Lung Cancer
Nursing care
Nurses have a wide range of duties, which may include personal care, observations, wound care, monitoring intravenous infusions, giving injections and other drugs, listening to patients' concerns, helping with practical matters (such as obtaining benefits), and writing reports.
People came into contact with nurses at every stage of their illness; in the outpatient departments, in the wards, and at home. In the outpatient department a nurse often calls patients into the consulting room. One man said that he found it upsetting when he was treated in an unusually sympathetic manner before he had received the diagnosis. At that stage he would have preferred to have been treated just like other patients.
He was upset that he was treated in an unusually sympathetic manner before he knew the diagnosis.
He was upset that he was treated in an unusually sympathetic manner before he knew the diagnosis.
Yes, when I initially got back to the hospital and had been diagnosed; you normally go and hand your appointment card in and they tell you to put it on a desk top and then you go and sit down and then the nurses when they pick them up they actually call people's names out, "Mr Jones can you come," or, "Mr Smith can you come," but when it came to mine they actually came across and gently whispered "Can you come with us." And you know straight away that there is something wrong and you're not being treated the same as everybody else. Although they think they're being so nice it's quite upsetting to find that they are being like that and you're not being treated normally.
Right.
And you know, a big lump comes in your throat and that's quite different. That was actually brought up at the support group and it's happened to quite a number of people.
That's interesting.
Yeah
So at that stage you'd rather just be treated like everybody else?
That's right, yes just treated, yes just call your name out and go in, in the normal fashion.
Having received the 'bad news' in the consulting room, patients were glad to have the support of a specially trained lung cancer nurse. Nurses sometimes offered reassurance and sympathy, answered questions, explained treatment; they also supplied a cup of tea or coffee, helped to communicate bad news to others, and advised people about benefits.
After she received the diagnosis her 'cancer nurse' explained her treatment and offered support.
After she received the diagnosis her 'cancer nurse' explained her treatment and offered support.
A tumour?
That I had a tumour in my left lung and I asked, 'Was it malignant?', and he said, "Yes I'm sorry it is. We can't operate because it's very near a main artery but we can shrink it and we've already planned a course of treatment for you," which I thought was very good. He said, "When you leave my office there'll be a young lady waiting to meet you and she'll explain anything you want to know," and that's when I met my cancer nurse and she's an angel. She made me a cup of tea and she told me that I'd got non-small cell cancer which I think is the best sort to have. She explained that I would have a course of radiotherapy which hopefully would shrink the cancer and that I had to go to our local hospital, not the same one, the one on the outskirts of town.
He describes the support and reassurance offered to him by his 'cancer nurse'.
He describes the support and reassurance offered to him by his 'cancer nurse'.
With treatment planned, one woman was grateful for the way in which the lung cancer specialist nurse helped her to prepare for her chemotherapy. The nurse took her to the chemotherapy ward, where other nurses explained what was going to happen.
Describes the support she received from her lung cancer specialist nurse and the nurses who ran...
Describes the support she received from her lung cancer specialist nurse and the nurses who ran...
Most people recalled the excellent nursing care they received once they were in hospital, and people mentioned that nurses made time to talk to them about their families, to listen to their problems, or to share a joke.
One woman described a day when she was crying and was comforted by a Macmillan nurse, and a man remembered a night when good bedside nursing helped to relieve his respiratory distress. One man said that a Macmillan nurse helped to speed up his treatment when delays occurred.
She recalls the comfort and support she received from a Macmillan nurse when she was in hospital.
She recalls the comfort and support she received from a Macmillan nurse when she was in hospital.
And she was really wonderful you know, I've only met her once since and that was at a, a speech that I had to do for Macmillan and she happened to be there and it was her birthday, it was five years afterwards and it was really wonderful seeing her again. But those are the people that you need around you, you know when you're going through something like this, they're absolutely brilliant yeah they can't do enough for you.
He recalls a night when good bedside nursing helped to relieve his respiratory distress.
He recalls a night when good bedside nursing helped to relieve his respiratory distress.
Some people said that they liked being cared for by a 'particular' nurse. However, one man observed that although a 'named nurse' was a good idea in principle, it did not always work in practice.
He couldn't fault the attitude or attendance of the nurses and that he liked having a 'particular...
He couldn't fault the attitude or attendance of the nurses and that he liked having a 'particular...
Do you think it worked, having a particular nurse assigned to you?
Yes, I think you just get' there's a feel good factor about feeling that someone's responsible for you rather than, half a dozen nurses any of which could be responsible. So I did like that, yes. It didn't mean that if, if I couldn't see her I, I couldn't ask someone else to get me something.
