I’m guessing that most patients hold nurses in relatively high esteem. Without them, the system grinds to a halt.
Nurses are often referred to as ‘angels’ or ‘heroes’ with superpowers to overcome adversity and whatever is thrown at them although Stokes-Parrish et al (2020) strongly reject these labels because they fail to truly recognise that nurses
……are skilled critical thinkers, strong leaders and managers, compassionate patient advocates, dexterous practitioners, and empathetic communicators.
Well, some are, plenty aren’t.
The superficial labelling of nurses as invincible and self-sacrificing can lead to unrealistic expectations and can detract from the skills required to perform the role.
Nurses are human and like any other profession, they are not a homogenous group. Some are good and some less so.
From an oncology patient point of view, I have seen the full spectrum over the years and the best really stand out. But then so do the worst.
When nursing care is at its best you feel it and it extends far beyond compassion, concern and kindness. It’s a relationship.
The challenges of oncology care require intelligence, critical thinking, and problem-solving skills and as a patient I see that.
But what really makes an impact is the humanity of nurses who are able to spend time with you whilst still being rushed off their feet. They chat, they remember, they connect, they make a difference.
Being a cancer patient is a very scary experience and especially so as an in-patient. You need to know that you are not one of many on the conveyor belt of suffering. You need to feel valued as a person.
Helping patients through their cancer journeys and treatments has many rewards and can provide nurses with profound satisfaction. But it can also be challenging and stressful.
In this regard, not all nursing care is equal and experiences can be mixed.
Some nurses are running on empathy and other nurses are running on empty.
When front-line oncology nurses are dealing with devastating diagnoses and overcrowded oncology clinics on a daily basis this places intense emotional demands on them. Add into the mix, workforce shortages and nurses are fighting fires.
What happens next I’ve seen many times before – compassion fatigue sets in and this can progress to burnout.
There is an important distinction between the two here.
Burnout is caused by a stressful and negative work environment characterised by exhaustion and cynicism.
Compassion fatigue is caused after prolonged and intense exposure to helping suffering patients, resulting in decreased ability to care, expend energy, or exhibit empathy and compassion.
When nurses are physically, emotionally, and spiritually exhausted then care becomes very matter-of-fact, routine and anonymous. It’s at this point, nurses struggle to empathise with their patients. I know, I see it all the time!
The technical part of their work is done pretty much on auto-pilot but patients can be de-personalised and seen as just one of many that come through the doors.
As Black et al (2014) note, “Notably, clinicians with compassion fatigue can still function well, but perhaps not consistently at the peak level they could normally achieve.”
We all want nurses who care for us to be doing their job at ‘peak level’ but this just isn’t possible. There are all manner of personal and professional pressures that impact on anyone’s ability to do their job.
I think one of the most important factors at play is the culture on the ward and what is allowed to happen there because that is something that patients pick up on and notice.
Oncology nurse managers have a critical role to play in creating the conditions for meeting the physical and psycho-social needs of patients and for patients to feel like they matter…..because we do.
Patient centred cancer care should be respectful, responsive and tailored to patients’ needs and preferences (Alessy et al, 2022).
A new professional framework to support those who provide care to people with cancer has now been released and it’s worth taking a look as a patient to make sure that you are receiving the care you should be getting.
Most patients are well aware of quality issues in cancer care but not everyone is always willing to report candidly on these.
If you see someone going the extra mile then tell them! Equally, if you don’t feel like you are getting the care you know you should, speak up or ask a patient advocate to do that for you.
Not everything will run smoothly in our care and there will always be a mixture of positive feedback, negative impressions and areas for development. Unless we say what they are, not much will change.
As Bourque and Loiselle (2022) note, interactions in cancer care have significant ramifications for both overall care experiences and health-related outcomes.