Dr. Sheelvanth and Dr. Neelam teams. Although the article highlights two patients with pancreatic cancer who ultimately did not survive, at MRMC we have many patients who have received positive outcomes after undergoing surgery and treatment.
I hope you find this article both informative and interesting. The Puzzle of Pancreatic Cancer, open the link imbedded in paragraph nineteen for additional information about immunotherapy.
Questions
- What makes pancreatic cancer so difficult to treat?
- Describe immunotherapy and how it can be used to fight cancer.
Send your answers to melissa.luebbe@ctca-hope.com, and please remember the guidelines for your responses!
Discussion Question
Oncology is such a special field to work in. We interact with people daily who have been handed a potentially fatal diagnosis. This fact requires that we have sympathy, empathy and most importantly - good communications skills. After reading Breaking the Ice please share some of your thoughts, ideas and experiences with everyone.
This article alone makes me emotional. Being a nurse is difficult itslef emotionally, but having to care for patients fighting for their lives is even more difficlut and emotional. We sometimes bring this home with us and continue to feel loss and sadness. The courage these patients have is tremendous and trying to match that with being strong supporters is at times jsut too hard. Holding back tears is something i struggle with alot, but i tell myself that this is what makes me human and a great nurse is the fact that i care and love so much. Healthcare at all is what shows your heart on your sleeves sometimes and just the humanity in people. Sympathy and Empathy are a must for all involved in our patients care.
ReplyDeleteThis comment has been removed by the author.
DeleteYes, I also find it hard to deal with these situations and work and try not to bring it home with us. Sometimes its hard to separate work life from home life because we grow an attachment with our patients
DeleteI wholeheartedly agree that nursing is an extremely emotional career. Just last night, I was reminded of how often I've cried for and with my patients and their families. As compassionate as we nurses are, it is near imposssible not to bring any of the emotional turmoil we feel home to our families. It would be really something to have debriefing/support meetings built in at the end of every shift so that we could bring less of it home.
Deletei agree. having emotions towards the patients we see is exactly what makes us human!
DeleteThis article expresses the very reason I work in oncology. It is acceptable to cry with, pray with, and hug a pt and their families. I need it as much as they do.
DeleteIn nursing school, 35+ yrs ago, they taught to "not cry in front of the patient." When I cried in front of the son of a sweet elderly man I cared for consistently, the son said, "Now I know how much my father meant to you and you truly cared about him." My tears spoke to him. Sharing your tears and caring is professional and is a part of oncology nursing. I agree, we are human.
DeleteThis article touched upon several topics that are sometimes overlooked and a last priority when our days get busy - individual, compassionate care. Each patient responds to an emotional event differently. As the nurse, we need to remember that our patients may not cope in the same manner we do, so what we may find insignificant may be incredibly important to the patient. That concept also comes into play with our patient’s decision making for their plan of care. In school we have all been taught how to SAVE a person’s life; not how to comfortably end it. If I remember correctly, my school spent 2.2 seconds on the topic of palliative care and dying. These topics though, are common players in the field of oncology. In the department I work with now, we usually do not discuss the transition to end of life care; rather our patients are grappling with the decision on what surgery to select- unilateral mastectomy, bilateral mastectomy, vs partial mastectomy. Some of our patients select bilateral mastectomies even though they were diagnosed with DCIS and could simply have a lumpectomy with radiation therapy and hormone therapy. So even though in my mind the less surgery the better and they would not need to worry about reconstruction, due to the patient’s anxiety and or personal choices they elect to proceed with a bilateral mastectomy with reconstruction. In the end, as our Director of the Board states, “it has been…and always will be…about the patient”. If they are fully informed and happy with their choice we are there to support them.
ReplyDeleteGreat read! It is sometimes very tough to watch families and our patients struggle to make the decisions with end of life care. I really feel we need more conversations here. I have personally felt at times that patients are pushed to make decisions, and then I experienced this in my own family. As we help my grandpa make very difficult decisions, I am constantly teaching my family that these are his choices, his life and that as long as he is informed and ok with his choices we should support his decisions. Its been rough, but it is really nice to know I am not alone in this situation.
DeleteYes I think the important thing to remember as caregivers is what is like to be in these patients' shoes and be able to emphasize with them
DeleteVery nice, Elizabeth. Thank you.
Deletei agree with you , Elizabeth. as long as they are well informed , we just need to support them with their decision.
DeleteElizabeth great observations. I agree with you that each individual patient deals with illness in their own way. As nurses, it is important to remember this and we must try to be there for our patients even when we don't have the same beliefs or views. This can be a challenge at times, but the best thing to remember is that our patient's wishes come first and we just need to be there to support them.
DeleteOne of the many challenges that we face here at CTCA, can be the patient’s views on holistic treatment and avoidance of primary treatment. Steve Jobs, did a lot of holistic things that didn’t cure him although may have fended of the disease. I didn’t know before reading this article that his cancer wasn’t “pancreatic”, but was a neoendorcrine tumor in the pancreas. Our patients do so much research from reputable and irreparable sources, and they come with preconceived notions. It is our job to accept them and meet them where they are and educate them as nest as we can. I have found it really challenging at times, when a patient blatantly rejects modern medicine and then has serious progression. I am able to have empathy because I myself have a very hippy dippy side to my beliefs, but I also believe, if you are going to ignore your doctor why go to your doctor when things get tough? However, I learned that I must meet the patients where they are, and it allows me to remain professional and help the patient with all the tools they will allow me to use.
ReplyDelete"Must meet the patient where they are.." Well said Kate! Not always easy when they reject or delay traditional medicine and then have progression. I always tell patients that it is their life, their body and their choice.
DeleteKate,
DeleteI couldn't agree more. We absolutely have to meet the patient where they are and be able to accept their choices and edcuate them to the best of our ablility and be there to support them.
This was a great article! It's a great reminder to make sure we look at every patient as an individual and not the type of cancer they have. Learning more about their personal life and viewing the patient as a whole person should always be at the forefront of our nursing care. By learning more about the patient's life prior to cancer, you can insight in who they are and how to best help them. By engaging in conversations like this, powerful bonds are also created betweens patients and nurses.
ReplyDeleteI really enjoyed this article too. I agree, having a bond with our patient that shows we care about their personal life and who they really are shows our committed patient care.
DeleteI agree with you Brittney, acknowledging that our patients have lives outside of their cancer diagnosis is very important. Their cancer should not be their identity. Learning more about their family, work, social lives can help us better care for them in difficult times as we can get more insight on how they handle stressful situations.
DeleteI feel this is a very difficult area of nursing. Sometimes its hard to know what to say to a patient/family member who is experiencing grief/loss/and these type of end of life stages. Sometimes I've found its not about what you say but more about just listening to family and patient's concerns, and just the presence of being there for them so they don't feel alone.
