This article has four additional links at the bottom of the initial page, Radiation Therapy .
Questions - please send answers to melissa.luebbe@ctca-hope.com ,
- List two potential side effects that a patient could experience during radiation therapy; then list two symptom management interventions for each side effect.
- There are many individuals involved in a patient's radiation treatment. From the initial consultation to completion of therapy who are these team members and what do they do?
Discussion Question - please post your responses to the discussion question on the blog.
A patient receiving radiation therapy can feel that much of what is happening to them is out of their control. What tools and services are available to patients that allow them to believe that they can have some control over the emotional and physical side effects of their treatment?
We could always help connect them with mind body or Dr. Sunn if the patient is having emotional difficulties with treatment. It can be very hard for a patient to be in a foreign place for upwards of 9 weeks by themselves. The patient is always ultimately in control of their treatments and can request taking a day off treatment if they desire (although we don’t recommend it.) We can also connect them with wound care if they are having physical side effects to help deal with that. We also give them some different options to help prevent radiation skin issues, so they have some decision when it comes to that. We also allow the patients to have some say in the time they would like to have their treatments throughout the day so they can make arrangements to go on the day trips or continue to work if they are local and would wish to.
ReplyDeleteI think giving the patient options of skipping a treatment, (although not recommended), along with having a choice in their treatment times, and what wound care treatments they use for their skin can help them to feel more in control of what is happening to them. I think that the patient needs to be reminded that our mind/body therapists are there for them to talk to if they need someone to talk to because they may forget that we offer this service. As a wound care nurse, I have noticed that more patients are being referred to us when their treatment is over, or mid treatment, but their skin is severely broken down. I feel that if the nurse makes a consult for these patients earlier on when the skin issues start, we may not see the skin breakdown issues as bad as we do when we finally are consulted. So just like remembering mind/body consults for the patients early on in treatment, remember to put that wound consult in for the patient who is just starting to have skin issues. This is good patient care and we will have better outcomes for our patients.
DeleteGood feedback, Brenda. I worked in XRT for 2 years previously, and early Friday - late Monday was a popular request from patients, so they could go home on the weekends. The therapists were always very accomodating!
DeleteYes, Lauren we do everything we can to assist and accomodate our patients:-) I love it when a patient reports that they are feeling empowered despite a less than ideal situation.
DeleteI definitely agree, Lauren. Especially while patients are inpatient, sometimes they are overwhelmed with the amount of doctors they are going to see and worry that they will "miss someone or something", so simply changing the time and having it be around the same time daily reduces a lot of anxiety and emotional stress for a lot of patients.
DeleteGood point, Stephanie. I could imagine if a patient can count on a given appointment time to be the same everyday, the routine might give them some comfort and predictability. It seems at this point in their lives they have no control and everything is unpredictable - so this may help.
DeleteA patient could always utilize our mind/body therapists, but need to know that they are a resource for them. Also, they could schedule an appointment with one of our psychiatrists. Pastoral care is always available for spiritual support. Being away from home for an extended period of time brings challenges of its own. Taking time for yourself by scheduling a massage, or going on some day trips that CTCA offers can help to alleviate some of this stress. As a wound care nurse, we are consulted to see some patients in the middle of their treatment, and some at the end of their treatment for related skin issues. Many times we use Medihoney patches to help with their radiation desquamation. For most patients, there is almost instant "gratification" with the application of the patch where the patient reports decresed pain/sensitivity to the area. The patient is instructed on the easy application of the patches, and is in control of their wound care, and can see their skin change/heal with nearly each dressing change. This helps to put the patient back in control of at least their skin care/wound healing.
ReplyDeleteI know from my experience as well, that if a patient has desquamation it can be very painful. It is amazing to me how quickly Medihoney patches and Vigilon will cool the burning feeling they are experiencing and how grateful they are to have the relief!
DeleteI agree Brenda-an ounce of prevention is worth a pound of cure:-) Applies to many disciplines here:-)
DeleteTools and resources available for the radiation patients at CTCA include those offered by the PEC teams and wound care. Dieticians, for examples, can help patients avoid unintentional weight loss, as one’s weight must remain stable throughout treatment, less the original simulation have to be re-done (Over time, weight loss will result in the radiation beams not hitting the target site.) Care managers can help patients with fmla letters for patient employers, as most treatment must take place daily, M-F. Pastoral Care and Mind-Body can assist a patient with developing a relationship with their spiritual side, as they face cancer treatment, and Mind-Body with related counseling issues. Specifically, Pat Dillow and the wound care team are instrumental with treating skin breakdown. (If a patient’s skin breaks down, treatment must stop temporarily, only to resume when the barrier is intact, once again).
ReplyDeleteTheresa Minniear, RN in Clinical Research
Skin integrity and nutrition are possibly the most vital aspects of patient care while undergoing radiation therepy. I am glad you mentioned these!
Deletei agree with you Theresa. We have a valuable PEC team and they are wonderful in giving their support to our patients. We really should uilize them esp. if our patients are having issues related to their treatment.
DeleteIn the Radiation Dept, at time of consult, the pt is asked when they would like to be scheduled for simulation and start of treatment, as we understand that they all have things going on at home that need to be considered in addition to their illness. Our Rad Onc schedulers make every effort to schedule simulations and treatments according to pt's preferences. We have a hospital scheduler in our department so that pt's can schedule other routine appts(massages, nutrition, Naturopathic, Mind-Body etc) when it is convenient for them, without having to leave the department. I have also had many pt's report that they enjoy using the pt portal on the internet to view/manage their journey at CTCA. Lastly, surveys, although at the end of treatment, can produce a feeling of empowerment for the pt as they reflect on their experiences.
ReplyDeleteBeing a part of the decision process instead of being told what is going to be done to your body is very empowering for our patients. Patients that are partners with us, handle the radiation better than patients who are here because some wants them to have radiation
DeleteI agree with Judy, it is very important that the patient is part of the decision making when it comes to their treatment because they are the ones who will be experiencing all those effects of treatment. I think they would adhere more to the treament if they feel empowered and they are well educated.
DeleteI compliment the fact that we have a scheduler within the Radiation Dept that can readily schedule appointments for patients with the other disciplines and various services such as massage, etc. Easy access to these additional options is empowering to a patient and can improve the overall experience.
