Coping with Cancer
CHS Staff Provides Love and Encouragement When It's Needed Most
This article was first published in Health View, April 2001.
Cynthia Williams knows that for some of her patients diagnosed with cancer, an admission to the fourth floor at Carolinas Hospital System can be an unsettling experience. Cancer is a new word in their repertoire, a word that has interrupted their day-to-day life with an unexpected and unwelcome diagnosis.
Nurse Manager
Cynthia Williams, RN
Yet as nurse manager on the cancer and dialysis unit, Williams is attuned to the unique needs of patients battling all kinds of cancers and the gamut of emotions that accompany the disease. She expects the bouts of fear, anger, uncertainty and grief that her patients encounter at times, particularly those who are still adjusting to a new diagnosis. "A lot of patients automatically think, 'I have cancer and I'm going to die,'" Williams said. "Yet today patients are living for many, many years with cancer," she explained.
Cancer treatment is as varied as the patients who receive it. Both the type of cancer and the stage it is in factor into the oncologist's recommendations. Many treatments can be done on an outpatient basis, such as the radiation therapy delivered by the linear accelerator at Carolinas' Radiation Oncology Department. The majority of patients undergoing chemotherapy can do so in an outpatient setting, either in their oncologist's office or at Carolinas' Day Hospital. "The trend is for patients to get chemo on an outpatient basis because they tend to do better when they can go home afterwards. So we don't do as much chemo on the unit as we did five years ago, but we are always here for the patients," Williams said.
One way the 36-bed inpatient unit serves patients is by managing their first chemotherapy treatment after a cancer diagnosis. Because a patient is unfamiliar with the chemo medicine at this point and how it will affect their body, education and information are an important part of the process. "When I go in to do chemo teaching, I'm going to wait for the family member to get there before I do it. I will train the patient and family member together. During this time, the patient is only going to hear so much, so a spouse or son or daughter will pick up a lot that the patient may not," Williams said.
Williams and the other nurses on the unit explain to patients how the strong chemotherapy drugs kill cancer cells, but also damage some normal cells. Because of this, patients may experience a range of side effects and have low blood cell counts, which can result in an increased chance of infection. Patients receiving outpatient chemotherapy may require inpatient hospitalization if severe side effects cannot be resolved at home.
Patients hospitalized on the oncology unit find nurses that are highly skilled at what they do. "I think first and foremost our patients need trust - to be able to trust that the nurses know the right thing to do," said Williams. All of the registered nurses on the unit are chemo-certified and have received special training on approaching patients with cancer diagnoses.
"I think the nurses, techs and secretaries are what make this unit what it is," said Williams. "We treat these patients a little differently because they are going through a difficult disease process," she said. She notes that the support and encouragement of the staff is essential. "We tend to start loving these patients as much as family members do. We're going through the treatment with them," she said.
Sometimes a patient's treatment involves a surgical procedure to remove a cancerous growth. While some patients recuperate on a surgical floor afterwards, others are admitted to the oncology unit, particularly if they will be having chemotherapy as a follow-up to the operation. Other patients are admitted to the unit in the final stages of their disease, when the focus is not on curative measures, but on managing pain and symptoms as the patient nears the end of life.
"Sometimes death gets to you, especially patients that you have been taking care of for a long time," Williams said. "We cry with the family, and go through the grieving process with them," she said. The nurses support each other with their grief, and when needed, talk with a counselor about the losses they encounter.
Support is an integral component of cancer care, and Williams has found a strong response to the prostate cancer support group she leads the fourth Tuesday of every month. Both husbands and wives come to the sessions, where speakers provide information and participants find a common bond with each other. Another group, one for women with cancer, will be starting in April. "To me that's providing excellent care - even after they leave the hospital," said Williams.
While some may consider fighting cancer on a daily basis to be an overwhelming task, it has quite the opposite effect on Williams. "I'm in awe of these patients and the way they deal with their diagnoses, the way their families deal with it. It makes me so appreciative of what I have, every day, every minute. Because of our patients, I love life so much," she said.
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