Clare Warnock

Connecting with Cancer

Book review: Connecting with Cancer

Practice development nurse Clare Warnock reviews a collection personal stories from people affected by the disease

Neutropenic sepsis: prevention, identification and treatment

Chemotherapy-induced neutropenia may result in significant physical, social and emotional consequences for patients receiving anticancer therapy. Chemotherapy-induced neutropenia also leads to delays in treatment and reductions in dose intensity. In some cases neutropenia may be prevented by the use of granulocyte-colony stimulating factor, but it remains one of the most common side effects of chemotherapy. Patients who are neutropenic have a reduced ability to fight infection and are at increased risk of developing neutropenic sepsis. Nurses need to be able to recognise the signs and symptoms of neutropenic sepsis to ensure early diagnosis and treatment. There are evidence-based pathways for the treatment of patients with neutropenic sepsis and nurses have the potential to develop services and initiatives to support best practice for this group of patients.

Skin reactions from radiotherapy

Radiotherapy is a widely used cancer treatment that can be used for curative and palliative intent. While it is effective, it can also result in side effects, including skin reactions. The type and severity of skin reaction experienced are influenced by intrinsic and extrinsic factors, and include erythema, dry desquamation and moist desquamation. These can make a significant impact on patients’ wellbeing as they have physical, psychological and social consequences. Accurate and structured skin assessment throughout treatment is needed to monitor reactions, evaluate interventions and plan care. Many patients have fears about the use of radiation as a treatment along with concerns about its potential side effects, including skin reactions. The provision of accurate patient information can help allay anxiety and improve their ability to cope with the challenges of treatment.

Breaking bad news: issues relating to nursing practice

The breaking of bad news was traditionally regarded to be the time when a doctor and nurse sat down with a patient and family members to provide information about, for example, a life-limiting diagnosis or a poor prognosis. However, breaking bad news is now generally accepted as a process, not a one-off event, and is considered to refer to any bad, sad or difficult information that alters patients’ perceptions of their present and future. Nurses have an important role in the process of providing information and helping patients prepare for, receive, understand and cope with the bad news they have been given. This article aims to help nurses understand the process of breaking bad news and discuss the challenges and difficulties that nurses can face when they are involved with patients who have been given bad news. It also provides guidance with regard to preparing for breaking bad news, giving difficult information, responding to possible reactions, and supporting patients and their relatives after they have received bad news.

Assessing the value of a nurse-led telephone advice and triage service

National guidance recommends that cancer patients should have access to a telephone enquiry service supported by trained oncology staff. Previous studies indicate that nursing care delivered by telephone has the potential to make a substantial contribution to patient care. However, its role in oncology has not been widely evaluated or explored. This article evaluates a nurse-led telephone advice and triage service for patients and relatives at a regional cancer centre. It provides insight into the range and scope of the service, suggesting that further evaluation is needed to explore the role and use of telephone assessment tools in clinical practice. The findings indicate potential challenges that can be faced when providing this service.

Competency framework for late effects care

Survival rates for children and young adults with cancer continue to improve, due to advances in therapies, multidisciplinary and supportive care. While treatments are associated with positive outcomes in terms of survival, there can be long-term negative consequences. These are often referred to as ‘late effects’ and may be experienced by patients years after treatment. There is therefore recognition of the need for long-term follow up and support after end of treatment and beyond, and of nurses’ role in such services. This article describes a project to develop a competency framework for nurses providing care to young cancer survivors, regardless of their current age. Generic elements of the framework may be of relevance to adult oncology nurses.