DeleteThat's wonderful that patients are offered times for treatment. Acknowledging that patients have other things in their lives that they have to do, and helping them to fit the treatment in around these things may help patients feel more in control. It may improve compliance with treatment, too.
DeletePatients have tools available to deal with the emotional and physical aspects of radiation therapy. Some include mind/body therapy, support services such as Survivorship, Cancer Fighters, all other modalities such a nutrition, chiropractic, accupuncture, etc. Wound care can be an essential part of treatent for patients with radiation burns, and education and lotions to help prevent those burns is an essential piece as well. All our friendly staff can be helpful to welcome patients during their long treatment stays as well.
ReplyDeleteGreat point Kari. It is important for us nursing staff to be friendly and maintain the Mother Standard of Care when taking care of our patients. A smile and a welcoming environment can go a long way!
DeleteAbsolutely! All of those departments play a huge part in easing a patient's stress during radiation. Patients feel very well cared for when they know that there is always a familiar face there to help them throughout their treatment with whatever bothering them, whether it be a wound or simply feeling overwhelmed.
DeleteOur patients are often extraordinarily complex. We are fortunate to have so many resources at our hospital, as these resourses are not as available in the community or academic based radiation departments. One particular patient interaction, at another facility, consisted of a patient with mets who experienced unconrolled pain, poor appetite, nausea, inability to sleep due to the required sitting position at nighttime related to a cervical neck tumor, constipation, and inability to find a ride to the radiation department for the daily treatment as the patient could not drive. Several hours later, many orders later, multiple phone calls later, each problem was addressed and managed. At the end of the morning, the patient said, "Why doesn't every doctor office have a nurse to solve problems like you did today?" We nurses have so much knowledge and problem-solving capabilities, I see issues resolved daily with the radiation patients. The collaboration of stakeholders between departments is necessary, and I witness it occurring daily.
ReplyDeleteDonna, thanks for this post. It highlights how much and how often patients need assistance to solve problems. Even whan a patient has all of the tools available to them to solve problems, often times those tools are of little use when the patient cannot utilize them independently. But by being a resource and advocate for your patient, your patient was able to utilize the best tool of all, his radiation nurse and all her skill. Great job!
DeleteChristi Ables - IR x1517
I agree very much with what you said Donna that at this difficult time that the patient is experiencing, collaboration among other disciplines is a necessity because if we keep that good communication with other disciplines, i think patient will feel more relaxed and will feel more trustworthy of us in the delivery of care.
DeleteI think the best thing we can do is give them all of the possible options and give them choices so they can feel like they have some kind of control and feel they made the best decision. I also think we can refer them to CAMS to help them cope with the stress in positive ways. Sometimes, just active listening can be the best medicine for someone trying to cope with all that life throws at them.
ReplyDeleteI agree Victoria. Sometimes just listening to our patients is all that they need.
DeleteAs a Radiation nurse, I feel the most important thing I can "do" for my patients is to educate them and prepare them on what to expect during the course of radiationtherapy. Some times this information is not completely absorbed initially, but during the weekly physician visits, I find it is a good time to reinforce the teaching. I have found when prepared for side effects, control is given. They may not like the side effect, but knowing how to deal with it and knowing it is common, and temporary, makes it easier to deal with.
ReplyDeleteThis education also is aimed at the caregivers, and offers them some control also. Knowing someone will listen to their concerns and address problems gives comfort and relief to our patients.
I agree Judy. The "unknown" is usually always worse than the "known". Education and support are key for our patients.
DeleteI am frequently reinforcing previous teaching at the weekly visits.
DeleteValid points Judy. I agree that reeducation at the follow up visits are very helpful. Stessing the points that the patients may not have heard or processed at the initial visit.
DeleteHow many times have we all heard the patient say; "No one ever told me ...." In retrospect, we can all identify that the patient was instructed but wasn't ready (overwhelmed) to learn the information at that time. Which is why reviewing and reinforcing is key as Judy has so eloquently pointed out.
DeleteThe beautiful part about treatment at MRMC is that it is truly comprehensive care. The patient and caregivers can address their whole beings. They can tap into any and all of the resources that we offer here; nutrition, naturopath, chiropractor, physical/speech/cognitive therapy, care management, pastoral care, and mind body. All services are available but if they do not wish to use them they are not mandatory. This gives the patient and caregivers empowerment over their care.
ReplyDeleteI agree with Tina abouth the comprehensive care that MRMC gives the patients. The patient has the empowerment about their care given to them at MRMC.
DeleteTina is absolutely right we have many service available. We offer these services to our patient's but it is their decision if and when they use them. I believe it can be a comfort and empowering to the patient just knowing the services are there.
DeleteI think one of the wonderful things that we do at CTCA is to let patients know about all the things available to them. At the same time, we don't force these services on the patients. They have a choice and control over whether or not, when, and to what extent they avail themselves of the service.
DeleteAt CTCA we can utilize Mind/Body, social work, survivorship, spiritual care, as well as all of the other disciplines to help give our patients the highest quality of care for both mind & body.
ReplyDeleteWell said, and I agree with providing our patients with the highest quality of care for both mind and body.
DeleteCTCA offers an array of services to our patients such as mind-body, pastoral care, survivorship, acupuncture and reiki therapy. All of these including some that are not mentioned are services patients can be referred to if needed. Wound care also does a wonderful job of helping those who may have any skin related issues post radiation therapy. I feel that as long as we educate patients on possible side effects and how to manage them along with the types of services we offer, patients will always feel empowered.
ReplyDeleteI absolutely agree, Sanah. Education is a running theme in cancer care and is especially important with radiation therapy!
DeleteAs priveledged as patients are to have access to all additional support, I think education is a key indicator. Education will empower to patients, families and caregivers.
DeleteGreat post Sanah
DeleteYes! Knowledge is power! It is not enough to care for the patients while they are in clinic or inpatient. We need to send them home with the information and tools they need to care for themselves when they are not with us.
DeleteComprehensive care is so vital to radiation therapy patients. I am so thankful that we have wound care nurses as resources to help with skin integrity issues, since that is one of the main side effects of radiation therapy. Fatigue is another that requires additional patient education and support (monitoring labs, nurse discussion on energy conservation, etc). As far as the emotional support, we, as nurses, can employ active listening with our patients to assess what further interventions are needed. It may simply be that the patient wanted to be heard. We can always lean on pastoral care, mind-body medicine, the MD, the pt's family/friends, psychiatry, chiro/acupuncture/massage, etc. I am so thankful to have the support system in place to care for our patients!
