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Challenges Faced by Oncology Nurses

Question:

Discuss about the Caring Culture for Oncology Nursing Practice.

The nurse is the heart of health care. Oncology nursing is among the most challenging yet rewarding fields. Nurses have a lot of roles to play when it comes to patient care. The oncology nurses deal with a cancer patient, these are patients with chronic illness who need a lot of care.

Oncology nurses always have the majority of work in the hospitals, they do a lot of chores related to caring for patients within the medical facilities right from diagnosis. In the past ten years, a majority of nurses raised a lot of issues or rather concern related to the quality of healthcare services they provided to the patients in the medical facilities.  Nurses complained about too much workforce within their areas of expertise which in turn resulted to poor health care for the patients with chronic illness.

The ecology nurses are an important team in the healthcare sector, these nurses often go through emotional and psychological problems relating to their caregiving at the health institutions. Cancer treatment involves a lot of things and stages most of the cancer patients who are under treatment cannot do their daily living activities, they need the support of the nurse in doing some basic activities like bathing, feeding, among others (Prescher-Hughes, & Alkhoudairy, 2007). The nurses also provide both emotional and psychological support to the patients as part of their caregiving. Patients with cancer go through a lot of processes and throughout the sessions, it is the nurses who provide all information needed for the purpose of treatment, and therapy sessions.

Nurses in the past ten years had a lot of inconsistency related to the care of cancer patients because some lacked required knowledge on how to take care of cancer patient, and the nurses were few compared to today. Nursing informatics and telemedicine are some of the two nursing specialties out of many others that have experienced dramatic adjustment in the last ten years.   The new technology experienced over and over again today has somehow helped the nurses in advancing healthcare treatment for patients in medical facilities.

With the increase in technology concerning cancer care, new cancers are emerging and even more expected in the future, hence the rapidly growing demand for much more improved technology for cancer care for the patient (Chernecky, & Murphy-Ende, 2009). The oncology nurses use informatics and telemedicine nursing to take care of patients with chronic diseases. Telemedicine is adversely changing how the nurses provide patient care with the increasing number of intensive care units. This technology has greatly increased ability in monitoring the progression of vital signs, adjusting patients’ safety, identifying unstable psychological status, and also detecting arrhythmias and preventing falls among others (Chatswood, Barton-burke, & Krau, 2017). These specialties in nursing have increased leadership opportunities and general health care for patients with chronic illnesses (Yarbro, & Buchsel, 2005). Oncology nurses play the majority roles and it’s important that these nurses are also cared for in order to provide a better service delivery. The number of oncology nurses is today increasing with the new registered nurses being trained in their specialty for an improved service delivery to the consumers Rice, n.d. There are some factors which sometimes hinder adequate health care services to patients with chronic illness and the nurses quality of work for example, the increase in demand for care to patients whose numbers are relatively high than the nurses, the aging workforce, decreasing interests in private practices, lack of adequate knowledge on how to care for patients with chronic illnesses, rural areas are sidelined, and burnout which has been the major problem (Fieler, & Hanson, 2000). These problems affecting nurses are the major reasons as to why some patients end up not getting the required treatment and even some patients end up dying because of lack of adequate information and knowledge on their treatment schedules. Nurses are human as well and despite the fact that they are guided by laws and principles, they sometimes also fall victims of the situation. Their responsibility to handle emotional and psychological situations that the patient is going through is not easy and that’s why sometimes they get affected mentally, physically and emotionally and therefore, not fit to offer quality care for the patients (Stoller, & Stoller, 2016). With the evolution of new technology in cancer treatment, the nurses are being trained on how to handle such kind of pain and difficult situations for them to also help the patients with chronic illness in their pain and agony (Neeraja, 2011).

