Conference Proceedings - School of Nursing & Midwifery - Trinity ...

School of Nursing & Midwifery, Trinity College Dublin: 8 th Annual Interdisciplinary Research Conference
Transforming Healthcare Through Research, Education & Technology: 7 th – 9 th November 2007
Conference Proceedings
information to increase the ability to interpret and manage
symptoms that were previously unknown to them or have changed
in character as well as providing details as to when to resume
normal activities. The findings suggest that, because the physical
impact of the cancer and the surgery is still significant in the postdischarge
phase, information related to these aspects of the illness
experience appear to take priority over information about what is
available in the community and how to handle feelings about the
illness
The CNS, who visited most of the participants at home, was the
most valued source of information in this post-discharge period,
recognising the physical and emotional vulnerability experienced in
the first weeks following discharge, working outside the
requirements of her contract she chose to visit the participants to
convey and explain the implications of the histology results in terms
of future treatment and prognosis and discuss any personal issues
or concerns.
‘Oh it has been fantastic, because until I knew that she (CNS) was
involved in it you think well, if I have got any problems who do I
get hold of. I mean Mr J (consultant) isn’t going to be interested.
Dr G (GP) won’t know enough about what has been going on
because all he has had is a letter saying I have had this and that
done and that is it basically. So how far his knowledge would go to
helping me if I have got any specific problems I don’t know. But she
(CNS) has expertise’ (1).
She was responding to the fact that this period is often the first
opportunity that individuals, who have previously been caught up in
the world of investigations, hospitalisation and surgery, have to
absorb and think about the implications of the fact they have
cancer. There was also recognition that visiting a patient at home
moves the balance to one where the participants, and not the
healthcare professionals, are in charge, they are no longer in the
patient role and are therefore, much more empowered. She
reported that they and their family members were much more open
and relaxed and willing to talk in their own environment. They can
cry, they can be distraught and they do not need to walk through
an out patient department afterwards and go home in a distressed
state. For these reasons, the CNS places great importance on
home visits at this point in an individual’s cancer journey; this was
clearly valued by the participants. The participants not visited by
the CNS did not receive any such information until their follow up
out-patient appointment approximately four weeks after discharge.
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