Comments that a named nurse may be a good idea in principle but does not work in practice.
Comments that a named nurse may be a good idea in principle but does not work in practice.
Did you feel there was a problem of continuity?
Oh yeah definitely yeah. I think they're very under-resourced, very under-funded.
Nurses were often seen to be overworked, particularly on the surgical wards. A man, for example, quoted earlier, said that although the nurses did an 'incredible job', he would have liked to have had more TLC (tender, loving care) after his operation, and another man complained that he hadn't received a lot of sympathy after his lobectomy. Occasionally communication broke down (see 'Talking to doctors and the care you received').
Comments that after his operation the nurses did not have enough time to give him all the...
Comments that after his operation the nurses did not have enough time to give him all the...
I think I'd have liked a little more attention. I don't think' I think it was after the operation I realised that they have a lot to do, and not enough time to do all, and really not enough time to look after patients. So for a lot of the time you're on your own, reading, or listening to the radio or whatever. But you are left alone, and it becomes scary, because you don't'. I suppose everyone' you can't get used to that sort of thing, I can't imagine you'd get used to it. So, it's scary because it's serious stuff, and it's ' to, to the nursing community it's everyday, but to the patient it's not. And it certainly wasn't to me, this was all, obviously the family came to visit me, I did have lots of visitors and I felt very' because I was' how far from home' about fifteen miles from home, and yet' My wife came in every day and some, sometimes twice a day, and I kept sort of wanting to make it easier on her and say, 'No don't come and see me so often', but really I wanted to see her, so'
Would you have liked the nurses to have had more time to sit down and talk?
Yeah, yeah. I'm sure, I certainly would. I felt that I didn't want to bother them because that's my attitude, my attitude to life anyway, so I didn't want to make their job any more difficult, but at times I had to ask for things, but I wouldn't ask until it had already got (laughs) it had already got to me a bit. So, you know, yeah, I would have liked more TLC [tender, loving care].
I think my first conclusion about the National Health Service, that not enough money goes in at the sharp end, I think most people would agree with me there. I think it's the nurses that need the support. I think there is far too much red tape, far too many managers. Get rid of half the managers and increase the number of nurses and you would solve the problems of the National Health in one go. I think that the nurses that are at the sharp end do an incredible job, and they care about what they do, they really do.
Comments that he did not get much sympathy from the doctors and nurses after his lobectomy.
Comments that he did not get much sympathy from the doctors and nurses after his lobectomy.
Those living at home were usually supported by a Macmillan nurse, a district nurse, or a specialist hospice nurse. Many areas have palliative care nurses, who are not Macmillan nurses but provide the same service. Depending on people's needs, nurses removed people's stitches or provided other nursing care, answered questions about the side effects of treatment, and organised practical help such as an extra mattress, or a grab rail for the shower. They also provided information about benefits or parking permits. Nurses also supported families. People were glad that they could call a nurse at any time during the day or night (see also 'Support for people with lung cancer', and 'Financial help').
Explains how the district nurses provided practical support after his operation.
Explains how the district nurses provided practical support after his operation.
Well I had the nurses, what do they call them, the district nurses because they used to come and see the wife, and then they found out about me, and they took me under their wing and they put a file out on me. And they've come round and they got me stuff where you have to, it takes ages to get it off the social services but they got it for me, they got me an extra mattress, what do you call it, things for sitting me up because I couldn't lie flat on my back at the time, I was propped up in my bed so I was lying like that you know. Got me one of them things where you put all your pillows on it like that and a thing to pull myself up, you know to get me up, to get me out of bed. They got me a shoehorn with a long handle so I could put my shoes on. And they just generally kept an eye on me.
The nurse offered practical support and got him a grab rail for the shower.
The nurse offered practical support and got him a grab rail for the shower.
Well the nurse come out, when I said I was having a problem getting in and out of the shower because we've got a shower over the bath so you have to step into the bath and being as I was getting a bit weak and wobbly you know, she had it measured up for a grip rail, well a grab rail they call it, so you can grab hold if you're feeling a bit sort of funny in the shower or anything, and a seat that clips onto the bath, that you can sit on to have a shower in, you know. Because we never used the bath since we had the shower, so she did get one organised, and we didn't have to pay for that which was good you know.
Some people did not want a nurse to call at their home. One woman, for example, said that she did not want a nurse after her operation because she felt she was cured and she wanted to forget she had ever had cancer. However, others would have liked to have had a bit more support when they got home. This suggests that some negotiation about frequency and type of contact with nurses would be useful.
