Teachable Moments in Misconceptions
Alene Nitzky, PhD, RN, OCN
Alene Nitzky is an oncology nurse, author of Navigating the C: A Nurse Charts the Course for Cancer Survivorship Care, Blue Bayou Press, 2018. She is a cancer exercise trainer and health coach, and is CEO/Founder of Cancer Harbors®.
Nurses can advocate for patients by opening eyes and minds at every opportunity.
As an oncology nurse, I hear all sorts of odd statements and perceptions about cancer. Sometimes it’s plain ignorance or insensitivity, and other times I am blown away when I hear a healthcare professional say them too.
I know I’m not alone in this experience, and I always like to think of these as teachable moments. I feel it’s my duty to correct or at least attempt to educate people who make these comments about cancer. No one is perfect, and we all have put our feet in our mouths before, but as healthcare professionals, we need to have empathy and think before we speak. We also have a duty to educate the public by correcting misconceptions about cancer.
Having empathy for the person who needs education is necessary too, but it’s important that we make them think. Examine these statements and think about how you, as a nurse, might be able to improve things for patients from these opportunities to open someone’s eyes or mind.
1. “You’re an oncology nurse? That must be so depressing!” Or “You must be an angel!”
I can’t do anything about their association of nurses with angels (last I checked I couldn’t find my wings or halo) but I think their intentions are good in saying that. I do like to educate them on the things nurses actually do instead of being cherubs flying around from room to room tending to the sick.
I tell them I don’t find it depressing. What I do find sad is when there aren’t enough nurses to take care of all the patients. But helping patients manage their symptoms and spend as little time in healthcare facilities as possible requires understanding of their disease process, their treatment, and how we can intervene to make them more comfortable and prepare them for independence and better functioning whenever possible.
Yes, it is emotionally taxing to get to know patients and their families and see some of them die. Knowing that you made them comfortable and eased their passage out of this world is important work, and I do it because I can. I take care of myself as well as I can after each death by honoring my memory of that person and restoring myself physically and emotionally so I can be there for the next patient who needs me.
2. “He got the good cancer.”
I am amazed that I still hear doctors and nurses say this! Hearing you have cancer is never good. And the nature of cancer itself is uncontrolled growth of cells, that needs to be stopped, in order to be sure it’s gone. There are no guarantees in any cancer that it won’t come back, and it is in the back of the patient’s mind, even if they’re lucky enough to have minimal anxiety about it. What’s acceptable for one person may be terrible and frightening for another, depending on their perception of the particular cancer they have.
3. “We should have a party for him when he’s done with chemo.”
Does he want a party? Maybe he is terrified and would like some reassurance that his support system isn’t going away. Asking him if he would like to celebrate would be a good first step, instead of assuming that’s what he feels like doing. Ask him, instead, “What can I do to support you going forward, now that chemo is behind you?”
4. “He has Stage IV? How long does he have to live?” Worse: “How long did they give him?”
No one can determine how long they will live with Stage IV cancers, and there are a multitude of factors that affect one’s response to the disease or treatment, regardless of type or stage of cancer. Personally, one of the things that sets my teeth on edge is when people think the doctor’s prognosis implies they are giving the patient a time frame, as if the doctor is some kind of omniscient deity. It sounds like they are writing off the patient as being done with living, which makes people who are uncomfortable with mortality disappear and abandon the patient.
I educate people that it’s better to focus on how well can the person with cancer live in the time they are here, which could be any length. If they think the doctor is doling out time, then they feel less control over their remaining time. It’s better to focus on how well they can live with the cancer, whether they choose to pursue additional treatment, and what they want to do with that time. Many continue working and enjoying as many life experiences as their health allows. They’re still living, their lives have as much value as anyone without cancer, and they need support in a world that has far too long dismissed them.
One thing we need to do, as nurses, is to remember that no patient will respond or feel the same exact way as another, but we need to advocate for patients, and correcting misunderstandings that could harm our patients emotionally is a great opportunity to do just that.