By Kathleen Wiley, RN, MSN, AOCNS®, and Barbara Lubejko, RN, MS
When the COVID-19 novel coronavirus pandemic hit the United States, in a matter of days clinicians were scrambling to find novel ways to screen, triage, and provide telehealth interventions to protect patients with chronic conditions who are especially vulnerable to COVID-19. As nurses, we are accustomed to helping patients in crisis acclimate to a changing environment, process large amounts of information, and have their psychosocial needs met.
The COVID-19 pandemic presents new challenges that nurses may not feel prepared or equipped to help their patients navigate. During tenuous and uncertain times, nurses must consider their patients’ psychosocial and mental health and get back to what makes us so trusted among patients and caregivers: therapeutic communication and comprehensive psychosocial considerations.
Communication to Ease Concerns and Anxiety
To help keep patients with cancer as safe as possible, clinicians are making the difficult decision to delay noncritical scheduled treatments to limit potential COVID-19 exposure and to prevent flooding the healthcare system. Understandably, patients with cancer become unsettled when procedures or treatments are delayed, but in some instances, it is the absolute right decision.
- Reinforce with patients the continuing need to decrease their risk of exposure to COVID-19.
- Help patients and caregivers understand that treatment decisions always call for carefully measuring risks and benefits associated with care. Explain that treatment delays during the COVID-19 pandemic are no different than treatment delays because of side effects and toxicities. For now, it may be in their best interest to avoid healthcare centers and possible further immunosuppression.
Reassure patients that they will be treated and seen on a case-by-case basis. Early symptoms of COVID-19 can be subtle, often mimicking those of common complications associated with cancer and its treatment. Nurses must stay in close communication with cancer care providers and adopt workflows based on a patient’s cancer diagnosis, current cancer treatment (including immunosuppressive drugs), and symptoms.
Psychosocial Strategies and Self Care
Amid the complexity of triaging patients with cancer during COVID-19, nurses must consider the mental and spiritual wellness of patients whose lives are upended right now. Helping patients and caregivers manage fear and uncertainty is where nurses shine.
- Review effective coping strategies. Patients may want to engage in mindful meditation, tai chi, or yoga practice from the comfort—and safety—of their own home.
- Encourage virtual support groups or clergy visits. The Cancer Support Community provides resources for online support.
- Remind patients that it’s ok to take a break. Constant engagement with social media and the news is overwhelming and may increase anxiety. Suggest that they disconnect and read a book or journal.
- Encourage patients to stay in touch virtually with their family and friends to prevent the negative effects of social isolation, and tell caregivers to check in with patients, especially older adults.
- Recommend taking walks outside and other forms of exercise that incorporate social distancing.
Remember: you are not alone; we are all in this together. ONS is your resource for professional support and guidance. Get ideas for psychosocial care on the Oncology Nursing Podcast and learn more about COVID-19 on the ONS resource page. Finally, ask questions and discuss solutions with other nurses on the ONS COVID-19 Community so we can all figure this out together.