Review Article

Roles of the Clinical Nurse Specialist and Nurse Practitioner in Survivorship Care

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ABSTRACT

Providing survivorship care for the over 20 million cancer survivors expected in the United States by 2020 will be a health-care challenge. The anticipated deficit in health-care providers will demand that follow-up care of this population be directed toward oncology advanced practice nurses (APNs), who are expertly trained to provide this care. Different disciplines working together can meet the broad range of physical and psychosocial issues facing cancer survivors and their caregivers throughout the survivors’ lifetime. Models for the provision of survivorship care include both academic and community settings and may be provided as part of a shared care model, with primary care physicians, oncologists, specialists, and advanced practice clinicians (nurse practitioners [NPs], clinical nurse specialists [CNSs], and/or physician assistants) coordinating and collaborating to provide the needed follow-up care, as well as pediatric-focused programs, disease-specific programs, and comprehensive survivor programs, usually within a large academic setting. This article will describe two different approaches by APNs providing survivorship care. The role of the CNS is discussed from the administrative perspective, describing efforts from an initial concept based on an individual system and subsequent plans to roll out survivorship care to seven other settings. The NP’s role is described as part of a large academic LIVESTRONG™ Center of Excellence program. With this examination of two different perspectives for the provision of survivorship care, the multiple roles of APNs and other health-care professionals among many models of care will ignite ideas for survivorship applications and promote the unique positions that NPs and CNSs share.

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