NURSING IN ONCOLOGY SERVICE: THE NURSE’S ROLE
1COELHO, Alexa Pupiara Flores Coelho
2; GIRARDON-PERLINI, Nara Marilene
Oliveira
3; BECK, Carmem Lúcia Colomé
4; DONADUZZI, Daiany Saldanha da
Silveira
5; DISSEN, Caliandra Marta
6; FREITAS, Natiellen Quatrin
7; SANGOI,
Thais Picolin
8; BORDIGNON, Juliana Silveira
9.
ABSTRACT
The object is to relate the experience of a nursing academic at an oncology unity, highlighting the nurse’s role. The insertion of the academic at the unity happened by PROFCEN (Programa de Formação Complementar em Enfermagem), an extension project that allows the contact of the nurse academics with different health services. The experience revealed a wide and necessary role that the nurse takes at the care of the oncological patient, seen in the lesions’ treatment, in the administration of chemotherapeutic agents, in
1
Experience report. Universidade Federal de Santa Maria (UFSM).
2
Presenter. Academic of 5º Semester of the Nursing Curse of the Universidade Federal de Santa Maria/UFSM - RS, Brasil. Member of the Research Group “Trabalho, Saúde, Educação e Enfermagem’’ of UFSM/Brasil. E-mail: alexa.p.coelho@hotmail.com.
3
Nurse Doctor. Teacher of the Nursing Department of the Universidade Federal de Santa Maria/UFSM – RS, Brasil. Member of the Research Group “Cuidado, Saúde e Enfermagem” of UFSM/Brasil.
4
Nurse Doctor. Teacher of the Nursing Department of the Universidade Federal de Santa Maria/UFSM – RS, Brasil. Member of the Research Group “Trabalho, Saúde, Educação e Enfermagem’’ of UFSM/Brasil.
5
Nurse. Master’s program in Nursing by Nursing Graduate Studies Program of the Universidade Federal de Santa Maria/UFSM – Brasil. Member of the Research Group“Trabalho, Saúde, Educação e Enfermagem’’ of UFSM/Brasil.
6
Academic of 7º Semester of the Nursing Curse of the Universidade Federal de Santa Maria/UFSM - RS, Brasil. Member of the Research Group “Trabalho, Saúde, Educação e Enfermagem’’ of UFSM/Brasil. PIBIC/CNPq exhibitioner.
7
Academic of 7º Semester of the Nursing Curse of the Universidade Federal de Santa Maria/UFSM - RS, Brasil. Member of the Research Group “Trabalho, Saúde, Educação e Enfermagem’’ of UFSM/Brasil. PROBIC/FAPERGS exhibitioner.
8
Academic of 7º Semester of the Nursing Curse of the Universidade Federal de Santa Maria/UFSM - RS, Brasil. Member of the Research Group “Trabalho, Saúde, Educação e Enfermagem’’ of UFSM/Brasil.
9
Academic of 5º Semester of the Nurse Curse of the Universidade Federal de Santa Maria/UFSM-RS, Brasil. Member of the Research Group “Trabalho, Saúde, Educação e Enfermagem” of UFSM/Brasil.
the providing of humanized, integral and holistic care, inter alia. The oncology nursing is a specialty and requires professionals with a wide technic-scientific and human supply, what can broaden the space and visibility that this professional has gained in the oncology services.
Descriptors: Oncologic nursing; Neoplasms; Nurse's role.
1. INTRODUCTION
In the last decades, it’s been seen a wide technic-scientific development at the oncological field, mainly with regard to the therapeutic, diagnostic possibilities and the early detection of disease, contributing to the increase of the average life expectancy of theses patients¹. Still, it is considered that there is still a challenging way to tread regarding the cancer treatment, not only in respect to the advancement of base technology, but also as regards to promotion of the holistic, humanized approach and emotional and psychological support are an integral part of treatment for these patients.
This is justified by the fact that the cancer is one of the most feared diseases and, culturally, it has strong connotation of suffering and death; and this social representation is connected to the fact itself being associated to the idea of radical and mutilating therapeutics, unclear prognosis and abrupt changes in lifestyle¹. Therefore, the cancer weakens those affected, with deleterious effects on body and mind, sexuality, corporeal image, etc.
So, is important that therapy be developed by professionals armed with the specific knowledge, commitment and, furthermore, sensibility, considering all of the uniqueness of falling ill. In this context the nurse stands as a professional which stays next to the patient, and who has a ruling participation in the construction of intervention and care strategies, by this way exercising influence above his treatment and life quality².
2. OBJECT
The present work aims to reveal the experience of a nursing academic at a unity of hospitalization to cancer patients, highlighting the participation and visibility that the nurse professional has achieved, in the oncology’s sector.
3. METHOD
It is reported the experience of an academic of the fourth semester of the Undergraduate Course of Nursing of a federal university in the state of Rio Grande do Sul / Brazil. The report focuses on contact of the academic with an hospitalization unit for patients with cancer from the University Hospital linked to the education institution, between December 2011 and January 2012, in a total of 120 hours.
