Abstract
working for the better welfare of the patient, it is a very large task force. There are as many team members as there are hospital employees in addition to the community workers who are involved. The person who is most essential in determining the overall leadership of the health team is the patient's physician, and close communication with him is essential so that we know and understand his plan for medical management. The dietitian is invariably called upon to help the cancer patient through those long periods of anorexia which may be accentuated by the effects of chemotherapy or radiation. The occupational therapist is of great help in enabling the patient to use the long hours of hospitalization as creatively and constructively as possible. The physical therapist is often an important resource person in making suggestions for exercises and positioning that can bring relief to the patient who is confined to long periods of bed rest. The clergy must attend to the overwhelming need for spiritual guidance in a time of great trial and testing. The social worker is often instrumental in helping the patient through a crisis situation and can be very helpful in directing the patient to the appropriate community agency. And, of course, the nurse's role (with the help of all auxiliary personnel) is to coordinate these aspects of patient care and to add to them her own special gifts which support, sustain, and rehabilitate the patient to the fullest possible extent. While writing care plans for cancer patients over the past few years, I have been more and more aware of the benefits this team approach affords as I have witnessed the amazing effect it has in achieving excellence as the goal of total patient care. In my experience with team conferences, I have found that the most persistent problem nurses face in working with cancer patients is the problem of communication and for many reasons. There is often the uncertainty on the part of the staff as to how much the patient knows of his diagnosis or, how direct should one be with the patient about the thing which is uppermost in his mind, but which he often tries to deny or ignore. Perhaps if we better understood how patients feel, we would be better equipped to help them. One of the most helpful guides for me has been a letter written by a cancer patient. I have selected these excerpts:
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