Nurses' experiences of being present when a diagnosis of cancer is given to a patient on an acute setting

Abstract

This study sought to explore nurses' experiences of being present when a diagnosis of cancer is given to a patient on an acute setting, through a qualitative approach. Data relating to the participants' views, feelings and experiences of being present during the delivery of a cancer diagnosis, was collected from a convenience sample of ten nurses, utilising both purposive sampling and snowball technique. The participants' comprised both enrolled and registered nurses, who at the time of the study, were working on a medical or surgical ward of an acute general hospital and who had worked on such wards for a minimum of five years. Data was collected from individual, semi-structured recorded interviews, aided by an interview guide. The interviews were transcribed verbatim and analysed through a thematic data analysis. Three main themes have emerged which were further divided into sub-themes. A) being present was divided in various sub themes being: breaking bad news, truth-telling, advocating for what is right, providing privacy, who should be present, respecting patients' rights and practicing advocacy. B) providing support is further divided into three sub-themes, namely: having a good nurse-patient relationship, identifying patients' needs and dedicating more time, and the last theme being (C) nurses' emotions. The findings reveal that the majority of nurses perceive the lack of bad news being broken properly, create feelings of anger and frustration amongst them. The nurses' presence was strongly related to an optimal nurse-patient relationship. Moreover nurses expressed a strong feeling of incompetency due to lack of training in this delicate issue. As a result of the aforementioned issues, nurses consider such an experience as being a negative one.

In the light of the findings one would recommend the inclusion of Continuing Professional Development (CPD) courses, aimed specifically on the nurses' role during the breaking of bad news, to improve nurses' supportive roles. These courses may also be aimed to equip nurses with strategies to help them face such an emotional experience. Further research is recommended in order to have a deeper understanding of this delicate subject.