Nursing Oncology

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Nursing Oncology Essay

Clinical weakness has been established a major course of muscle weakness in the long run hence weakening the functionality of the elderly as a result of mechanical ventilation. This article aims to appraise the physiological reactions to a timely consistent flaccid exercise protocol with an objective of preventing muscle weakness especially in adults who require mechanical ventilation. Mechanical ventilation has become a useful medical procedure in nursing oncology that rejuvenates the functionality of a patient’s body by repairing the old muscle tissues and replacing them with functional new ones. The article focuses on the benefits of early exercises by evaluating the effects of this nursing strategy.Nursing Oncology Essay

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The results of this experiment are quite promising outcome in patients subjected to early exercise showing stability of cytokine levels hence providing physiological foundation for benefits of early exercises. The primary cause of muscle weakness is critical illness. The critically ill condition fatigues the tissues in human body and hence faulting the required functionality of the different organs within the human body. Fatigue of the muscles leads to inflammation. Fatigued organs hence reduce their functionality in the body.Nursing Oncology Essay

Introduction
Research indicates that elderly are in a great risk of suffering from muscle weaknesses since their muscles having been exposed to greater strains than those of the young people. Fatigue reduces the mobility of a patient hence diminishing the muscle mass of the immobile part. Diminishing muscle mass means an individual has less strength and hence the body can resists to small amount of threat. It is for this reason that the elderly people are more prone to bacterial and physical attacks since the body has a minimal ability to fight the strain brought in by the bacteria.Nursing Oncology Essay

Mechanical ventilation therefore set in as a very importance procedure to rejuvenate the diminishing muscle and sustain the ability of the different body tissues to perform their unique role in the human body and slow down the process of aging. With fatigued muscles, the recovery processes becomes quite complex and overwhelmed by unnecessary setbacks. This is a major reason why the elderly patients tend to spend much time in the hospital beds nursing the setbacks of their recover process in comparison to the young patients who recover rather fast and effectively.

To help the elderly recover from critical illnesses successfully, medical practitioners have established mechanical ventilation as the most appropriate way of sustaining the muscle functionality of an elderly patient hence ensuring that the different organs in the human body are functioning at their best level. However, it is important to note that mechanical ventilation is quite a sensitive medical procedure that requires state of the art facilities to enable a successful procedure. Unfortunately, these facilities are available in very few medical facilities across the globe.Nursing Oncology Essay

In fact, only 15% of the health care facilities across the globe can afford the right equipment to facilitate successful mechanical ventilation. Not forgetting that there are certain cultural principles upheld across different cultures that might not authenticate the procurement of a mechanical ventilation process no matter how critical the patient needs such a procedure. The medical practitioners are therefore faced with serious challenges in the form of resources as well as socio-cultural beliefs upheld across different cultural set ups. We are caught in medical dilemmas at some point in the quest of identifying the way to overcome a certain ailment.

According to research, mobility is probably the only method of strengthening the body muscles that is acceptable across the divergent socio-cultural set ups across the globe. The most important thing is however the realization that mobility is indeed a readily available method of strengthening the body muscles of a patient hence equipping the patents body with the endurance and strength required in the mechanical ventilation procedure. Nursing the elderly patients is characterized of greater risks in comparison to nursing the relatively young patients. To reduce the risk of mortality of the elderly therefore, different health care facilities have embraced the early exercise approach as a preliminary requirement to strengthen the muscles of the patient prior to the mechanical ventilation procedure.Nursing Oncology Essay

Nursing oncology has certainly brought in the techno-modern health care aspect that lacked in past. It is a change that increases the hopes of procuring successful muscle rejuvenation procedures hence sustaining the body functionality of the elderly. It is however prudent to administer a patient to early exercise to reduce the risks affiliated with critical illness. The changes witnessed in the health care sector supplement the endless research activities aimed at mitigating the adverse effects of muscle weaknesses and inability of the elderly to respond positively to health care procedures. Mechanical ventilation encounter has personally increased my medical care experience and hence it can effectively administer and manage the condition of different patients depending on their age, health risk and financial ability.Nursing Oncology Essay