ReplyDeleteWell said Amy. Presence alone without having to utter a single word speaks volumes. This is a VERY sensitive manner and thus should be approached tactfully.
Deletethis is great to see. i'm still in nursing school now and they stress using silence at times when necessary to comfort patients and family members. its good to see that this practice really is beneficial and can make all the difference in sensitive times.
DeleteAgreed, the act of silent presence is more comforting and reassuring than awkward cliche-laden conversations.
DeleteI agree this is a challenging part of nursing. Maybe because to be most effective and impactful we need to be "REAL" and present in the moment.
DeleteWorking in oncology has many benefits. One of the is being becoming close with our patients. This is my favorite thing about my job. I love that I know my patients, and get to see them each time they come. We all develop relationships and makes our job so much more rewarding. The unfortunate side that this article talks about is very much true. As nurses we have to support our patients, but also our empathy and compassion are tested when you see a patient decline. I find that it really helps to talk about what a patients loves, such as their family and pets. I feel that this takes them away from their current situation and brings them so much happiness and puts them at ease.
ReplyDeleteI also love getting to know my patients. I have a patient who has spent alot of time on our floor. Her daughter decided to show me a video of her father, the patient's husband, singing with his band. My patient's face just lit up with love and happiness watching the video. I learned a whole lot about my patient in that moment, and it was very special.
DeleteRecently, while standing in line in the cafeteria, I was approached by a woman with very curly auburn highlighted hair wearing a face mask. She asked me if I recognized her. The connection was immediate the moment she spoke, I recalled her voice and as I looked into her eyes I felt a flood of emotions wash over me. She has such an amazing sparkle and vivacious personality; I told her that I would never ever forget her. She then shared with me that her lymphoma had returned and that her stay here has been prolonged due to the side effects from the oral chemo while they are adjusting the dosages. In my mind I recalled all of the personal hardships that she went through during her initial treatment here so many years ago (her husband left and they later divorced, being away from the support of her children and her mother, her love of cooking and the joy that she emanated as she would talk about her grandchildren). As she continued to express how devastated she was that the cancer had returned, I couldn’t help but be filled with compassion, empathy and sympathy to everything she’s going through. No matter the setting, without even realizing it, the nurse from within was automatically assessing her for depression/fear/grief, how best to support her, was she here alone , does she need to talk further, what was next on her agenda, where was she staying, what is her ANC, the list goes on… She stated that she is hoping the chemo is going to help but that she can’t wait to go home. I asked how the grandkids are doing. She lit up like a sparkler stating that her next one is due in January. My encounter with her was a 5 minute roller coaster ride of emotions ranging from the true joy of seeing her again, the devastating diagnosis, to the excitement that a new baby brings. Our collective nursing hearts are truly amazing as we are continually doing this with every single person we meet. Practicing and reminding one another to utilize holistic self-care techniques is absolutely essential in the world of oncology nursing care.
ReplyDeleteDebbie, What a wonderful story! Your entry is the first one I read. It is so heartbreaking to see them have a recurrence. But we learn so much from them! And thanks for the reminder of self-care.
DeleteDebbie,
DeleteYou shared a beautiful story! I believe this is why are nurses because we are compassionate, care and are able to connect with our patients. I believe you made a difference in her life, just like she made a lasting impression on yours.
This article truly does reflect many of the emotions I have had working at an oncology facility. Just last week I had a patient as me why his doctor was giving up on him when he was not ready to give up. He just knew that there had to be something else out there that could be done for him and was hurt that his physician did not agree. It was comforting for me, though, to be there for him in his time of need when he needed someone to talk to this about. We cried together about what the future may bring as he began to accept that death truly may be near. Although there are times where emotions are high and you cant help but think of how much you will miss the one you have grown so fond of, it is a light in your day to know how much you have helped them along each day so far in their journey and that brings a smile to my face each time I think of all of the patients i have met and ever lost.
ReplyDeleteI think it is so very important to really listen to our patients and their wishes. It's OK to ask them, sometimes more than once, "what do you picture your future to look like?". This tells so much about where the pt is with their process. Do they want to "fight to the end" or "not be in pain"? I had one pt recently who had family that pushed and pushed for more treatment. When speaking to the patient, he stated "I'm afraid of what dying feels like. I don't want to be in pain". It broke my heart to know he and his family weren't on the same page. I also think it's even more difficult to have the hospice talk at our facility. We are the place that advertises miracles. It's so hard to tell someone who came so full of hope that we cannot give them what they want most.
ReplyDeleteI agree with you. The Hospice talk (at times) can be a challenging one. Patients are afraid, and families do not want to give up. I have come across this many times like you mentioned.
DeleteElisa.... that is such a difficult conversation to that with someone over the phone. To listen and really hear what your patient is explaining.
DeleteWhat a great article. Oftentimes in the medical field, doctors and nurses alike get caught up and focus merely on the task at hand. Patients become room numbers or a diagnosis and we lose the spiritual connection that lured us into the profession. The article was humbling and served as a reminder to take the few minutes to listen and converse with patients. In a matter of seconds you may learn more than you would have otherwise learned over the duration of their stay. Other times, presence alone is all the patient needs! If treating from a Holistic approach, needs are individualized and the WHOLE person heals!
ReplyDeleteI agree, sometimes we are so pressed for time and getting our tasks done that it makes for a very limited interaction with our patients. On the other hand, sometimes it doesn't take much to convey our care and concern and share our compassion.
DeletePerfect timing for me! I always hold on to hope for all of my patients, but saying good-bye to the ones we become close too is very difficult. When I graduated from nursing school, I was relieved to learn it was okay to let the patients see your tears. They do know how much we care. I recently had a wonderful experience when visiting a patient. Always smiling during treatment and now going to hospice, still smiling and knowing it's okay with her. We talked and expressed our love and appreciation for one another. I cried as I left the room and realized what amazing people we are privileged to know and care for.
ReplyDeleteI love how our organization has allowed us to be this emotional support for our patients. I rememeber the same thing in nursing school, the instructors saying that we shouldn't get too emotionally invested in our patients. Our patients teach us so much about life and about the blessings that we share with one another. This is so powerful and amazing. We have the best patients.
DeleteI agree with you Tina, we are privileged to be a part of a patients' last days. When we have established relationships with them, this brings closure and peace to both. I always feel sad when I am not the one who takes care of a patient that I have a relationship with because I know that they patient probably feels uncomfortable expressing their emotions if it's a new nurse they see and they are given bad news.
DeleteThis article was great reminder of how we need to be present with our patients. It is important to listen to them and really get to know them. They are not just the 45 y/o w/ X cancer. Remembering they are a person who is just like you but have a cancer diagnosis. We should feel privileged to be a part of their journey. There are times I think the patients come to see us for emotional support as well as help with their disease.
