The need for a nursing presence in oral chemotherapy.

As cancer treatment shifts from IV to oral chemotherapy, patients have less contact with nurses and face the increased responsibility of maintaining their own health care. The authors conducted focus group interviews with 18 oncology nurses using the grounded theory approach to explore the nurses' perceptions of current practices and ideas regarding opportunities to improve nursing practice for patients receiving oral chemotherapy. The nursing presence is becoming invisible and, therefore, these patients are isolated more in current practice. "The need for a nursing presence" emerged as a core category. Nurse involvement in patient entry into oral chemotherapy was perceived as important for identifying patients at risk for nonadherence. In their partnership with patients, nurses should be attentive, connect with patients, elicit patients' unmet needs, and provide committed patient support. Rather than the traditional reactive approach, proactive patient care is required. In addition, nurses are expected to coordinate patient care and facilitate interpersonal relationships among healthcare providers. Coordinated proactive care leads to predictive care to meet the future needs of patients, including the prevention of adverse events. The roles and responsibilities of nurses in oral chemotherapy must be clarified so that the nursing presence is clear to patients and other healthcare providers.