Oncology nurses in their professional life experience unique, challenging and rewarding relationships in a multidimensional way. The aim of this study was to describe, from their perspective, how they experience and react to this world and how much are they satisfied with their work. Through this study, I want the oncology nurse’s voice to be heard and that the derived data to be applied to the benefit of the field of oncology at least in the specific area where the study is performed. In-depth, semi-structured phenomenological interviews were done. Findings show that the oncology nurses, dealing with cancer patients and their families, experience many different relationships, rewarding experiences and stressors and a number of ways of their coping with them. The challenging interpersonal relationships with management and other members of the health care team are also highlighted. This enables the oncology nurse to be both on the giving and receiving end of the intensely emotional environment they work in.Nursing Oncology Essay

LITERATURE REVIEW

According to World Health Organization, deaths from cancer are on a rise with an estimate of 12 million deaths in 2030. (Fact sheet, feb 2009). The majority of nurses, in all practice settings, will feel the impact of the disease at some time during their career and this impact affects the care they provide. According to Bott, M., Endacott, R., Watts, R. (2006), “The nurses in this study reported that they constantly faced a number of professional and personal issues when addressing the practical, emotional, and psychological demands of patients with cancer. There was a general recognition of the uniqueness of each patient’s needs and that these needs could change over time whether it be the timing of the provision of information or assisting the move from curative to palliative treatment”. According to Papadatou, D., Papazoglou, I., (2002), “It became apparent that health professionals’ grieving process was affected by how they perceived their role, interventions, and contribution in the care of the dying child, which in turn was influenced by the social and cultural context in which care is provided to children with cancer” (p.1).Nursing Oncology Essay

The oncology nurse is challenged by the fact that every cancer case, every type of cancer the course of every cancer illness and the way patients and families responds to this illness is different. Now, more than ever, competent nursing care is a basic right of cancer patients and their families alike. Every individual expresses grief differently and same is the case with health care providers of terminally ill patients. According to Papadatou, D., Papazoglou, I., (2002),”Physicians’ grief reactions involved crying, sadness, withdrawal, and recurring thoughts of the dying conditions and the death of the child. They frequently reported guilt feelings and an active search for philosophic explanations that would make their distress more tolerable. They rarely sought support among colleagues and experienced grief as a private affair”.Nursing Oncology Essay

In addition to grieving, nurses undergo a number of stressors while working with dying patients and to cope up with them, supportive, constructive and understanding work environment is essential which would aid in improving job satisfaction. According to Bott, M., Endacott, R., Watts, R. (2006)., “The findings from this study suggest that professional support is an area that may be improved in an effort to improve job satisfaction”.

Working as an oncology nurse has been a life changing experience. I have grown not only as a nurse, but also as a person. My eyes have been opened to the value of life, and not just life itself, but the precious thing that is a healthy life. I cannot count the number of patients from the beginning of my nursing career until now that have told me, “Well, I just didn’t think my symptoms were a big deal” or “The doctor told me I needed additional tests but it didn’t seem important at the time and I didn’t have any money”. The lack of patient education and provider follow-up in situations such as these is disheartening to observe. Experiences I have had with patients combined with their life stories have fueled my desire to become a family nurse practitioner. A healthy life is something that I want everyone to know.Nursing Oncology Essay

Besides this, it is important to note that professionals working with cancer patients will need the necessary knowledge and skills to acknowledge and explore patient’s feelings if they want to give them the reassurance and care they need. It then becomes obvious that significant demands are placed on nurse’s skills, knowledge and emotional resources. According to Bott, M., Endacott, R., Watts, R. (2006),”They found that nurses’ self-perceived educational needs in caring for patients with cancer included the need for more knowledge and skills in providing psychosocial care and communication”.

Nurses play a significant role in oncology nursing as the practice entails the roles of direct caregivers, educators, psychosocial support, consultants, supervisor, and researchers. Health promotion in the nursing field enhances the patient’s enthusiasm towards maximum health status, while altering their lifestyle to achieve self-motivated stability of bodily, poignant, collective, divine, and logical health. Lifestyle changes can be achieved through learning experiences that promote awareness and boost the patient’s motivation. Nursing Oncology Essay Furthermore, by exposing families and patients to opportunities and environment that makes it easy to participate in healthy practices serves as the means to the same end. Thus, this research paper aims at elaborating on the role of oncology nursing in availing care to cancer patients and families during treatment and the challenges they encounter. It also discusses the initiatives through which suffering and death due to cancer should be eliminated.

