Bsc_in_Palliative_Care_Nursing

OLO 1: Topic: psychological effects of treatment OLO 1: Reflect upon the psychological effects of cancer and its treatment upon an individual, members of their families or those who care for them. • Reflection upon support and communication with female breast cancer This reflection is based on a discussion between me as the healthcare professional and an in-patient on the ward. The patient is a 44-year-old female with a primary diagnosis of metastatic breast ca with lung mets. She was admitted to the ward for symptom control, specifically titration of her analgesia. During this discussion, the patient talked about how her friends are reluctant to visit her in the hospice because they think she must be dying. She asked me whether she was dying and we talked at length about this as well as looking for ways that she could maintain her social life whilst being an in-patient at the hospice. Firstly, I led the conversation in the direction of the number of patients who are admitted to the hospice for reasons other than terminal care and the overall percentage of patients who are discharged home after their problems are resolved. I felt it was important to begin the discussion with this information, to give the patient some perspective. We then went on to discuss how she felt and whether she felt she had declined significantly prior to admission and whether this had prompted the admission in the first place. She did not feel that she had declined, though she did feel like her symptoms had increased and the pain was now more of a problem at home. This was reflected in her admission criteria, symptom control. We talked about her blood test and scan results and that there was no evidence that her physical condition had declined significantly since these tests. We talked about this being a ‘blip’ in her journey and the possibility of the increase in pain being due to psychological reasons. I explained that this did not detract in any way from the very physical symptoms she was experiencing and we talked about how a person’s emotions and feelings can sometimes manifest through a person’s physical health. We talked about how the anticipation regarding the next cycle of chemotherapy may have triggered these feelings, which had then manifested in an increase in her leg pain. This patient explained that she has two close friends who visit regularly and who she feels able to talk openly with. I encouraged her to talk to them about her concerns and fears and to ask them to relay information other friends regarding her eagerness to see them. I also suggested meeting friends outside of the hospice to maintain social contact, but to allow the connection with the hospice to be broken temporarily which may make her friends feel more comfortable. It was also important that the patient did not feel that she had changed socially due to her hospice admission. Her interaction with others is extremely important for her and this is something which needs to be maintained throughout her admission. We discussed that fact that the hospice provides holistic treatment and this means that the non-physical factors are just as important as those that we can see. In reflection, this situation has highlighted the importance of maintaining a patient’s psychological wellbeing whilst they are undergoing treatment. The psychosocial aspects of a person’s cancer journey can sometimes override those physical symptoms and are key to how an individual responds to and views their treatment.