Nursing Process: Approach to Care Benchmark
The nursing process entails a systematic strategy to care by utilizing fundamental client-focused methods and critical thinking that underscores the need for evidence-based practice, nursing intuition, and goal-oriented tasks to assess, diagnose, treat, plan, implement and evaluate a health issue (Leslie, 2018). As for this approach, nurses determine the health care needs for individuals, which offers a platform for responsive care approaches to patient needs and expectations (Leslie, 2018). As a leading cause of death globally, applying the nursing process will be critical in reversing the trend. Persons who have cancer are susceptible to many health challenges, encompassing reduced white blood cell count, infection, skin problems, bleeding, pain, fatigue, nutritional problems, and psychological stress. Thus, applying the nursing process tool creates a holistic approach in patients with cancer, ensuring nurses formulate assessment, patient education, care coordination, direct patient care, symptom management, and supportive care relevant to individual patient needs (Fusco, 2015). The paper focuses on the contribution of the nursing process in cancer treatment and management towards reducing the adverse health outcomes due to complications that accompany the disease. To this end, the paper aims at describing the diagnosis process and staging of the disease, cancer complications, factors that contribute to incidence and death rates in America, and the effect of education and support while situating how the application of the nursing process remains instrumental in providing safe and effective care for cancer patients.
Diagnosis and staging
Early cancer detection and diagnosis entail identifying the presence of the disease and assessing the stage. The diagnosis covers initial diagnosis, detection of recurrence, or the identification of precancerous lesions that predispose an individual to cancer, providing grounds for early intervention and prevention. According to National Cancer Institute (2020), early detection is an effective strategy for reducing deaths from cancer. Early detection and treatment of cancers often produce better long-term survival plans and enhanced quality of life than in persons whose cancers are detected when symptoms appear. The screening and early detection allow physicians to identify malignancy or a precursor lesion early enough before symptoms emerge. The use of HPV assay, examinations such as VIA visual inspection with acetic acid, and imaging such as mammography are some of the approaches that help identify unrecognized cancer or the precursor lesions in asymptomatic persons. The decrease in cancer mortality by 25% between 1990-2015 in the US is attributable to early detection through screening, particularly due to the introduction of high-quality cancer screening for breast and colorectal cancer (Brawley, 2017). Such statistics underscore the importance of early detection and diagnosis.
The diagnostic interval takes shape through clinical diagnosis, diagnostic testing and staging, and subsequent exposure to a treatment plan. Such interval commences when a health care physician establishes the presence of cancer. Patients with suspicious findings must receive diagnosis tests (through imaging and laboratory tests), confirmation of pathology, and staging surveys. With a pathological diagnosis, which is essential before initiating a treatment plan, the physician assesses cells for the presence of cancerous liaisons (WHO, 2017). The test and procedures for obtaining cells for analysis may encompass fine needle aspiration, blood tests, endoscopy, core needle biopsy, surgical biopsy, and radiology-directed biopsy. The physician must document distinctive evidence of cancer before advising for staging or treatment.
After establishing the presence of cancer, the physician exposes the patient to staging examinations. Staging is critical for assessing part of the body affected by cancer, the size of the tumor, the level of cancer, and whether it is spreading to other parts. The staging process can be through radiology, clinical findings, surgical findings, used singly or collectively. Evidence-based protocols are critical in staging tests because different cancers require different treatments (WHO,2017). Accurate staging contributes to effective cancer treatment because an individual presenting with distant cancer require different treatment with localized cancer. The typical staging systems encompass metastasis, node, and tumor (Bauer, 2016).
The complication in patients with cancer
Patients with cancers experience oncologic complications, which indicate the disease progression. Such complications may also arise due to exposure to chemotherapy or radiation during treatment. Cardiac tamponade is a complication due to the compression of the cardiac muscle resulting from fluid accumulation in the pericardial sac. The pericardial constriction by a tumor causes fluid accumulation. Patients experiencing myocardium constriction have challenges with cardiac filling, reducing blood flow in the ventricles, and stroke volume. Patients with lung cancer, lymphoma, breast cancer, and leukemia are at the greatest risk of experiencing this complication (Professional Nursing Development Education Department, 2010).
The second complication is the increased intracranial pressure, which occurs when the volume of either of the three constituents in the skull and meninges increases. Such components include cerebral blood volume, cerebral spinal fluid, and brain. Such complication results in death and brain herniation if not successfully treated (Professional Nursing Development Education Department, 2010). Brain metastases are the most common form of intracranial pressure, affecting approximately 20-40% of cancer patients.
Spinal cord compression occurs when neoplasm in the epidural space encroaches on the spinal cord. This condition result from metastatic disease. Cancer patients who metastasize to the bone are likely to suffer spinal cord compression (Professional Nursing Development Education Department, 2010).
Side effects of cancer treatment
Cancer treatment may damage healthy cells, leading to side effects. Such side effects depend on the kind of medicines and type of treatment.