ReplyDeleteI agree Sheila. I have dealt with many patients throughout the years and one just recently where the patient and family came for support. Although we cannot be in their shoes, we can certainly empathize with them and show them support. The patient was initially very upset with coming in for followup care to the point of anger. But after he saw the doctor who answered his questions and concerns and provide his ultimate view, you could see his anger decrease.The option of hospice was proposed and accepted. He wanted to go home and was allowed to do so. He was appreciative of his care, and his caregivers gave hugs when they left even though knowing he would not be returning. Tears were shed but peace was evident.
DeleteI am the "emotional" one in my family. Almost everything makes me cry. I empathize and sympathize with people so often that it was almost a joke in my family. Then I found nursing as a career. I have worked with the elderly since 1987 and in 2011 I started working in oncology. I think both have allowed me to be free with my feelings and I think people appreciate that I am genuine in my emotion. This article, I feel, helps those that are not as open, feel slightly more comfortable expressing their emotions and those of us who do express ourselves freely feel validated. It reminds us to take the time the pt needs and be fully present with them and give them the time that they need to hear what is happening and offer them the support they need.
ReplyDeletePatricia, you make such an excellent point! I think this article would be good for newer nurses to read in order to let them know that the idea of always having to be stoic is not realistic or healthy! We are human just like our patients. Now, we can't be blubbering all over the place all the time, but this article definitely showed there is a time and place to support our patients through emotion and caring and not just medical intervention, especially at the end. Thank you so much for sharing!
DeleteTheresa Minniear - Clinical Research
ReplyDeleteI have only ever worked in adult oncology, having started at CTCA 10 years ago, when I graduated from nursing school. To this day, “Isn’t that so sad?” is the most common question I get, when outsiders hear that I work in oncology. I always respond with “Yes, at times—but there is a lot of joy and success stories, too.” The article talks about connecting with patients as real people--with careers and family--as opposed to seeing them as a mere diagnosis. Good advice...to this day, I admit I never know what to say to a person who is faced with bad news, including progression. I always say “I will be praying for you.” For what more can I offer, except my words? Lastly, working at MRMC always makes me think about a saying I read, in light of aging: “Do not fret about growing older. Many are denied the privilege.”
Love that about the privilege of growing older Theresa:-)
DeleteI love this Theresa. So perfectly said.
DeleteI am constantly comparing/contrasting my past experience in ER/Critical care with the present in Oncology. For over 20 years, patients were total strangers, to be taken care of quickly and then discharged or transferred to the care of another. There was little opportunity to get to know pts or their families. Typically my patients were folks that had an acute onset of disease or unexpected trauma. Additionally, rarely was there follow up on how the patient did or if they even survived. Emotionally, I have found oncology to be extremely demanding. The pace, although busy day to day, is slow and painful sometimes as you see the patients going through their journey that sometimes lasts for years. Seeing patients almost daily for weeks on end and getting to know them makes it difficult when the outcome is less than desirable. When I journeyed with my Mom in her battle with terminal cancer, I saw for the first time the stark contrast between the world of emergency/critical care that was familiar to me and oncology, a complete mystery….
ReplyDeleteWhat a beautiful, poignant article. The part I really related to was at the end when she talks about when patients make decisions to end futile care. One of our patients on stem cell, beloved by all of us, but one whom I was particularly close to was dealt the blow that his leukemia had come back in full force after receiving his stem cell transplant. I worked the night before he was to be discharged home on hospice, and I begged one of my co-workers to care for him that night because I couldn't bear to do it. However, come morning, I knew I had to be a brave little toaster and say goodbye. I brought him some nausea medicine, and my hands have never shook so hard trying to open a pill blister. We attempted to talk about the things we would talk about, sports, our dogs... but in the end we just hugged and cried knowing this was it. One thing he said during our talk really struck me though. One of the only reasons he was still remotely functional was the fact that we were pumping PRBCs into him every day. He told me he couldn't keep taking such a precious product, knowing it could really be helping other people, since his situation had become futile. There was something so honorable in him making that connection and that it was part of his decision to go enter hospice care. That was the hardest goodbye I've had in five years of working in stem cell nursing, and I would be lying if I said typing this didn't make me mist up a bit. I feel so privileged to take care of such an amazing group of people, even when that care includes saying goodbye.
ReplyDeleteThank you, Katrina, for sharing such a personal experience and close bond you shared with one of you stem cell patients and finding the courage to say good bye!
DeleteI loved this article. I work on the inpatient oncology unit and it can be a very busy and task oriented place quite often. I have only ever worked at CTCA and on this floor since entering the medial field. However, I feel like our team becomes very close to our patients and their familiies. We learn their preferences, quirks, and needs and they become second nature. These people become part of our family. When it comes time for a patient to enter hospice care, it is often difficult for the patient and family. We become saddened knowing we won't see these family again. However, reflecting back on how so many of these amazing patients have changed our lives is so incredible. And when they remind us that we have also impacted their last few months or even days of their lives, it makes everything that much more emotional. These are people, not numbers or rooms or even "patients". They are our equals and we all come into one another's life for a reason. Simply being there to listen, or hold someone's hand, or even give them a smile means the world..oftentimes to us all. Healing takes part in not only the body, but in the mind, heart and spirit too.
ReplyDeleteI agree that it is incredible how much a patient can affect our lives or even change part of our practice! They have such insight. I agree there are times when just being present with a patient, no words needed, is just what they need. An active presence.
DeleteExactly. We really do have through each stage with our patients. When they are fighting, we fight with them and when they are ready to let go we have to make sure that we can do whatever necessary to comfort them.
DeleteI believe that if you are comfortable with patients and their families during the death and dying process, the right words and actions will come, especially if you are a seasoned nurse. No two families are alike and if a relationship is established most of us will find the right way as the circumstances dictate Relating to Katrinas response, I am always grateful to feel the strong emotions when you are losing a patient to the disease or have to be present when that news of no hope is delivered, a reminder that I still have and need my compassion.
ReplyDeleteMary, I agree with your statement "the right words and actions will come". We can take classes and be scripted in what to say but if you let your heart lead you it will be so much more meaningful to the patient.
DeleteSo true...the right words and actions will come. Or at least we hope. If there is nothing but awkward silence, perhaps that is what you, and/or the patient really needed. Just your presence with no words at all.
DeleteBrenda Chiappetta
Wound care
I love being a nurse and caring for the oncology population. It can be hard when you create such wonderful and strong bonds with a patient to learn they are not doing well or have passed. But we are so lucky to have interacted with them! There are moments during care that we can touch and change a patients life and during these the patient can do the same for us! I think it is a privilage to be able to care for someone in this setting.
ReplyDeleteI would like to touch on a controversial subject that was mentioned in this article, “Death with Dignity Act”. Not sure if the law will ever be enacted in the state of IL, but if it ever did I would fight against it. How is this considered patient care, if you no longer have a patient to take care of? What happened to the ethical principles, beneficence and nonmaleficence , “do no harm”? Florence Nightingale would be rolling over in her grave if this law existed in her time.