Oncology nurses offer specialist care to patients with cancer and this is extended to the patient’s families as he/she moves along the disease path starting with diagnosis to treatment and health restoration. Alternatively, the patient may enter remission, to relapse, and eventually death. Thus, the nurses should employ the nursing process in assessing the patient’s needs as well as the family needs as identified in the Oncology Nursing Society (ONS) (Wilkes & Burkes, 2013). These include early detection and prevention, providing the patients and families with the necessary information on how to cope, the right diet, and how to protect the family members. Additionally, it is imperative to assess their mobility, sexuality, and ventilation of the patients’ rooms while making sure they are properly oxygenated. More so, the nurse should identify alternative and complementary therapies, palliative, and end of life care and survivorship. Additionally, in a bid to improve and defeat cancer, the oncology nurses should use factors such as communication, community development, education on better health practices, and organizing workshop to educate the patients and families on better health practices (Forshaw, 2016).Nursing Oncology Essay

Role of oncology nursing
Oncology nurses’ primary concern is the well-being of the cancer patients and their respective families by offering physical and emotional support. Cancer care requires a committed team of healthcare expert with absolute knowledge, clinical skills, and opinionated and in-depth understanding of the needs of cancer patients (Barton, Wilkes, & Ingwersen, 2001). More so, for oncology nurses to be competent in their roles, it is imperative for them to work hand in hand with the physicians, nutritionists, pharmacists, psychologists, spiritual leaders and psychiatrists in providing comprehensive care to the patients as well as their families.

According to Barton, Wilkes and Ingwersen (2001), Oncology nursing roles vary from focusing on cancer patients’ care, community screening, detection, and cancer prevention. Additionally, nurses perform an assessment of the patient who has cancer while educating them on ways to cope with the disease. It is through provision of direct patient care that nurses are able to manage cancer symptoms while providing supportive care to the patients and their families. In addition, other oncology nurses focus on improving patients care by carrying out cancer-related research conducted through clinical trials. In situations wherein care is afforded to the cancer patient, the oncology nurse has the responsibility of guaranteeing round the clock care to the patient’s “direct-care” through monitoring and observation while documenting patient’s assessment, judgments and the intervention methods used. Notably, it is the role of the oncology nurse to avail to the patients and families with accurate and consistent information regarding the course of treatment, the methods of administration, and the potential risks that might arise due to the side effects.Nursing Oncology Essay

Further, oncology nurses play the role of patient’s advocates. They assist them in making clear, and concise decisions regarding treatments based on the patient’s goals, values, and communicating these decisions to the medical team. Precisely, it is the role of the oncology nurses to listen to and make their patients comfortable in voicing out their fears and anxieties. In addition, oncology nurses plays an important role in the research setting as he/she assists the patients in understanding the purpose of the procedure, benefits, and risks associated with it while making them aware of the impact of the procedure or treatment on their lifestyle (Barton, Wilkes & Ingwersen, 2001).[Need an essay writing service? Find help here.]Nursing Oncology Essay

Challenges Facing Oncology Nursing
Difficulty in collaborating with the various organizations specializing in the field of oncology is the main challenge facing this field of nursing. In addition, the increasing knowledge of on the safety and efficiency of the chemotherapeutic agents is a common challenge in oncology nursing as nurses are forced to administer chemotherapy in outpatient clinics, oncologists’ office, or the patient’s’ home environment. This presents oncologist with the difficulty of working with the chemotherapeutics agents in a similar manner as the research nurses and inpatient medical nurses (Barton-Burke, Wilkes, Ingwersen, & Barton-Burke, 2001).

Ethically, oncology nursing is facing a range of challenges ranging from moral uncertainty, moral dilemma, and moral suffering. The moral dilemma is a situation where the nurse is uncertain of the prognosis given to the patient by the attending physicians, thus, to avoid confusion, the nurse is forced to withhold information. Moral dilemma refers to the doctors’ aim on prolonging patient’s physiological life without considering life’s quality and disregarding the significance of informing the patient or his family thus leaving the burden to the oncology nurse.

