Role of the Clinical Nurse Specialist in the Support of Patients – Care Example

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"Role of the Clinical Nurse Specialist in the Support of Patients" is a great example of a paper on care. Some medical decisions are hard to make and therefore require comprehensive consultations from various professionals.   Communicating bad news to a patient can be very challenging, especially when it comes to the choice of words (Cheah, Dollah & Chang, 2012; Kinghorn, Gaines & Royal College of Nursing, 2007).   Patients can be adversely affected by news about critical ailments either emotionally, psychologically, or physically (Cooper, 2006). Narayanan & Koshy (2010) argue that many people are usually not ready to accept the reality of critical illness, and therefore it may be difficult to communicate such news to them.

In order to expound on the approaches and challenges associated with breaking bad news, we consider a case of a 36-year-old newly wedded man, James, suffering from rectal cancer. Case At 36 years, James is at his most active years in life. He is faced with numerous responsibilities and hard life decisions to make. As a newly married man, James has several ambitions and plans with his wife, for instance on how to get children and live a happy life together.

    James started having strange health conditions soon after marrying. He started complaining of frequent gas pains, nausea, blood in his stool, and fatigue. The wife advised him to visit the hospital in order to know what was wrong and also to acquire treatment. After analyzing his condition and conducting a series of tests, the doctors realized that James was suffering from rectal cancer. Rectal cancer is among the dangerous types of cancer whose treatment is associated with challenges such as infertility, permanent stoma, and other biological problems (Corner & Bailey 2009; Swan, 2006).

Communicating the bad news to James is not a simple task for the physicians, and many considerations have to be made. The news may elicit a painful emotional reactions, Psychological distress, physical weakening, and other negative repercussions. News about infertility after treatment can be very painful to the couple, considering the fact they are newly married and with no children. Potential treatment Various medical approaches that can be employed to treat rectal cancer. However, the treatment approach chosen depends on the stage of rectal cancer development, tumor location, and the risk factors involved.

Fawcett & McQueen (2011) states the treatment options include radiotherapy and surgical operations. Rectal cancer can be cured if noticed at its early stages of development through the available treatment methods (Bayless & Hanauer, 2011; Otto, Lutz, 2014). Before commencing treatment on rectal cancer, the patient should be provided with all information regarding treatment options including the possibility of having a stoma (Kozarek, Chiorean & Wallace, 2014). Additionally, a stoma professional should be responsible for advising the patient on the care and management of the stoma. Life with stoma Living with a stoma can be very challenging since it is not common with many people.

Once a surgical operation has been conducted and an opening created to dispose of human waste, it is imperative to care for the stoma at all costs (Burch, 2008). It is usually advisable to avoid meals that result in excess gas production. In addition, one should avoid engaging in rough sporting activities that might expose him/her to injuries on the stoma (Dougherty, & Lister, 2011). The role of the cancer nurse specialist A cancer nurse specialist is an integral part of the multi-disciplinary team involved in treating a rectal cancer patient.

The cancer nurse specialist standardizes the admission of patients in wards, organizes treatment appointments, and offers psychological support to traumatized patients (Valentini, Schmoll & Velde, 2012). In addition, the cancer nurse specialist educates the patient on strategies to adopt new life after treating in order to reduce stigma.                       As a healthcare professional, it is advisable to choose an appropriate approach to communicating bad news to patients and their loved ones.

An appropriate approach aids the affected parties to accept reality and cope with the situation (Berger, Shuster & Roenn, 2006; Vincent, 2010). Impromptu breaking of bad news can lead to further medical complications, and therefore one must be very cautious when conveying such information. Breaking bad news by healthcare professionals The approaches adopted by medical professionals to break the bad news to patients presently are above average as discussed in this paragraph. Medical professionals are trained on how to convey bad news to patients, spouses, and relatives (Zeppetella, 2012).

As a medical professional, the basic step in communicating bad news is to plan what to tell the patient. Prior planning is important since it prepares an individual on how to handle the patients and the reaction the patient might portray after receiving the news. The next step is to interrogate the patients in order to know the information he/she has regarding the illness (Ahuja & Nettles, 2014). The interrogation step is crucial as it gives the physician an insight into where to start when giving the bad news.

