In this issue of ISNCC Academic Express, we highlight a study by Charlotte T. Lee and colleagues exploring Canadian ambulatory oncology nurses’ experiences with virtual care and interprofessional collaboration. As virtual and hybrid models become increasingly embedded in cancer services, the study draws attention to an often less visible dimension of nursing practice: the coordination work required to deliver safe, continuous, and person-centred care across virtual and in-person settings.
Using a mixed-methods sequential explanatory design, the research highlights strong collaboration and role clarity alongside challenges in preparedness and support for virtual nursing practice. Importantly, the findings illuminate oncology nurses’ evolving role as “coordination architects”—connecting patients, providers, information, and care settings while supporting assessment, escalation, communication, and follow-up. This study provides valuable insights into how competency-based preparation, effective communication and documentation systems, and recognition of coordination as clinical labour can strengthen virtual oncology nursing practice and evidence-based cancer care.
Virtual and hybrid care are now routine in many oncology programs. Virtual and hybrid care are now routine in many oncology programs. What has received less attention is how this shift has changed the coordination work underlying safe cancer care. In our study of Canadian ambulatory oncology nurses, a clear message emerged. Oncology nurses are not simply delivering care through a screen; they are increasingly acting as coordination architects who design, maintain, and repair the connections that make safe cancer care possible.
Using a mixed-methods sequential explanatory design, we first surveyed ambulatory oncology nurses across Canada, then conducted follow-up interviews to explain survey patterns. Nurses perceived high levels of interprofessional collaboration and strong understanding of their role within the team. Ratings were lower, however, for perceived ability to enact virtual nursing practice, and nurses expressed neutrality about how adequately prepared they felt for virtual care. Notably, nurses who reported receiving training did not differ significantly from those who did not, suggesting that “training” is inconsistent in content, depth, and relevance to real practice demands.
Interviews clarified why. Nurses described uneven onboarding and variable guidance, particularly for virtual assessment and escalation. Virtual encounters often require more deliberate planning and follow-up to compensate for limited physical assessment cues and fragmented information across platforms. Beyond the clinical interaction itself, nurses described expanding coordination work: aligning schedules and care plans, bridging communication between providers and settings, troubleshooting technology, ensuring documentation continuity, and proactively identifying when a virtual pathway is no longer appropriate and must shift to in-person care.
When nurses are expected to function as coordination architects without adequate scaffolding, the system relies heavily on individual workarounds. Our integrated findings suggest that strong role clarity and collaborative values are necessary but not sufficient. Virtual oncology care requires system-level supports commensurate with the complexity of coordination work, including standardized, competency-based preparation; clear expectations for virtual assessment, triage, and escalation; reliable documentation and communication pathways; and workload models that recognize coordination as clinical labour.
In Canada, the Canadian Association of Nurses in Ontario practice standards are explicit: coordination across providers and throughout the cancer continuum is a core nursing responsibility. Standards 4 and 5 explicitly describe the nurse’s role in navigating patients through the health system, ensuring seamless referral, and communicating across teams. In ambulatory virtual care, these standards are enacted through the supportive care functions nurses perform at every contact: symptom monitoring, patient education, psychosocial check-ins, and follow-up after medical visits. They are the mechanism through which ongoing supportive care needs are identified, communicated, and met. When coordination infrastructure is inadequate, it is precisely these functions that fall through the gaps. What this study reveals is a system gap. The standards exist, but the infrastructure to enact them in virtual environments does not consistently follow. If virtual care is here to stay, the coordination nurses are already performing must be recognized as clinical labour, not absorbed silently into individual workload. Oncology nurses are already performing this coordination work. Recognizing and supporting it is fundamental to safe, continuous, and person-centred cancer care.
Author: Charlotte T. Lee,
RN, CON(C), PhD,Toronto Metropolitan University, Canada
Source：
Lee CT, Ng F, Mirzadeh P, Borycki EM, Buick C, Newton L, Lounsbury J, Wong J, Moura S, Kweon A, Marcelo K, Fitch M. Understanding oncology nurses' experiences with virtual care and interprofessional collaboration in Canada: A mixed-method study. Eur J Oncol Nurs. 2026 Jun;82:103170. doi: 10.1016/j.ejon.2026.103170. Epub 2026 Mar 23. PMID: 41926834.
