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Biomedical subjects

D L Volker

Publications and source records attributed to D L Volker.

8 recordsLinked to original sources
PubMedDate not supplied

Infection in the cancer patient with an ostomy.

One of the most common reasons for ostomy surgery today is cancer. Because cancer is frequently treated with combined therapy, the surgery that results in an ostomy may be only one component of the overall therapy. The ET nurse is frequently the only nurse who cares for the patient on a consistent basis as he or she crosses medical-surgical therapies, and the ET nurse may be the one to first notice changes in the patient. Knowledge of the increased risks of infection and methods of prevention and therapeutic approaches are critical to the care of a patient who is undergoing such therapy.

Aged↗
PubMedDate not supplied

Oncology nurses' experiences with requests for assisted dying from terminally ill patients with cancer.

PURPOSE/OBJECTIVES: To explore oncology nurses' experiences with receiving requests for assisted dying from terminally ill patients with cancer. DESIGN: Descriptive, naturalistic. SETTING: RNs who identified themselves as direct care providers or clinical nurse specialist members of the Oncology Nursing Society. SAMPLE: 40 oncology nurses who responded to a randomized, sequential direct mailing submitted 48 stories for analysis. METHODS: Anonymously submitted written stories analyzed using Denzin's process of interpretive interactionism. MAIN RESEARCH VARIABLE: The experience of receiving a request for assisted dying. FINDINGS: Four main themes emerged from the thematic analysis: Control, Conflict, Covert Communication, and the Enduring Influence. Eleven subthemes included the Cry for Help, Hastening the Process, What if, Managing the Morphine, Countering With Palliative Care, Collision of Values, Sense of Distress, Dialogue Around the Request, Silent Knowing, the Unforgettable, and Reflections on Lessons Learned. CONCLUSIONS: Experiences included a mixture of direct-patient and family requests for pain relief, anticipatory fear of future pain, desire to end life before unacceptable deterioration, family requests to hasten the dying trajectory, and others. Stories reflected the larger societal struggle with desires to control life, health, and the dying process. IMPLICATIONS FOR NURSING PRACTICE: Nurses should be prepared to respond to such requests in a compassionate and helpful way that is respectful of both the patient's and the nurse's personal values. Diversity of individual values and priorities may trigger some patients to seek assistance in controlling the timing and circumstances of death. Thus, continued study of nurse, patient, and family member experiences with this ethical dilemma is warranted.

Adult↗
PubMedDate not supplied

Carcinogenesis: application to clinical practice.

The evolution of cancer is an intricate, multistage process involving the interplay of numerous variables that both inhibit and enhance the growth and spread of disease. An understanding of the process of carcinogenesis is vital to successful care of patients with cancer. Nurses play a key role in translating information to patients about prevention and health promotion, diagnostic testing, treatment approaches and side effects, and the need for frequent and long-term follow-up. Many patients and their families are well aware of the continual, often exciting, advances in prevention, detection, and treatment of malignancies. Understandably, they look to oncology nurses and other healthcare professionals for guidance and understanding of how these changes might affect their healthcare decisions.

Carcinoembryonic Antigen↗
PubMedDate not supplied

Needs assessment and resource identification.

Given the constraints of the current healthcare system, the mandate for patient education is clear - a time-efficient and cost-effective approach. This article explores the concept of conducting a needs assessment as a means of clearly and efficiently delineating learning needs and learner characteristics. Tools for collecting and documenting pertinent patient data should be used to consolidate information and should be accessible to all members of the healthcare team, avoiding costly duplication of effort. Other valuable resources include patient education exchange groups, which can be composed of representatives from all interested healthcare organizations in a designated area, and the identification and use of free or low-cost teaching tools.

Attitude to Health↗