The other step is to study the patient in order to understand the urgency with which he/she awaits the news (Kinzbrunner & Policzer, 2011). This is a crucial assessment since it provides an idea of what information to give first in order to minimize the impact. The final step is to break the news. Communicating the diagnosis for critical illnesses is the most challenging experience for both the patient and the medical professionals (Holland & Frei, 2010).   Medical professionals should adopt a psychological approach in order to present the news in a chronological array that will not hurt both the patients and the loved ones. Barriers to the smooth delivery of bad news to patients Healthcare professionals related barriers Healthcare professionals form the basis for the effective conveyance of bad news to the patient or relatives.

However, some obstructions such as inadequate formal training on communication skills and language differences pose a challenge to the smooth breaking of bad news (Lilienfeld et al. , 2011). Healthcare professionals often rely on experience and forget about improving their communication skills.

In addition, sometimes doctors handle people from diverse ethnic and racial backgrounds and therefore language becomes a problem (Altman et al. , 2010).   As a result, the communication approaches chosen sometimes to break bad news are inappropriate and defective. Patient-related barriers The patient’ s perception and personality type are other obstructions to effective communication of bad news (Dark, 2013). Most patients rarely accept reality regarding the doctor’ s report and therefore breaking bad news becomes challenging. According to Nolte & McKee (2008), people have varied personality types and therefore react differently to bad news. This bars the healthcare professionals from effectively conveying the bad news to patients or patients’ relatives. Conclusion Conveying bad news to patients, their spouses, family, or relatives is a challenging practice that physicians regularly experience.

It requires outstanding communication skills. Healthcare professionals should always be considerate when delivering bad news in order to prevent eliciting other health complications to the recipients of the information.   The stakeholders in the healthcare sector should join hands in eliminating or managing the barriers to the smooth delivery of bad news to the concerned parties.      

References

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Altman, G., et al. (2010). Fundamental & advanced nursing skills. Clifton Park, NY: Delmar Cengage Learning.

Bayless, T. M., & Hanauer, S. B. (2011). Advanced therapy of inflammatory bowel disease. Shelton, Conn.: People's Medical Publishing House.

Berger, A., Shuster, J. L., & Roenn, J. H. V. (2006). Principles and practice of palliative care and supportive oncology. Philadelphia: Lippincott Williams & Wilkins.

Burch, J. (2008). Stoma Care. Chichester: John Wiley & Sons.

Cheah, W., Dollah, N. & Chang, C. (2012).Perceptions of Receiving Bad News about Cancer among Bone Cancer Patients in Sarawak General Hospital - A Descriptive Study. The Malaysian Journal of Medical Sciences, 19, 3: 36-42.

Cooper, J. (2006). Stepping into palliative care 2: Care and practice. Abingdon: Radcliffe.

Corner, J., & Bailey, C. D. (2009). Cancer Nursing: Care in Context. Chichester: John Wiley & Sons.

Dark, G. G. (2013). Oncology at a Glance. Hoboken: Wiley.

Dougherty, L., & Lister, S. E. (2011). The Royal Marsden Hospital manual of clinical nursing procedures. Chichester, West Sussex, UK: Wiley-Blackwell.

Fawcett, J. N., & McQueen, A. (2011). Perspectives on cancer care. Chichester, West Sussex, UK: Wiley-Blackwell.

Holland, J. F., & Frei, E. (2010). Cancer medicine 8. Shelton (Conn.: People's medical publishing house-USA.

Kinghorn, S., Gaines, S., & Royal College of Nursing (Great Britain). (2007). Palliative nursing: Improving end of life care. London: Baillière Tindall.

Kinzbrunner, B. M., & Policzer, J. S. (2011). End of life care: A practical guide. New York: McGraw-Hill Medical.

Kozarek, R. A., Chiorean, M., & Wallace, M. (2014). Endoscopy in inflammatory bowel disease. Cham: Springer

Lilienfeld, et al. (2011). 50 Great Myths of Popular Psychology: Shattering Widespread Misconceptions about Human Behavior. Hoboken: John Wiley & Sons.

Narayanan, V. & Koshy, C. (2010). ‘BREAKS’ Protocol for Breaking Bad News. Indian Journal of Palliative Care, 16, 2: 61–65.

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Otto, F., Lutz, M. P. (2014). Early gastrointestinal cancers II: Rectal cancer. Cham: Springer

Swan, E. (2006). Colorectal Cancer. Chichester: John Wiley & Sons.

Valentini, V., Schmoll, H.-J., & Velde, C. J. H. (2012). Multidisciplinary management of rectal cancer: Questions and answers. Heidelberg: Springer.

Vincent, C. (2010). Patient Safety. New York, NY: John Wiley & Sons.

Zeppetella, G. (2012). Palliative care in clinical practice. Dordrecht: Springer.

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