Your health-related questions answered here
Re: Men have a role to play in the battle against cancer, Health Supplement, October 11th.
Haydn Shaughnessy should be commended for his conscientious understanding of a woman's experience of breast cancer and his role as a partner in this life-saving operation. As he assigns self-blame in order to cope effectively with the disease, this admirable transfer of guilt serves to motivate him in his relentless support of his wife, Roos. However, self-blame as a coping strategy often serves to alleviate the distress of the sufferer while significantly increasing the stress of the carer.
As Haydn Shaughnessy points out in his 12 steps, the cancer process is a major life crisis which naturally causes a stress response and in turn elicits distress, with a resultant loss of sense of self. This is a natural and essential experience in order to adjust to and embark on life's treacherous journey of cancer. The plight to make sense of the cancer process manifests itself as a subjective experience, the outcome of which should be anticipated rather than criticised, through a system of support, guided by individual needs and coping strategies. A diagnosis of cancer triggers extreme psychological distress; this is not an indication of personal weakness. The family can embark on a journey of self-help by empowering themselves and their loved one to adapt through various coping strategies.
Haydn Shaughnessy has embarked on this journey by developing 12 well-grounded coping strategies. He has been empowered to cope by establishing control over the care of his wife, the resulting impact being a decrease in the level of distress experienced by all concerned. In taking control as a partner in the journey to recovery he has assisted in adjusting to the disease through the sharing of suffering. . . a gifted attribute. Hayden and Roos, keep well.
Rachel Fox, Oncology Nurse Education Co-ordinator, Beaumont Hospital, Dublin.
Re: Interview with nurse Orla O'Brien, Health Supplement, October 25th
In the interview with Orla O'Brien, the assistant director of nursing in charge of ICU and cardiology services, what struck me most was that her biggest challenge was "the recruitment and retention of staff".
There is no doubt at this time when the health service as a whole is under considerable pressure, the need to retain and recruit specialised nurses has never been greater.
Intensive care nursing as a specialty developed in response to the need for specialised knowledge to monitor and support critically ill patients with failing organs. Today, intensive care nurses are educated in the specialised care of the critically ill providing evidence-based practice.
Although specialised knowledge and skills are essential, the holistic approach to patient care is integral to all aspects of intensive care nursing. The challenges for all intensive care nurses include a need to continually develop and expand their knowledge, to maintain competence, and to embrace change and innovation in a highly pressured environment.
The question that must be asked is why is the recruitment and retention of staff in ICU such a challenge? Is it the job, the magnitude of the responsibility, the continual need for professional development, the pain of watching patients and their loved ones suffer, and the ever-present spectre of death?
Is it politics, the constant pressure on the service due to the limited availability of critical care beds, the migration of nurses to areas with affordable housing or even simply the lack of car parking spaces?
These questions must be addressed to ensure that patients who are critically ill receive the care they need and deserve. Their life is quite literally in the hands of those who care for them.
Niamh Cleary, Intensive Care Nurse, Ashtown, Dublin