Delivering Cancer Care With Compassion
Inspired by his mother's career as a nurse, Ryne decided to attend the nursing program at Western Kentucky University. After his internship with the Oncology Nursing Society, he chose to specialize in oncology. The internship helped Ryne gain skills outside the classroom, such as talking to people, understanding the context of health care, and recognizing that people come from various backgrounds. This experience helped him gain a better insight into working with cancer patients who were often severely ill and receiving inpatient care.
Early in his nursing career, Ryne worked with several patients who would come in for chemotherapy. One of his earliest memories of delivering difficult news involved a patient whom he had been taking care of for a few months. The patient received results from his bone marrow biopsy, indicating the severity of his cancer. That experience reframed Ryne's idea about what it means to care for people. Patients are not "room 234 with leukemia" but human beings with a family, background, and history. Having tough conversations brings out the humanity in healthcare.
Ryne believes healthcare providers should have more formal training to learn how to deliver difficult news to patients and their families. He addresses two important topics to consider: treating patients and providers humanely. In other words, having tough conversations requires a balance of tactfully delivering difficult news to people while also taking care of the community that has to deliver the difficult news. Ryne believes provider burnout should be discussed more, especially in nursing.
When working with physicians who may not have the same level of compassion as him, Ryne saw that as an opportunity for him to fill that gap as a nurse. Sometimes, Ryne was in the same room with a physician who did not deliver news to the patient in the way that he would have wanted it to be given. Once the conversation was over and the physician walked out of the room, he would usually stay after to answer any further questions and give his business card. Ryne believes nurses play an important role in answering questions and clearing up misunderstandings during and after clinic visits.
When initiating the end-of-life discussion, Ryne highlights the need to recognize the patient's priorities through shared decision-making. He defines shared decision-making as determining what is most important to the patient and their family. This process includes reviewing different treatment options early on, discussing types of care that the patient might need, and planning potential referrals to ensure that the care administered by the medical team aligns with the priorities of the patient and the family. Furthermore, Ryne emphasizes that it is a continual, iterative decision-making process because priorities change in people's lives as they go through their healthcare journey. Moreover, there could be deep-rooted issues between family members that the healthcare team will be unable to solve immediately. As a result, they need to work with patients and their support systems to solve these issues.
