18 July 2014

The Big 'C'

'Uh, Déborah, what is cancer?'

I looked up from my teaching notes and blinked at the five men circled around me in the wound care room of the OR.

'What did you ask?' I question, assuming I must have misunderstood.

'You're talking about dressings for patients with cancer, but we don't know what that is.'

I looked at each one, hoping I'd get an indication that they were joking . . . but they weren't.  Four OR Techs and a NurseAnesthetist-in-training, and they didn't know what cancer was.


Three mornings a week I spend about 45 minutes teaching our wound care team important things like The Anatomy of the Skin and The Physiology of the Wound Healing Process and Proper Positioning of the Wrist and Ankle for Splinting and Casting.

At first they tried to use our sessions as a way to show off everything they already knew . . . and prove that they had nothing to learn.  But very quickly they began to realize just how complex the wound care process is, and their hunger to learn grew rapidly.

When we began these sessions three months ago, it was nearly impossible to get them to answer questions, let alone ask one like 'What is cancer'.  But somehow they have come to feel safe . . . safe to try, safe to answer incorrectly, safe to offer an opinion, safe to laugh at my mistakes (and their own), safe to learn, and safe to ask questions.

One of my vivid memories from when I was little is an infomercial that was on TV.  It was a Saturday morning when the cartoons should have been on . . . I remember, because we were only allowed two hours a week, and so we had to choose wisely.

I did not choose the infomercial, but there it was.  I have no idea why it wasn't turned off, but I will never forget the hairless little girl from St. Jude's Hospital and the blonde woman with the perm who told us that we needed to send a check to help make the bald girl better.  After that I was afraid of catching Leukemia because I didn't want to lose my hair too . . . but I did want to go to that big hospital and play in their waiting rooms and get presents from their gift shop.

That was the first time I heard about cancer.  And I was five, maybe six.

I imagine we'd be hard pressed today to find anyone in NorthAmerica over that age who hasn't heard of cancer.  We all have a friend or loved one that has battled for their lives because of the horrific rebellious cells that we call cancer.  None of us are beyond it's reach.

'We know it's a disease.  We read it in the diagnosis box.  But we don't know what it means,' the wound care team admitted.  'Can you explain it to us?'

I stumbled over my French . . . mainly because I was so shocked to be explaining to five grown men what cancer is.  They were gracious with my response, but I could tell it hadn't fully satisfied their hunger to understand.

So this morning, we broke it down . . . Cancer 101.

Each one denied having ever heard of DNA and they knew nothing of how cells divide.  They asked questions about specific patients that they had seen . . . and were horrified to hear about metastatic tumors.

I was teaching a man nearing retirement what I had first heard about as a five-year-old . . . and nothing was discussed that was more advanced than 8th Grade Biology.  But I'm pretty sure that only the NurseAnesthetist-To-Be had made it to the 8th Grade.

One of our major obstacles to improving the quality of care that our patients receive is the low level of education that our nurses and nurse aides have.  The nursing programs in this country do not include a Skills Lab . . . most have never placed an NG-Tube or a Foley Catheter before arriving for their first day on the job.

We have a desperate need for nursing education . . . I'm not a nurse.  I can't teach a nurse how to be a nurse, and neither can a doctor or a surgeon.  We can teach clinical physiology and functional anatomy.  We can model how to take a medical history or do patient education.

As non-nurses, we can only do so much.

What we need are nurses . . . nurses who can help teach the basics.  Nurses who can model professionalism and compassion.  Nurses who can show what it means to be excellent.

What do you think?  Will you join us?  For a few weeks?  Or months?  Maybe even a year or two?

1 comment:

Lisa Kukkamaa said...

How heartbreakingly difficult! It really makes me wish I were a nurse...I'd be there in a flash. :(