Challenging situations when administering palliative chemotherapy – A nursing perspective

A Review of “Challenging Situations When Administering Palliative Chemotherapy—A Nursing Perspective”

“…The unforeseeable outcome of PCT and the dilemmas experienced by nurses have not been well described in the literature, but Näppä et al (2014) reported narratives of nurses' clinical experience that affirm the existence of these dilemmas. Näppä et al (2014) described how nurses can be "stuck in the middle" between patients, relatives, and physicians having neither the power nor knowledge to act according to their own perception of what is right.…”

“…Näppä et al (2014) described how nurses can be "stuck in the middle" between patients, relatives, and physicians having neither the power nor knowledge to act according to their own perception of what is right. When the doctor has not had a discussion about dying with a patient, the nurse faces the moral difficulty of talking to patients about ceasing or delaying PCT even if he or she believes it to be in the patients' best interest.…”

“…The uncertainty that they experience about their role can lead to moral distress because of administering potentially toxic agents with questionable outcomes to vulnerable patients (Sun, 2010). Näppä et al (2014) explored the experiences of nurses when administering palliative chemotherapy to incurable patients. Palliative chemotherapy treatment (PCT) was described as treatment that is unable to cure cancer but is intended to decrease harmful symptoms, tumor burden, and pain, as well as increase quality of life and prolong life.…”

Palliative chemotherapy decision-making: A holistic perspective

“…If a physical environment is found to compromise privacy, dignity or communicative effort of the patient/family, the nurse must take an active role in amending the environment or locating a more suitable place. [15] 3.2 Perform a holistic assessment Given that nurses spend the most time with the patient/family of any healthcare team member, [18] their input is essential in guiding the patient's care plan. To support the patient/family during the end-of-life period, and during the palliative chemotherapy decision-making process, the nurse may utilize a strategy called the holistic assessment.…”

Care Provided by the Health Team Under the Perpective of Patients in Palliative Chemotherapy: An Existential Analysis

“…5 Estudos que abordaram pacientes com câncer em terapia paliativa revelam que o manejo dos sintomas, principalmente da dor, pode melhorar a qualidade de vida dessas pessoas, além de propiciar melhor controle da doença. 6,7 Contudo, no que se refere à quimioterapia paliativa, para que seja de fato benéfica, o tratamento farmacológico deve ser associado ao acompanhamento e controle não medicamentoso dos sintomas, de forma a contemplar os aspectos psicológicos, sociais e espirituais que possam causar sofrimento aos pacientes. 6 Não obstante, a ausência de equipes de cuidados paliativos em grande parte dos serviços de saúde no Brasil, assim como de locais especializados para esse tipo de atendimento, pode ocasionar questionamentos e equívocos em relação às terapêuticas e cuidados, deixando o paciente à mercê de seus sofrimentos.…”