According to Grundy (2006) body image is a challenge observed in many patients as they undergo cancer treatment especially from surgeries and chemotherapy their body structure is subject to alteration and these changes have an impact on their self-image, confidence, and sexuality confidence.Nursing Oncology Essay

Health promotion in oncology nursing
Several health promotion strategies can be implemented in assisting cancer patients to improve their overall health conditions. These include participating in physical activities, offering nutritional support (Varricchio, 2004). Consequently, management of their healthcare providers and medical regimens while adjusting their lifestyle. Physical activities comprise of taking strolls, riding bikes, and swimming while the nutritionist advised them on the significance of eating fruits, vegetables, diet supplements, and avoidance of foods with additives.

Varrichio (2004) asserts that access to health care and medication is of paramount to the cancer patient. Thus, an emphasis is placed on communication, as it is fundamental in coordinating care among consultant and cancer- care providers as the patient moves through the trajectory of cancer treatment and beyond. Finally, in a bid to promote their health, cancer patients are advised to perform some adjustment in their lifestyle such as stress avoidance, energy conservation, and requesting for assistance. Stress and energy conservation is achieved when the patient participates in activities such as yoga, relaxation exercises, and acupuncture.

Conclusion
In conclusion, it is imperative for nurses to educate the community on the importance of undergoing the cancer-screening process. The process gives nurses an opportunity to educate individuals on the necessary behaviors in reducing risks, and the symptoms to watch out for. Thus, giving nurses greater chances of detecting cancer-related disease in its early stages and warranting better chances of outliving the disease as opposed to the later stages, thus, lowering cancer death rate. Additionally, nurses and physicians should have a clear line of communication to avoid misinforming the patients on their prognosis and finally, patients and families should be educated on health promotion strategies.Nursing Oncology Essay

In order to provide holistic care, lots of things need to be born in mind. According to Rooven. V., Roux, D.L., & Kotze, W.J. (2008)., “the multifactorial effects of cancer have a serious impact on the psychological wellbeing of the oncology patient. For oncology nurses who want to render holistic care to patients and their family, these have important implications.”

The aim of the study is to explore the perceptions of oncology nurses and ruling out what affects the care they provide.

PROBLEM STATEMENT

Since I work at an Oncology Unit, I come across a number of terminally ill cancer patients regularly and I know that, in providing for the unique needs of cancer patients and their family, a broad variety of experiences and feelings are encountered. Therefore, I would like to explore that what do oncology nurses feel while caring for such patients and that whether their experiences are limited to extremely stressful feeling or it can be rewarding as well. These experiences, and how nurses cope with them, are illuminated in the interviews and their analysis.

In order to highlight the above problem statement, the research question is formulated as: What are the Oncology Nurse’s lived experiences and perspectives about end of life care of terminally ill Oncology patients?Nursing Oncology Essay

The objective of this study was to accurately describe the lived experiences of the participating oncology nurses.

RESEARCH DESIGN AND METHODOLOGY

This study was based on a qualitative, explorative, and descriptive research design of inquiry. The focus of the study guided the selection of the participants. Purposive sampling design was used. All of the participants were, at the time of the research, working full time in the specified oncology unit. The sample included eight registered nurses with an experience of about two years or more.Nursing Oncology Essay

Participants were informed about the aim of the study, the voluntary and confidential nature of their participation, as well as of the possible benefits and outcome of the study and permission to do this study. For this, informal informed consent was taken by all participants.

DATA COLLECTION

The data was analyzed and was initially systematized and then core themes and sub themes were identified. Semi structured interviews were conducted and open ended questions were asked. Questions focused around five major themes. These included their interest in Oncology (did they chose working in Oncology as their practice areas by themselves), their perspective about terminal illness, motivation to work in the field (what factors made them continue working in Oncology), major challenges and responses (how they managed with the stressors they come across while dealing with patients and the work environment) and satisfaction with work. These themes were based upon the research questions that guided the study. The sub themes included nurse’s personal experiences with death and illness, stressors and rewards, their coping mechanisms, their degree of satisfaction and whether they desire to stay or leave the unit.