ReplyDeleteBeing a good listener is one of the best skills that a nurse can have and it goes a long way in offering support for a patients emotional and physical needs
DeleteI agree, being a good listener is one of the best skills that a nurse can have to assist with patients emotional and physical needs. I also think that mind and body can be of beneficial and letting the patient be the driver can be beneficial. We have lots of services that are available and patients should be encouraged to take advantage of. Education also is critical as the more knowledge we have or empower our paitents to have, the better the outcome. Nancy C
DeleteWe really have a great wound care department. I think this is a great resource for any post radiation wound issues. Pastoral care is another great resource, and one that we really need to take into consideration, based on the patient's spiritual needs. We cannot forget to support that particular part of them.
DeleteYou couldn't have said it better Sarah! Sometimes all that a patients wants is to be heard. I often find that patients prefer to confide in their nurses instead of family members. We are fortunate to be in a position to listen!
DeleteTo help a patient feel more in control of what is happening to them both physically and emotionally, I believe education is extremely important. If a patient can understand why they are receiving a particular treatment and learn ways to manage potential side effects, they will be more accepting of the therapy. All members of Radiation Team are important and all can offer active listening, compassion and encouragement. As an added benefit, CTCA offers a multitude of other services that patients are privileged to use. Some of these services include: Wound Care, Psychologist, Mind-Body, Pastoral Care, Dieticians, Naturopathic physicians, Radiation physicians, Nursing, Survivorship, and Physical Therapy.
ReplyDeleteI agree with you sheila, very well said.
DeleteSheila, I agree that education and information are very important in helping a patient know what to expect and how to cope with the treatment. If a person knows what to expect, they might feel less out of control.
DeleteYou mentioned offering active listening and encouragement. Sometimes being able to share feelings of losing control and frustration with someone who will listen, can help lessed those feelings.
We could always have the patient seen by mind body, pastoral care, or the phychiatrists if needed. We give the patinet a choice if they want us to contact either department to talk with the patient. We also encourage the patient to come to us if they have a question or they feel they have a side effect from the radiation treatment. The patient is seen weekly by the Radiation Oncologist while under treatment. The patient is always checked to see about the side effects from radiation treatment, so we can take care of the side effects as soon as possible. If the patient is losing weight we get nutriton involved for the patient to help them with the weight loss. Skin reactions, we can get the wound care nurse involved to help the patient. The patient also wants to have time off, they can discuss this with the doctor to have the time off from treatemt. Naturopathic physcians can help the patient with supplements to help them get through the treatments and side effects. Also to help the patents who are for weeks for treatment is the staff encouragement. Sometimes the patient is down and may just need a hug or just have someone to talk too.
ReplyDeleteSometimes just your mere presence at the patient side can be so consoling to the patients and give them the sense of reassurance.
DeleteWe can have them see mind body, pastoral care, or the phychiatrists if they would like to be seen. CTCA offers a service for almost anything for the patient to make sure there needs are met. Very accomodating. Always making it known to the patient that if they need anything, we can help and we will help. Going to all ends to making sure they know they are in great hands. Encouraging, Listening, to a Helping hand.
ReplyDeleteYes, CTCA is lucky to have so many different services to our patients! We are very lucky to have all of these added members of your hospital available to offer to our patient's. It's also incredible that they are all offered in the same building.
DeleteEvery health care professional that participates in a patients cancer care can help maintain a patients sense of control over their illness by simply keeping them informed of developments, changes, additions to their treratment and diagnosis. It seems to make a big difference. A patients involvement with other patients via group therapy, support cicrcles is very beneficial as well. No one can walk in a patients shoes quite like another patient facing many of the same cancer related issues.
ReplyDeleteYes, exactly! Anyone involved in the patient's treatment plan can offer assistance when a patient has a need. Addressing the need to the best of your ability and scope is the first step in providing excellent care.
DeleteWe have so much to offer at CTCA, but I like your comment about the support group. Sometimes that's all they need to know is that they are not alone in thier battle.
DeleteI agree that each health care provided involved in the patient's care can help them maintain a sense of control. I think we need to make sure we extend the support of other CAMS that the patient may not have had contact with yet. Allow each patient to full amount o support that we can provide for their particular situation.
DeleteEmpowering the patient to know and understand all of the available services CTCA offers while undergoing radiation is important. Each patient has their own personal mind body therapist on their PEC team. Radiation usually is done for weeks at a time. Explaining to patient's that they can utilize their mind body therapist frequently, even daily throughout their treatments can help support them emotionally. If the patient is in need of something greater than coping skills and a shoulder to lean on, we do have psychiatrists available. In addition to their mind body specific team members, the radiation team is also available to reassure the patient that their radiation related symptoms are temporary and normal.
ReplyDeleteI agree with your response Brittney. We are truly lucky to work in an organization that treats the whole patient and not just their disease. Our mind/body therapies are excellent at what they do.
DeleteWe are lucky to have so much available to support out patients here at CTCA. From nursing staff, patient care techs, mind-body, psychiatry, massage therapy, support groups, pastoral care, financial aid, and each and every department has their way of showing support for our patients along their journey. And I think we all DO support our patients in a deeply meaningful way.
ReplyDeleteGreat minds must think alike, because as I read many of the posts, it seems that many of you agree with my thought that knowledge is power. Educating a patient provides them knowledge that helps to make informed choices, understand what is expected during and after their treatment, and reduces fear of the unknown. All of which, I believe, lend themselves to restoring a sense of conrtol for the patient. In addition to the powerful tool of knowledge and preparedness, at CTCA we believe strongly in mind-body-spirit. Control of what is going on with the body may not always be possible, but when you help patients tap into the strength of their spirit and help them to attain a peaceful mind, it may help them deal with the things that are out of their control. Mind Body, Pastoral Care, holistic care, beauty services, accupuncture, massage, support groups and meetings, all of these are made available to our patients in large part to address this very important aspect of living and dealing with cancer.
ReplyDeleteChristi Ables, RN - IR x1517
I like Judy's comment about educating the patient, from the onset. It is important to prepare patients for the potential side effects. It can be difficult to understand that lying on a table, for a matter of minutes each day can cause so many problems. A little education, upfront, can go a long way to understanding and dealing with potential problems.
