Note. ONS Diversity Champions shared their thoughts on cancer disparities for the June installments of RE:Connect. For more information about the ONS Diversity Champions, check out the Diversity Tool Kit here.

 June 27, 2008

Nurses Help Patients With Disparities Caused by Preconceptions
Tara Fedric, MS, RN, CNS, OCN^®

Mrs. E was a 57-year-old African American patient who had just undergone her seventh hip surgery. As her nursing student’s instructor, I was making rounds on patients, and as I entered the room, she was lying very still in bed with tears running down her cheeks. I asked her to share what was bothering her, and she told me she was in terrible pain. She went on to tell me her story.
               
Mrs. E was a well-educated woman who worked for the state government. She had a history of chronic hip problems, having had several surgeries on both of her hips over the past few years. She discussed how she had become dependent on pain medications and had ended up in a rehabilitation program. She was now having a very difficult time getting adequate pain medication for the level of postoperative pain she was having. She said it was insinuated that she couldn’t have narcotics because she had been through rehab. She felt that part of this attitude by the nurses was because she was black. She told me she was very careful about taking anything that would cause a relapse, but because she was newly postoperative and in severe pain, she felt she needed to be appropriately medicated.

The oncology unit in this hospital had a nurse who worked closely with patients on their pain management. The student and I went to her for help with Mrs. E. Very quickly, we had assessed the patient’s situation, her pain levels since surgery, and the medication that had been ordered and administered. It was obvious that things were being mismanaged. We contacted the physician, gave him our information, and asked that her orders be changed.

We obtained an order for a continuous IV dose of morphine, a patient-administered dose, and an additional booster. With this in place and after some teaching by the student and me, we made the patient comfortable in bed, darkened the room, and left her to rest. By the end of the shift the patient was alert, talkative, smiling, and very happy to be comfortable. She continued to heal, getting up for physical therapy, and decreasing her dose of morphine until she was able to change to a milder po medication.

So I thank the oncology nurses with their knowledge of pain management, for taking the time to truly “care” for their patients, no matter what the situation. And I know that their patients thank them also!

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June 18, 2008

Finances Are a Key Factor in Cancer Disparities
Wyvonia Woods Harris, MS, MDiv, DMin, RN, Clinical Research, Finance, Memphis, TN

When I am asked, “What do you do?” I carefully chose how I answer. The reason that I feel it is necessary to do this is because of experiences over the past 40 years. I have been a student, new, experienced, and now a seasoned nurse. I am also an ordained minister, so I am careful to listen to others when they discuss situations that are caused by what I call “whole-body experiences.” These experiences can be caused by physical, mental, and/or spiritual losses.

I work as a clinical research nurse, and I am amazed at the stories people tell when you start discussing health issues. I have heard stories of wives who are ill because they only have enough money for one person’s prescription and they makes the decision that the husband needs the medication more because of his heart condition. I have also watched families torn apart because of life and death decisions and no one has ever discussed end-of-life issues. Today I heard a patient say that she would have to drop out of a clinical trial because of the price of gasoline and not being comfortable with using money for gas that she could be using for food. I was saddened to think that life can be measured by the gallon. I believe that nurses are key connections by giving preventive education and consistent follow-up care.

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