Neutropenia, a factor of reduced blood cells, is commonplace for patients receiving chemotherapy. This is because chemotherapy drugs function by killing fast-growing cells in the body. In the context of cancer patients, they work on cancer cells and white blood cells (CDC,2021).
Lymphedema is another complication in patients whose lymph nodes have been removed during surgery or damaged during radiation treatment. Such a situation leads to fluid accumulation under the skin, causing body parts to swell (CDC, 2021).
Also, patients exposed to chemotherapy experience hair loss, a condition known as alopecia (CDC, 2021).
Methods to lessen physical and psychological effects
Cancer patients experience pain and are also under greater psychological pressures. Cancer patients can benefit from stress management training courses, which help promote life value, self-efficacy, and quality of life (Lee et al., 2018). With a stress management plan, cancer survivors access self-development, realize the value of life and promote their interpersonal relationships (Lee et al., 2018). Approaches such as Qigong exercise intervention can reduce psychological challenges such as anxiety, fatigue, depression and enhance sleep quality in breast and prostate cancer patients. Through the Qigong exercise intervention, an alternative and complementary medicine enhances blood circulation, heart and lung function, moderates emotions, regulates homeostasis, and allows self-healing (Lee et al., 2018).
Also, patients with religious backgrounds turn to their prayers and other religious activities to cope with physical symptoms and emotional reactions to the ailment (Mosher et al., 2014). Such an approach helps them derive comfort from their belief that a super being controls the future, reducing their worries.
Factors contribute to Americans’ yearly incidence and mortality rates of various cancers.
Cancer is the second leading cause of death in America. Approximately 600000 persons die annually, while over 1.6 million live with the disease. Lifestyle choices such as smoking and secondhand exposure to smoke contribute to 90% of lung cancer deaths in America. Smoking causes cancers such as mouth and throat, larynx, kidney, colon, rectum, liver, stomach, pancreases, urinary bladder, acute leukemia, and cervix. Exposure to secondhand smoke exposes nonsmokers to a 20 % to 30 % increased cancer risk (CDC,2021).
Exposure to sun and tanning beds causes skin cancer, a common condition in the US. For instance, melanoma, the deadliest type of skin cancer, is a factor of exposure to ultraviolet (UV) light from turning beds or the sun (CDC,2020).
Persons suffering from obesity or being overweight are at risk of 23 cancers. Such cancers include breast cancer, colorectal and uterine cancer, which make up to 40% of all cancers diagnosed in the country (CDC,2020).
Excessive use of alcohol increases the risk of cancer in all genders. For example, taking more than 15 drinks in men or eight drinks in women per week increases the risk of colon, rectum, larynx, pharynx, liver, and esophagus (CDC, 2020).
How the American Cancer Society (ACS) might provide education and support
The ACS promotes a healthy lifestyle and emotional support to cancer survivors. The entity offers information to individuals diagnosed with cancer and their families, providing daily help and emotional support (American Cancer Society, 2021). ACS offers free transportation and lodging to cancer patients while assisting them in making decisions concerning their care by offering relevant resources, plans, and services. ACS offers accurate and up-to-date information on cancer on its website while maintaining a 24/7 helpline for any individual with a question concerning cancer (American Cancer Society, 2021). For instance, the entity has specialists ready to answer questions concerning treatment alternatives and potential side effects, allowing cancer survivors to learn how to cope with the disease and accompanying adverse effects.
I would recommend the 24/7 service and the provision of all relevant information concerning cancer. These plans are essential because they offer cancer patients answers to troubling diverse questions; hence, getting answers is critical for promoting their quality of life.
how the nursing process is utilized to provide safe and effective care for cancer patients across the life span
The nursing process allows nurses to pursue a holistic approach and continuous patient attendance when caring for cancer patients throughout the entire disease course. Thus, they can safely and effectively take patients through diagnosis, treatment, possible recurrence, the time marking their survival, palliative care, and assisting them in undergoing a peaceful death.
The first stage of the nursing process requires nurses to gather information concerning the patient’s spiritual, sociological, psychological, and physiological status (NursingProcess.org, 2021). Such an approach is critical for cancer patients because it allows them to narrate their health history and their family while providing the nurses with leverage to observe them and gather relevant data. As the initial touchpoint, this phase establishes the foundation for a long-term relationship between the nursing team, the cancer patient, and their family, defining the success of the subsequent phases.
In the diagnosis stage, nurses must make a concerted effort by utilizing evidence-based approaches and the right technology to establish the existence of the disease where possible executing multiple diagnoses to settle at the informed judgment. This phase is crucial in ensuring appropriate staging and avoiding misdiagnosis.
The nurse must engage the patient in the planning stage and agree on the diagnoses, an approach that situates the concept of patient autonomy and involvement in the decision-making process. The nurse must educate the patient and provide them with alternatives while asserting the advantage and disadvantages of each, empowering the patient to make the best choice. This approach corresponds to the nursing process requirement that nurses assign clear and measurable goals for the anticipated beneficial outcome (NursingProcess.org, 2021). As of this phase, nurses must utilize evidence-based nursing outcomes classification to track the patient progress.