ReplyDeleteI always think our patients have some special issues to deal with, many being far from home, for an extended period. Sometimes a spouse has to stay home, work and care for the home and other caregivers can't be gone, for an extended period. This can leave the patient alone for parts or the entire treatment. In this case, our roles become so much more important, to provide safe care, while still giving the patient optimum independence and, yet, help them feel they are still in control.
Pastoral care, Mind/Body and, even Psych services can be vitally important, just as mentioned, in providing emotional support and prayers, for the faithful. Many, who depend on attending church each week, have to forgo this, while on radiation. Dieticians must help the patient choose appropriate meals, from a menu, rather than a family member, cooking. Nurses assess the patient for the safety of returning to a hotel room, rather than to home, each day. Even the transport system, at MRMC, become a vital part of our radiation patient's well being and success at completing treatment.
In addition to listening to what our patients say, we "listen" to what they don't say; thinking ahead of what their needs and challenges might be and anticipating them. Going that extra step, for our patients, empowers them to feel the best and the safest, they can, so they can focus on what else is important to them. That is the ultimate feeling of control, I believe.
I agree with both Judy and Margaret about educating patient's from the beginning. Our patients are NOT medically trained individuals... And often times we forget this (i think). Its easy to explain the same thing over and over to the patient, but if we are not intentional with assessing and breaking down the information to the patient's at a level of their understanding from the onset of care, than we often fail them in the end. I feel that we do provide several opportunities to help the patient understand, but we also need to remember.... they can barely comprehend that their life is hanging in the balance. Everyone wants to live forever.... Being told that may not be an option anymore is quite a smack over the head.... Let alone alllllllllll the information we provide them in their multiple appointments everyday.
DeleteI think we do many things very well at CTCA. Giving patient's scripts for possible symptoms and side effects that they can fill if the symtoms occur puts the patient at ease and offers them assistance with physical and emotional needs. Them knowing how to reach out to the care team also provides emotional support. And all of the education materials provided to them that they can refer back to to review to determine if what is happening is common or expected gives them some knowledge of what to expect empowering them. They may not hear everything we say at the initial visit but having the tools to review empowers the patient.
ReplyDeleteI agree with Patricia. Giving the patient many different ways to help them control th situation. Each patient is different
DeleteKnowledge is power. Empowering patients can help them make decisions that are best for them. Being able to make a decision that impacts them, can help patients feel more in control.
DeleteWe have many resources available to assist our patient's feel more in control of their personal situation during treatment and after. We have a fabulous Mind and Body Department which includes meditation, relaxing tools,and just someone to talk to other than your own caregiver, Reiki and much more. We also have support group available and Pastoral Care.
ReplyDeleteI agree with the above, many resources and/or tools to guide our patients to put them at ease. But sometimes its just being able to talk to somebody other than their caregivers that can make them have this feeling of control and that they are making the right decisions.
DeleteI agree with Marjory we have a great team here at CTCA. We should encourage our patients to use all tools available to them during their treatment, or inform them of all our services.
DeleteWe are all aware of the resources that CTCA has to offer from mind and body to pastoral care to massage. These are all ways of putting patients at ease during treatment. Also, as a nurse just being there for our patients, being available to answer questions and guiding them may all a patient needs to feel in control of their treatment plans. This may also be as simple as allowing them to choose their treatment daily times. Providing information on what to expect during treatment, educating our patients so they feel like they are knowledgable and in control.
ReplyDeleteI agree, it can be as simple as giving them options for what time of the day they treat. For some people the more options the better.
DeletePatients having radiation therapy, no matter how well educated they are with the treatment would still feel overwhelm with all the things that are happening . fortunately we have a lot of tools and resources that are availble for them when ever they need it for example is the wound care they are having that skin reactions as a side effect of the radiation , we have the mind and body department when they need to relax , and emotional support and the dietician most especially when they are having side effects like nausea and vomiting and diarrhea. as nurses , we just have to educate them with all the different resources that is available for them that would help a lot during this transition.
ReplyDeleteI do believe that patient will feel empowered if they were included in the planning of their treatment form intial discussion & planning.Discussion on potential side effects its management & interventions. Referrals to nutritionist in case of mucusitis, Wound nurse for skin irritation; Mind body for emotional set back, Pastoral care for faith & devotion; patin management for intractable pain and other reources offered by our facility CTCA at MRMC. and knowing that there is always available help is needed anybody can fight and conquere treatment and cancer.
ReplyDeleteI agree on this, making patients to be part of their treatment makes them feel more in control and empowered.
DeleteI agree, by involving our patients in their treatment plan and by giving them options and ancillary support, they will feel much more empowered and in control of their care.
DeletePatients here at ctca have more options and tools available to them than other facilities. Pt have thier clinic nurses to check on them every treatment and allow the patient to ask questions to help them stay in control. They are there for advise to empower that patient. We can assist with the ND to provide supplements that the patient can take when they need to feel in control of side effects. We have mind body to assist with stress and anxiety if the patient wants. We have caremanagers to help the patient outside of ctca to gave control over their care and side effects. By knowing all the staff is there for the patient could help them feel more control and stable.
ReplyDeleteTammy, I agree that we have a lot to offer out patients whether they are here or at home. All of the services that you have mentioned are so helpful to these patients and makes a world of difference. Care management does a wonderful job of managing these patients and helping them get the things they need once treatment is done and they return home as well as while they are here. Staff is defenitely beneficial in helping these patients transition
DeleteGiving them as many options as possible will help them feel that they are participating and in control of their treatment. this could be as simple as offering multiple treatment times during the day and letting them choose. Giving different options for side effect management, such as anti-emetics that are prescribed. We also have so many resources here at CTCA including the PEC team, pastoral care, psychologists, and mind and body. Many of our nurses are also certified in holistic nursing which can be incorporated into the patient's care.
ReplyDeleteHi Andrea,
DeleteI hadn't thought about giving the patients options as to treatment times as being a resource to help them through their treatment, but it definitely is. I know when I work with inpatients who are receiving treatment, giving an option of a time sometimes means the difference between receiving treatment that day or not. A lot of times patients wake up feeling sick and groggy and are not up for treatment. As the day goes on though, they sometimes start to feel better as they get up and moving.
It's true that patient can't control there symptoms after radiation treatment. For example: Radiation to the neck in Neck Ca. It affects there oral all the way to there guts. In the long run they end up having a tube feeding. Physically and emotionally it affects the patient. Extensive training and teaching is really important. Nutrition consult is on the top and big impact. They need all the nutrition that they required, High in protein for inflammation and tissue damage repair. And of course all the other health care provider team will follow up on the patient's need.
