Implications for Nursing Practice
Symptom management is at the heart of nursing's scope of practice. It is the bedside nurse who spends countless hours with the patients, assessing their sleep habits, how they fluctuate based on treatment regimens, and how insomnia impacts the patients' quality of life. Nurses play a unique role and have the opportunity to utilize both pharmacological and nonpharmacological treatments to help patients attain optimal sleep.
There is certainly room for growth and development of the role of the nurse in the screening, assessment, treatment, and education regarding insomnia. With adequate training, advanced practice nurses can educate nurses in brief CBTi interventions appropriate for inpatient and outpatient oncology settings. In the trial of Espie et al, oncology nurses conducted the CBTi intervention, which shows the adaptability to oncology clinic settings. Future nursing curricula must require education in sleep hygiene, insomnia, and evidence-based interventions.
In order to incorporate sleep assessment and intervention, preparation must begin in undergraduate nursing education. An overview of normal sleep, the prevalence of sleep disturbance in oncology patients, assessment skills, and evidence-based interventions must be included in nursing curricula. Clinical competencies can be included in medical-surgical and psychiatric nursing course work. Continuing education and staff development programs must educate nurses on advances in therapies, as well as refreshers in good sleep hygiene to incorporate in patient care.