Despite extensive efforts to prevent cancer and find its cure, each year cancer causes a lot of suffering in people. Although many are cured, they undergo devastating suffering along the way arising from psychological, physical, financial, and spiritual problems. Research by the Canadian Cancer Society shows that one in two Canadians (45% of women and 49% of men) develop cancer in their lifetime: these are 2010 estimates (2017). Not only do cancer patients need comprehensive treatment but also particular attention to themselves as whole persons. It is where nurses come in play as experts who understand the causes of their suffering and what it would take to make them complete again. They make the person, instead of the disease, the focus of their attention. This paper analyses the role of a family nurse in the Smith family case. Maggie is a surviving cancer patient in a six-week post-op recovering at home. To help the family through the emotional healing process, the paper analyses how the nurse assesses evaluates and implements various methods of the family playing different roles.
Family nursing in Canada and challenges faced when dealing with cancer.
The prevalence of breast cancer in Canada is relevant to family nursing now more than ever. With the family situation mentioned above, it is prevalent that Ben and Maggie are grappling with the issues of cancer survivorship which slowly destroy families from the inside. Family nursing in Canada plays a vital role in such situations whereby it focuses on the family unit taking a team approach to healthcare. A family nurse performs various duties commonly performed by other physicians. With their ability to write prescriptions and a broad knowledge base in patient care, they play a vital role in family care. Family nurses assess the entire family identifying the risk factors and health problems affecting them. Moreover, they develop interventions addressing particular health concerns while implementing them for the improvement of the patient as well as their family. When it comes to dealing with a fatal illness like breast cancer, Canadian families face many challenges. Most families experience various emotions as they learn to live with cancer. The reactions and adjustments mostly depend on how they meet other crisis and problems. Nevertheless, these emotional challenges include fearing uncertainty, anger, denial, anxiety, stress, guilt, depression, loneliness, sadness, and isolation. Since Maggie is dealing with depression, this will take a toll on her entire family. As we all know depression is a very serious condition affecting cancer patients. Therefore, identifying it earlier lessens the risk of suicide in a cancer patient.
Assessment: As a practicing nurse, it is vital to realize that cancer patients are different with different kinds of pain. Since Maggie is a surviving breast cancer patient, one must carefully assess how she is recuperating as well as dealing with the pain. Most mistakes in diagnosing causes of various syndromes and failing to manage the problem stem from neglecting the assessment (Adler & Page, 2007). Moreover, the nurse must remember that Maggie is suffering from depression hence interpersonal skills are essential when engaging as a health educator:
- Believe Maggie’s complains.
- If Maggie suffers from pain, take a careful history of the pain complaint and emotional state placing it temporarily in her cancer history.
- Assess the characteristics of her emotional state and each pain. It includes its pattern of referral, and its aggravating and relieving factors.
- Evaluate Maggie’s psychological state and carefully perform a medical and neurological examination.
Studies that assess patients within the first year of diagnosis show that about 42% is experiencing a psychological or psychiatric disturbance in the form of anxiety, depression, or both, in turn, compromised the quality of life. Life-threatening illnesses like cancer have been associated with the development of post-traumatic stress disorder (PTSD) in some women (Adler & Page, 2007). Keeping this in mind, the nurse must carefully assess Maggie’s situation as a health educator to prevent the case going to worse.
Diagnosing: After assessing Maggie’s situation, one should correctly diagnose the condition of Maggie’s case. Since Maggie is in the transition phase of survivorship, she still struggles with the system of being cured of cancer. Breast cancer survivors develop behaviors like anxiety and fear of developing other illnesses. Practitioners should tread carefully when giving a full patient diagnosis according to their assessment. On Maggie’s case, she is psychologically distressed, and depression is unique. To determine the extents of Maggie’s grief, we must rely on the patient to tell us how her moods have changed from the cancer diagnosis to survivorship period. No one but Maggie can accurately report her feelings-not her husband, not the nurse, not her children. Numerous studies have shown, in fact, that a patient’s reports of an emotional state are consistent, reproducible, and reliable. The psychological adaptation or adjustment to cancer is an ongoing process whereby the patient attempts to solve specific cancer-related problems and manage emotional distress.