ReplyDeleteAn initial consultation should be given to the patient to explain benefits, risks, and side effects of treatment. This is a very important step as it allows the patient to ask questions. After the consultation, treatment planning should be completed with the patient and caregivers fully involved. The planning process can also give the patient assurance that the right area and dose of radiation will be administered. There are many tools available for patients experiencing side effects of radiation. The most common physical side effects are skin reaction and fatigue. I see this all the time with my patients. It is important to empower them with information on how to control the side effects. Knowledge is always a great tool for physical and emotional control. I think written handouts on treating and preventing side effects is a must for all patients. This way they will always have a reference with them if they experience side effects. Skin care handouts are essential to give the patient ideas on how to keep the skin clean and dry, stay out of the sun, and treat affected areas with specially formulated creams or lotions. Other tools that may be important for some individuals undergoing radiation therapy include support groups, caregivers, financial aid, or home health care.
ReplyDeleteAt CTCA, we have many resources available to our patients including mind-body, Reiki, massage, acupuncture, psychiatry, and pastoral care. When these services are utilized, they can be very effective depending on the patient’s emotional needs. Our oncology nurses can teach patients the importance of following up with these departments for increased quality of care. Our model of the PEC (patient empowered care) team includes these departments when returning for medical oncology visits to ensure continuity of care.
ReplyDeleteGreat point! To let the patient know that the PEC team is always available and ready to support the patient with what they need! Pastoral care is another great resource for the patients to use. Along with what you have stated, financial aid is also a great resource to help the patient and their families with things they may need outside of the hospital!
DeleteThere are tools and services available here at CTCA that allow patients to work through the emotional side effects. We have mind-body therapy, guided imagery, support groups that allow the patient to make a connection between their mind and body whether they may be aware of it or not. This may allow the patient the choice of accepting these services and further their knowledge.
ReplyDeleteThere are medications and nutritional support that the patient can choose to utilize. The patient can take anti-nausea medications or vitamins to promote quality of life. The patient can meet with a nutritionist to promote healing and ensuring proper nutrition
I feel and believe patients should be involved in their plan of care from the beginning of treatment to the end so they have a greater understanding of what they will be and are going through. Here at CTCA, services such as mind and body, pastoral care, meeting with the nutritionist, and going to support groups help patients understand and realize what they are going through, and also helps them gain knowlegde, so they feel they can be in control of their plan of care.
ReplyDeleteI agree patients need to feel they have some say so with there treatment. I have had patients return to see us (garden clinic) for some questions and concerns while they are receiving treatment. Sometimes patients just need to feel they can go to anyone they feel a connection with. I have had many patient say they do not want to go home for radiation treament because we have spoiled them with our great care.
DeleteI think the use of CAMS is an effective tool to allow patient's to feel they have better control of their emotional and physical side effects of treatment. The use of the naturopathic provider, mind body, and psychiatry can be beneficial for the patient to support this. We need to also make sure the patient is properly educated in what to expect during and after treatment. The patient should know that they have the support of Care Management, and that they can call with any questions or further concerns. .
ReplyDeleteApproximately, 13yrs ago my mother was dx with breast cancer. She did not treat at CTCA. Watching her struggle with chemo and radiation treatments, I think have helped make me a better nurse. I do not think that my mother was able to express how life changing this dx was for her and how scared she was at the time. I really do appreciate what "we" do for our patients. How much we help them through this process. Patients can feel like they do not have control or power over anything during their treatments. If patients would like assistance with any issues that they are having I know CTCA will be here to help the patients and caregivers. Patients at CTCA are able to contact their care & pain managers 24/7. The surgical team is available to the patients for any questions, and of course radiation & oncologist teams. Patients also have mind-body, physical therapy, nutrition, naturopaths, survivorship, and mental health professionals to help our patients.
ReplyDeleteGiving patients options, allowing them to make a choice can help with the feeling of control. Also, making sure patients are aware of what to expect (potential side effects) from treatment
CTCA does have a plethora of valuable resources to help our patients. I believe many of our patients come here to regain control of treatment when other facilities have treated them like a number. I love that we do not treat our patients like numbers here.
DeleteGuiding the patient early on in their treatment to all appropriate ancillary departments is key to giving the patients the most sense of control in their treatment. The more options and choices they are given for all useful assistance in their care the more power over all their care they will feel. MInd body, wound care and cancer fighters are all great options for patients to utilize during their long radiation treatment. Also something as simple as giving them the power over when they are scheduled can help tremendously.
ReplyDeleteJolie, I agree that when patients understand the process and options that they understand, they can maintain control and dignity during the treatment process.
DeleteWhen I speak to patients, one of the things they cherish most about coming to CTCA, is that they can meet people that are going through cancer treatments and they feel supported by being in an atmosphere dedicated to the treatment of cancer. Connecting patients with support groups can allow them to find emotional support through peers who have gone through and are going through similar experiences. Support groups can be found in person and online. I also think that staff consistency can help patients develop and maintain familiar relationships from visit to visit, which increases a sense of security and control over their treatment. A relationship allows them to pick up where they left off instead of reexplaining and answering the same questions over and over. It also allows them to confide in their caregivers and make requests they may be uncomfortable making with a new caregiver.
ReplyDeleteHaving some sense of control over what is happening to you is a real basic need. I think it is easy to forget how very difficult it is to be away from home, family, friends and life as they know it for such an extended period of time. I am proud of the variety of quality services offered and available at CTCA. There have been many impressive comments noted on the value of educating our patients. Sometimes however the amount of information can be overwhelming. Initially there are so many emotions and much information to process. I think it important to have continued communication throughout the treatment of the tools and services available. The emotional and physical needs may change during the course of treatment so frequent reinforcement can be valuable.
ReplyDeleteI agree with Debbie, CTCA offer many great services for the patients but the amount of information can be overwhelming. Our job as CTCA staff is to remind our patients of the services they can utilize.
DeleteThere is so much to be said for reinforcing and ongoing education of the services that we offer here at CTCA. I agree with Debbie and Malgorzata that the inofrmation overload that our patients initially receive truly requires that we encourage and empower our patients so that they make the best choices for their health care.