The Importance of Technology in Cancer Care

There has been cancer treatment in the past decades and with the rapid increase in the change in technology, research, and treatment, there has been a big gap closed in relation to cancer patients’ care and treatment mortality rate. The oncology nurses today have the knowledge required for them in handling cancer patients’ right from diagnosis to the whole treatment process till recovery and nurses bear the responsibility of taking care of the patients with a positive attitude and optimism to make the patient feel comfortable during their treatment (Christ, Messner, & Behar, 2015). Nurses have various roles that are required of them when taking care of the patients. First, it is their responsibility is the patient's assessment, the nurses should be able to assess a patient’s past health history, emotional and physical health, health practices and to make the family have a knowledge of the disease and treatment required (Barton-Burke, Wilkes, & Ingwersen, 2001).

The second role of the oncology nurses is to educate the patient, these nurses often have a priority compared to other members of the health team in having a one on one communication with the patient. The nurses educate both the patient and family members to familiarize them with the disease and its stages of treatment for the purpose of working in a unified manner with the family for a positive outcome at the end of the patients’ treatment.

Another role of oncology nurses is coordination of care which is the most important role as it puts together multiple and complicated current technologies used in cancer diagnosis and treatment. This care involves direct care to the cancer patient and this is done through, management of symptoms, arranging referrals, medical record documentation and getting involved in therapy sessions (Moorcraft, Lee, & Cunningham, 2014). The patients have the right to take the nurse's contact detail in case of any inquiry about health-related issues concerning the patients’ treatment. With improved modern cancer care, coordination also involves communication with different health staff to improve health care to cancer patients.

There are variable responses concerning the question of the level of satisfaction working in oncology. Some caregivers said that they were satisfied with the care and support they gave to their patients and that they are happy seeing their patients get the help they need in a professional way. Others said that oncology is so depressing and it is sad for them because they know that cancer cannot be cured and they get worried about the patient and the care that their family will have to give them on a daily basis. But at the end, no one was willing to leave their area of expertise. Different cancer patients experience different situations during their treatments, there are those who experience great care from their caregivers throughout their treatment period and those who have had a difficult time with their caregivers during their treatment (Barraclough, 1999). A patient who experienced great care from the caregiver said that, building the bond between her and the caregiver was the best thing she ever did, this is because it is through that bond that she was able to learn a lot about her sickness and the treatment process, it is through the bond that she had the courage and believe that she would go through the treatment process with someone who believed in her and gave her the best care when she really needed it (McCormack and McCance 2006). She continues to say that relationship with the caregiver is very vital because the caregiver provides a lot of support both to the patient and the family, and with that, she had a positive attitude towards the treatment and her medications.

Roles of Oncology Nurses in Patient Care

Another patient said that through good communication and understanding with the caregiver, she was able to open up and ask her caregiver any question that came into her mind and she never hesitated to answer any single one of them. And through this, the caregiver was able to know her preference and how she wanted her treatment to be which has really been great impact throughout the treatment period. Those patients who do not get along with the nurses often have a hard time during their treatment, because they have low self-esteem and a negative attitude towards themselves. And these patients often do their own research and do what they think is right for them and the majority end up having complex symptoms which worsen their conditions. Caregivers are there to offer care to their patients and that’s their area of expertise. It is important that they learn how to deal with patients because most of them are frustrated and gave up. Their training should incorporate dealing with such issues, but on the other hand, it is the patients’ responsibility to get along with the caregivers for them to get better treatments by understanding their disease and the treatment process involved (McCormack and McCance 2006). If a patient gives a nurse a humble time and an opportunity to work professionally then the patient will develop a positive energy in going through her treatment.

The current caring culture experienced by patients has improved compared to the past decades. In today’s care environment the nurses have better skills and knowledge required of them however much it has not yet fully hit the targets. According to Garrett, Happ, Costello, & FriedOken (2007) the strategies, techniques, and devices of Argumentative and alternative communication (AAC) can be used significantly to solve communication barriers that may hinder effective communication (Bott, Endacott, Watts, 2006). Effective communication is identified as a necessity across the health care repeatedly because it directly affects the quality of patient care. This communication care model is important in any kind of environment, it is through communication that the caregiver is able to understand the patients need. Therefore, communication is a vital tool the current caring culture because, through communication, the nurse is able to educate the patient and also listen to the patient, it is through communication that both the nurses and patient can come to a consensus and it is important also in the decision making process (Happ, Roesch, & Garrett, 2004). Communication has adversely increased the patient-nurse relationship which has positively influenced the patients’ participation in the treatment. This care model is based on a patient-centered model which enhances understanding of the patients need.

