TABLE 2.

Key Quotes

Theme 1: Registered nurses benefit from the unique one-on-one care and support provided to patients by Care Management by Oncology Nurses (CONNECT) through a sense of personal and professional fulfillment, however, they also experience emotional risks related to closer connections with patients.	You feel a connection with these patients. And then you feel a little closer with them once you really get to know them…CONNECT gives you a little bit more of an in-depth look at what they go through.
	The most satisfying thing about being a CONNECT nurse is just the overall feeling that you are improving the quality of their life.
	I think every oncology nurse needs to take this [training]. It absolutely changes the way you talk to patients, the way you interpret what the patients are saying…I can’t say it enough, I just think I’ve absolutely benefited as a nurse.
	It has opened my eyes…when I sit down with my patients it just broadens the discussion. It’s taught me to be a little more aware. With CONNECT I feel that I give the highest level of customer service and customer satisfaction – that if that were my mom in that chair, or my brother, that there isn’t any better care that they could receive other than what I do for them while they’re in the clinic.
	Hearing that they [the patients] are actually getting something out of it is very rewarding.
	You’re really sitting and paying attention on a one-to-one basis.
	I get a lot of job satisfaction knowing that I’m helping somebody not just through treatment, but helping them future plan. It’s really…good to know that I’m helping people to move forward a little bit with their future planning. And you can tell they really appreciate it, so that makes me want to keep doing it and to help more patients that way.
	You’re developing these deeper relationships with patients. You’re seeing these patients at their worst. You’re getting to know them, you’re getting to know their family, what their issues and concerns are. You kind of, well obviously after stuff like that, you’re going to grow attached to these people. Whenever something happens to them or when you’re finished with your CONNECT visits with them it’s difficult. I’m more stressed.
Theme 2: Registered nurses felt that participating in CONNECT enhanced their communication skills with patients, particularly in discussing goals of care and advance directives.	I think it [CONNECT] helps you to listen to the patients a little better, as far as just kind of realizing all of the things that go on in their lives.
	It’s beneficial to other patients too…there’s times where I will “pull a CONNECT” with them.
	I feel more comfortable with them [advanced directive conversations]. You know, after you’ve done it a couple of times you tend to have a script going that can kind of get you through it. You know what you’re going to say.
	I think it kind of opens your eyes. To have those [goals of care] conversations a little sooner…and it’s given me the experience to having that conversation. It’s not something I was comfortable with before. And it’s definitely getting a lot easier. So, you know, then I can have more of a positive impact with patients.
	Once you’ve talked about some of those things so many times your ability to approach it and your verbiage and things get better and better and better as you do it more and more. So, I’m definitely more comfortable with it.
	You know, the more that we do these CONNECT visits, as with anything else, the easier it gets.
	It [communication] has definitely changed. I do find myself saying things and phrases that I would not normally have said, like “can you tell me a little more about that” and “how does that make you feel” and all those things that are taught in the CONNECT class that normally are probably not part of my communication.
	I’m more comfortable to ask…to ask the harder questions.
Theme 3: Feelings of increased stress, frustration, and guilt related to time spent on CONNECT were minimized with support from leadership, coworkers, and the CONNECT nurse project manager.	I think it’s hard because…we have a whole schedule of patients getting treated, and so it’s increased our stress and definitely increased stress on the other nurses, the non-CONNECT nurses, because they’ve had to pick up our load.
	It’s just extra support for us, and if you have questions or you feel like you’ve done something wrong, you can always go to [the nurse project manager] and she always has good ideas. She always comes up with strategies to help you.
	I don’t feel like I take it [stress] home with me, like I don’t take the burden home with me as much – but I definitely feel like that’s because [the nurse project manager] and the other CONNECT nurse are just so supportive. It’s just so important to have some kind of support system like that.