DeleteI have seen a lot of patients that have undergone or are still going through radiation treatment, yet, sometimes I can't help but feel the harsh effects of this treatment to the entirety of their body. As a nurse, I learned to be more compassionate as to what they're going through and learn to emphatize with them in a manner where they could feel that despite of their condition someone cares and is willing to be there for them as their advocate.
ReplyDeleteAt CTCA, we have a diverse group of people that can work with these patients while undergoing their treatment. For the physical attributes of this treatment, we have excellent oncologists that can explain to the patient the side effects of the treatment. The wound care nurses that can give profound advises and recommendations to the patient on what to do when severe desquamation of the skin arises as a side effect of the treatment. The Physical therapist, will be there "rock and shield", that in the event that the patient can hardly move will be there to offer their service to bring them back to their normal energy and strength. The dietician on the other hand, will be there " strength" because as their body continue to decrease in weight, they are there to inform them that there are other possibilities that can be tried to keep them away from being cachexic and that life has to go on with savor and flavors of positivity and endless optimism. The naturapathic medicine that we have in this facility is like another thing that the patients can try and working at the bedside, some patients really find this very helpful because of its natural content.
On the emotional side, we have Mind Body and Medicine, psych consults, pastoral care that can be a good tool and resources in shedding some light and positivity for the patients.
We are so lucky to have such an incredible team to offer to our patients to help support them get them through such difficult treatments! You did a great job explaining how everyone can work together and help strengthen different parts to ultimately help the "whole" person. I feel it is our job to ensure that patients know about all of the support available to them and help them receive anythine and everything they are open to.
DeleteRichie,
DeleteYou did a phenomenal job at describing the services that we have at CTCA that aid our patients feel as if they have control over certain aspects of their lives. On the other hand, when they do not feel "in-control" there are people that are apart of the patients PEC Team(s) that empower them ask for help when they are feeling "helpless" and know that no matter what we all are working for their best interest. The most effective way to help the patient is to make them aware and educate them on all things available to them even when the need has not presented itself. When the resources are presented before the need arises, the patient can feel empowered in knowing that whatever side-effect they may experience, there is always someone or something there to support them. Great post. Thank you for sharing. :-)
I will agree with many of my colleagues, education is key! By providing education to patients and caregivers, we empower and encourage them to participate in their care. Knowing what to look for and taking immediate action will become a crucial in managing side effects. Also, being aware of resources available and using them will help them achieve or regain control. Mind body/pastoral care/care management and the rest of the CAM team are available under one roof! We count with various disciplines to help the patient get through treatment.
ReplyDeleteJessica,
DeleteI agree! It's difficult for a person in the same position as our patients and at times they can feel as though they have no control over what's going on. I think that introducing them to the mind body, acupunture, massages, and pastoral care is a great start in letting them make some positive decisions on what happens to their body. I'm glad we are able to provide these things in the same building as their treatment!
This is so important! From the beginning patients here are able to make choices about their treatment and how they want to manage their symptoms. That is empowering!
DeleteAs others have mentioned, the best way to give the patient back control is to give them the education and support they need to actively participate in their plan of care. We are so lucky at MRMC to be able to have such a wonderful variety of support staff to truly care for the "entire" person. As nurses we need to educare our patients on side effect management and how to contact their team with questions or concerns. We also need to help ensure they are aware of and can utilize all the resources available to them. We are unique at CTCA in that we truly try to help each patient as an individual achieve their highest level of functionality and quality of life, and that is why patients return to us.
ReplyDeleteA patient who is encouraged to participate in decision making about their care and who actively participates in their treatment is probably more able to feel in control of their life. We do alot for our patients at CTCA, and have many resources to educate and empower them.
DeleteReceiving radiation can produce a lot of anxiety for patients. Some dread it, some look foward to it. Our facility is very good about diving into all those possible feelings of not being in control. I mainly see the inpatient side of this. When a patient is admitted, they feel like so many things are happening at once and they have so many people to see and things to do throughout the day. Many times, admissions are unplanned so they worry that their schedule will be thrown off and that they won't be able to receive their radiation while they are in a hospital bed. Like stated in earlier comments, simply adjusting the radiation time for what works best for the patient and making it consistent can make all the difference. It helps the patient feel a little more in control and also helps them keep their day straight. Some even look foward to it because they love the therapists in the radiation department and it breaks up their day of being in a hospital room all day. It also puts them at ease knowing that departments like nutrition and wound care are there to help support the patient while they are receiving this treatment and to help them physically handle cancer as well as mentally and emotionally.
ReplyDeleteFor these patients receiving radiation I believe that the first thing that would benefit them with coping with these reactions would be educating them on the side effects, including emotional, that they may feel after treatment. When someone is aware of something that may or may not occur they prepare. It doesn't catch them offguard and overwhelm them as much. With the knowledge of radiation and the side effects they know what needs to be done, for example what soaps and lotions not to use for a skin rash. Feeling knowledgable about our bodies is the start of feeling in control.
ReplyDeleteI think that education before treatment starts explaining possible and probable side effects for the treated site will help patients when those side effects may happen. There are medications and services that can help patients manage their side effects as well. Patients have mind/body, acupuncture, massage, pastoral care, GI, and the beauty salon for wigs. Patients also have support groups where they can share experiences and how others have managed their own treatments. I have heard from so many patients how beneficial it has been for them and how they have bonded with one another by sharing their experiences through the treatment process. I think that we do a great job here at CTCA managing and helping our patients through a tough time and making it a more positive experience.
ReplyDeleteHi Pam, Radiaiton has an excellent resource booklet that they given patients with extra handouts. Patients are told so much that to have in print is excellent.
DeleteCTCA provides supportive services to patients which are not made available in other cancer centers. Education is a key component, as many others have already posted. Timing is critical as every patient is different on when they are ready to learn and accept new information. Knowledge is empowering for the patient and may help patients gain better control, when they understand what is happening. We have many services to offer: Mind & body specialists, pastoral care, acupuncture, social services, care managers, naturopathic medicine, nutritionists, rehabilitation, survivorship support, financial counselors, quality of life, smoking cessation are just a few I can think of with many more. Patients have a collaborative team of care providers to help them through their journey with cancer both physically and emotionally.
ReplyDeleteThe collaborative care team at CTCA radiation is what sets it apart from the free standing radiation clinics. One building, one place, one CTCA.