ReplyDeleteI agree with a patient having the right to autonomy, but if a patient ever came up to me and told me to kill them, I would order a psychiatry consult, survivorship support, social worker, chaplain consult, mind-body and perhaps give the patient my ears to listen to them and my arms to hug them and fight for them when they aren’t feeling like fighting anymore.
Tha hadest thing is saying goodbye to the patient you become to love and you feel like they are your family . what makes our organization unique is that we traet each person as an individual not just a room number. I feel so much responsibility taking care of our patients, listening and talking to them most especially on times like this. sometimes just being there, holding their hands and givine them a hug means a lot.
ReplyDeleteI agree with you about saying goodbye, and most times the patients I grow attached to are the ones who are not long for this world. Maybe because they are so sick, they are seen more frequently and it gives for time to make a stronger bond.
DeleteYes, saying goodbye is the hardest, especially when you know the prognosis is not good. You do have a sense of attachment to our patients, because we do see them multiple times, know lots of things about them, and really do treat them like family. They become a part of you, an extension of you...what you have taught them, and the care that you have given to them.
DeleteBrenda Chiappetta
Wound care
This is so true, Vilma.We treat our patients like our family and they are not room numbers but unique individuals. Sometimes being there for them-listening and holding their hands and giving them a hug means a lot!!!
DeletePreparing patient going for surgery is difficult. Patient have alot of questions and concerns and I always find myself struggling to find the right words to say. No patient are the same and so no answer is the same. The phrase that i always say to my patient is to pray to God and God will not give you anything that you cant handle.
ReplyDeleteI feel this job is incredibly difficult and I am very frequently placed in a tough spot. I am always improving my skills and abilities to handle situations. And on occasion I become very attached to a patient. It makes me happy and keeps me motivated when I can see I truly make may patients lives better.
ReplyDeleteI agree with the article that the patient is more than their disease. When I meet with the patient, I try to learn details about their lives, beyond the cancer and symptoms. I try to remember something which is important to them. When they return for a follow up appointment, these are examples I may ask, "So how was the Alaskan cruise?" or "Did your daughter have her baby yet?" or "What are you doing with your time since you have retired?" I want the patient to know they are so much more than a breast cancer patient or a prostate cancer survivor, that they are viewed as interesting people with a wealth of experiences. This humanizes our interactions.
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ReplyDeleteOnce I decided to become a nurse, I always knew that I wanted to do Oncology. I always say that the best part of my job, really is my patients. I have developed such strong bonds with so many of my patients. My brain really does work in a crazy way. I can almost always remember where my patients are from, in what room we did the initial consult, what they do for a living, things about their families, etc. Many patients are touched and amazed when I remind them of all of these things. Now if you ask me anything about when my child achieved certain milestones, I am usually clueless. but my patients, for whatever reason, I can remember. I also, when appropriate, utilize humor a lot with my patients.
DeleteI love being a nurse!Working in an oncology specialty facility has pros & cons; Cons... when you hear your patient receiving bad news, like metastasis, progressing disease or need to go to Hospice care. Pros.. when you hear remission, no tumor detected, tumor marker is down et.al. Being a nurse you are expected to responds or communicate in such manner that empathy or sympathy is present. I wish it is always good news, but there are many times bad news can't be prevented. The time I struggle especially if the patients are very young single or married with young children. I learned that being there listening, holding their hands and my favorite gesture is giving a hug is much more effective than words.I also remind them not to loss faith,be strong, and let our Almighty God take care of you. This article is helpful, because it reminds you that simple conversation & tricks can let you determine how to care for the patient and caregiver.
ReplyDeleteI completely agree, Imelda. The time that was hardest for me was a young single mother that passed. I suppose you imagine yourself in that position and the feeling overcomes you. On the other hand, I believe that is what makes us great nurses, the ability to care so greatly about others that we barely know.
DeleteTotally agree with you Imelda, when I run out of words, which happens to me many times... I just give my patients a big hug, stay with them and just be there for them..
DeleteThis article really highlights what CTCA nurses do day in and day out. The tips/tricks are great reminders on how to connect with our patients to make a positive impact even in the face of hospice/death. Finally, CTCA nurses have the knack of blending purpose with task, an art that is not well cultivated or encouraged by other organizations.
ReplyDeleteThe nurses here at CTCA have that special connection and special skill to become one with the patient. We feel what they feel and we laugh and cry and pray with them. Do not find this in many places.
DeleteWe are privileged to work in Oncology and share a sincere part of ourselves so profoundly with patients. The CTCA environment really promotes focus on the individual person, their needs and wants. We sincerely care about and treat the total person and their families. Not the cancer. I hope we never take the unique nature of our environment for granted or minimize the impact. The quote that rings in my ears is "I can live without a cure. But, I cannot live without hope." We are the hope! In a variety of unique positive ways we provide hope with a listening ear, a warm smile, a sincere hug, a gentle touch or just shared silence.
ReplyDeleteDebbie, I love the quote you have shared! We do work in a unique and special environment where we are encouraged to get to know our patients and TREAT them like FAMIY.
Deletei love the quote as well! We are the HOPE!!!
DeleteI have been in oncology over 6 years now and I still don’t know what to say when patients are near the end of this life. I am especially at a loss for words when they say they are scared to die. It is hard to talk to patients about our personal beliefs as we don’t want to “impose” those beliefs on that patient. The patient may be offended or in some cases become more fearful. That is why it is important to listen to the patient, ask questions, and as the article stated, get to know the patient. I’m not known to be an “emotional” person. I almost feel “hardened” by life circumstances and maybe even working in oncology. Sometimes I just feel “used to it”. Sometimes it’s hard for me to connect with patients, maybe because I fear the emotions. I think a good practice for myself and others who may struggle with these issues is to try to open your heart, try to relate, and try to send positive energy. As the holistic nurses know, sending lovingkindness and peace can be very powerful and life changing.
ReplyDeleteI really enjoyed this article, even as an oncology nurse for 8 years validating what I feel helps me. It is never easy seeing someone you care for or any human being suffer physically or emotionally . I am always amazed how much more I get from my patients then what I feel I give them. I find the courage and strenght that we see every day in our patients is amazing and a true gift. It has truly changed my perspective on my own life.
DeleteYES Krista! continue to send that lovingkindness and peaceful intentions. It is so hard to stay neutral and not have others judgements imposed on the patients. I agree with the article that we as holistic providers should be present for the patient and support them in their own journey and their own decisions.
DeleteIn Julianna Paradisi's article it was interesting to envision what it would be like to practice oncology nursing in Oregon where there is a Death with Dignity law. I feel that we here are evolving our practices. As a holistic provider I realize that there are phases to life- everyone will be born and everyone will die. As nurses to support people through all the transitions that they will face in life will include birth, sickness, and death. Our environment offers healing and hope always; So when our patients realize that death is no longer avoidable it becomes difficult at times to help them transition. Our genuine caring and support in our patients decisions is so important to help our patients and their families come to Peace.
