A Cancer Journey – See the person as well as the disease.
Audrey Griffin is a remarkable woman. She contacted us at the beginning of her treatment for a second cancer of the breast because she had heard that we were developing material to help students prepare for professional healthcare practice. She gave permission to put the interviews and her name on the open access project website and to use them in whatever way we felt may be of benefit to students.
From time to time you may come across blogs from other brave individuals who are going through a bad time and each one will contain a range of thoughts, experiences and information. The best way for all healthcare students to better understand the best way to practice their craft is to observe others and to learn from their patients who are, after all, simply people who are dealing with a health threat that could one day come our way. For further learning please view “For a Doctor, Survival and Transformation – When a Doctor Becomes a Patient”.
J Fam Pract. 2004 Apr;53(4):299-306. Self-doctoring: a qualitative study of physicians with cancer. Fromme EK1, Hebert RS, Carrese JA
Audrey’s story is intensely personal but in no way unique. The views that she expresses are all her own but the questions that were asked come from her discussions with a medical practitioner who has been talking to patients for more years than I can remember.
You can listen to each of the 3 interviews by clicking the links at the bottom of this page in your own time or follow this post to get a feel for the main messages that Audrey gives us.
She talks about how care should be personal and be person-centered and not cancer-centered.
Audrey describes how we should treat people who are going through a difficult journey. She tells of good treatment and support from her oncology team who deal with her concerns and fears, give her time despite being busy, how they don t use jargon and put her at her ease by being relaxed, open and genuine. They don’t judge and seem to understand what is going on inside her head.
She reminds us that she is a ‘person not a patient’.
PERSON CENTERED CARE
Think About:
Staying calm and maintain eye contact
Remember to preserve people’s dignity
Watch how others talk to and examine patients
However, we know that sometimes it can go wrong. Gives examples of poor care particularly when she was examined and a lump was found and the doctor just ordered the nurse to organise a mammogram without even talking to her. He didn’t even look at her face and then left. She felt like a specimen on a slab but the nurse came over and held her hand.
Think About:
Did anyone feel uncomfortable?
Were they put at their ease?
Think about someone who was difficult to talk to and someone who seemed happy to see you and how you can help people feel involved in a conversation
EXAMPLES OF IMPERSONAL CARE
Support comes from different places; from family and friends and during treatment from fellow patients.
It is hard to tell her family and felt there was no special support for them. It is very hard for families because it is difficult to share their concerns and worries. Her friends were great as she is very close to them and felt she could tell them more about her concerns than her parents because she didn’t want to hurt them. Her friends were instrumental in her recovery.
Support during treatment: what were the high points? The good bits were her oncology team because they are approachable, contact is easy and the nurses are great as well with phone contact at any time but really helpful to meet other patients who are at different stages of the journey and they give her a lot of information. We are all in it together.
SUPPORT FROM FAMILY & FRIENDS
When treatment is over, survivor-ship and looking forward becomes important. The continuing follow up by the oncology team is OK but extra support with her well-being would help you move along the journey. A health programme would be advantageous. Counselling will wait until treatment is nearly finished because that is when she takes back control and so she needs help with setting goals.
SUPPORT DURING AND AFTER TREATMENT
Think About:
How do we help her deal with her fears and feelings?
How do we deal with our emotions during a consultation?
Part of feeling some control is in sharing in decisions about treatment. There are two clips that show how she gained from being assertive and how she takes some control over her future health.
SHARED DECISION
PATIENT CONTROL
My feeling is that we don’t gain much from ‘asking permission’
So how do we develop the skills and attitudes that make us better practitioners?
The basics of ‘communication’ are taught in clinical skills labs and the challenge for the student is to translate this into clinical practice. Clinical placements offer a privileged opportunity to listen to our patients; to observe our tutors and to identify the things that we need to improve.
An educational portfolio is a useful vehicle to list the learning needs and to compile the various clinical encounters that help address these needs. Read more about this at http://www.eprepp.ie/eportfolios/.
This process of reflective learning is the ability to reflect on an action or experience to ensure continuous learning. This is a process that will stand you in good stead all through your professional career. Read more about this at http://www.eprepp.ie/learning-by-reflection/
To View the Cancer Journey Videos in full please click below :
A Cancer Journey – After the Diagnosis
A Cancer Journey – Dealing with Treatment
A Cancer Journey – After treatment