A Nurse's Take on Being There for Young Adults With Cancer
Debi Fischer is a nurse at the University of Miami surgical oncology step down unit. Prior to that she worked in orthopedics and neurology for many years. In addition to her nursing experience, she has earned a master’s degree in social work. Becoming a Licensed Clinical Social Worker was a lon-sought-after goal which she finally attained. She is a caregiver for her family and her dogs as well.
What can we, as oncology nurses, do to decrease young adult patients’ anxiety and improve their outcomes on their paths into the unknown?
As a surgical oncology nurse, I often work with young adult patients. When I think about them, two words come to mind: surprise and resolve.
Surprise, because almost no one expects young adults to get cancer. If there is a genetic cancer story at play in the patient’s family, then a cancer diagnosis may not come as a huge shock. The age of onset, though, may still be shocking. In the United States, cancer strikes more than 70,000 young adults annually. The National Cancer Institute categorizes a “young adult” as between 15 and 39 years of age.
The other word that comes to mind when I think about my young adult patients is resolve. I have noticed that younger patients with cancer have more determination to come through this experience one way or the other, and they are practical and realistic about their journey.
What can we, as oncology nurses, do to decrease young patients’ anxiety and improve their outcomes on their paths into the unknown?
Become a Great Listener
First, perfect your listening skills. You may believe that you are a good listener already. But what can you say to the patient who might be 2 or 3 decades younger than you? It has been my experience that letting the patient explain what has happened to them so far regarding their cancer treatment and their possibility to achieve remission is a good place to start.
Help Patients Adjust to Their New Normal
Be prepared to discuss young patients’ cases in depth with them. Often, younger patients are more matter-of-fact about their diagnosis and have researched their diagnosis thoroughly. They may even question you about things like the benefits of different types of foods or brands of bottled water. Older patients, I have found, are not as concerned with brand names. Other concerns for a younger patient may involve keeping their routine going if they still work or are attending school. They may want to discuss how to schedule their treatments around classes or jobs. Or if that is impossible due to their declining health, they may have very specific questions for their health care team due to their “new normal.”
Don’t Forget Mom and Dad
I find it amazing sometimes how adult patients’ parents, who might be in their late 60s to 80s, find the energy to wait on their adult child. Caregiving is a task that requires a herculean effort. Imagine the countless times this person walks to the nurses’ station to get water or an extra blanket. I marvel at the older relative taking their adult child for a spin around the hall with an IV going, and often in surgical oncology, (total parenteral nutrition) TPN infusing through their PICC line. It is as if they are saying, “world, we are still going to make it out of here and we are not giving up.”
The adult caregivers have their own set of needs. I have seen exhausted 80-year-olds who probably need to lie down. They probably have their own meds with them that they need to take. Offer some juice, water, coffee, and pudding if your unit has extra. Try to see what you can do to make things easier on the adult caregivers. Can you find a more comfortable chair for them to sit in as they keep their child company? They may be at the end of their proverbial ropes in trying to help their cancer-stricken adult child. Creature comforts such as blankets, a recliner, and a folding bed go a long way. Maybe they need to speak to a priest, minister, or rabbi if their child declines. Sometimes, even a hug at the end of a shift can help this parent who never expected to find themselves in this situation.
Keep Them Comfortable
What else can the oncology nurse do for this young patient? Make sure they are occupied. Try to ensure that their TV is working and the wi-fi connection is set up. Also, give them privacy when they want to wind down and when they want to have visitors. Imagine going into a room full of 20- somethings all there to visit one of their buddies. It can be quite depressing to witness this scene, but also, quite inspiring.
Oncology nurses often wonder, especially during quiet moments in the middle of the night, how all this could be happening to someone so young? None of us have that answer. We can just try to help the younger patient navigate their road.
Adolescents and young adults with cancer. National Cancer Institute website. cancer.gov/types/aya. Accessed Sept. 5, 2018.