Running head: EXPERIENCING A HEALTH CHALLENGE OF OVARIAN CANCER

Experiencing a Health Challenge of Ovarian Cancer

The Effects on Clients
Gurpreet Pabla
822 331 047
Humber College
Paul Jeffrey
Thursday November 13th, 2014

EXPERIENCING A HEALTH CHALLENGE OF OVARIAN CANCER

The movie Wit is a heartwarming story about a woman named Vivian Bearing who gets
diagnosed with ovarian cancer. Vivian is forty-eight years of age and she is a university professor by
profession. The movie starts with Vivian being told she is diagnosed with stage 4 insidious ovarian
cancer by her Doctor Harvey Kelekian. Dr. Kalekian convinced Vivian to take part in his deliberate and
aggressive chemotherapy treatment. This treatment also serves the purpose of research for a new
chemotherapy protocol developed by Dr. Kelekian. Vivian starts the chemotherapy and endures side
effects such as hair loss, vomiting, and loss of self and sense of humanity. On her eight month stay at the
hospital Vivian also experiences much un-ethical and un-human behavior from the nurses and doctors.
Throughout the story Vivian also experiences flashbacks of her life before her diagnosis such as, Vivian
as a little girl spending time with her dad. The chemotherapy worsened Vivians health but her physicians
disregarded her well-being and continued to indulge in their research. Vivian`s code status changed to Do
Not Resuscitate or DNR but Jason, the second physician still continued to resuscitate to keep Vivian for
their research instead of respecting her wishes. Vivians primary nurse, Susie Monahan, was her number
one advocator. She created a good therapeutic relationship, environment, and met all patient needs. Vivian
passed away towards the end because the chemotherapy was not effective and her health declined.
On the course of Vivians chemotherapy, she experiences side effects such as loss of hair on her
head and eyebrows. The intensive chemotherapy that Vivian endures results in the loss of hair all over the
body. She experiences this side effect just prior to the start of her chemotherapy. It is an unfortunate side
effect because Vivian had a full head of hair prior to her diagnosis, and with the loss of hair resulted in a
decrease in self-esteem too. Vivian also endures the side effect of vomiting. Vomiting is defined by matter
from the stomach that has come up into and may be ejected beyond the mouth, due to the act of vomiting
(Medicine Net,2014). Vivian experiences vomiting before the mid-point of her chemotherapy because of
the increase of intensity of her therapy. The chemotherapy affected her immune system greatly. Vivians
body compensated for the chemotherapy medication by vomiting. Her immune system is not use to the
overwhelming amount and intense medication that it tries to reject it by vomiting. Lastly, Vivian

EXPERIENCING A HEALTH CHALLENGE OF OVARIAN CANCER

experiences tremendous pain due to her hysterectomy and her rigorous chemotherapy. Pain is defined as
physical suffering, feeling, or discomfort caused by illness or injury (Merriam Webster,2014). Her
chemotherapy caused much generalized pain throughout her body and predominantly in her abdomen.
She experiences her pain towards the start of movie, before she started her chemotherapy. Vivian also
experiences psychosocial effects such as the loss of her self-worth which began in the beginning of the
movie. Vivian was treated more like an object than a patient. Her Doctor, Harvey Kelekian was further
concerned with the experimental aspect of the treatment that he does not take much concern for the
symptoms and feelings towards her treatment. He was more focused on the objective factors of Vivian
and her treatment progress, than how she felt enduring the chemotherapy. Vivian also had no sense of
support, or having a support system because she did not have family or friends whom came to visit and
comfort her. This is seen towards the end of the movie when Vivian can no longer handle her diagnosis or
her treatment alone. Only towards the end of the movie she developed a therapeutic relationship with her
primary nurse. Lastly Vivian also experiences the psychosocial effect of lack of empathy from her
doctors for the state of her health during the increase of intensity of her treatment. Towards the mid-point
of the movie Vivian realizes her own doctors cannot empathize her pain and tolerance for the treatment
because they were never willing to reduce or stop the doses of medication even though her health was
declining.
From all the effects of Vivians diagnosis and chemotherapy the priority nursing care should be
managing her pain. The nurse should further investigate pain management for Vivian because her
chemotherapy treatment caused much generalized pain throughout her body but primarily her abdomen.
Towards the mid-point of the movie, Vivian starts to show physical signs of intensive pain when she is
curled up in her bed holding her abdomen with her arms and making facial expressions of frowning
eyebrows and squinting eyes. Vivians pain is also increased due to the prior hysterectomy before the start
of chemotherapy. A hysterectomy is an operation to remove a woman's uterus (Wed MD,2014). A
hysterectomy also results in chronic pelvic pain (Web MD,2014).