ReplyDeleteTerry Peters October 14,2016-I really connected with this article. It's tough being a nurse, but being in a specialty that the outcomes for the most part are not good,can make it that much more difficult. Our patient's relay on us not only for care, but support and hope. We develop strong bonds with our patients and are there every step of the way whether good or bad. We have conversations about vacations and family and unfortunately end of life. I feel honored to be able to help a patient and their family transition from active treatment to hospice. Some patients are very open and not fearful, while others may not be ready to give up or their families are not ready to give up. I make myself available for those hard conversations, I do not try to avoid them. Our patients look to us in many ways we may never know. I believe people should transition peacefully with no pain. I encourage patients and family members to enjoy this time, say the things you've always wanted to say or do the things they've wanted to do (if possible). Passing can be as beautiful as being born a time to celebrate a life. However, I try to meet the needs and wishes of my patients during times of transition.
ReplyDeleteI enjoyed reading this article. I, myself, enjoy very much working as an Oncology RN for 12 years. When people ask me, "How can you do this everyday", "You must really enjoy and love what you do which makes you a special person". Absolutely!! I enjoy what I do and WHO I do it for---the patients!! We need to spend more time with our patients and really listen to them--because it is comforting to them, and to us, and then we really get to see and know "who they are!.
ReplyDeleteI get that comment alot all the time. Or people will say, "It must be so hard to work in that environment." I think people imagine a very depressing environment, when in fact I enjoy what I do very much and I love making my patients smile and laugh.
DeleteThis article really resonated with me as I feel exactly the same way with my patients, and ask them many of the same questions. What is hardest for me is when I have a patient that I have come to know with wound care and/or ostomy teaching and you find out they are going home hospice and you are saying your final goodbyes, knowing that you will never see them again, and what their near future holds. I will often sit with them for extra time and just be present with them, letting them talk. We share some laughs, we share some tears, we share some time in silence. These goodbyes are never easy. They can't seem to thank you enough for your care and compassion. We teach our patients and families many things, but many times they teach us so much more. They remind us how fleeting life can be, how every day is a gift, and not to sweat the small stuff...and in the scheme of things, it's ALL small stuff. I leave them with a hug, looking into their tear welled eyes, and tell them to go home and enjoy this time with their family. As I head to the door, with tears in my eyes, I whisper a prayer for them and their family. This process, although I seemed to have become an expert in, doesn't get a single bit easier the more it is done. It is a constant reminder of our own mortality, and that one day it could be us on the other end.
ReplyDeleteBrenda Chiappetta
Wound Care
I am going to add on here - will not take my reply the other way. Prior to seeing a patient I review their chart and find out their job, family, where they are from... I tailor my teaching to the pt and discuss how this relates to their life. This makes a difference what I show and teach them. One time in ICU i was chit chatting with the wife and I always wonder if I am right or wrong - her husband was going home hospice. When I said good-ye she gave me a hug and thanked me for allowing her to breathe and not just talk medicine. Lesson well learned. Pat
ReplyDeleteThis was a great article. The most fulfilling moments for me are the times to be there with the patient to simply listen to the patient, hold their hand, hug them, let them know I care for them, and smile. They make my problems seem so easy. I have been there for the bad news, good news to celebrate, and all kinds of news in-between. Whatever I can do to make a patient’s day alittle bit better means everything to me. It is an honor to be with the patient during their journey. There will always be sadness day to day, so I try to concentrate on the small things and the good things.
ReplyDeleteThis was an excellent article. I have been a nurse over 20 years. I never have and still don't feel comfortable with a patient who has a poor prognosis. However, I am much better with it than I used to be. I really envy a nurse I used to work with who was so good with hospice patients. I asked her how she did it and made the patient and the family feel so much better after talking with her, even if they were very angry to begin with. She said she would just listen to them and try to imagine how she would feel in their shoes with little time left. It really helped me. I always feel like I will cry and will be unable to talk, especially to the people I get really close too. I also had a very close person tell me not to be sad but to celebrate the great life he had and that everybody dies at some point. Now I try to find out their interests. Most peolpe like to talk about everything except the medical stuff so that is what we do.
DeleteNinfa Bontes 10/19/16 - Every living creatures do have a beginning and a terminal phase in life. As the saying goes, better enjoy life while you are still "young and kicking," sounds so good to be true, right? Our journey in life is so much unpredictable that at one point we don't even know where we are and to the extent, how do we get out of a challenging situation??? Having said that, I always inspire my patients to reminisce the most meaningful and happiest moments and memories of their life encounter and of course the quality time spent with families and friends. This article reminds us to a positive way of approaching end of life crises to anyone faced with the difficult situation. As nurses at the bedside, we have a complex role in dealing with these difficult challenges of our patient's near death situation or hopelessness. I truly admired how the author conveys her positiveness teaching us how to use creative ways to allow a positive recollection of true to life unforgettable moments in our patient's lives. I think this would lift up their fighting spirits if there is still hope left, profoundly reduces their stress, and conveys a positive inner feeling to better prepare them to that path. Being compassionate and making patients feel so special is always our Mother Standard way of caring our patients. I agree to everyone that our role is so emotionally compelling that we sometimes join them in tearful moments of our conversation with them and families.
ReplyDeleteI agree that patients love to reminisce. As nurses we are in a perfect role to lift up our patients spirits. Reminiscing about the good times in the past is an excellent way to do that. It takes our patient back to a happy place and time in their lives. I really enjoy doing that with my patients and learning about them.
DeleteThis was a great article to read. As nurses, patients depend on us a lot for support and advice during their treatments. We have to be able to be open and honest with our communication with them and their families in order for them to trust us. One of my favorite things about being a nurse and working in the clinic is getting to know my patients and their families. Being there for good news and bad news, they know that our team will be there for them every step of the way. We will celebrate with them and sympathize with them. When patients tell me that I have made their day just a little bit better, when they give me a hug before leaving the clinic, or when their family members thank me for what I do for their loved ones, I know that I have done my job. Many of my patient touch my life as well. That is one of the joys of being an oncology nurse.
ReplyDeleteI feel like I understood what this author was trying to get across, personally. When people find out that I work with oncology patients, it never fails that I hear "that has to be really hard". They instantly feel sad for me because they imagine that all of our patients are bed ridden and dying. I quickly correct them and explain that most of the patients that I see are in good spirits and besides the lack of hair on some, you wouldn't know they were sick if you would pass them on the street. I see approximately 20+ patients a day, some I see on a regular basis and some I have never met. It's inevitable that you begin to build a relationship, some the bond is much stronger than others, even if you try to not to. There has been many times that a patient I felt close to began going "downhill" and I have to pretend I don't notice. When the day comes that they pass, honestly I try to keep it together but as I read this article I can understand why it's important not to hold back as much. I will continue to build relationships and keep this article in mind.
