Introducing the case study

Published on 09/04/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 22/04/2025

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19 Introducing the case study

Chapters 19–24 follow a patient diagnosed with breast cancer, in the form of a case study. Each chapter identifies a stage of the patient experience. As the case study unfolds, there are a number of activities to complete. In each activity, you are given the opportunity to explore a variety of nursing interventions and provide holistic support for both the patient and her family. You are encouraged to refer back to the anatomy and physiology, and other health theory, in Sections 1 and 2. Practical exercises are suggested for you to do either while on placement or by reflecting on previous experience. It is, therefore, useful to have your notes from Sections 1 and 2 handy since you will be directed back to some of the activities you have already completed.

By working through one patient experience in this way, you can follow through aspects of integrated care introduced throughout the book. You are also encouraged to link the NMC principles and competencies to various stages of the patient’s experience.

Journal papers are suggested for each of the exercises. These papers may not refer specifically to the cancer experience, but encourage you to think across different disease groups. For example, section on complex discharge suggests a paper exploring the challenges of discharging a woman with multiple sclerosis. This helps to focus and consolidate and build up your knowledge, as well as provide underpinning evidence to apply confidently in your future clinical practice across a range of clinical settings.

From the point of diagnosis, patients encounter many different physical, psychological, social and economical effects of cancer and its treatment. Their experience will be unique and the time frame for each individual will be different. As healthcare professionals, we are generally unable to predict the overall outcome. We can, however, surmise a number of possible phases patients may experience. Figure 19.1 outlines these different phases which can help healthcare professionals to identify support and services that patients might need at different points.

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Fig 19.1 Cancer patient pathway

Depending on the type of cancer/palliative care placement (hub or spoke) you have been allocated to, you may care for patients at a specific stage in the cancer experience. For instance, if you are on an oncology ward, you may experience patients receiving cancer treatments and undergoing a review of their symptom management.

It is worthwhile to read all of the chapters in the case study. This gives you an insight into what patients have experienced prior to their current situation, as well as what might be ahead of them. It is also a good idea to arrange some insight visits to some of the other clinical environments within the pathway. To help you do this, go back to Section 2 to identify other cancer/palliative care treatments and experiences.

Case study introduction

Michelle is a 44-year-old woman who has been diagnosed with a non-specific type of breast cancer. She is married to Simon with three children, aged 8, 11 and 16. Michelle works part time as a receptionist at a GP surgery. Her parents and parents-in-law live a considerable distance away and are in their mid-70s. Michelle has a good network of friends locally and she attends a gym. She is a Catholic but her beliefs and religious practices in that faith have not been adhered to and she admits she is a ‘lapsed Catholic’.

The remaining chapters focus on the following:

• Chapter 20: Michelle receives her diagnosis and discusses treatment options.

• Chapter 21: she experiences treatment and associated complications.

• Chapter 22: she develops complex symptoms associated with advancing disease.

• Chapters 23 and 24: two alternative endings to Michelle’s cancer experience.

• Chapter 23: as Michelle’s disease advances, we explore palliation of her symptoms and care as she moves towards receiving last days of life care.

• Chapter 24: the final pathway explores how she makes the transition to living beyond cancer.

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What cancer is Caring for the patient undergoing radiotherapy How cancer is diagnosed and the impact of diagnosis Transferable skills for future placements Caring for the patient undergoing biological therapy Last days of life