Tina Dahl always sits close beside a new patient, quietly observing as they wait to see the oncologist for the first time. She knows that what happens during that first conversation will help her to discover what makes this person tick. What is important to them? What are their worries? And how much do they already know about their treatment?
This is the kind of holistic, whole-person approach that her patients have come to value so highly in her work as a cancer nurse at Rigshospitalet in Copenhagen, Denmark. Most cancer patients only see their doctor at the beginning and end of a course of chemotherapy, as well as once midway through. Tina typically sees 90 patients over the full 6 months of their treatment course. She adds that sometimes she spends more time with her patients than her own family.
“As a nurse, I am key to the patient’s journey. It’s important to meet in the right environment, to observe their body language and establish a good connection from the outset,” she explains.
“Some patients have done a lot of research and feel their situation is overwhelming. Others know very little, don’t ask questions and need to be guided through the treatment pathway. My job is to create a sense of well-being for the patient and to give them the energy to see that they will get through it.”
Tina adds, “When we succeed with this, as we fortunately often do, then we’ve done our job well. Of course, there are also some who die from breast cancer, and that’s when it becomes very difficult.”
Guiding the way
People are very different, Tina points out, but she believes that we all have an inner reservoir of strength which we can call upon in times of hardship. And, after 20 years working in cancer care, she knows the subtleties involved in helping patients to help themselves.
“It’s OK to have a bit of fun together,” she insists. “We make sure we have time to bring a sense of lightness, and it really helps people to find and mobilize the resources they have inside. It’s clear that we work with something which is very serious and heavy, but we still have to live.”
Today, a cancer nurse’s increasing workload involves observing and treating the patient, referring back to the oncologist, answering questions, and making information accessible and simple. Tina gets to know her patient’s innermost thoughts and fears, as well as details of their physical symptoms. She spends time reassuring them so they can relax a bit and accept that what they are experiencing is all part of the process, and will pass.
“One of the most challenging tasks is to get them to believe this. Then, I can get them to focus on what they need to do in the present moment.”
Good days and bad
“Our patients sometimes have difficulty with their body image since they have lost their hair and eyelashes and feel very tired. When they come through the door and I see them looking sad or tired, I address what I see. Then I take some time to talk about the actual problem before getting to the practical work with chemotherapy.”
Tina continues, “It’s a good day when a patient comes in and tells me about something that they’re doing which builds their confidence. It may be someone who has gone for a walk despite being completely exhausted. When a patient tells me this, I know they have listened and are doing something which will improve their treatment process. I then back them up and say that is exactly what you need to do, and when they tell me their story they get inspired to do even more.”
She concludes, “Motivating others is not as easy as it sounds, but when I succeed it’s a really good experience. We get a lot of praise for our work, and I think it’s because we use our resources to sit and spend time with people, to understand what’s meaningful to them and what their strengths and weaknesses are. It doesn’t require anything fancy – you need to sit there and listen and build on what you see.”
