Curricular instruction on what to expect both practically and emotionally from the patient and his or her surrounding support system will be instrumental in preparing to help these individuals navigate the difficult course of treatment.
Designed Nursing Case:
Instruction through the Electronically-mediated approach would ultimately segue into graduating involvement with real case management scenarios. The practical design of this aspect of the curriculum will revolve on breast cancer, which is useful for our purposes both because of its commonality and its high survival rate with early detection and properly stewarded treatment. Therefore, nurses undergoing the curriculum would follow up the GEM driven instruction period with engagement of several written case scenarios. Said scenarios would describe subjects undergoing chemotherapy for breast cancer treatment with differentials including age, additional health considerations, family circumstances, socioeconomic context and a host of other circumstances which might impact treatment. Nurses will be asked to compose treatment strategies centered on the biopsychosocial realities of the respective case scenarios. This will include description of engagement of family members and patients. The primary concept at play in these case scenarios will be treatment and consultation under the biopsychosocial umbrella.
The concept activities driving the treatment approach will be 1) medically-driven procedures and 2) long-term self-care consultation. The first of these concept activities denotes the administration of chemotherapy and treatment of its side effects with proper bedside manner, effective communication to the patient's support system, provision of thorough information preparing the patient for the experience and compassionate responsiveness to the rigors of the treatment both physically and emotionally. The second of these concept activities refers to the consultation necessarily to facilitate the transition from inpatient care to home self-care. Nursing procedure and orientation should be directed toward providing the patient and family with lifestyle-driven ways of coping with treatment and reducing the risk of recurrence. To the point, "as more individuals diagnosed with breast cancer are surviving for extended periods of time, oncology nurses are providing long-term follow-up care. Part of the care should include proper screening and patient education for healthier recovery and prevention of further healthcare complications as a result of cancer treatment." (Limburg, 55) This is especially a point of focus given the rigors of standard chemotherapy treatment procedures and the various lifestyle adjustments that may be necessary to cope with these rigors.
In accordance with the strategy driving the curriculum referred to by Bunce-Houston, the written practicum would be followed up by engagement of three courses of treatment. Nurses engaged in the educational process would be paired with a mentor and his or her attending healthcare team on two full courses of inpatient treatment for lower risk breast cancer patients. These would be defined as patients in high-survival rate chemotherapy scenarios. The training nurse would shadow treatment while developing a personal relationship both with the patient and the patient's family. Though primary consultation would be provided by the presiding and qualified nurse, the training nurse would be present for all such consultations and would be invited to offer input as the process of treatment proceeds to the eventual discharge of patients.
On the third case, the training nurse would be assigned to preside over the process with the nurse's mentor serving in the role of consultant. This would give the training nurse the opportunity to establish the lead dynamic in a relationship with the patient and the patient's family or support system. This would also allow the training nurse to take the lead in consultation for long-term self-care.
The curriculum described above creates a foundation for the competency of educating and empathizing with the patient and his or her support system first through instruction, then through simulated treatment scenarios and, finally, through real treatment scenarios. The ambition is that RNs engaging this course of education will possess the basic competencies required to standardize inpatient treatment in relation to chemotherapy.
Bunce-Houston, M. (2010). Maintaining Chemotherapy Administration Competency in a Small Hospital. The Oncology Nurse-APN/PA.
Chambers, M. (2007). GEM-Nursing. Tennessee Center for Nursing.
Lakhan, S. (2006). The Biopsychosocial Model of Health and Illness. Connexions.
Limburg, C.E. (2007). Screening, Prevention, Detection, and Treatment of Cancer Therapy-Induced Bone Loss in Patients with Breast Cancer. Oncology Nursing Forum, 34(1), 55-63.
Plante, T.G. (2010). Contemporary Clinical Psychology. John Wiley and Sons.
Pollin, I., & Kaanan, S. (1995). Medical Crisis Counseling: Short-Term Therapy for Long-Term Illness. New York, N.Y.W.W. Norton & Company, Inc.