced practice nurse functions in a clinic setting, whereas an organizational project demonstrates how successful implementation of the role can be particularly effective when applied to palliative care of the patient with cancer. Implications for practice resulting from implementation of the blended role in palliative care are reviewed.

To explore the nature of spiritual care in patients with cancer and discuss the Moral Authority, Vocational, Aesthetic, Social, and Transcendent (Mor-VAST) Model, a new theoretical model for assessment. Published articles, online references. Discussions regarding spirituality often do not occur for a variety of reasons but may affect physical and spiritual health of an individual. Assessment of spirituality should be an integral part of cancer care. The Mor-VAST model can assist clinicians in discussing spirituality. Nurses should be aware of resources for referral to chaplaincy, but they can be a part of the process of spiritual support. Educational opportunities are available for nurses who wish to address their own spirituality so they can address spirituality comfortably and confidently with their patients.

To obtain detailed information about the preferences of patients with cancer and their need for information about side effects of cancer treatment to design an interactive multimedia educational program. Qualitative. Regional rural academic medical center. 51 patients and 14 spouses of patients who either currently were undergoing or recently had completed chemotherapy or radiation therapy for cancer. Focus groups. Information needs and common and distressing symptoms. Patients wanted information about the process of getting treatment, specific side effects that might occur, and the impact of treatment on their lives. Patients sought information from a variety of sources, but many found that other patients were the most helpful source. Although most patients wanted as much information as possible so they would be prepared for whatever happened, some patients preferred to avoid information about possible side effects. Several obstacles related to information were reported, including access to providers, communication difficulties with providers, informational overload, and problems with retention. Several aspects regarding information needs confirmed previous findings, and new aspects were illuminated. This led to a conclusion that multimedia technology offered many advantages to meet these informational needs. New approaches to patient education that will meet the needs of patients as well as clinicians and educators need to be developed.