In the implementation phase, patients with cancer present with different complications depending on the type of tumor and the extent of the disease. Thus far, nurses must design treatment plans that are responsive to individuals and expectations (NursingProcess.org, 2021). As of this phase, the nurse must monitor patients for signs of change to institute nursing care that integrates all dimensions of life. The nurse must employ a dynamic care plan that is responsive to the patient’s needs, with adaptation to the demands the cancer disease generates and subsequent treatment (Lavdaniti, 2017. With personalized care that addresses the physical, psychological, social, and spiritual needs of a patient, nurses achieve positive health outcomes. The nurses must offer patient education and collaborate with colleagues to manage the disease and the accompanying complication, walking the patient through the journey across the disease life-cycle.
Nurses establish goals in collaboration with the patient, family, and other physicians relevant to each cancer patient. Therefore, it remains critical to evaluate whether such objectives are met during and after treatment. The approach is necessary to establish whether the patient’s condition has improved, stabilized, or deteriorated (NursingProcess.org, 2021). Suppose the evaluation demonstrates that the set goals have not been met. In that case, the nursing team and other health care providers must identify the gaps and institute insights into the new nursing process.
The contribution of liberal arts to the nursing process
Liberal arts and sciences significantly contribute to knowledge build-up for nursing students. As part of the educational discipline in the nursing curriculum, they offer nursing students the opportunity to grow their creativity, critical-thinking while enhancing their ability to offer holistic care (Kooken & Kerr, 2018). Also, liberal arts enhance nursing students’ communication skills, think globally, make decisions, navigate diversity and enhance decision-making abilities (Kooken & Kerr, 2018). For instance, mathematics help nurses work with patients utilizing the nursing process by enhancing their decision-making capabilities while providing them with skills to calculate the right dosages. Social sciences help the nursing students to learn skills such as empathy and the need to embrace diversity, enhancing nurses’ ability to work with diverse patient populations (Kooken & Kerr, 2018. With physical sciences, the nursing professionals can understand the underlying causes of disease and enhance the knowledge of how different drugs can impact the body system, ensuring the right prescription after diagnosis and treatment.
American Cancer Society. (2021). How we’re providing support. American Cancer Society | Information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin. https://www.cancer.org/about-us/what-we-do/providing-support.html
Bauer, F. (2016). The importance of preoperative staging of rectal cancer using ultiparametric MRI part II: TNM cancer staging. Chirurgia, 111(6), 463. https://doi.org/10.21614/chirurgia.111.6.463
Brawley, O. W. (2017). Cancer screening and early detection. Holland-Frei Cancer Medicine, 1-19. https://doi.org/10.1002/9781119000822.hfcm039
CDC. (2021, May 12). Side effects of cancer treatment. Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/survivors/patients/side-effects-of-treatment.htm
CDC. (2020, December 16). Cancer. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/cancer.htm
Fusco, E. (2015). Nurse practitioners’ growing role in oncology. Oncology Times, 37(7), 4-5. https://doi.org/10.1097/01.cot.0000464265.70590.ad
Kooken, W. C., & Kerr, N. (2018). Blending the liberal arts and nursing: Creating a portrait for the 21st century. Journal of Professional Nursing, 34(1), 60-64. https://doi.org/10.1016/j.profnurs.2017.07.002
Lavdaniti, M. (2017). Holistic nursing approach to patients with cancer. Journal of Nursing & Care, 06(01). https://doi.org/10.4172/2167-1168.1000e136
Lee, Y., Lai, G., Lee, D., Tsai Lai, L., & Chang, Y. (2018). Promoting physical and psychological rehabilitation activities and evaluating potential links among cancer-related fatigue, fear of recurrence, quality of life, and physiological indicators in cancer survivors. Integrative Cancer Therapies, 17(4), 1183-1194. https://doi.org/10.1177/1534735418805149
Leslie, J. (2018). Employment of the nursing process to facilitate recovery from surgery: A case study. OJIN: The Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02ppt07
Mosher, C. E., Ott, M. A., Hanna, N., Jalal, S. I., & Champion, V. L. (2014). Coping with physical and psychological symptoms: A qualitative study of advanced lung cancer patients and their family caregivers. Supportive Care in Cancer, 23(7), 2053-2060. https://doi.org/10.1007/s00520-014-2566-8
NursingProcess.org. (2021). Nursing process steps. Nursingprocess.org – Your Guide to Nursing & Health Care Education. https://www.nursingprocess.org/Nursing-Process-Steps.html
WHO. (2017). Guide to Cancer Early Diagnosis. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/254500/9789241511940-eng.pdf
Professional Nursing Development Education Department. (2010). CRITICAL CANCER COMPLICATIONS. Community Hospital Garden City, MI | Garden City Hospital. https://www.gch.org/documents/critical-cancer-complications.pdf