Ovarian cancer can be distressing and difficult to cope with. How health professionals communicate with patients is crucial in helping women to understand their disease and its treatment and to come to terms with it.
Many praised the treatment they had received from their doctors. Women greatly appreciated being cared for with kindness and sensitivity, being treated as a person rather than a number or an illness, and receiving personal telephone calls from consultants rather than from secretaries. Some women said they appreciated straight talking from their consultants. Others said their consultants encouraged them or inspired confidence.
Praised her doctors for straight talking.
Not all, however, had such positive experiences. Some women complained that their consultants had been insensitive or patronising. In some cases the diagnosis could have been delivered with more kindness or at a more appropriate time and place (see ‘Learning the diagnosis’). A few women disliked their consultant so much that they asked to be treated by someone else. One woman was angry with a doctor who had told her she would never get cancer again, yet she developed a recurrence after 10 years in remission. Another recognised that her consultant communicated badly because he desperately hated giving bad news.
Her oncologist spoke to her in an insensitive way.
Although some women said that they thought communication was almost as important as an ability to treat, one was clear that she would rather be treated by a good surgeon with ‘an unfortunate manner’ than a nice person who was ‘a bad surgeon’.
It is often hard for patients to know what questions to ask and some women said that doctors did not volunteer enough information. Doctors sometimes appeared to be too busy to spend time with patients or answer questions. Increasing the number of doctors could help with the time constraints, but women suggested that doctors could also point to other sources of support and cancer information.
She found it hard to know what questions to ask – her doctors did not tell her enough.
Her oncologist always seemed too rushed to spend time with her.
When asked to give advice to health professionals women most often mentioned communication, saying that communication skills needed more attention. Doctors should better understand how patients react and be sensitive to their needs; in particular they should be given time to take in their diagnosis before being overloaded with other information or asked to make decisions. Doctors should be kind, respect and listen to patients and involve them in their treatment, take the time to talk frankly and explain thoroughly and patiently, even if this means repeating some details. They should not be patronising or use jargon, and realise that insensitive remarks can have lasting effects on patients.
Advises doctors to explain things in simple terms and to allow patients time to take in their…
Advises doctors that insensitive things said can have lasting effects on patients.
Hospital nurses were frequently praised for their skills and compassion and for creating a friendly atmosphere in the chemotherapy units. They often made themselves available day and night for patients to phone if they had problems. Nurses also sometimes asked questions on behalf of patients, acted as go-betweens with consultants or sorted out practical problems, but their reluctance to interpret test results could be frustrating.
Praises the chemotherapy nurses for their skills and for creating a friendly atmosphere in the unit.
Praises the chemotherapy nurses – they made themselves available 24 hours a day for patients with…
Although oncology nurses were highly appreciated, nurses and auxiliaries on general wards were occasionally criticised. Agency staff were seen as a particular problem because they did not know the patients. Nurses were very busy and did not always have enough time to give emotional support. Not everyone wants to be treated differently because they have cancer, for example one woman felt that a nurse didn’t talk to her as a normal person and another said she wanted normal, business-like communication, neither serious nor flippant. One woman was upset by a nurse who told her, “It’s not the sort of gynaecological cancer I would want”.
Women also commented on Macmillan nurses, whose role is to provide support and information to people with cancer – and their families, friends and carers – from the point of diagnosis onwards (see ‘Resources’ section). Women praised them for being helpful in talking with them about their illness and treatment. Some women were alarmed by being introduced to a Macmillan nurse because they thought that, as in the past, Macmillan nurses were brought in to help people only when they were dying. One woman disliked the rather jolly attitude of one of her Macmillan nurses.
The Macmillan nurse discussed her illness with her and her family.
Many expressed sympathy for the doctors and nurses who work in cancer care, recognising that it must be hard to work in an environment where so many patients get bad news. Women were often agreeably surprised by how good their cancer teams were, saying they ‘couldn’t be faulted’ and describing them as brilliant, wonderful, amazing. Some had not expected such high quality care and communication in the NHS and thought they had been lucky.