Cancer Care Affordability and the Healthcare Team: Expanding an Assessment of Clinical Perceptions and Attitudes in Nursing.

Objectives: To investigate nursing staff perceptions of financial toxicity (FT), its causes, and their role in mitigating it, as well as their prior training in addressing financial concerns.

Sample & setting: 535 RNs, advanced practice providers, and ancillary staff at an urban comprehensive cancer center.

Methods & variables: Respondents completed an online survey, adapted from prior work with physicians, as part of a quality improvement effort.

Results: Most respondents (76%) felt (a) they should play an active role in interventions to minimize FT and (b) they should be aware of a patient's risk of FT. A greater proportion of advanced practice providers felt they should play an active role in interventions compared to RNs (chi-square = 4.1, p = 0.04). Most respondents reported receiving no training on costs of care (87%) or how to have cost conversations (91%). Recommendations for mitigation included offering telehealth visits and changing follow-up intervals.

Implications for nursing: Nursing staff, including RNs and advanced practice providers, want to play an active role in preventing and mitigating FT but often feel they do not have the training to do so. Future efforts should focus on FT education for nursing staff.