Have you considered the possibility that your patient may be going through an identity crisis brought on by their cancer diagnosis?
Who am I?
We all have an identity, defined by Merriam-Webster as “the distinguishing character or personality of an individual.” With our identity comes labels such as mom, teacher, or in our case, oncology nurse. As nurses, taking care of others comes naturally to us. It’s what we do. It’s who we are, our identity. Our patients also have an identity, who they are, how they describe themselves. Three little words have the potential to disrupt that entirely: You have cancer.
We know a cancer diagnosis is life-altering, but can we really fathom to what extent? Have you considered the possibility that your patient may be going through an identity crisis brought on by their cancer diagnosis? We have to treat the person as a whole, not just the disease. Cancer changes abilities, roles, relationships, and values. A patient once told me “The day I was diagnosed, I said goodbye to that person. I haven’t been the same since.” Can you imagine feeling as if you’re no longer “you?” Let’s try to understand.
Studies show that those affected by cancer often take on the identity of a survivor, patient, or victim after diagnosis.
The word “survivor,” in relation to cancer, is one that has been widely used and promoted in recent years. It is intended to promote empowerment, with “survivorship” meaning living after diagnosis. Some embrace the identity while others may be reluctant, fearful that they may not in fact be cured (the idea that you have to be cancer-free to be a survivor). Studies show that the survivor identity is most common and is correlated with a better psychological state.
Some simply identify as a “patient,” which is appropriate, during treatment. Feelings associated with this identity are often loss of control and/or hope. They are no longer in control of their own health. Continuing this identity after treatment though can hinder healing, both emotional and physical.
Lastly, some take on the identity of “victim.” They feel a loss of power and vulnerability. Some don’t want to be “labeled” and “just want to be treated normally.” Everyone’s journey is different and we must be sensitive to that.
Cancer has such an impact that it will likely be part of a person’s identity for the rest of their life. A person is never quite the same after their cancer journey, whether that be physically or emotionally. Physical scars or aches and pains are a constant reminder of what they went through. Doctor’s visits yield a whole new level of anxiety after the cancer experience. Is it going to come back? Am I ever going to feel “normal” again?
What can we do as healthcare providers to help them through this ever-evolving change in identity? Meet them where they are, at that minute. Help them adjust to the new change in their role at home, their decrease in or loss of abilities, and/or refer them for counseling that will help identify these changes and promote coping. Reflecting back on the question posed earlier (“Can you imagine feeling as you’re no longer ‘you’?”) I’m sure it’s safe to assume that most of us would answer “no,” but that’s where empathy comes into play. Try, for one minute, to imagine what it must be like to be in their shoes, and take care of them the way you would want them to take care of you. Address the person in their entirety, not just their cancer.