CABRERA, Andrea Marie M.

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Case Study: Treatment Plan

Mr. John Doe is back in the hospital after 3 months of successful Chemotherapy and Radiation. He
is very enthusiastic to see his Health Care Team. However, this time he comes in for a fever of 40
degrees C after Chemotherapy. You hear from him that the mass in his heart is gone and responded
in full to Chemotherapy and Radiation. However, on his repeat Chest X-Ray to rule out Pneumonia
the Doctors see a small mass and nodules on the apex of his Right Lung.
In light, of previous events in the past 3 months and being diagnosed with Cardiac Cancer and now
the possibility of Small Cell Lung Cancer after 3 months of successful Chemotherapy and Radiation
of the heart – he must deal with a new change in his treatment plan and a new diagnosis.
He tells you that the Cancer Center invites him often to share his stories and give talks to new
Chemotherapy patients. And after a long meaningful discussion with him he tells you “I am just
thankful I was given the chance to fight where many were not given the chance at all.”

1. What is your role now?

Being a part of the health care team, once the diagnosis is given to the patient by the physician, as
the nurse I will focus with the patient’s well-being by providing care and offering encouragement to
him. With these cases, nurses must monitor the physical and emotional health of the patient. Also, I
will establish effective communication to build a nurse-client relationship with trust as its foundation.
Showing openness, respect, and support to the patient by believing and sharing the same hope
alongside with him that he still has a chance to fight for his life.

2. What strategies would promote continuity of care and improve team communication?
To promote continuity of care nurses as well as the members of the health care team must have
communication, collaboration, and cooperation. Therefore, having good team communication will
help promote continuity of care. This could be done by having effective health care documentation.
However, poor communication between the health care team may put the patient’s life to risk
(Yule et al., 2006; Gawande et al., 2003 as cited in Robson, 2016). To have better communication the
team leader must develop a positive culture within the team by being open to questions and
clarifications, A team must also have mutual support and look after each other for the well being of
the patient. All must ask professionals and set aside personal problems with each other if there is any
(Robson, 2016).
According to Robson, W. (2016), there are tools and techniques to have a better team
communication. These are close-loop communication, readback, SBAR tool, checklists, the three-
bucket model, safety huddles, and debriefs.

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 3. How might a family meeting be helpful in this case?
The family is the support system that the patient needs while overcoming another battle in his
life. Educating the patient and the family is one of the duties of a nurse. According to Reiger, P.T &
Yarbro, C.H. (2003), nurses has bigger opportunity than other member of a health care team to
communicate with the patient and their family, giving a nurse the chance to build rapport and develop
the knowledge of the patient and his family about the disease. Moreover, conducting a family meeting
will be helpful for them to understand what the disease is, the treatments that the patient will receive,
as well as the possible side effects that the patient may experience. A family meeting includes
explaining complex medical terms and answering to questions regarding the patient’s condition.

4. What special needs would you perceive the children having at this time? How would you
meet these needs?
According to the American Cancer Society (2016), a cancer patient's children must know the basic
knowledge about the situation of their parent. However, children ages 8 and below does not need detailed
information about the disease and children ages 8 and above must be aware especially those who are in the
stage where they are being independent. Children often blame themselves for what happened to their parent.
They assume that it is their fault that their parent had cancer and sometimes they worry that cancer is
contagious. As a nurse, I will explain to them in a quiet place and time to explain the situation but with the
presence of their mother. Second, is to make them understand in a professional way that this is not their fault
and that cancer will not give them flu. And that they can be the support system that their father needs the most.

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References:

American Cancer Society (2016). Helping children when family member has cancer:dealing with
diagnosis. Retrieved from: https://www.cancer.org/treatment/children-and-cancer/when-a-
family-member-has-cancer/dealing-with-diagnosis/how-to-tell-children.html

Reiger, P.T & Yarbro, C.H. (2003). Role of the oncology nurse. Retrieved from:
https://www.ncbi.nlm.nih.gov/books/NBK13570/

Robson, W. (2016). Tools and techniques to improve teamwork and avoid patient harm. Retrieved
from: https://www.nursingtimes.net/download?ac=3023133

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