EXPERIENCING A HEALTH CHALLENGE OF OVARIAN CANCER

To help Vivian cope with her pain many interventions can be done by a nurse to provide relief.
These interventions are medicinal aides and non- medicinal aides. The first intervention that can be put in
place by a nurse is administering prescribed medications for pain management. These medications would
commonly include analgesics and opioids such as Tylenol, and Advil. These pain medications are always
prescribed by the doctor and written in as p.r.n or when necessary drugs. This means doctors prescribe
pain medications which are not administered on a daily basis but are prescribed in case of when a patient
does obtain pain; a nurse then has medication readily available to administer. Another intervention a nurse
can use to help provide pain relief to a patient is teaching the patient breathing techniques such as slow
rhythmic breathing, or inhale/tense, exhale/relax (ACS,2014). An example of an inhale/tense, and
exhale/relax technique is taking a slow, deep breath and as you breathe in, tense your muscles such as
your arms (ACS,2014). This non-medicinal aide will help Vivian and other patients with her condition,
focus on the pattern and depth of their breathing that their focus shifts from their pain to their breathing.
This is an easy intervention that can be done by a nurse because techniques like such allow patients to
help themselves and give them a sense of independence because when they are in pain they can do these
self-reliving techniques which will make them feel better. The last intervention that a nurse can practice
which will specifically focus on providing aide to Vivians pain is practicing medicinal procedures such
as nerve block or spinal analgesia (ACS,2014). This procedure must be prescribed by a doctor and are
often administered by nurses. A nerve block is a procedure where a local anesthetic which is often
combined with a steroid is injected into or around a nerve or into the space around the spinal cord to
block pain. After injection the nerve is no longer able to relay pain so the pain is relived for some time
(ACS,2014). This procedure will ultimately numb the nerve so the patient will feel no pain at all. All
these nursing interventions will aid to the process of pain management for patients in pain.
Inter-professional collaborative strategies are also a good use of resources to help patients such as
Vivian to help cope with their pain. Inter-professional care is the provision of comprehensive health

EXPERIENCING A HEALTH CHALLENGE OF OVARIAN CANCER

services to patients by multiple health care professionals who work collaboratively to deliver the best
quality of care in every health care setting. It encompasses partnership, collaboration and a multidisciplinary approach to enhancing care outcomes(Health Force Ontario,2014). The first health care
profession which in collaboration with nurses can aide in the pain management of a patient are Doctors.
Doctors are professionals whom bring knowledge and the authority to diagnose patients, prescribe intense
drugs, and develop chemotherapy for cancer patients. Doctors are seen as the health care providers whom
prescribe procedures and medications to patients and nurses work with them because they are the health
care providers who implement the orders that the doctors prescribe. In the case of providing aide for pain
management, a doctor would be the one to prescribe an analgesic and the nurse would be the one to
implement the order when the patient needs it. That is an example of health care professionals
collaborating to deliver the best care for clients. The second inter-professional strategy that will help
provide pain management care to a patient is collaboration between nurses. Nurses play an important role
in patient care because they spend the most time and provide the majority of the patient care. Nurses work
alongside doctors, families, and other nurses to provide the patient with the best therapeutic care. They
implement doctors orders but also provide therapeutic strategies of their own such as deep breathing for
pain control. Nurses work alongside other nurses and often collaborate on different care giving
techniques. Nurses also help each other out by delegating tasks to one another that would provide timely
care to their patients. This will help nurses give better care to their patients when aiding in pain
management because while one nurse is teaching a patient breathing techniques to a patient to help cope
with pain, another nurse can be delegated a task to care for another patient in the time being. So timely
care is provided. Lastly, for faith-based individuals, the hospitals pastor can bring a patient spiritual
support. When medicinal strategies are not working, patients tend to turn to their faith for help, or
encouragement. Pastors can bring a patient a sense of hope and a sense of believing that the pain will go
away and they can conquer the disease. These are the many inter-professional techniques that can be
provided to help patients cope with their pain.