ReplyDeleteWhat a fantastic article. I no longer hide my tears from patient's and their families. We are all human and to show emotion is to show we care. It is never easy to face a patient after they have been given bad news or decided to stop treatment but this is what an oncology nurse must do. And it must be done with grace, kindness, empathy and compassion. I am humbled, honored and grateful to share some of the most intimate moments with our patients. I have gained so much respect and admiration for their bravery in this fight. They fill my heart and a special place exists for each one.
ReplyDeleteCathy, My patients hold a special place in my heart to. We are who we are due to these moments in our life. RM 87 bed 2, one of my patients for the night. I see a young woman in the corner of the hospital room, daddy's little girl, watching her daddy take his last breath. That is not what she wanted to do. I could sense it. I went over to her and said "it is okay to go to him, it is okay to hold him." I left the room, came back in and where was daddy's little girl? She was curled up in the hospital bed with him with her head on his chest. That is the moment that I will never forget and nor will she. She needed to know in an unknow time that it was okay to be daddy's little girl one last time. This was 7 years ago. Tami Z.
DeleteTami, thank you for sharing this
DeleteWhen we moved to the new tower, 2nd floor combined with ICU and began taking med onc patients, too. Which meant for the first time in many years, I was taking care of DNR and hospice patients. Working in SIU, we did not get those patients. I didn't realize how it was affecting me until the first time I was assigned one of the hospice patients and I started crying right in the collaboration room. Being there for a patient at the end of life is so very special though. I feel honored when I am in that position and I feel that I am not just the patient's nurse but also the family's.
ReplyDeleteI completely agree. Even though taking care of end-of-life is very hard it is also very rewarding . Experiences that you never forget .
DeleteBreaking The Ice was an excellent article and it reaffirmed the importance of getting to know your patient on a more personal level. I enjoy learning about my patients and their past and present careers and lives. I can see that patients enjoy sharing that part of their lives with me. It makes me feel more "connected" to my patients and I can see a sense of joy in their eyes as they share their story. They aren't just a patient in the infusion center for a chemotherapy infusion, they have an identity, they are a mother or father, they identify with their current or past employment. For a moment they get to share their story with me, their infusion nurse, and I feel so honored that they do. No two patients are the same, no two stories are the same. I feel that when patients allow you into their world and share their story with you it makes you connected in a way that makes it easier to share sympathy and empathy in a very genuine way.
ReplyDeleteBeing a nurse requires a lot of talents all put together and every single nurse puts them into practice when caring for our patients, some may have the ability to teach how to care for a wound, some may have the ability to listen to the patient or the family members, some may be able to provide some especial support while the patient and family are going through the tough decision process of continuing treatment or opting for palliative care, or going home hospice. On every single circumstance we are there to help facilitate any process whether is on the floor or in the clinic, Rad/Onc; etc. On a couple of occasions while caring for patients with a very advanced disease they have asked me: “What would you do? And in more than one occasion I have felt that knot in my throat, and the feeling that I just want to cry along with them, which I have done on one or two cases, because it is unfair to see how a life is steadily “wilting” away in front of you. It is challenging at times to figure out - right on the spot when you are asked a difficult question to say “just the right words”. In circumstances with a patient on a very advanced stage it is even more difficult to suggest options. If I had to make a decision for a family member I would prefer for them to be at home with the family around them.
ReplyDeleteHortensia Aiello
Just like many of us here at CTCA, we get close to our patients and some of them feels like family. One day , I received a call from our surgical waiting room, to my surprise I saw one of our patients who become very close to me. I was soo excited to see them but I also saw a very sad face from both of them. They came to tell me that they are not coming back here anymore because there's nothing CTCA can do for them. At that very moment, it felt like my heart stops beating, the world stop spinning and there was SILENCE.... Like what you see in a movie; you see the talking, people moving around, lips moving but no sound... when my senses came back. I felt soo sad and don't know what to do and what to say. So I just stayed with them, sat down and listen to everything they've said. They started talking about the time they found each other, to their wedding day, the kids, the grandkids and all the joys and laughter in between as well as all the struggles, sorrows and sadness and till the time we met here at CTCA. Unknowingly, tears started flowing from my eyes and to their eyes as well. I still could not find the right words to say... so I just gave them a BIG HUG, said some prayers with them and said my GOODBYES... and they're gone.
ReplyDeleteNursing is both an emotionally draining and rewarding career. Working as a nurse has taught me how to navigate through many different difficult situations. Reading the article, Breaking the Ice, reminds us that every patient and every patient’s situation is unique. It can be hard always trying to find the right words to say, especially working with cancer patients every day. In my experience, I have found that non-verbal communication can be just as effective, if not more effective, than verbal communication. I feel it is also just as important to listen to your patient and their family members and actually hear their concerns, thoughts, and feelings. It is the small things during difficult times that are the most helpful. Lastly, I want my patient to know that I care and that I will be there for whatever they need.
ReplyDeleteBreaking the Ice-reminded me that every patient, spouse, sister caregiver is unique. I see them at the worse time of their life, thin, ash gray, bald, lifeless. Who was this person before that cancer took over their life? I too try to see who that person was prior to this battle. What did they love? What do they want to continue to love and to do. It is very important to help them live their life over cancer and not let cancer live over them. This is the beauty of what CTCA has to offer unlike other centers. Healing the mind, body and soul to continue to fight but accepting the defeat when they are ready and then guiding them to the end with dignity. Tami Z.
ReplyDeleteTami beautifully put. I agree with you and believe that what we do here at CTCA impacts the lives of patients, caregivers, and family members going through there journey. It is always for me an honor to be a part of each patients journey by the simplist gesture to setting up hospice. Such an honor.
DeleteYes, we often see patients and their families and a low point in their lives. It is so important to try and see the person as someone who is more than just their disease. I know I've been guilty of forgetting at times, as I focused on the treatments, the disease course, and the tasks that needed to be done. Your last statement about healing is so right on. We can help our patients heal what can be healed. Healing doesn't always equate with cure. I believe there is always some sort of healing to be done at the end of life.
DeleteAS a nurse and recently losing my mother to her cancer I had a chance to see the compassion and empathy provided to my mother and family from the nurses in the hospital. It was very strange to be on the other side of the coin. I am that one that provides the support, empathy, and compassion to my patients and their families. To me it is just good nursing. From just listening to helping with whatever the patient needs is an honor in providing dignity and respect to these patients and their loved ones.
ReplyDeleteThank you for your transparency Pam and I am sorry for the loss of your mom. Your mom was very lucky to you to be there with her.
