by Courtney Jarboe, Bioethics Program Student
“It’s not good news.“
In a small exam room, we heard these words as my sister’s tears began to fall. No one wants to hear that you have breast cancer. Beyond the discussions of treatment options, however, there are a number of issues that clinicians need to consider. The following are recommendations based on my personal experience with my sister’s diagnosis.
1. A Folder
At the test result meeting, my sister received several medical record documents, along with various resources, pamphlets, journals, and business cards. However, there was no folder to house all of this. As we approached the close of the appointment, juggling the paperwork I ended up having to ask the physician assistant for a folder. Why is this a problem? First, these are important documents. The documents should be kept organized and together in one place. Keeping things together was not necessarily on the top of my sister’s list. By simply providing a folder, the clinicians would decrease the likelihood of her losing important information.
More important, most of the pamphlets and resources had ‘Breast Cancer this… Breast Cancer that…” on the covers. Often this was in big, bold headers. What if she isn’t ready to brand herself in pink moments after receiving such devastating news? Does she want everyone in the waiting room to know her diagnosis as she walks out of the clinic? Does she want have her children come across these items accidentally before she is ready to share? By keeping these items in a folder, this gave my sister at least some degree of privacy about her results and diagnosis.
2. Appointments and referrals
In my sister’s situation, she was told she that may want to meet with an oncologist, who was resident at the hospital. She was told that it would be easy to set the appointment, but to do this my sister would need to go back to the registration desk. Easy, right? Not necessarily. For a woman who just received such devastating news, setting up something as simple as an appointment may not be all that easy. Her schedule was the last thing on her mind, let alone how she was going to ‘fit’ cancer into it.
It wasn’t as easy as the clinician claimed. My sister went to the registration desk and the staff member was apparently new. After much back and forth, my sister finally said (loudly, for everyone to hear) I have cancer.
Rather than send the newly diagnosed cancer patient up front to schedule these appointments, process these transactions in the exam room out of the public eye (and certainly not with a new staff member). Even though physician assistant or clinical might not have access to the scheduling system, couldn’t they quietly work that out with the registration staff and then circle back to the patient? During my sister’s result meeting the physician’s assistant stepped out of the room while the surgeon discussed her options for surgical procedures. During that time, they could have worked out the other details for the next appointment. Perhaps they could have gotten a list three of available times from the registration desk and circled back after the surgeon’s conversation.
After surgery my sister was in a predicament. One would think that it would be common sense to say hey, after surgery, your typical bra isn’t going to be useful or practical. However, she only received the usual wound care information sheet, not information about which bras are best following a lumpectomy. Give women a heads up. There are more important things to spend energy on than trying to find a bra.
Perhaps these recommendations are already in place in other hospitals and clinics, but my sister’s experience wasn’t as smooth as it could have been. Attention to the little things could go a long way to alleviate some of the unnecessary burdens that in my sister faced. More so, a woman’s trust and confidence in the healthcare community can be found even in the little things.
[The contents of this blog are solely the responsibility of the author and do not represent the views of the Bioethics Program or Union Graduate College.]