DISCUSSION OF FINDINGS AND RESULT

The participants shared different experiences, both positive and negative. One central theme was common. All of the participants experienced that the field of Oncology, though challenging and highly demanding is very unique and rewarding as well. They dealt with difficulties and knew how to cope up with them. The analysis follows as:Nursing Oncology Essay

Decision to work in the field of Oncology

All the participants had an experience of about more than two years, while it ranged from 2.1 to 12 years. Most of the nurses didn’t decided by themselves to join oncology. They were assigned by hospital administration (nursing services). The nurses reported that they were initially unhappy and anxious because it was not their prioritized area. However, within a short span of time, they reported to overcome their reservations.Nursing Oncology Essay

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Terminal illness

The analysis showed that a number of participants took terminal illness as a stressful event. They related terminal illness with poor prognosis, where no other treatment option works and when death is near. They reported that they associate terminal illness with hopelessness. They felt that when there is no hope of living and no cure could be done and when death is near, the stage is terminal illness. This feeling, they said is very upsetting because one knows that there is not a lot that could be done. Comfort care is the only cure for their patients at this stage of their disease.Nursing Oncology Essay

Motivation to serve oncology

Despite a number of stressors, oncology nurses highlighted significant rewarding experiences as well that motivated them to work in oncology. These included caring for someone who is in much greater pain and discomfort than any other patient with any other form of illness. Participants reported that cancer is a suffering and is a disease that progresses gradually. When one sees their patient deteriorate slowly over time, losing their energies to fight back, it becomes a responsibility for them who know the required knowledge and skill to help alleviate their suffering and pain. A few also reported that they come across the feeling of sympathy when they see them suffer and this makes them work in every possible way they can. Others feel empathetic towards them. Some reported that caring in last days of suffering patients gives them a sense of satisfaction. One of them reported that it is like a worship to care for them.Nursing Oncology Essay

Major stressors and challenges they encountered

Two main categories of stressors were highlighted. Firstly, difficulties related to the poor prognosis and death of cancer patients and secondly, work place stressors.

Findings reveal that the major stress resulted because the participants felt powerless and helpless because of their inability to decrease the pain and discomfort that resulted because of the course of disease and the side effects of the treatment modalities (chemotherapy and radiation). Other stressors included the denial of patients about their progressive disease and the denial of families at the announcement of death of their loved ones. Dealing with the grief the family members feel and their non acceptance becomes a challenge for the participants. The participants reported that they feel depressed and worried about uncertain situations that could happen any time with their patients. Sometimes, it is very difficult to explain patients and families about their disease prognosis as well as their treatment options because of their different level of intellectual understanding and because of their varied languages and multiple cultural influences. Responses to death differs form custom to custom. Few of the participants also reported that some times, on the announcement of death, families respond strangely and that their violent behavior becomes a threat to the security of other patients, their families and the working health care team. Besides, a few participants stated that after their patients depart, when they go back into the departed patient’s room or at their bed-side, they recall all the memories of them and become upset. Few participants reported that since they cannot directly help the families financially, seeing them suffer from economic crisis is also very difficult.Nursing Oncology Essay

Other findings reveal that there are other areas of concern that are challenges for the participants. These include shortage of nursing staff at the time of acute emergency. Because of the staff turnover, nurse’s retention is less which leads to heavy work load upon remaining working staff. The participants reported that since oncology is a critical area and is very demanding and challenging in terms of quality of time required by dying patients and their families, more of the skillful and competent nurses are needed to carry out the need. Others say that since nurses have been recruited in oncology not on the criteria of priority, they are less skillful and competent to deal with acute oncology emergencies and grieving processes. This becomes another big challenge. Interpersonal relationships with colleagues and other members of the multidisciplinary team is sometimes also a constraint in providing quality care to patients.Nursing Oncology Essay