The Impact of Positive Relationships Between Patients and Caregivers

This tool has mostly been used in different health care specialties to understand the patients need and to assist them in solving issues that may arise. Through communication patients can easily express themselves, for example a patient who cannot read and write would need the help of a nurse to maybe help in filling forms and explaining medical terms, without communication there cannot be quality health care but instead misunderstandings, and this can lead to poor diagnosis which may later create a lot of complications to the patient. Quality services benefit both the patient and the nurse and this is the reward of most nurses, to see that their patients have fully recovered or on their journey to recovery (O'Donnell, 2008). If the nurses are committed to quality care services by involving the patients in every step required by educating them and at the same time hearing their views reduces the risk of poor treatment of such patients. The current caring culture has nurtured caregivers to be the immediate contact person of the patient, and this practice has helped a lot because it creates instant responses because of a good communication channel. If a patient starts experiencing different reactions after a certain treatment and they communicate with the caregiver explaining what he feels, the caregiver will immediately take action and look for an alternative for the patient.

Communication as a tool is also important between the caregivers and the health team in a medical facility, because through communication, and the nurse is able to ask the health team questions about particular symptoms and even seek the necessary advice from the healthcare team on how to handle situations regarding a patient’s illness Wittenberg-Lyles, 2013. All this is important because it can affect the patients’ outcome positively or negatively. The current health care has advanced the communication system between caregiver and the patient by introducing the telemedicine through which they can monitor their patients and communicate even if they are not within the health facility. With this improved communication system the patients are certain of quality treatment and assessment by their caregivers. Although nurses should not only rely on technology as the basis of communication.

Patients with chronic illness may sometimes develop some conditions overnight. Some patients may stop hearing, talking, seeing, and even stroke which may interfere with the brain also known as behavioral barriers. According to Kissane (2017), it would be of help if the nurses are trained on other means of communication so that if in any case, the patient experience such difficulties the nurse is still in a position to take care of the patient without having a misunderstanding or looking for an interpreter. In such cases, the nurse will have to reevaluate the methods of communication in order to understand the patient. This may not be an easy task if the nurse has no single idea on how to adapt to a patient’s condition causing some nurses to react in return the patient may be affected and they may refuse to communicate. Another communication barrier that may hinder communication between the caregiver and the patient is a language barrier. People come from different communities speaking different languages, which some nurses may not understand, this will force the nurse to look for someone who speaks the same dialect to translate and this may lead to slow and late treatment of the patient. Cultural barrier also affects communication because of the diverse culture that people come from, for example, a patient can be from a culture where they do not know how to read and write but with AAC it is possible to support health literacy for this kind of patients (Yarbro, Wujcik, & GobeL, 2011).

Training of nurses is a recommendation that would go a long way to helping to curb these kinds of barriers which may affect effective communication. Health literacy is important to all patients, especially with chronic illness. There should be public awareness in educating the patients of symptoms of different diseases and illnesses in order to improve response to medical checkups. However much technology has adversely improved health care for patients with chronic illness, the care given to them is way more important than the treatment its self, meaning nurses are a necessity to any healthcare facility. The nurses should develop a positive culture whereby they understand their patients despite their barriers. They should also create a bond with their patients for the purpose of understanding each other and progressing together throughout the treatment and decision making (Patlak, & Levit, 2009). The government should also put in adequate measures to help improve the nurses’ welfare. The government should train more nurses about oncology nursing to help in reducing fatigue and other factors that may influence low productivity in caregiving (Chang, & Daly, 2016).