DeleteI think that educating our patients about all of our services here at CTCA can help the patients feel more empowered. We offer many great services like naturopathic, nutrition, reiki, message therapy and pastoral care. By encouraging our patients to take advantage of some of this services they will feel more in control. I know many of the Radiation patients find message therapy and reiki very helpful while on treatment.
ReplyDeleteElvia has stated the key is education, for patient's empowerment. We in radiation are always trying ways to make education better. The information book that we have is concise and written for the lay person to understand. Along with allour departments we are a one stop place and that alone is very empowering.
DeleteElvia makes some great points. I think we do a great job of letting our patients know we will accomodate them as much as possible and if it is safe. This allows them to feel empowered.
DeletePatients have many tools available to help them deal with all aspects of radiation therapy. Some include radiation clinic nurse, care manager, dietician, naturopath, mind/ body therapist, pastoral care care, just to name a few. Any/ all support can help a patient to feel more empowered and in control of their treatment.
ReplyDeleteI agree with Mary. There are many different areas and tools available to patients and each one helps build the empowerment patient's feel about their treatment and care.
DeletePatient have many services to help cope with and feel empowered during their treatment. Mind/Body, accupuncture, psychiatric all are available to help the patient feel more control during treatment. These along with many other services can help our patients physically and emotionally throughout their radiation treatment.
ReplyDeleteThere are many services to support the patient at MRMC from PT to speech thereapy, Mind and Body, naturopath, nutrition, wound care... Pt's are well educated by the radiation team of these services and offer referrals along the way.
ReplyDeleteI agree With Patty that patients are well educated of all the services available in the hospital. But of course as long as Love is present in all aspects of services that is being rendered to our patients, they will all feel equipped and strong enough for any bumps on the road.
DeleteThe nurses that I work with in radiation are very good at teaching their patients. Although it is an overwhelming situation, the patients are given options from treatment choices to the different modalities to manage their symptoms. We have so many resources for them to plug into. Basically, they are continually making choices, even about what they eat or how soon they ask for help. The sooner they can see how much control they do have the better off they are. Patients who are more proactive about how they take care of themselves tend to tolerate treatment easier than those who don't.
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ReplyDeleteThe PEC team model is very helpful in addressing these needs. The patient should be working closely with the nurse, care manager, dietitian and naturopath (also wound care, if there are skin integrity concerns) to keep the often alarming side effects of radiation therapy at bay. They should also also be reminded of pastoral care/mind body services at their appointments. It is the nurse's job to do careful assessments to uncover any side effects, report to the provider so that medical interventions can be initiated, and to educate the patient regarding proper home care and comfort measures. Knowledge is power, and if the patient is shown how to utilize each specialist they are offered at CTCA and taught to properly manage their side effects and symptoms when they are away from us, it will help them maintain a sense of control of their care and treatment
ReplyDeleteI agree with all the comments this month. We allow and should encourage our patients to put some control back in their treatment regimens as long as it is safe to do so. I think most if not all the nurses and staff who work here do this every day by truly listening to our patients and their needs. On the occasion when we can't meet our patient's every request, our patients feel in control because we listened and tried.
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ReplyDeletePatient's should have control over their treatment. We can help them feel that control by empowering them through all the ancillary departments that are available in our hospital. By teaching our patient's at the beginning of their journey about the availability of those departments we can help them both physically and emotionally. We can help them mantain control and maintain a good quality of life. Patients will be able to make better informed decisions if we continue to teach and referr them to the appropiate person or departments to help them.
ReplyDeleteGreat minds do think alike! Prior to reading all of the other blog posts, I was thinking the same things. We are fortunate to work in a hospital that provides so many services for patients. In navigation, I have been working with head and neck patients, and find that our resource of the GI department and our registered Dieticians are also vital for patients and gives them a better understanding of how important nutrition is and what interventions (feeding tube placement) may be possible in the event they require it. When patients know what side effects and possibilities to expect, they are more prepared and less frightened when a change occurs. We also have our wonderful Naturopaths, Mind/Body therapists, Psychiatrists, Pastoral care and accupuncturists to provide care and support. Our patients thrive when they are part of their care and part of the decision making process.
ReplyDeleteThe team effort of our stakeholders is really more than enough for a patient receiving radiation therapy to believe and feel that they can have some control over the emotional and physical side effects of their treatment. This place is amazing and we can even hear that from our patients all the time. "I have never seen a hospital that shows so much concern to their patients". Does this sounds familiar . Yes, because we hear that all the . And our common answer is " It is all by God's Grace that we can do all these" , Isn't it? We all do it out of LOVE..
ReplyDeleteThere are many areas to aid in the empowerment of patients. Mind-body, physicians, nurses, medications, nutritional support, pastoral care, and access to support groups just to name a few. Each one I believe helps building in the empowerment.
ReplyDeleteYou make a great point about the nutritional team I was only thinking emotional support. I also did not take into consideration pastoral care- they are a big help for our patients.
DeletePatient with cancer in general feel that they have lost control of their body. Patients at CTCA have the option of meeting with a mind/body therapist on site to help them express some of their concerns and to help alleviate some anxiety. Patients can also utilize pastoral care as well as any one of the multidisciplinary team members. Patients also have the option of attending support groups where they meet others who are undergoing similar treatments. Patients tend to feel more in control if they know what to expect and if they know that they have a choice on what they would like to do. So the most important thing we can do for our patients is to educate them on what to expect. Our radiation department is excellent at educating patients on how to manage and/or minimize their side effects. Patients are assessed prior to each treatment and appropriate actions are taken to help alleviate their symptoms.
ReplyDeleteWe could help our patients gain control by giving them a say in their schedule. Some patients like to sleep late, so those patients should be scheduled in the afternoon. Our schedulers are very good in juggling the schedules to accommodate our patients appointments even with the other members of the PEC team who really gives a very good and wonderful support. Physical side effects such as skin irritation are very well managed by our wound care team. By applying the cream, medihoney and vigilon, our patients feel the soothing effect those treatments give. Emotional side effects are managed by Dr. Sunn/Bloom, mind-body team and pastoral care. Sometimes just sitting quietly with patients is enough. Action speaks louder than voice.
ReplyDeleteGood post Jennifer, Aligning the patients care to a time that is most appropriate for their schedule can reduce stress for the patient.
