Cancer is a term which is used to denote a disturbance of cellular growth. It generally refers to a number of diseases as there are currently more than one hundred fifty types of cancer which arise from any body tissues.
According to the main classification of cancer in accordance with tissue type the patient suffers from sarcomas which is cancer originating in bones, muscles and connective tissues.
According to the primary site of diagnosis and the metastatic behavior of cancer the common spread of the bread cancer is the bone-lung-liver-brain.
The burden of chronic disease on the patient is very hard it means that the care coordination is of central importance. In this connection the role of the primary care provider is vital. A nurse who has to be a primary care provider also fulfills the function of the coordinator of the patient’s care. One more important function that a nurse has to fulfill is the effective transfer of information and its link to efficient treatment.
Cancer management is a vital and multidisciplinary endeavor, consequently, knowledge and understanding of the main principles of oncology nursing is a basis of any successful care. Practice of oncology nurses requires detailed knowledge of psychological, biological problems caused by cancer.
Mary Johnson writes, “Nurses are expected to be expert in assessing patients’ physical and emotional status, past health history, health practices, and both patients’ and families’ knowledge of the disease and its treatment. It is essential that a detailed nursing history and physical examination be completed. An oncology nurse is expected to be aware of the results and general implications of all relevant laboratory, pathology, and imaging studies”.
It is of great importance is to plan patient’s care and evaluate the patient’s progress, physical complaints and prognosis. It is of far greater importance for a nurse to support a patient emotionally. Thus, the following nursing priorities are to be put forward.
The first assignment to be fulfilled is to support adaptation and independence of a patient.
Secondly, it is necessary to promote comfort. Thirdly, it is highly recommended to maintain optimal physiological functioning and prevent complications. Finally, it is important to provide adequate information concerning the treatment needs, disease results etc.
On the basis of the situation and the history of the disease the following goals can be set. First of all it is desirable that a patient deals with the current situation realistically and without being too stressed. Secondly, it is required to maintain control of pain. Thirdly, it is planned that any further complications are prevented and minimized. Additionally, the corresponding and timely therapeutic choices are to be made.
While addressing the problem of the correct nursing diagnosis for cancer the following facts have to be taken into account, namely feelings of anxiety and restlessness, stress and increased tension caused by the threat of death, feelings of hopelessness and inadequacy.
Thus, the desired outcomes which are aimed at during the work of a nurse are lessening of fear, and display of appropriate range of feelings. Additionally, it of importance to reduce anxiety to a manageable level. Thirdly, active participation in regimen has to be achieved.
It is necessary to point out, though, that my personal reassurance and knowledge have to serve as an important guidance in providing adequate and efficient nursing. Personally, I consider that the way of life and its quality depend to a large extend on the emotional state of a patient. Consequently, I believe that it is of paramount importance to support the suffering patient emotionally and restore her to normal state. It could possibly be achieved through persuasion and establishment of interpersonal contact. I strongly believe that the main task of the healthcare support of the limbering patient
The first strategy which can be applied in the Thomas’s situation is achievement of a display of appropriate range of feelings and lessening of fear. In order to realize this strategy it is necessary to establish trust and sympathy during communication. Furthermore, it is advisable to talk over all the possible actions which have to be taken in order to improve the present psychological state.
As Mrs. Thomas is currently suffering from stress caused by such factors as pain, fear of death, agitation and restlessness caused by worries over her husband’s possible suicidal and lack of connection with sons, friends and acquaintances it is advisable to reassure her in necessity of social communication. Furthermore, sons have to take an active part in the support of their parents. Mr. Thomas does not have to be the only person her supports his
Mrs. Thomas has to be reassured that the death of all her female relatives does not inevitable mean her death. Positive outcomes and recovery over breast cancer should help Mrs. Thomas be more stable emotionally.
