Opinion: Clear Communication Is A Form Of Patient Advocacy


We can help our patients feel supported is by providing them with clear information about their treatment plan and what to expect. By doing so, we empower them to take control of their own health.

Debi Fischer, MSW, BSN, BA, LCSW, RN

Debi Fischer, MSW, BSN, BA, LCSW, RN

Advocacy is naturally embedded into the workflow of oncology nurses and clinical social workers. According to Blackburn et al, advocacy is defined as “identifying a cause or issue, building support for this cause, and influencing decision-making bodies, such as state or national legislatures, to take action toward a desired outcome.”1

The most famous nurse advocate was Florence Nightingale, who is credited as being in the background as a “shadow author”1 for early health care policy. Lillian Wald, also a nurse and social worker in the 19th and early 20th century was an early advocate.1 Today, Deborah Mayer, PhD, RN, AOCN, FAAN, interim director of the National Cancer Institute’s (NCI’s) Office of Cancer Survivorship, is in a key role as an oncology patient care advocate. She has been appointed to the NCI National Cancer Advisory Board as well as the National Cancer Moonshot Initiative Blue Ribbon Panel.1

As oncology nurses we are all patient advocates. There are ways to help support our patients on institutional and other levels. In my opinion, 1 small way we can help our patients feel supported is by providing them with clear information about their treatment plan and what to expect. By doing so, we empower them to take control of their own health.

Teresa Knoop, MSN, RN, AOCN, an oncology nurse consultant and secretary of the Oncology Nursing Society Board of Directors, recently published in editorial on Cancer.Net about how the oncology nurse can help their patients. The components of advocacy, according to Knoop, include “education, advocacy, support and reassurance.”2

The first part, education, homes in on quality-of-life issues a nurse can address with new patients. It is imperative that the oncology nurse guides them to relevant, factual information.

The second part, advocacy, is where the oncology nurse applies their knowledge of the wholistic picture to the patient. The patient’s story emerges, and the nurse can pinpoint where they may need extra steps in their journey to become survivors.

The third part is where the nurse knows the score in terms of referrals. These can be generated to the social worker on the unit, for home health care if needed. The dietician can arrange for nutritious easy to swallow meals, or a tube feeding if ordered. Another key referral is pain management since this is the hallmark of postoperative cancer treatment. Today, younger patients may also need a referral regarding their fertility options because of the ravages of chemotherapy. A tailor-made program from the oncology nurse that addresses the patient’s level of education, culture, and financial backdrop is also a consideration.

H.R. 414

The Cancer Care Planning and Communications Act came to fruition in 2021. This bipartisan act was introduced to Congress by Representatives Mark DeSaulnier (D-CA) and Earl L. “Buddy” Carter (R-GA), cochairs of the Congressional Cancer Survivors Caucus. Known as H.R. 414, the goal of this act is to fashion “a Medicare service for cancer care planning, a key priority of the National Coalition for Cancer Survivorship.”3

Basically, this proposed bill would allow doctors to bill Medicare for the time spent creating a blueprint for a patient’s care.The billable time starts when they create the treatment plan, when a new pathway in treatment occurs, and at the end of treatment, when a patient transitions into posttreatment survivorship. It is thought that this bill will improve doctor-patient communication and help prioritize giving patients a plan which includes their anticipated treatment options and potential symptoms.

“Patients and survivors need a roadmap to guide their care, both during treatment and in the transition to post-treatment care,” Shelly Fuld Nasso, CEO of the National Coalition of cancer Survivorship stated in a news release. “In our State of Cancer Survivorship Survey, less than 20% of cancer survivors received a survivorship care plan. The Cancer Care Planning and Communications Act would ensure that cancer survivors get the help they need to navigate and coordinate their care.”

With so many breakthroughs in medicine and more options for patients, it is easy to forget that patients need clear and concise communication regarding what can be expected from either treatment plan. Education and planning are both an important part in making sure that patients feel adequately supported during their journey.


  1. Blackburn R, Johnson KG, Chaveleh S. Advocacy: the pivotal role of oncology nurses. Clin J Oncol Nurs. 2020;24(1):103-106. doi: 10.1188/20.CJON.103-106. PMID: 31961847
  2. Knoop, T. How your oncology nurse can help you during cancer. Cancer.Net. February 22, 2023. Accessed February 27, 2023. https://www.cancer.net/blog/2023-02/how-your-oncology-nurse-can-help-you-during-cancer
  3. U.S. House Reps. DeSaulnier and Carter introduce bipartisan cancer care planning and communications act (CCPCA). National Coalition for Cancer Survivorship. July 15, 2021. Accessed February 26, 2023.

Related Content
© 2024 MJH Life Sciences

All rights reserved.