Coping strategies

There was a balanced response when the question regarding the impact of the care they provide under stress, was asked. Participants reported that it does not affect them at all, because they see patients as someone in dire need of their service and they do their best in all sorts of circumstances with their knowledge and skills. However, there were others who said that when mentally disturbed, care is affected. Cancer patients consume more time than other patients and in providing them so, rest of the patients gets less attention. On the question about how they cope up with these challenges and stressors, multiple responses were gathered. Participants reported that they seek in-depth knowledge on the specific disease and its management and practice more in order to remain confident while dealing with their patients and communicating with their families. Besides, they work with interdisciplinary team to approach positively to the patients. Nursing Oncology Essay This includes seeking support and help from doctors, nutritionists, pharmacists, radiographers, pain management team etc. Some reported that since they know that there is no other who could take care of them competently, they are the only ones. This thought gives them motivation to move on and remain optimist and hopeful. Additionally, there were some, who said that they were fortunate enough to get such a huge opportunity to help the sufferers. There were some, who shared that the management personnel help them in managing their daily stressors. They counseled them with their knowledge and experience and guide them well. Few also mentioned that discussing issues with their colleagues and close friends in their available time helps reduce their stress. Few also shared that the more they communicate with patients and families, they more they feel relaxed and positive to move ahead.Nursing Oncology Essay

Satisfaction

There are different responses over the question of degree of satisfaction while working in oncology. Few of the participants replied in assertion. They stated that they are very satisfied with the type of work they do. They justified this by giving reasons that they are blessed to have an opportunity to serve someone who needs them the most and since they have, with time, learnt the skills and have knowledge how to manage such patients, they have a desire to do more for them. There were others, who stated that they are not satisfied in oncology and feel that this domain of nursing is depressing, cancer is not curable despite you put in all your efforts and that life for these patients is miserable. A feeling that cancer patients will depend upon their families one day completely in doing all activities of daily living, is bad and they cannot see these patients suffer that badly.Nursing Oncology Essay

Despite of all of whatever participants highlighted, no one reported to have a desire to leave the field of oncology. All reported that they have with time, adjusted in the field, caring for such patients and they never want to leave them. They said that despite of our dissatisfaction with the field, we have adjusted to work with the dissatisfaction and there still is feeling to work for them.Nursing Oncology Essay

When asked, what should be done to improve job satisfaction, they enumerated a number of things. Motivation, positive feedback and appreciation from the management will help them a lot. Besides, staff counseling on a regular basis and frequently allowing staff members to ventilate their feelings will be of beneficence. Additionally, staffing should be adequate and more on that, competent, skillful and responsible staff nurses are needed and that nurses who are interested in joining oncology should be given priority by the nursing services to work in the field. Moreover, application of nursing theories should be included in practice. Management should give ample time to increase the knowledge, skills and application of the critical concepts of oncology.Nursing Oncology Essay

LIMITATIONS OF THE STUDY

The specific limitations that enumerated below:

  1. Because of the sample size and the nature of the study, generalizing the findings is difficult. However the richness of the data provides insight into the experiential world of the oncology nurses.
  2. Interviews were conducted only in one teaching tertiary care hospital’s oncology unit. It did not included data from out-patient settings.Nursing Oncology Essay

RECOMMENDATIONS FOR FURTHER RESEARCH

In the light of research findings and limitations, following recommendations for nursing practice, education and research is formulated:

  1. A detailed support programme could be developed for oncology nurses in order to rule out their stressors and find ways to resolve them and that management needs to be sensitized regarding the unique needs and challenges of oncology. This can be done by organizing frequent meetings and discussion sessions with them, hence boasting up job satisfaction.

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  1. More emphasis should be given from the management side to assess and facilitate the nurses about core concepts of oncology and palliative care.Nursing Oncology Essay
  2. In-service programmes and workshops need to be developed to enhance the skills of nurses working with terminally ill patients.
  3. The management should consider the need for increasing number of competent care providers for such a critical and demanding field of oncology.
  4. Themes identified from the study could be explored more using quantitative research approach.

CONCLUSION

The study provided evidence that the field of oncology is a unique field that differs in many respects from other areas of nursing. Nurses in oncology, more than any other field, recognize the essence of giving. They recognize that an important dimension of being human is the lasting dignity that should be continued throughout the chronic illness of cancer. A lot needs to be done to soothe the dying clients. Field specific knowledge, hands-on skills and positive attitude is all that is required to meet the challenges of the filed. Nursing Oncology Essay