Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Background: Interdisciplinary collaboration in cancer treatment requires strong systems support to facilitate communication and coordinate care. Non-professional support staffs (administrative assistants, secretaries, office staff, medical assistants, and phlebotomists) play an integral role in caring for patients and their family members living with cancer. Although clinical professional staffs (physicians, nurses, social workers, allied health professionals, and chaplains) typically receive formal education and support to help them cope with the emotional issues in caring for oncology patients and their families, support staffs paradoxically do not—despite extensive and extended contact with patients and families during the course of treatment and palliation.

Purpose: This paper reports on formative work undertaken by an interdisciplinary research team aimed at identifying support staffs experiences with the same stressors faced by highly trained oncology health professionals. Findings are being used to develop interventions aimed at education and support programs for support staff in cancer treatment.

Methods: Using organizational theory on burnout to frame the interview guide, focus groups were conducted with a purposive sample of the oncology center's support staffs who work with cancer patients and their families on a daily basis. Seven focus groups with a total of 55 participants were conducted within a 10 month period. An oncology social worker attached to the cancer support programs serves as moderator and facilitated the group discussions and content analysis. Social work and nursing clinicians familiar with the culture of the institution worked with the research team to identify organizational and linguistic nuances related to the institutional culture.

Results: Themes that emerged among the support staff included the importance of relationships with the oncology patient/family, difficulty dealing with death and dying, being at a loss for words when trying to comfort patients, coping with difficult patients, taking care of oneself, supporting colleagues, and heightening support staffs' stature within the oncology center.

Implications: Despite the institutional expectation of extensive contact with cancer patients and families facing death, support staffs receive little or no education and support. Support staffs experience death and dying first hand. Education and support programs based on models employed with professional staff are needed. Efforts to develop a sense of community and support among support staff are needed to increase job satisfaction and staff retention.