Intervention: The nurse should engage both Ben and Maggie in working out their emotional state. Applying the attachment theory to Maggie’s case, the couple integrates interpersonal relationships as a way of engaging each other in dialogue.
Implementation: In the final stage of implementation, the nurse should use her role as a health educator in engaging Ben and Maggie on various ways of communicating with each other. The first step is coming up with a plan on how they support each other during this hard time.
Assessment: The role of a family nurse in advocacy is critical when it comes to their families. During the assessment period, the nurse should evaluate what Maggie wants as a patient. When a nurse plays an advocate role, they are liaisons, communicators as well as interpreters (Ferrell & Rhyner, 2010). Advocating means standing up for the rights of a patient while minding the rights of the family. Correspondingly, the nurse should analyze Maggie’s equality and how she is feeling towards her family’s treatment and response to her situation.
Diagnosing: Additionally, when diagnosing Maggie’s condition as an advocate, we must rely on her account of how she feels her family treats her. As mentioned above, the technique of listening to a patient is an important one. Furthermore, the diagnosis process can be carried out via a model developed by Betty Rolling Ferrell, a researcher at City of Hope National Medical Center. This model explores the extensive effects of treatment on all dimensions of the quality of a patient’s life: social, physical, spiritual, and psychological (Ferrell & Rhyner, 2010). With this model, the nurse efficiently determines how the patient and her family treat and respond to each other.
Intervention: When it comes to the intervention process, both parties should sit down and communicate with each other regarding how they handle each other.
Implementation: The implementation process guides the family towards treating each other more appropriately and lovingly.
Assessment: The rehabilitation process starts at assessing both the patient and the family with their coping strategies. Psychological therapy is a technique equipped with nurses who contain an array of cognitive measures that help the patient and family lessen their distress (Stone & Sheila, 2010). They diminish the patient’s anxiety and delirium.
Diagnosing: Diagnosing through counseling can only be handled through one on one sessions involving the patient as well as family members. They must communicate how they feel to move to the next stage.
Intervention: In the intervention process, the nurse must speak with Maggie and her husband about the differences in their perception and the communication difficulties they have. The nurse must educate them on Maggie’s depression stating that depression commonly affects cancer patients (Stone & Sheila, 2010).
Implementation: During the implementation stage, the counseling sessions should help Ben and Maggie understand each other’s concerns improving their ability to share them.
Ergo, the article shows that family nursing plays a crucial role in treating cancer patients and their families. When a nurse practitioner encompasses the three roles discussed above, there are high chances that the family relationship improves, becoming stronger when dealing with cancer. Cancer rehabilitation is an essential aspect of family nursing, and people should not hesitate to seek the help they need.
Adler, N.E., & Page, A.E.K. (Eds.). (2007). Cancer care for the whole patient: Meeting psychosocial health needs. Washington, DC: National Academies Press.
Klimmek, R., & Wenzel, J. (2012). Adaptation of the Illness Trajectory Framework to describe the work of transitional cancer survivorship [Online exclusive]. Oncology Nursing Forum, 39, E499–E510. doi:10.1188/12.ONF.E499-E510.
Oxlad, M., Wade, T.D., Hallsworth, L., & Koczwara, B. (2008). “I’m living with a chronic illness, not….dying with cancer”: A qualitative study of Australian women’s self-identified concerns and needs following primary treatment for breast cancer. European Journal of Cancer Care, 17, 157–166.
Rolling, F.B., & Nessa, C., eds. (2010). Oxford Textbook of Palliative Nursing. 3rd Ed. New York: Oxford University Press.
Stone, D., Bruce, P., & Sheila, H., (2010). Difficult Conversations: How to Discuss What Matters Most. 2nd Ed. New York: Penguin Books.