Understanding the older person with
cancer: a qualitative study of two wards
Tentative findings
Antonia Lannie, PhD student,
Supervisors Prof. R. Barbour &
Dr.J.Corlett
Findings
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Ward as a ‘half way house’
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‘Etiquette’
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‘Emotion work’
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‘Hope’
The ward as a ‘Half Way House’
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I think hospitals are a great place if you need them. I
needed them. Not only me but my wife did as well.
That’s why I’ve always had that attitude; hospitals are a
great place if you need them and I’ve needed them …I
would say it’s a safe place. (Male Patient)
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Giving them company to reflect on life that is there. (Health
Care Professional)
The ward as a ‘Half Way House’
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When am I going home? because regardless of how
well off you are and how much attention you get, the
psychological state of a person who is ill and who
thinks about this illness is, ‘Will I be safer to be here,
or be in my own house?’ And ironically you always
feel safer going to hospital and when you are here
you want to go home. (Male Patient)
It’s a barrier they don’t want you to cross-they are
quite happy to be independent, but when they do need
you they still don’t want you to do it, but you need to
do it. (Senior Staff Nurse)
‘Etiquette’ –relationships
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I feel they could inform you more. May be there are certain things
etiquette, or whatever you call it, stops them from saying too much I said
to one of the doctors, ‘What’s your opinion, never mind your professional
opinion, what’s your opinion?’ And he said, ‘I’m not allowed to air
opinions (Male Patient)
… but she is a very funny person. Her vibes, I don’t know how to word this
to be sociable. (She often says ) .‘Don’t worry about it, don’t worry about
it.’ But I do worry about it. It is a very funny thing to say to a patient.
(Female patient).
I think it’s because it’s their (relating to Doctors ) general practice and
things like that. They have to be good whether they want to be good or not
they’ve got to bite their tongue and be good. (Female patient).
‘Etiquette’ – Professional and personal
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I always remember meeting a junior doctor once and she said, ‘that’s
terrible,’ you know about this patient, ‘How could they, how must their
wife be feeling and how must their mum and dad be feeling?’ and it was
like, ‘Whoa, whoa, whoa, you have to stop right there, you can’t think like
that.’ And you have to stop, that is the challenge…there some people that
do get involved but I have never been like that, never, because I just don’t,
it’s not that I don’t think it is professional, I am not saying that but I just
think it is a coping mechanism is not to get too involved. (Senior female
Staff Nurse)
here it is different because you are forming different relationships with
your patients and also because they are younger as well you empathise
with them… maybe it’s because I am getting older as well, I am a bit
more emotional as I get older (Researchers emphasis) .(Junior female
staff nurse)
‘Emotion Work’
-Patients dealing with others’ emotions
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…they feel for their family as well as themselves.
(Health Care professional)
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They (his family) will look after her (his wife), no
doubt about it….you won’t need to go to the
undertaker and break her heart or anything because
everything has been done (Male Patient)
Emotion work; Dealing with
Professionals’ emotions
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‘Don’t worry about it.' (Researcher's emphasis)
But how the hell could you worry, you have to worry
about it. I’m worrying about what’s going to happen
to me and she’ll go, ‘Don’t worry about it.’ That’s
the kind of, now that’s not nursing care, it’s not
really. They need to say things better than that; she
needs to put it in a better way. It’s not for me to say.
(Female patient)
‘Hope’
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And to give people hope, you try to give people hope
but you don’t want them to be too ‘well this is going
to cure me’. It is finding that balance. You don’t
want them to think that after this I’ll be cured. It is a
balancing act. (Senior Staff Nurse)
Some people grab hold of what you are saying with
two hands (Senior Nurse CNS)
The non toxic side of the treatment now, is massive.
(Junior Staff Nurse)
‘Hope’ - The Clinical and Social
Construction of Dying
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Well, put it this way anybody that’s got this I think they
would think the same. I had a neighbour, he died, and
he went through the same thing as I have. He went
through chemo, he went through this and was tired and
all the rest of it. Well I’m going through the same
problems and he died because he had enough, had
enough. Well I think I’m going the same way, I’ve had
enough, so I know I am going but when I don’t know.
But hopefully I don’t suffer at the end (Researcher’s
emphasis). (Retired nurse and patient)
Questions
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Do you think it’s helpful to think of the ‘ward as a half
way house’ ?
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Is ‘etiquette’ helpful or a barrier ?
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Do you recognise any of these patterns of ‘emotion work’
?
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How do we think about the use of ‘hope’ in our clinical
practice ?