Practice Standards
CANO/ACIO has a document outlining practice standards of care, which are available here.
Nursing Role Related to :
Standard 1
Standard 2
Standard 3
Standard 4
Standard 5
Standard 6
Standard 7
Standard 8
Standard 9
Nursing Role Related to Standard 1: Individuals with
cancer and their family are entitled to care that is individualized,
holistic, and responsive to and respectful of individual differences,
such as but not limited to, developmental, physical, cultural,
spiritual, social, economic, philosophical, political, or gender.
Nurses meet the health care needs of individuals, families and populations. The nurse provides care beyond boundaries defined by time, place, or structured formal support mechanisms and providers. For example, nurses provide care in the client’s home, work on weekends and holidays, when other health care team members may not be available. The nurse provides care in communities where other professionals and system supports are not available. The nurse focuses on who the individual and family is and what their needs are, as compared to a focus on treatment modalities. The nurse considers patient hopes and desires, the wholeness of the individual and their family context. The nurse coordinates a team focus of care.
The nurse uses a nursing framework to guide patient assessment so
that the essential elements of individuality are included in the
interpretation of health and planning for care. The nurse goes beyond
the traditional models of health and disease treatment. Assessment data
are interpreted within the context of who the person is and within the
context of that person’s life. The nurse knows and considers who this
person is (personhood) and where she/he is from. The nurse determines
the meaning of the treatment for the person and considers if the
individual and family have the physical, structural, supportive, and
financial resources necessary to complete the treatment while
maintaining quality of life (i.e. Can the individual and family afford
the treatment? Do they have access to the treatment?). The nurse
recognizes the gender, cultural, and religious influences on the
experience of cancer. The nurse sees the person (child) with cancer
rather than the cancer in the person (child). The nurse adapts treatment
to the needs of the individual. The nurse recognizes and assesses the
environment and community of the person. The nurse considers
socioeconomic variables and determines the availability of resources
(e.g. supportive care drug costs). The nurse appreciates the diversity
of individuals and families and recognizes the influence of age,
cognitive ability, education, and cultural and ethnic contexts.
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Nursing Role Related to Standard 2: Individuals with cancer and their family are entitled to care that is family centered incorporates growth and developmental needs of each member and is respectful of the family’s resources and coping style.
The nurse recognizes and assesses the impact of cancer on each
individual family member and the family as a whole. The nurse recognizes
the family as defined by the individual. The nurse recognizes the
impact of cancer on family roles, dynamics, processes and development.
The nurse uses a nursing framework to guide patient assessment so that
the essential elements of individuality are included in the
interpretation of health and planning for care. The nurse goes beyond
the traditional models of health and disease treatment. Assessment data
are interpreted within the context of who the person is and within the
context of that person’s life. The nurse knows and considers whom this
individual is, that is, their personhood. The nurse explores and
ascertains if the individual and family have the physical, structural,
supportive, and financial resources necessary to maintain quality of
life. (For example, can the individual and family afford the treatment?
Is there access to the treatment?). The nurse recognizes the gender,
cultural, and religious influences on the experience of cancer. The
nurse adapts the care plan to the needs of the individual. The nurse
recognizes and assesses the environment and community of the person. The
nurse considers socioeconomic variables and supports the individual in
family membership and the role in the family.
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Nursing Role Related to Standard 3: Individuals with cancer and their family have the right to self-determination, the right to access information, the right to make decisions about their health care, or the right to have an advocate, if they are unable or choose not to participate in decision-making.
The nurse establishes partnerships with the individual with cancer
and family that are based on mutual trust and respect. The nurse bases
partnerships on negotiation with children and parents. The nurse ensures
that patients are viewed as the hub of the process, that they are fully
informed, that they know all the options available, and that they are
part of all decisions in which they choose to be involved. The nurse
ensures that individual and family needs determine interventions. Where
the individual and family wishes are incongruent, the individual’s
wishes take precedence.
