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Palliative care, careful discussions help patients cope with diagnosis
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NEW ORLEANS – The consequence of poor nurse-to-patient communication is a patient who is more fearful of a cancer diagnosis than may be necessary, says Cyndi Cramer, BA, RN, OCN, PCRN, clinical administrative supervisor and educator for Tampa General Hospital, FL.
Proper communication is perhaps the most important part of the cancer journey. Patients often feel hopeless, helpless and abandoned by healthcare providers.
According to a critical-care survey conducted by Oncolink at the University of Washington and funded by the National Cancer Institute (NCI), “48 hours after [patients] were admitted to the ICU, the majority of them didn’t understand basic information, such as what their diagnosis was, what their prognosis was or what their treatment was,” reports Cramer. “Out of 123 families of patients who died in the ICU, more than 80% said they didn’t get sufficient or clear information,” she adds.
Reversing this trend may begin with early palliative care, which, unlike hospice, is used for patients in all disease stages. Studies reveal that patients who partake in palliative care live longer than those who do not, stressing the positive effect it has on communication and patients’ overall wellbeing. American Society of Clinical Oncology (ASCO) president George Sledge, MD states, “while improving survival is the oncologist’s primary goal, helping individuals live their final days in comfort and dignity is one of the most important responsibilities of our profession.”
To help patients cope with a devastating cancer diagnosis, several decision aids are now available that can guide them through the decision-making process. Additionally, oncology nurses can effectively hold difficult conversations about diagnosis, prognosis and treatment options by taking the following steps: Allot adequate time for the discussion, pausing frequently so as not to overwhelm the patient; establish the patient’s level of knowledge of the disease; gauge how much the patient wants to learn and respond to emotions. Each of these strategies will likely ease patients’ fears and empower them to take control of their care.
Disclosures: Cyndi Cramer, BA, RN, OCN, PCRN reports no relevant financial disclosures.