DeleteStem cell transplant is a unique part of hematology/oncology. We tend to get attached to our patients from start of there treatment and to discharge and follow up. Providing care giver post transplant sometimes is challenging especially to those who don't have a close family ties. When we give our patient teaching prior to transplant, we discuss how important to reach out to her family as a care giver, she is very hesitant. But now that her family knows what is her situation , they all wanted to come and see her.
ReplyDeleteAs my oncology experience lengthens I have learned that patients enjoy you taking the time just to be listened to. Just a little bit of time for them to express their feelings and their story goes along way. Not only have I listen to stories, been there for my patients with verbal and nonverbal support. Ive cried with them, Took time to reach out to them and their caregivers. Every day is a new experience and I've gained and lost a lot of friends.
ReplyDeleteI've had to be part of many conversations about the current research treatment is not working and we must close the door on that treatment. It is a difficult transition for the patient, doctor, and entire care team. I am very impressed with the passion I have observed in our doctors to seek out every last treatment that they can offer to their patients. I feel privleged to see this in action and I am always listening for graceful ways that they deliver hard news. I am a fan of many of our MDs, nurses, and entire array of staff.
ReplyDeleteI can imagine that you are involved in some very difficult conversations with patients when research/trials have to end for a patient and they feel like there is nothing left for them. On the flip side, you probably get to see a lot of success stories and share in the joy patients experience when a new treatment shows promise.
DeleteBeing semi new to the oncology field is very different that working in the in-pt setting. When I used to work in the in-pt setting, I really never developed long term relationships with my patients because they were in one day and discharged within hours or the next day. Coming to the outpatient setting is very different, you have the opportunity and honor to develop long term relationships that are difficult to say good-bye to when the time comes. Working in this type of setting I have learned that being present is the most important thing, no words mught be said but just being there is more than enough. I have also learned that you don't have to put on this stong face if you are really hurting for a particular pt, it is ok to let your emotions show because our patients then know that we are genine and that we truly care for them.
ReplyDeleteIt really is a privilege, an honor, to enter into our patients' lives in the way we do. We do a lot of laughing in the clinic. But appropriately so. We laugh when something is funny. We cry when something is sad. I always want my patients to know that I take my job in caring for them very seriously, and that they mean the world to me. I want to give them courage, give them my support, give them whatever is in my power to give. They are valuable, loved human beings. They have a purpose, and they had a life and an identity way before they ever walked in our doors. I so highly value getting to know them, cheer them on, and even grieve with them. They enrich my life more than they'll ever know.
ReplyDeleteI couldn't agree with you more Jenifer. It's ok to laugh and cry... and I love that we get to be those "special" people to them along their journey. We meet so many wonderful people - we are truly lucky to be a part of it all.
DeleteThis was such a great article. There were two patients I had the pleasure to take care of this week that did not want to accept the hospice referral. Both, said similar things that's your opinion doctor, but I'm going to live till I'm 80yrs old. In my family, I'm the emotional one - the one that cries at a hallmark commercial. This week watching these two families, my heart broke. I did what I could for both patients. I do not feel comfortable discussing hospice with patients. I feel this is such a personal and private decision patients should be making with people who absolutely love them. Yes, I care about my patients, but I love my family.
ReplyDeleteI enjoyed this article. Allowing our patients to see we truly do care for them and are interested in getting to know them and their story can make all the difference. I have gained so much from getting to know my patients. I love the extra tips to help open that road of communication even greater. I have been reading Facebook posts and articles of a friend that recently lost a baby... and just the other night I was able to use the suggestions to ask about the child lost - name etc... A patient had confided that she lost one of her sons and when I asked her his name etc - you could see her face light up and the tone in her voice change when talking about him. (In the past, I would really never know what to say after hearing such news.) Thank you for finding yet another good article.
ReplyDeleteAfter reading the article "Breaking the Ice", i felt the emotions that the author was trying to convey. We, as nurses need to be strong cause we are the pillars that the patients leaned on.Sometimes we become emotionally attached because we treat our patients like a part of our own family. I have one patient that the doctor wanted to put on DNR status and the husband couldn't decide what to do. I stayed in the room and just listened to him. He told me the story of how he met his wife, their courtship and the ups and downs of raising their kids who are all grown ups now. He didn't want to let go because he was afraid of facing the world by himself, afraid to wake up without the wife beside him, and feels like he didn't want to be a bother to his children who are busy with their own families. In the end, he was able to agree to the DNR order.
ReplyDeleteIt is always fun to talk to patients about their lives. I enjoy asking them about their families. That way the patient is more like a person to the staff, not just a body parts. I have supported many patients at the end of life over the years.
DeleteI find that I get emotionally attached very easily. I think that works against me in many ways, and wish I had the strength to prevent this. I also try to just actively listen to a patient or caregiver, because sometimes I think that's more important then anything. There is only so much as I nurse I feel I can say, outside of providing advice based on professional experience.
DeleteIndeed, we as nurses can truly find a way to alleviate if not to stop the agony of our patients during the melancholic phases of their lives. Yes we give our best in everything we do for them, but sometimes we always feel that we do not hold each and everyone's lives in our hands because we all have our destinies. After reading the article "Breaking the Ice", I somehow can relate to what the author tries to do for the patient. In my practice as a bedside nurse, I am often times affected by the emotions of the patients I care for in a daily basis. If they are sad, happy, or angry I feel it but sometimes the mere fact that you are there by their side and trying to hold their hands pacify them and give them that feeling that they are not alone in this journey. Battling cancer is very challenging for it does not only drain a patient physically, but also mentally and emotionally. I always come across of a patient who was told that he or she has only a month or two to live, and that is very hard not only on the part of the patient but as well as to their families. Sometimes you see them displace their anger on you but all you can do is extend your patience and understanding and pray for them that somehow they may accept the reality and to make the most of what time is left to be happy. One time I had a patient who had asked me a question and said "Richie, are you afraid of dying?" I was startled at first and was shocked of the question but when it sink in to me, I told the patient that I am not because because we are all going there and its just a matter who goes first and when. I also told her that my faith is strong enough that no matter what happens I am always prepared and ready. After saying that to her, she smiled at me and said that because of me it made her decision very easy and she hugged me said I feel I am ready. At that moment, I cried with her and just whispered "just have faith, God is with you all the time."
ReplyDeleteI read the article, Breaking the Ice. I have been taught not to get emotional with patients. I have supported many patients when given bad prognosis, I have held them when they cry and give them information on palliative and hospice care--the difference between each and the benefits.
ReplyDeleteThank you for sharing Mary. I also enjoyed reading the article, Breaking the Ice. You stated that you were taught not to get emotional with your patients, however your description of how you support your patients to me sounds emotional. Everyone's emotional response is different and I believe your way of providing your patients support is emotional. One does not have to break down and cry to be emotional, simply holding your patients and supporting them is enough.
DeleteThis makes us, nurses unique. I was once told by a grieving family that they were happy that we were there for the patient because they cannot be strong or stand to see their dying family.
