ONS Connect - March 2008 - (Page 17)

UpClOSE&prOfESSiONal Nurses Discuss Working With Challenging Patients [By Camille A. Servodidio, RN, MPH, CRNO, OCN®, CCRP, Contributing Editor] Lynne Rossier, RN Beth Gouge, RN C aring for patients with cancer can present challenges; however, Beth Gouge, RN, a clinical nurse in oncology at Memorial Health System in Colorado Springs, CO, and Lynne Rossier, RN, oncology staff RN for Cancer Care Associates in Royal Oak, MI, both demonstrate a willingness to face those difficulties. “I remember my first 92-year-old end-of-life patient whose children had a difficult time deciding if their mother should become a do not resuscitate (DNR) patient,” Beth recalls. “Although the patient had enough and did not want any more treatments, her children were not ready to let go. Interestingly, it was the respiratory therapist who was able to coach her children to become comfortable with a DNR order for their mother.” “There will always be people we consider ‘difficult’ or angry,” Lynne says. She tries to remind herself that patients’ anger is directed toward the disease and/or treatment and is not a reflection of their feelings toward her. “One of the hardest things to learn as a nurse is not to take a patient’s frustration or anger personally,” Lynne says. “On rare occasions, a patient is so angry or so impatient that a nurse is rendered completely ineffective. Our unit’s strategy is to have another nurse take over the care of the patient.” Beth has experienced demanding patients, those in denial, and those with unrealistic expectations. She seizes every opportunity to educate her patients. She encountered a personal friend, who was a patient on her unit, who said, “If it ended now, I would be okay with it.” She encouraged him to fight and pointed to a picture of his children and grandchildren to remind him of his family. Lynne says that she tailors her approach according to each patient. “Some patients like discussion, some like quiet, and some require more input.” She recognizes that “it’s important to treat each person in a way that is most comfortable for them, and not what makes us comfortable.” Lynne remarks that noncompliant patients can be very difficult. She finds it frustrating when patients complain about side effects but will not comply by taking their pain or antiemetic medications. Beth relies on resources such as fellow nurses, the charge nurse, and multidisciplinary team members to assist in such situations. ✱ Contributing Editor Camille A. Servodidio, RN, MPH, CRNO, OCN®, CCRP, is an RN coordinator/project director for the Connecticut Breast and Cervical Cancer Early Detection Program at the Hartford Hospital Cancer Clinical Research Office. March 2008 ONS CONNECT 17

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ONS Connect - March 2008 Contents Editor's Note Just In From Then to Now A Year in the Life—Month Three Web Connect Capitol Connection Notice Nursing Now Recognize Hepatic Sinusoidal Obstruction Syndrome in Patients With Cancer Caregiver Care Elasticity of Cells May Help Researchers to Identify Cancer Calendar of Events ONS Congress Your Thoughts and Comments Are a Valued Decision-Making Resource Staying On Top

ONS Connect - March 2008

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