Reflection on previous experiences

As you start your preparation for this placement it is important to consider how you are feeling. This can be governed by two key perspectives; the public image of cancer and palliative care and your personal life experiences.

Some of you may have experienced a family member or a friend being diagnosed and treated for cancer. This might mean that this placement is a particularly challenging one for you. Preparation is therefore essential in order to make sense of your feelings and experiences.

Reflecting on our personal and professional experiences can be a good way of understanding what we have encountered. Using a ‘model’ to guide reflection provides structure and helps to devise an action plan in order to develop practice in the future. Although there are many reflective models available, we have used Driscoll’s (2007) reflective model as it is a simple, three-part model that can be adapted to a wide range of situations:

Writing a reflective account is also an excellent way of demonstrating the NMC competencies. We return to Driscoll’s model in Section 3 (see Appendix One) so it is good to start using it early on in your preparations. If you have used and feel confident using another reflective model previously, continue to use it instead.

What your perception of cancer may be

Cancer is a word we are all familiar with and it probably affects most of us in some way, directly or indirectly, but we rarely stop to consider what cancer is. What can we do to reduce the risk of developing cancer? What does a diagnosis of cancer actually mean? This first section helps you prepare for a cancer/palliative care placement by helping you to consider what your pre-existing attitudes and beliefs might be regarding the disease and outcomes. It also refreshes your knowledge and explores possible situations you may encounter, as well as identifying opportunities that might be available.

For many people, cancer is a bewildering disease and often a taboo subject. Some people cannot use the word ‘cancer’ as it evokes such a range of emotions and thoughts. There are many misunderstandings and assumptions of what cancer is and what causes it. You may have had contact with someone diagnosed with cancer, heard stories about treatment and watched media coverage. As a student, you may have an idea of what you will see and experience while on placement. However, it is important to remember that there are around 200 different types of cancer, each behaving differently (some spreading, some not, some causing death, some not). Each cancer is treated differently and each individual’s reaction to the diagnosis of cancer varies enormously, as does their experience.

Your placement will involve caring for patients who are living or dying with cancer. It is important to remember that patients with cancer do not always die and dying patients do not always have cancer. Much of what you will learn on this cancer/palliative care placement will be transferable to other care settings, as the majority of individuals with cancer are cared for in non-specialist healthcare environments (Gill & Duffy 2010).

Cancer is a chronic, complex and long-term disease that affects every aspect of an individual’s life. Caring for a person and their family starts before diagnosis is given, often in the setting of general practice surgeries and outpatient clinics. Once diagnosis is confirmed, the patient will be under the care of a specialist and may undergo a variety of treatment options which may include surgery, hormone therapy, biological therapy, radiotherapy and chemotherapy.

Even when treatment has been successful and individuals are disease free, patients may be monitored for years, many having to contend with numerous effects of cancer and the consequences of treatment. Alternatively, some may require end of life care. These patient pathways can span over many years or last for just a few days, can take many different routes, pose a range of challenges and bring great rewards.

High-quality and focused nursing care is central to supporting a patient and their family through such an experience and can be incredibly fulfilling. This placement should be a positive experience, and will equip you with essential skills that can be transferred to your next learning placement, into your theoretical work and a variety of assessments. It will result in a better understanding of what cancer is and how it affects patients and families.

The public image of cancer and palliative care