Annie

Annie is a 23 year-old mom with a face full of freckles and large green, curious eyes.  She was diagnosed with a rare form of cancer, and brought almost immediately to the inpatient floor of her local hospital where she began a course of chemotherapy.  Annie was a new mother; however her baby had to remain with his grandparents while Annie’s husband was at work.  To be away from her little boy was devastating for Annie. Nights were the worst, as often her husband or mother would come to visit with her infant son, only to leave her alone again when visiting hours were over. During the second round of chemotherapy, Annie became very sick and was told that the chemo was too hard on her heart.  The doctors had to abandon the idea of chemo and decided, in collaboration with Annie, to move on to surgery. Annie was extremely anxious about the change of plan, but knew she did not want to risk chemo again. Annie needed constant reassurance that the surgery would be a success, as her greatest wish was to be able to go home, and be a mom to her baby one again; and to be able to watch him grow into adulthood.

As Annie went through the system, the image that came to her mind was that of “feeling like a guinea pig.”  She said the medical profession treated her like a curiosity because of the kind of cancer she had.  She said some of the nurses did not speak to her when looking after her, and she said this made her feel like “she was not a person.” She said someone had come to see her for support and focused on a past tragedy in her family, rather than the new diagnosis of cancer. Annie said a resident had come in one day when she was on the inpatient floor, and was looking for the tumour in the wrong place.  She asked if he had read her chart, and he responded that he had glanced at it.  Annie said this did not give her a great sense of being in safe and knowledgeable hands.  One of Annie’s memories was that of waiting an interminable amount of time when she rang the call bell.  She said she felt alone and forgotten when no one showed up for half an hour or more.  Annie said she knew the nurses were busy, and there were some very caring ones, however this did not take away from that deeper feeling of loneliness.  Annie had however met a social worker who said she provided her  with a great deal of comfort throughout her ordeal.  “Someone who could be there for me while I was in the hospital. Someone I could rely on.”

Annie had the surgery and has returned to being a full time mom to her healthy baby boy.  Annie said her community nurse was “fantastic” and regularly made contact with her doctor at the hospital whenever she had concerns or needed to consult.

When asked what she would like to change or see improved in the medical system as a newly admitted, young cancer patient, she said she would have liked  more reliable information on her type of cancer, so she could have read up on it and understood her diagnosis; to be assigned someone who would provide supports throughout the whole experience, from receiving the diagnosis to discharge. Annie did have a social worker, but not until she became an inpatient and after she had been on the floor for a few days. Annie came to realize that the social worker was not only an emotional support, but also she could access various resources for example find a wig at no cost.

Safety Competencies to think about: “Working in Teams” Annie had someone who was able to advocate for her and provide resources both in the community (nurse) and in the hospital (social worker); “Recognize, Respond to and Disclose Adverse Events” after the second round of chemo doctors reacted in an honest, timely and effective manner, communicating to the patient about the adverse reaction of the medication, and planned for prevention of further occurrence of such an event; Communicating Effectively for Patient Safety would also tie into the chemo versus surgery issue that the doctors found themselves in. The doctors recognized that through the routine treatment of chemo, a safety issue arose, which they communicated to the patient, and  moved to an alternate plan with a view to providing the best plan of treatment for the patient. Another point of interest within this competency would be Annie’s need to secure well researched, reliable information from the doctors about the unusual kind of cancer she had been diagnosed with.