The integration of the academic at this unit was made through the Programa de Formação Complementar em Enfermagem (PROFCEN), a university extension project conceived and promoted by the Board of Nursing Course of the institution above. The project aims to enter the academic to the municipal public health services, by monitoring the activities of a service nurse, providing opportunities for experiences with different health services
It is established has prerequisites that the academic already has technical-scientific knowledge related to the chosen service. Besides, the academic has to fill in a formal documentation in which a professor gets responsible for the academic and the assistance nurse of the service gets compromised to welcome him and insert him in his daily work, showing the unity’s operation, the making of the nursing procedures and the process of the nurse’s work in the assistance care and in the administration of the health services.
4. RESULTS AND DISCUSSION
At each shift’s beginning, the responsible nurses and physicians make a round at the unity, visiting each patient in his bed, evaluating his general clinical state. After, both nurses and physicians go to the nurse’s room, accompanied by the resident nurses and physicians. At this point, the prescriptions are made upon the discussion of each case, as well the scheduling of such cases. This process of multiprofessional work allows an interaction and effective information’s exchange between the professionals, culminating in a better assistance quality.
This system was an achieve of the unity’s nurse, which argued being this the way of claim its participation role at the decision’s take. That points to a nurse that looks for the recognition and consequent visibility, by its professional action, both among the multiprofessional team and in relation to its care object – the patient³.
Tracking all this process, watching the performance of the nurses and being inserted in his working routine, the academic had the dimension of the responsibility focused in this professional.
That can be observed, e.g., in performing of the tumor lesions’ bandages. Besides determining the best way of cover, the nurse is responsible for watching over the lesion’s evolution, identifying phlogistic signals, assessing abscesses, quantifying and qualifying the secretion’s drainage, what denotes his role of assessing patient care needs, deciding about the care4.
Another example occurs in the administration of chemotherapeutic agents, as this role is exclusive to the nurse. The nurse musts know the sequence in which each medicine is administered and the side effects of each one may cause. The nurse should stay in the patient’s room during all infusion of some medications, alert to any signal or adverse symptom, being the nurse’s role taking the urgency measures in the case of intercurrences. The risks involved in the chemotherapy’s process make necessary the quality of the care to the treatment’s success².
Another nursing care essential for the safety of the chemotherapy process and that at the oncological unity is exclusive of nurses, is the peripheral venipuncture. The special responsibility and technique involved in this procedure lies in the fact that in patients undergoing antineoplastic infusion, the venous network is generally fragile and difficult to visualize³; additionally, venous access must be thickened and accurately secure, thus avoiding the risk of leakage, which in the case of vesicant chemotherapy, can cause serious problems³.
The importance of safe venous catheterization, and the technical skill required to perform and it is known for patients in the unit, and represents a strong concern for them each cycle of chemotherapy. It is in this context that the nurse is recognized by them as someone who plays a central and vital role to their treatment, what might be perceived in coexistence and dialogue with them during the permanence of the academic at the unity. The visibility of the professional nurse in the patient emerged from his indispensability, the importance of his role and security conveyed by him during the course of care.
It is noteworthy, however, that the nurse's role and visibility gained by him go far beyond technical care inherent to the therapeutic process. The nurses and nursing technician of that unity play a constant health education work, listening and dialogue. They
understand the complexity of the care of people in chemotherapy treatment or in palliative care and they understand that the adhesion to the treatment and the courage of each oncological patient needs to fight for his own life is potentiated at the presence of the complicity and the commitment of a human, incentive, qualified and present nursing.
5. CONCLUSION
The demands of an oncology unit are permeated with technical and scientific complexity, as well as a big emotional charge presents in the ill by cancer. Therefore, the nurse who chooses to work in oncology needs an intellectual and human support compatible with the responsibility focused on his hands, for each dressing change, each infusion of
chemotherapy, each nursing procedure represents a commitment to someone else's life and
prognosis.
For these reasons, the nurse is an essential actor in the cancer treatment services, either by his clinical necessity or by his role as a human and holistic support, what justifies o growing recognition and visibility that have been achieved by him in this and other areas.
Thus, the contact of the academic with the oncological unity, with the patients and the team was intensively constructive, as it revealed the importance of the interdisciplinary, the importance of the dialogue exercise, as well the importance of the exchange of the technical and scientific knowledge in the construction of new knowledge and in the formation of an engaged professional.
REFERENCES
1 Cascais AFMV, Martini JG, Almeida PJS. Representações sociais da pessoa estomizada sobre o câncer. Rev Enferm UERJ. 2008; 16:495-500.
2 Sherman JR. Aspectos psicossociais do câncer. In: Love RR, organizador. Manual de oncologia clínica da União Internacional contra o Câncer. 6ª ed. Nova Iorque: Springer-Verlag; 1994.
3 Brunherotti MR. Intervenções no extravasamento de quimioterápicos vesicantes: revisão integrativa de literatura. 2007. 143 f. Thesis (MA) - School of Nursing of Ribeirão Preto. Universidade de São Paulo, Ribeirão Preto, 2007.
4Castanha ML, Zagonel IPS. A prática de cuidar do ser enfermeiro sob o olhar da equipe de saúde. Rev Bras Enferm 2005set-out; 58(5):556-62.
5Rodrigues FCP, Lima MADS. A multiplicidade de atividades realizadas pelo enfermeiro em unidades de internação. Rev Gaúcha Enferm. 2002; 25(3):314-22.
