Facilitating End-of-Life Care for Patients With Breast Cancer

Oncology nurses and advanced practice providers (APPs) are an often-used resource used to support patients with cancer during end-of-life discussions and the implementation of palliative care, according to an oncology nurse practitioner.

La-Urshalar Brock, MSN, FNP-BC, CNM, spoke with Oncology Nursing News® about facilitating care for patients with breast cancer as they near the end of life.

Brock emphasized the difficulty in seeing patients that nurses and APPs have known for months or years reach that stage, as is frequently the case with breast cancer. Despite this challenge, said Brock, it is important to understand that part of the role of oncology nurses and APPs is to make the end of life comfortable and to understand patients’ medical or emotional needs.

Among the ways oncology nurses and APPs can provide support, mentioned Brock, are working with families to determine what level of care is needed at the end of life and starting conversations about what this stage of care will look like.

Brock is part of the Breast/Gynecologic Specialty – Medical Oncology at Winship Cancer Institute of Emory University in Atlanta, Georgia.

Transcript

It is a hard subject to talk about for…a lot of us nurses as well as physician assistants. We are seeing these breast cancer patients on a regular basis for months to years, and so it can be difficult to see someone start to progress in terms of going towards those final stages of end of life.

So just trying to be there for the patient as best as possible, trying to be very supportive and answer questions that you know that you can answer, and if not, trying to get someone else involved.

Using palliative care is really good in terms of trying to just talk about what things look like moving forward, what things are available. I mean, that can also be done in clinic, though.

Our nurses work…hand-in-hand with the patients. We know nurses are the ones that are pulling the portal messages. They’re answering the phone calls a lot of times…we know that they really get to know these families, and so just trying to be there and trying to see exactly what [they need].

Do they need an inpatient hospice kind of consultation? Do we need hospice that’s going to come to the home? Is it something that we need to set up so that they can start interviewing, or do we just need to start at the very beginning in terms of just talking about “What is palliative care?” or “What is supportive oncology?”

Just getting it in the very beginning and getting them to know that system and that [nurses and APPs are] there to help with side effects and how someone feels, just to get them to feel the best that they can. I think it’s very important.

This transcript has been edited for clarity and conciseness.