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Nursing Role Related to Standard 4: Individuals with cancer and their family are entitled to care that is respectful of and responsive to their community of living. The individual with cancer and family are entitled to assistance in navigating through the cancer and health care system.
The nurse works with the individual in helping/guiding that person
through the cancer care and health system. The nurse appreciates the
individual and family perspectives on cancer, understands the community
within which care is provided, and the barriers and issues experienced
by the individual and the family as they try to access the cancer care
system. The nurse is sensitive to the life change that cancer brings to
the individual, family and community, and helps the individual in role
transition. The nurse may make contact with the individual and family
prior to their entry into the system to guide and navigate. The nurse
promotes seamless care with appropriate and timely referral to other
health professionals in the system and in the community. The nurse
recognizes that there may be an abandonment of and by the community of
living (such as school, work, social circle of friends) and helps the
individual and family to deal with this transition.
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Nursing Role Related to Standard 5: Individuals with cancer and their family are entitled to care that is coordinated among providers and across the continuum of cancer control (prevention, screening, early detection, pre-diagnosis, diagnosis, treatment, survivorship and palliation).
The nurse is aware of individuals and populations at risk, due to
genetic predispositon, lifestyle or environmental factors. The nurse
supports the individual within the plan of care and promotes healthy
lifestyle and health promoting activities. The nurse monitors the
individual and family’s progression through the cancer experience and
system, and communicates with others to connect the individual with
resources within the health care system. The nurse works within an
interdisciplinary team, ensuring that there is communication between and
among team members to facilitate care planning and intervention.
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Nursing Role Related to Standard 6: Individuals with cancer and their family are entitled to a supportive, knowledgeable, caring and therapeutic relationship with care providers throughout their cancer experience.
The nurse is willing to engage in the cancer journey with the
individual and family. This relationship is built on trust and mutual
respect. The nurse negotiates with the individual the boundaries of the
relationship. The nurse recognizes the longevity and chronicity of the
journey. The nurse is willing to enter into and share with the
individual and family as they experience vulnerability, hope and
despair. The nurse is willing to take risks, be vulnerable and make
changes. The nurse must understand and know her/himself and be willing
to engage in a therapeutic patient-nurse relationship.
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Nursing Role Related to Standard 7: Care delivered to individuals with cancer and their families is based on theory, science (physiologic and psychosocial sciences), and incorporates principles of evidence-based practice, best practice or available evidence.
The nurse acquires and constantly updates her/his knowledge base.
Literature and research are critiqued, and relevant findings are applied
to care of the individual with cancer and family. The nurse uses
knowledge to guide, question and change practice. The nurse moves
knowledge from the theoretical to the practical. The nurse engages in
life-long learning maintaining the knowledge base in response to
advancing knowledge, technology and treatment modalities. The nurse
collaborates within the health care team to change practice. The nurse
has a role in conducting or participating in research and evaluating
initiatives.
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Nursing Role Related to Standard 8: Individuals with cancer and their family are entitled to care that is professional and incorporates ethical principles and legislative requirements.
The nurse safeguards the rights of the individuals and families. The
nurse reflects on the impact of the cancer journey. The nurse meets
Standards of Practice, ethical guidelines and regulatory directives. The
nurse engages in life-long learning and reflective practice. The nurse
is responsible and accountable for her/his practice and professional
development. The nurse uses critical thinking and professional judgment
to guide practice. The nurse identifies moral and ethical dilemma and
seeks guidance in resolving issues.
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Nursing Role Related to Standard 9: Individuals with cancer and their family are entitled to care within a system that has patient-focused, professional leadership.
The nurse is a voice for patient care at all levels; from the direct
patient care level to the corporate level to the local, national, and
international levels. The nurse is visionary, creative, and innovative
and has the courage to make difficult decisions. The nurse supports
professional practice, influences change and has an impact on the values
of an organization. The nurse is a champion for the individual with
cancer and family. The nurse contributes to the development and
implementation of policy within the organization, and advocates for
system change.
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