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Elizabeth (Lib) Cooper RN November 5, 2016
Patient Experience in the Cancer Care System Elizabeth (Lib) - - PowerPoint PPT Presentation
Patient Experience in the Cancer Care System Elizabeth (Lib) - - PowerPoint PPT Presentation
Patient Experience in the Cancer Care System Elizabeth (Lib) Cooper RN November 5, 2016 Presentation Agenda Overview of Treatments and 1 Services at
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Presentation Agenda
Overview of Treatments and Services at cancer agency
1
Definition of Palliative Approach to Care
2
Overview Pain and Symptom Palliative Care Program
3
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Centre for the North
Sindi Ahluwalia Hawkins Centre For the Southern Interior
Abbotsford Centre Fraser Valley Centre Vancouver Centre Vancouver
Island Centre
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What do They Feel?
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First Visit
- Meet with oncologist and
nurse
- History and Physical
- Need more information
- Tests will be ordered
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First Visit cont’d.
- Treatments explained
- May be referred to medical
- ncology, radiation
- ncology, surgery, pain and
symptom management
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Confused
Questions?
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❑ 55 Year old female ❑ Severe Pain right chest wall, ribs ❑ Anxiety++++ ❑ Referred to pain and symptom nurse by surgical suite nurse (bronchoscopy) for severe right sided chest pain ❑ Substance abuse (actively using)
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Patient
Nutrition Oncologist Pain and Symptom Manageme nt/Palliative Care Clinic Patient and Family Counseling
Nurse
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❑ Respiratory Therapy ❑ General Practitioner ❑ Nurse Practitioner ❑ Homecare Team
❑Secretaries and Unit Clerks
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Patient
Surgical Suite Clinics Chemo Room Radiation Therapy Area Phone Line
Nurses Available in….
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- Surgery
- Radiation
Therapy
Radiation Therapy
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- Surgery
- Radiation
Therapy
Surgery
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- Surgery
- Radiation
Therapy
Chemo- therapy
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- Surgery
- Radiation
Therapy
Hormonal Therapy
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- Surgery
- Radiation
Therapy
Targeted Therapies
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CUTTING EDGE
Personalized Oncogenetic Genome
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Looks at the individual cancer cells.
POG Study
Reduce Tumours Identify Drivers Block Growth
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POG Case Study
❑ Female 68 years old ❑ Metastatic colon cancer ❑ Chemotherapy ❑ Referred to pain and symptom management palliative care clinic
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POG Case Study
❑ Disease Recurred ❑ Identified Protein as driver
❑ Result?
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POG Case Study
❑Identified BP medication ❑Known to Block Pathways to Protein
Disease is barely detectable!
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Pain and Symptom Management/Palliative Care Helps improve quality of life for patient and caregivers For cancer related symptoms Pain, nausea, shortness of breath
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Pain and Symptom Management/Palliative Care For those with symptoms anywhere along trajectory Help with emotional and social concerns Assist with transitions, advanced care planning
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Pain and Symptom Management Team
Doctor with specialty in pain and symptom management/palliative care Nurse with specialty in pain and symptom management/palliative care Pharmacist, Counsellor
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Palliative Approach to Care
1
Many People are Cured of their Cancer
2
For Others becomes Chronic Disease
3
Integrate Palliative Care Earlier
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“Palliative care is an approach that improves the quality of life of patients
WHO Definition of Palliative Care
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and their families facing the problem associated with life- threatening illness
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through the prevention and relief of suffering by means of early identification
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and impeccable assessment and treatment of pain and
- ther problems,
physical, psychosocial and spiritual.”
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“…..is applicable early in the course of illness, in conjunction with other therapies that are intended to
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prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.”
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- Palliative Care DOES NOT just
mean End of Life care
- The illness does not need to
be incurable in order for a person to receive a palliative approach to care
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Dr.Pippa Hawley, January 2014
Disease Management Palliative Care
Cure Control Survivorship Hospice
Symptom Management and Supportive Care
The Bowtie Model of 21st Century Palliative Care
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Disease Management Palliative Care
Cure Control Survivorship Hospice
Symptom Management and Supportive Care
Cycle repeats
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Disease Management Palliative Care
Cure Control
Rehabilitation
Hospice
“Palliative Care is for Living Well”
Survivorship Bereavement
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Disease Management Palliative Care
R e s e c t i
- n
- f
b r e a s t t u m
- u
r
Cure Control
Survivorship
Hospice
Pain and Symptom Management
“We need to look after the disease and the rest of you”
Expectation: Cure
Adjuvant chemoradiation Nutrition Information Counselling Tamoxifen Physio and Exercise
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Expectation Cure
❑ Breast cancer ❑ Post mastectomy neuropathic pain ❑ Referred to Pain and Symptom Clinic
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Disease Management Palliative Care
Surgery Radiotherapy Survivorship Hospice
Pain and Symptom Management
“We will always be part of your care team”
Expectation: Cure Unlikely
Nutrition Counselling Chemotherapy Hormone Rx Palliative Procedures Clinical Trial?
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What Does this Mean for you, the PeriAnesthesia Nurse?
➢ Inform your patients that there is always something that can be done. ➢ Educate yourselves and your colleagues about the palliative approach to care.
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What Does this Mean for you, the PeriAnesthesia Nurse?
➢ Refer early. ➢ Anyone can refer.
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