Every nurse has been in a situation where he or she is staring at a discharge document, thinking, “This patient will need an immense amount of outside support to adhere to this treatment plan.”
A 37-year-old patient with breast cancer without a means of transportation requires daily trips to a radiation clinic. A 69-year-old patient with colorectal cancer, newly retired and on a fixed income, has copays for the oral agent ordered as part of his treatment plan. The case studies could write themselves.
Barriers for Nurses
Nurses are usually most comfortable providing support for managing treatment-related side effects, and the positive outcomes of such interventions are well documented. Although financial and economic assessment may be uncomfortable for nurses, it is of the utmost importance in helping patients and the healthcare team recognize potential barriers to adherence to their treatment plan.
Nurses face various barriers as they try to identify patients’ financial needs. Lack of a standardized approach to assess financial needs is of primary concern. Additionally, patients either are not forthcoming with financial barriers or different family members were more in tune with financial struggles and concerns. Finally, financial needs and concerns change over time throughout the disease trajectory, and needs for support and resources emerge that perhaps were not issues earlier in treatment.
How to Help Your Patients
What may help a nurse with financial assessment and support is an awareness of resources for patients with cancer and their families. First, patients and their families must be referred to interdisciplinary healthcare professionals as indicated. Social workers, nurse navigators, and case planners are instrumental in identifying resources for patients and are in tune with national and local organizations offering support.
Many pharmaceutical companies offer patient assistance programs to help provide medication for those who cannot afford it. Various organizations throughout the cancer care community provide assistance in not only medication cost management, but copays, transportation, living arrangements, and child care. The Cancer Financial Assistance Coalition, a coalition of cancer support and financial assistance organizations, provides a database of sorts for healthcare professionals seeking to provide financial advocacy to their patients.
Improving Treatment Outcomes
A lack of financial and economic support during cancer treatment can have negative impacts on quality of life and a patient’s likelihood of adhering to a treatment plan. Consider the cases listed earlier and the implications if no one supports or advocates for those patients. In both instances, it may be that the patients were too embarrassed to mention to anyone on the healthcare team that they need support. Simply asking the needed questions of all patients encountered may help reduce embarrassment by giving permission for patients to admit their barriers to treatment plan.
Nurses do not need to have all of the answers to the barriers their patients may face, but they should demonstrate comfort in assessing and providing referrals for support. This type of advocacy is no less important than symptom management advocacy, yet may have the same impact on preventing poor outcomes.