DeleteOne of the greatest tools a patient has to help them attain a sense of control is the nurse. The essence of nursing is helping patients to live with their medically prescribed treatment plan. The nurse is aware of the potential side effects and will then help provide education that is meaningful to the patient. A knowledgeable patient will be an empowered patient in most cases. When a patient has a nurse involved in their care they will also have the benefit of having someone empathetic to the emotional struggle they may be facing secondary to their diagnosis or the physical alterations caused by their prescribed treatment plan. Having someone like a nurse just take the time to listen to their concerns, fears and problems can give a patient a better since of control with the affirmation that someone know what they are going thru and that the nurse is there for their support. With increase knowledge of the patient unique circumstances the nurse may then advocate for the patient by requesting referrals and prescription to services and treatments that may further improve coping with the treatment plan.
ReplyDeleteGreat post Bena,
ReplyDeleteI think you hit upon something that makes us nurses here at CTCA more able to assist patients in their treatment plan. As nurses we are empowered and can consult for mind body, pastoral care, and wound care to help patient. The ability for us to do this give the nurses much more ability to intervene and improve a patients reaction to their treatment plan.
There are many services the CTCA provides for our patient, but I think the most important is Mind and Body and Wound Care. The Mind and Body is to give emotional support for patient’s who come for treatment by themselves-so they don’t feel alone and have someone to talk to about there fears etc. The Wound Care services provide relief and education on the proper care of the side effects of the radiation on the skin. I think it is beneficial because some patients do not know what to expect with radiation and it can be discouraging.
ReplyDeleteAs with all courses of therapy the patient may go through periods that they are mentally, spiritually, emotionally and even physically not able to support themselves and may require assistance from others. It is in these moments that patient need their care providers to advocate for them, and help support them in finding tools and services that will make the radiation less stressful in how they feel, see themselves and possible side-effects.
ReplyDeleteOne of the great things about CTCA is that we try to think far into the future and prepare the patient for what may come and offer services that they may need. From Naturopathic medicine, to Mind/Body care, nutrition, spa & salon care, physical therapy to support groups and social services; we have so many people and teams that center the patient to feel empowered in their care and decision making. When patients are experiencing emotional issues they have the ability to just vent and talk to someone that will be a supportive listener and never make them feel belittled. On the other hand, if the patient is not experiencing smells, tastes and food as they used to there are dieticians that can offer food choices that meet their needs or Naturopathic MD’s that can prescribe supplements to change the way the body responds to food or increase energy to counteract the fatigue the patient may experience.
Whatever the patient’s needs are CTCA has a team member that can help the patient have a sense of normalcy, empowerment and control, and if we don’t have someone to immediately tend to the patient’s needs we have people from patient advocacy to care management that will find someone outside of CTCA to aid the patient. It is that dedication to complete patient care and satisfaction that keep our patients coming back, and developing trusting relationships with our stakeholders; knowing that we will go above and beyond to make them happy.
Feeling "out of control" is not unique to patients receiving radiation treatment. A diagnosis of cancer can lead to feelings of loss of control, regardless of the treatment. Patients and their families/loved ones have to deal with many losses, including the loss of "normalcy". Radiation therapy can require daily treatment, and last for weeks or months. Normal routines can be disrupted by that type of treatment schedule. Treatments can leave a patient feeling fatigued, and that further disrupts their usualy routines and ability to do the things they "normally" did. At CTCA we have many different services to help patients regain a sense of control over their lives. First, we partner with the patient to determine their care. Patients are involved in making decisions about which type of treatment to pursue. Mind/Body medicine staff and psych providers are available to help the patient process what's happening to them, and to help them find healthy ways to cope with what they're experiencing. We have staff who can help a patient connect with the things that are important to them spiritually. Sometimes this helps patients feel more in control. There are all sorts of CAM services available to patients to help them be as healthy as they can be, again, helping restore a sense of control. Nutritionists, physical therapists, naturopaths and more - all can help a patient manage side effects of treatment.
ReplyDeleteAt CTCA we have opportunities for patients to talk with other patients who are going through or have been through treatment. Talking with others can be helpful and may enable patients to better cope with everything that's going on, and they may realize that they can be more in control of what's happening.
One of the things I struggle with most as an oncology nurse is working with patients that have very little control over their condition. I truly make advocating for my patient one of my greatest priorities, and truthfully, despite all the advocating I can provide, sometimes I still feel like patients do not have the option to have control over their healthcare needs. Now, that is a general statement that I provide an understanding of little control our patients have, so giving them the ability to have a sense of control is crucial.
ReplyDeleteCTCA does a fabulous job at making this the centralization of our care! We have PATIENT-centered care! Which means that we do our best provide the patient will enough resources and education to feel that they have complete control over their treatment decisions and their quality of life. We have multiple CAM ancillary departments, both inpatient and outpatient, to be resources to patients and caregivers to have the autonomy, encouragement, and education to make the best choice for themselves. We have our MindBody Department that provides reiki, yoga, relaxation techniques, and so many more options to assist patient during tough situations. We also have the support from our nutritionist, physical therapists, and naturopathic to support our patients through their journey!
Unfortunately, sometimes are cancer patients feel like they have lost control of their body due to their cancer. Emotionally it is hard for some patients to accept that they have cancer and to seek treatment. The patients also may have emotional issues when they being radiation treatment due to possible hair loss and dermatological changes. We have a great team that is able to take in account and help our patients. We have a great wound care team who stops skin irritations before they get out of hand or heals the wounds when they do occur. We have couple of psychologists that the patients can talk to in order to get off what is on their mind. Our mind & body team is fantastic about talking with patients and letting them express their concerns. We also offer Reiki therapy for the patients to feel well balanced during their treatments. Overall, I believe that we do a great job at addressing the patient’s issue, the patient just has to be open to the help.
ReplyDeleteThe main tool that the patient has is knowledge. The more informed they are, the better their ability is to make the choices that allow them to be empowered to help manage the side effects that they may have. Knowing that we are available for them to ask questions, we offer reassurance and reinforce expected and potential side effects. In addition, we regularly remind patient to utilize any/all of the resources that CTCA has to offer them throughout their treatments here. This allows our patients to control what and if they want to participate in.
ReplyDeleteGiving patients Opportunity to hear from the Radiation Oncologist the plan of their treatment getting an informed consent can help them to feel they are making choices to help fight the cancer. information on what to expect and how to manage side effects and what to report to the doctor, nurse or care manager can help a patient to feel more in control. Listening to the patient concerns and addressing the concerns can also help the patient to feel that they are heard and will be helped as needed through the process.
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