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The second strategy in nursing is minimization of pain level and ensuring effective medication. Spross and Yeager point out,
“Because nurses spend more time with a patient who is experiencing pain than do any other health professional, it is of utmost importance that the nurse be knowledgeable about pain assessment and both pharmacologic and non pharmacologic management of pain, in order to provide good pain control as well as patient and family education.” (Spross, Yeager)
Another strategy which can be applied for treatment of Mrs. Thomas is physical activity. While applying this strategy it is important to pay attention to the physical state of the patient. It is necessary to increase physical activity gradually, taking into account complaints and wishes of the patient. At the same time increase of activity which can be connected with walks visits of acquaintances and other entertaining activity which would arouse positive emotions would be of great help.
C. Create a holistic nursing action plan appropriate for managing Mrs. Thomas’s care at home.
The Holistic nursing: Scope and Standard of Practise (2007) provides information necessary for holistic practice. The holistic approach in health care system means focus of wellness, unity as well as interrelationship of humans and environment. The main aim of holistic approach is connected with establishing and restoring emotional balance of the patient. Holistic nursing is a kind of healing which is based on self-care, establishing of relationship with the person. Holistic nursing is connected with interconnectedness of emotions, mind and body. Peace and comfort as well as a sense of harmony are the main targets in healing a patient for holistic nurses.
The holistic action plan has to be based on the standards of holistic nursing practice. Thus, as the first standards requires collecting comprehensive data about the person’s health and situation it is necessary to evaluate data which includes physical, psychosocial, spiritual, emotional and mental assessments. Moreover, such facts as lifestyle, family issues, beliefs, values and risk behaviors have to be identified. Furthermore, diagnostic procedures, connected with the person’s status have to be interpreted.
The second point on the holistic plan is diagnosis of health issues. The data have to be assessed on order to determine the diagnosis or issues identified as problems, needs and potential patterns. The implementation of the holistic nursing has to be carried out in partnership with family members.
Thus, the following holistic plan can be put forward:
- Assess her pain tolerance and administer analgesics as prescribed.
- Encourage her to discuss her thoughts and feelings about her illness
- Suggest that she talk with her husband and children about her worries, needs and wishes
- Discuss dietary changes and medication which will minimize the effects of chemotheraphy.
- Discuss possibility of visiting a breast cancer support group where Mrs. Thomas can share experience with other women who undergone chemotherapy, mastectomy or radiation.
- Encourage to verbalize fears about prognosis.
- Teach about dietary as well as lifestyle changes which can help to minimize complications.
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Functional ability of Mrs. Thomas can be optimized only through encouraging being more active. The first step on the way to crease her activity would be reassuring of the necessity to visit centers of support. An important argument in persuading the patient to try to be more active is to point out to the necessity to support her husband. Mrs. Thomas has to understand that her husband can feel much better only in case of her recovery.
It is essential that the adequate and appropriate medication has to be applied in order to decrease pain. At the same time it is of far greater importance to reassure Mrs. Thomas that her recovery is impossible without being more functional and active.
It is highly advisable that the patient tries to stick to the obligatory regiment which supposes adequate degree of activity.
At the same time the process of recovery can do in the advert direction. In this case it is necessary to work out the corresponding plan of actions. Thus, in case the self-care plan of Mrs. Thomas fails, it is important that the nursing has to be provided to her day and night. As decided by a doctor Mrs. Thomas can be taken to hospital. At the same time the main task of the nurse during this stage is to make sure that Mrs. Thomas wants to recover and everything is done in order to help her.
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The community health nurse has to intervene in treatment of Mr. Thomas chronic depression as it the emotional state of Mr. Thomas has an immediate connection of the psychological state of Mrs. Thomas. It is highly advisable that Mr. Thomas keeps to the regiment and continues to take pills against his depression. Moreover, Mr. Thomas has to resort to the help of his sons in difficult situation. It is important that he shares his fears with the others. It is possible that he also visits support centers and gets advice of a psychologist.