The government should also put in place adequate facilities in the health facilities to accommodate all cancer patients including those in rural places who need care units for the need of better treatment. Information should be spread throughout to reach everyone including the indigenous groups and those who live in rural areas to be aware of the chronic disease and their effects. The human resource should implement strategic measures that protect the nurses by introducing shifts in the workforce because the nurses also have families and due to excess work and the demand they do not have time for their families. The patients need great care throughout their treatment and they should also be cooperative and open to the nurses for them to have quality treatment because through cooperation the nurses will be able to understand what they want and help them or advise them accordingly ((Schaffer, & NorlandeR, 2009).

Conclusion

Cancer is the chronic illness that affects people across all ages and those who are at high risk of getting cancer are those in the old age. Cancer comes in different form and shape, and we have a wide variety of cancer types and with the improved technology more types of cancer are being discovered. Cancer patients are vulnerable and their treatment can make them go through a lot of pain, weight loss, and hair loss among others and throughout the treatment they have the oncology nurses who are their caregivers and managers. Oncology nursing demands a lot of time, care, and demand. These nurses are the caregivers and they have taken it as their responsibility to make sure that patients who are suffering from chronic illness get absolute care throughout their treatment. It is our responsibility to be patient with the nurses and also understand their pain and struggle in taking care of the patients. Nurses are the backbone of any health facility because they are the ones who provide a majority of the services in the health facilities.

Nurses are a phenomenon in their line of duty and they deserve rewards and appreciation for the work they are doing because they sacrifice their time and energy to make sure that the patients have the best care as possible. Nurses undergo a lot of stressors especially when they see they see a cancer patient dying, this makes the other cancer patient not to fight back, but the nurses take in all their patients and families pain but they do not give up on their patients, they care for them to the very end. Without the caregivers, most cancer patients would not make it because of the kind of work that the nurses do in order to support them through the process of treatment. Above all the government has done a tremendous job in supporting new technology and funding researches with the aim of better health care treatment for patients with chronic illness.

References

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Barton-Burke, M., Wilkes, G. M., & Ingwersen, K. 2001. Cancer chemotherapy: a nursing process approach. Sudbury, MA, Jones and Bartlett.

Bott, M., Endacott, R., Watts, R. 2006. "Barriers in Providing Psychosocial Support for patients with cancer." Cancer Nursing. 29(4):309-316.

Chang, E. M. L., & Daly, J. 2016. Transitions in nursing: preparing for professional practice.

Chatswood, N.S.W., Barton-burke, M., & Krau, S. D. 2017. Advances in oncology nursing. Available at https://nls.ldls.org.uk/welcome.html?ark:/81055/vdc_100040750099.0x000001.Elsevier.

Chernecky, C. C., & Murphy-Ende, K. 2009. Acute care oncology nursing. https://www.cli

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Garrett, K., Happ, M.B., Costello, J. & FriedOken, M. 2007. AAC in the ICU. In D. Beukelman, K. Garrett, & K. Yorkson, (Eds.) Augmentative Communication Strategies for Adults with Acute or Chronic Medical Conditions. Baltimore, MD: Paul H. Brookes Publishing Company.

Happ, M., Roesch, T. & Garrett, K. 2004. "Electronic voice output communication aids for temporarily nonspeaking patients in a medical intensive care unit." Heart and Lung, vol.33, no.1 pp 92-101.

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Prescher-Hughes, D. S., & Alkhoudairy, C. J. 2007. Clinical practice protocols in oncology nursing. Sudbury, Mass, Jones and Bartlett Publishers.

Rice, V. H. n.d.. Handbook of stress, coping, and health: implications for nursing research, theory, and practice / Virginia Hill Rice, editor.

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Wittenberg-Lyles, E. 2013. Communication in palliative nursing. Oxford, Oxford University

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https://public.eblib.com/choice/publicfullrecord.aspx?p=4037411.

Yarbro, C. H., Wujcik, D., & GobeL, B. H. 2011. Cancer nursing: principles and practice. Sudbury, Mass, Jones and Bartlett Publishers. https://public.eblib.com/choice/publicfullrecord.aspx?p=3319239.

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