Explains that she did not want a nurse to call because she wanted to forget she had had cancer.
Explains that she did not want a nurse to call because she wanted to forget she had had cancer.
No.
There was a nurse, you said a nurse called?
Well the nurse came but she was very nice but I didn't want her.
Didn't you?
No, no I told her nicely, you know she came and she said, as I told you she said she'd be coming for a few weeks to see me, you know see how I was going on. And so I said, "Well why are you coming?" she said, "Because you've had cancer." I said "Yes but I've had cancer, but I haven't got cancer now," so I said "Do you mind if you don't come because I want to forget I've had cancer?"
Yes I can understand that.
And that was how I felt, I wasn't, I wasn't being, you know I wasn't being discourteous to her at all but that's just the way I wanted it to be, I'd had cancer, the cancer had gone and that's the way I wanted it, I wanted it just to go and that was that. And that's the way I've looked at it ever since.
One woman recalled that she felt a bit shaken when a 'palliative' care nurse arrived at her house. She was taken aback because she thought that 'palliative' care implied she was no longer receiving active treatment. One hospice nurse was clearly aware of the possible distress that this might cause and suggested she should be thought of as a 'district nurse'.
Says that it 'shook' her when a 'palliative' care nurse called at her home, but that the nurse...
Says that it 'shook' her when a 'palliative' care nurse called at her home, but that the nurse...
Yes I have a palliative care nurse. That, when I came out of hospital after the sickness, when the cancer had shifted, these people started contacting me, people coming to take blood, to assess blood sugar levels, and palliative care nurses coming to chat to me about you know care in the home and what they can do for me and that sort of thing. That shook me a bit as well the palliative care nurse coming, I mean I know what palliative means and I thought, 'Oh, it means not treating,' just you know. But again I think you can have these people for a long time and I'm intending to (laughs) and so they're there to help you deal with practical matters really, or seem to be.
What sort of practical matters can she help you with?
Well apparently there are allowances you're eligible for, she can talk to your GP on your behalf, she can, what else, well she has, these people that were taking the blood sugar the care in the, the community nurse thing, she can deal with them for you. She can get you a disabled parking permit (laughs); always handy things like that. What else, I have got a list somewhere of things that she can do.
And how often does she come and see you?
Well she, I had an initial appointment and then we re-arranged when we were going to see her again. Oh that's right that's the other thing that is quite useful when you've sort of got an ache or a pain and you just think she'll talk to you about that. Because you can become a bit sort of is this the cancer or is it actually that I've just got a sore finger so it can be quite useful to say "What do you think this is?"
So do you call her up or does she come and see you?
I save them up my list of sort of aches and pains and moans and groans and she says chemotherapy that's the answer to most things it seems. But I'll tell you what she's supposed to, she told me to say that if anybody says that you need a Macmillan nurse they're the sort of NHS equivalent of a Macmillan nurse if people know what that means. I don't really know what that means but that's what they are. So I think you can use them for all sorts of things and they are on call, so if I wanted to talk about something I could call up and there are about four of them for this area.
Another woman was upset when she was introduced to a nurse from the local hospice during a consultation with a specialist. After the consultation the nurse offered her a long weekend in the hospice. At that time the woman felt well, and she found the conversation shocking.
She felt upset and shocked when the nurse from the local hospice wanted to introduce her to it.
She felt upset and shocked when the nurse from the local hospice wanted to introduce her to it.
There was a person there [with the consultant], a lady. I cannot honestly remember if I was asked permission or not, or, I mean they must have said who she was but I really wasn't taking it in. And afterwards she took me to another room and, she was a special cancer nurse from a local hospice, which shocked me quite a lot. She offered me a long weekend in the hospice, which, you know, I was just, well, I was very shocked with the whole thing.
I think she used the word 'when' I need medication I can go into the local hospice for about seven days while they work it all out, which to me was an awful, awful shock because I was not ill. Why would I want to go into a hospice? I was not on any drugs, so there was no way that I felt ill at all. I was coping with things, so, quite, well, I dismissed it completely. But it broke me. I'm not a person that can easily be broken but it actually broke me, and coming out of the hospital I was very, very upset thinking that I was going to die the next week. The following day the hospice phoned me up, a different person, asking me if I'd like to go and meet the staff at the hospice, which again I replied, 'No'. I'm too strong, you know, this was too sudden, no one had explained anything to me, why would I need to go to a place like that? So the answer was, 'No'. It did almost totally destroy me, I lost quite a lot of will [to live] at that time.
Last reviewed May 2016.