EXPERIENCING A HEALTH CHALLENGE OF OVARIAN CANCER

Resources outside the hospital can continue to facilitate the clients wellbeing and also help
manage their pain. Ovations: the Cure for Ovarian Cancer is an organization which supports ovarian
cancer research, awareness, and patient programs. They provide a website which educates patients on the
types of medicinal therapys offered to clients for ovarian cancer such as chemotherapy. They also
provide techniques on how to cope with the physical side effects of ovarian cancer such as, pain, decrease
in skin integrity and hair loss(Ovations,2014). They provide a toll free number, 866-922-6382 for anyone
who has questions on ovarian cancer, in addition to that the also offer an email,
info@ovationsforthecure.org for answers about ovarian cancer. For treatment information they offer the
website, www.ovationsforthecure.org. Another community resource clients can use is the Cancer Hope
Network. This is an organization which is primarily based online and it is a support group in which you
can ask cancer survivors questions about anything to do with ovarian cancer and you get an answer back
though online chat. Getting feedback from survivors of cancer provides much experience and support for
patients currently diagnosed with cancer(Ovarian Cancer Support Group,2014). Getting feedback and
experience from other cancer survivors allows current diagnosed clients the ability to ask the type of
coping techniques for pain were accomplished, that way the same techniques can be used. They offer a
phone number 1-800-552-4366 to set up a profile and match you with a survivor.

References

EXPERIENCING A HEALTH CHALLENGE OF OVARIAN CANCER

American Cancer Society. (2014). Guide to controlling cancer pain: non

medicinal treatments for pain. Retrieved on November 9, 2014, from ACS
website:http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffe
cts/pain/paindiary/pain-control-relaxation
American Cancer Society. (2014). Guide to controlling cancer pain: Other
types of pain medication. Retrieved on November 9, 2014, from ACS
website:http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffe
cts/pain/paindiary/pain-control-other-medical-methods-to-relieve-pain
Health Force Ontario. (2014). Interprofessional care. Retrieved November 9,
2014, from health force Ontario website:
http://www.healthforceontario.ca/en/Home/Policymakers_and_Researchers/Interprofe
ssional_Care
Medicine Net. (2014). Definition of vomit. Retrieved November 7,2014, from
medicine net website: http://www.medicinenet.com/script/main/art.asp?
articlekey=6005
Merriam Webster. (2014). Define pain. Retrieved November 7, 2014, from
Merriam Webster website: http://www.merriam-webster.com/dictionary/pain
Ovarian Cancer Support Groups. (2014, January 1). Retrieved September 23,
2014, from http://www.ovariancanada.org/in-your-region/ontario/newsevents/2013/ovarian-cancer-support-groups
Ovations for the cure of Ovarian cancer. (2014). Awareness. Retrieved
September 24, 2014, from
http://www.ovationsforthecure.org/aware/aware_treatments.php

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Veal, F.C., Bereznicki, L.R, Thompson, A.J., & Peterson, G.M. (2014).
Pharmacological management of pain in Australian Aged Care Facilites: Age &
Ageing, 43(6), 851-856.
Wed MD. (2014). Womans health: Hysterectomy. Retrieved November 9,
2014, from Wed MD website: http://www.webmd.com/women/guide/hysterectomy