ReplyDeleteI believe that we are the rock on patient's journey. They express their emotions of sadness, being angry, doubt, depressed, acceptance and peace with us. Our healing touch is powerful as our presence being there with them or by just listening to their story. In the line of what I do, I always talk to patients on the phone and I had this patient that has too many questions and I tried my best to answer them one after the other. I want to involve other departments but the patient said, you have done a wonderful job just by talking to me and listening to me. Found out his family was not yet ready to talk about his condition.
Beena Patel
ReplyDeleteWorking as an oncology nurse has not been the easiest thing for me to do. I have found that the hardest thing for me to deal with is how much i differ from some of my patients when it comes to coping with the issues at hand. But,as nurses we need to understand that it's their body and they have the right to choose how they would like to take care of themselves. The best thing to do is just listen and be sympathetic towards our patients.
Lisa Hammons
ReplyDeleteWorking with oncology patients near end of life is very emotional but also very rewarding. Nursing brings many opportunities to help patients and families find peace when there is no treatment left. So many of our patients are so reluctant to accept that there is no more treatment and they beg for anything, even to try treatments that have failed for them in the past. Many patients feel like they are giving up hope if they accept hospice and they just keep saying they want to fight. I try to listen to them and acknowledge their feelings, but also try to let them know that accepting hospice doesn't mean they are giving up on hope, it just means they are hoping for something different, a peaceful time with family in their home where they can enjoy every moment with those that they love. As a nurse working remotely, I never get to meet my patients, but I feel close to many of them since I am the person they most always talk to when they call with a problem or question, so often I am the person they talk to when they are struggling with the physician’s recommendation for ending treatment. Those conversations can be rather difficult but also gratifying.
I still struggle with this. I find the longer I am in oncology the harder time I have with the loss of each patient. I can provide emotional support to them, but I find it hard sometimes to say what might be the right thing, or what they might find therapeutic in some way. I hope at some point to find the words that carry enough way to elicit an emotional therapeutic response that a patient finds helpful. I think the article for me personally was very helpful since this is an area of weakness for me.
ReplyDeleteSometimes the words you say aren't as important as letting them know you are there. Listening can be more powerful than any words we can come up with. I hope you can find a way to ease the distress and pain you feel when a patient passes. Remember to take care of yourself so you can continue to care for others.
DeleteAs I have only been here a little over a year, this is my first oncology job and first nursing job. Initially, I was hired to work in the port rooms, which was sometimes the worst part of the day for some patients, I am poking them with a hollow needle into their chest, I couldn’t imagine having that done every few weeks or even living with a port inside me. They would come in very gloomy and down that this was another start to their day of this battle they are facing. I found out quickly that the best way to make them smile and come out of the darkness was to talk about anything BUT their cancer. I figured that if I can be the ONE appointment that they had in their long day that had no talk of cancer, that would remind them of their normal life before this journey, they would come out of the gloomy mood they were in as they walked into my door. It worked EVERY time. Patient’s would always tell me that they loved talking about their life with me and helping them take their mind off things and leave my room smiling and laughing. I think this is a technique I will continue to use in my practice here, unless the situation requires me to address their cancer in depth.
ReplyDeleteWhat a wonderful way to help your patients, Mallory! A common feedback that I get from new patients who are coming to CTCA for the first time is that they finally feel as if they are not a number, that they feel they are cared for. Thank you for creating an opportunity when a person can feel they are unique and special, especially in a moment that can so often be dehumanizing.
DeleteI really appreciated this article. Developing rapport and trust with our patients is so important. Making sure that they know that we see them as something more than their disease helps them, but I agree with the author that this technique helps us as well.
ReplyDeleteI recall once taking care of a patient who had a feeding tube and was due for her bolus feeding. Her husband hovered over me throughout this, giving his tips and coaching me. Once completed, he heaved a sigh and told me "You did everything right." He then eagerly pulled out their engagement picture, forty years old, from his wallet and proceeded to share with me how special his marriage had been to him and how his wife contributed to that. He was compelled to make sure she had the best care because of this. It moved me so much that I know I tried even harder to give my best care to this woman. When we take the time to learn who our patients are, we are able to provide them with more personalized care and truly be effective as nurses.
Diane, I love that we really get to know our patients, like family. WE look forward to asking them about their children or their pets or how an event in their life went. They so appreciate that we remember "who" they are and have a special bonding.
DeleteDiane,
DeleteThank you for sharing I know that it is hard sometimes to get close to our patients for fear of losing them. I had another infusion nurse ask me how I handled the loss of one of our patients who was dear to most of us. She was overwhelmed with sadness due to the loss. I told her that I am sad too but I find it healing that we give comfort and love to our patients and that makes me at peace that they are residing with the lord. I have had my own personal experience with the death of close loved ones and know that the feeling of peace that comes in the near moments to death let me know that there is a greater power and that gives me peace.
I enjoyed reading the article. I think the things the author said can be applied to every field in nursing, not just oncology. People like to tell their stories and want to be "known" for who they are, what they love, the things that are important to them. When living with a cancer diagnosis, it becomes very important. Patients and families with cancer lose so much to the disease. They need to know that the things that made them "who they are" are still there. Talking about those things and reminisicing means the cancer/disease can't take those things away. I think one of the best things we nurses can do is to help patients and families plan for the end of life. We all die, how wonderful to be able to die on our terms and knowing that we haven't left undone the things that are important to us.
ReplyDeleteI enjoyed the part in the article that the instructor discussed about assessing the patient before looking in the computer and how the patient's rated what was important to them. Listening and forming a bond was important, eye contact and answering questions. These all seem so simple, yet we are all so rushed. The patient wants to feel valued and heard.
ReplyDeleteChristina Moreno
ReplyDeleteThis was an amazing article really relates to our daily encounters with our patients. A lot of our patients have a horrible connotation of the word hospice care and they think that it is a death sentence. I would never push someone toward treatment or hospice but I do explain to them that hospice care is really comfort care and that a person can come off of hospice as they want. I really have a respect for people who have accepted their diagnosis and want to embrace their life to the fullest while they are able. I had a patient not very long ago who said that the cancer had spread to her brain. She was debating whether she wanted to continue therapy or to enjoy the time that she has left with her family and daughter in particular and make a memoir for her daughter to have. This kind of talking makes a nurse realize the value of life and appreciate it so much more. I know that the job is emotionally taxing but at the same time rewarding. I feel that even though we may not always be curing the cancer, we are emotionally providing for the patients and mentally that is what they need. I know that sitting down with a patient instead of standing over them makes a huge mental impression that we are more caring and responsive to their needs. I have incorporated this in my practice and the patients really appreciate the extra time. Life and death is a normal process and when you are able to accept this then you are truly at peace with where you are in your life.
the thoughts, ideas and experiences with everyone.