Three Ways Nurses Can Set an Example for Supporting People Who Have Cancer

Much has been written about cancer as a metaphor for sport, games, competition, and even war.^1,2,3 As a nurse and athlete with a recreation degree, I often find myself contemplating what the thought process is behind some of the things people say when it comes to talking about cancer. Even some healthcare organizations include these metaphors in advertising, using phrases like "game-changer" or "beat cancer" with images of beefy NFL quarterbacks to promote their services.

If you feel compelled to frame cancer as a sporting event, remember that for the patient, it's not a game or a season, and no one trains for it. It's like putting someone's 90-pound great-grandmother in the middle of an NFL scrimmage.

People have a hard time responding to cancer, even healthcare professionals (how many times has a colleague asked you if being an oncology nurse is depressing?).

On social media, the responses to someone with cancer seem to fall into 3 categories: cheerleading, thoughts and prayers, and avoidance. Taking the sport metaphor further, cancer can stir up emotions in spectators when they lack the experience, maturity, or stability to not take things personally. It's sort of like a sports fan throwing a tantrum in the bleachers over a missed field goal.

Cheerleading involves saying things like "You've got this!" or "You can beat this!", but the person with cancer doesn't know if they do or will. The person saying it knows even less.

Nurses can play a strong, supportive role in educating the public on avoiding these tropes and clichés.

For example, thoughts and prayers are nice, but how about actions? You should ask the person, "What can I do for you?" or "How can I make some physical effort toward improving your well-being right now?"

One patient I talked to said they couldn't believe it when their nurse said to them, "I'm praying for you to beat this." To the nurse, it might have seemed a nice thing to say, but the patient bristled at it.

Nurses can support patients by not making these gaffes and being an example to others observing our care. We can ask, "How can I best support you now?" or "How can I continue to support you as your needs change?"

Here are some things nurses can do to support their patients.

• Correct overheard misconceptions and misinformation wherever possible, tactfully but assertively. You are a professional and carry more weight than the average layperson, which includes social media comments. People will learn from you. While this isn't going to help your patient directly, every bit of education is valuable to the public's collective understanding of cancer.
• Be an example of calm, practical support. Ask those two questions above in front of caregivers and family/friends so they can see how it's done. Explain your rationale for asking in front of them: "I'm asking this because I can see that you're really struggling to get through the day with everything you have on your plate." Or "I'm asking because I know you're hanging in there now but what are you going to need when your spouse goes back to work?"
• Keep a file of notes on support services or practitioners in the community that you hear about from time to time, including when you are not at work. Learn a little and then provide this information to navigators and patients. Ask patients what or whom they've found helpful in the community. You never know what little piece of information passed on in conversation might be helpful or even life-changing to someone.

While we can't be there for every moment each patient with cancer is going through, we can be part of a solution to what is an otherwise difficult experience for which no one seems to be trained or prepared.

References

• Sontag S. Illness as Metaphor. New York, NY: Farrar, Strauss, & Giroux; 1978.
• Bach P. Dr. Peter Bach on "avoiding the breast cancer 'warrior' trap." Health News Review website. healthnewsreview.org/2014/08/dr-peter-bach-on-avoiding-the-breast-cancer-warrior-trap/. Published August 4, 2017. Accessed July 23, 2018.
• Stordahl N. What does "beating cancer" mean anyway? Nancy’s Point blog. nancyspoint.com/beating-cancer-mean-anyway/. Accessed July 19, 2018.