Date of Learning Log: 26/04/2024
Time: 09:30-16:00
Learning Activity 1: Complex Genomics: Cancer
In this learning activity, I learned about the pathophysiology of cancer, genetic considerations, and how to manage the illness. We explored the different types and conditions of cancer, cellular mutations, the differences between benign and malignant tumours, metastasis, and coping with living with cancer.
Cancer is a broad term encompassing a range of diseases characterised by the uncontrolled growth and spread of abnormal cells within the body. Typically, cells undergo a regulated growth, division, and death process. However, cancer arises when this process malfunctions, resulting in the formation of tumours—abnormal masses of tissue—or, in some instances, cancers that affect the blood and spread through the bloodstream without forming tumours.
Metastasis occurs when cancer cells infiltrate surrounding tissues and spread to other body parts through the bloodstream or lymphatic system. Cancer often stems from genetic mutations that alter the function of specific genes, leading to abnormalities in cell growth, repair, and death. Solid cancers typically result in the development of tumours, which can be either benign (non-cancerous) or malignant (cancerous). Malignant tumours can invade nearby tissues and organs.
The signs and symptoms of cancer can vary depending on the type, location and stage of the cancer. Typically, when cancer begins the signs and symptoms are absent. A mass grows, and ulceration may appear; unexplained weight loss, fatigue, and persistent pain can be an imitator of other conditions and may frequently occur in individuals with other conditions.
Cancer can be caused by various factors including environmental exposures – these are exposures to radiation, chemicals and pollutants, lifestyle factors – smoking, poor diet, lack of physical activity, and excessive alcohol consumption. Studies have shown that some cancer deaths are related to infectious diseases, including viruses, bacteria and parasites, e.g. HPV – cervical cancer.
Diagnosing cancer typically involves a combination of several tests and procedures aimed at identifying the presence of cancer, determining its type, and assessing its extent or stage. Most cancers are initially recognised from clinical signs and symptoms screening. Investigations such as tissue biopsy, blood tests, x-rays, CT and MRI scans.
There are different types of cancer treatment available, which also depends on the type of cancer, its location and its stage. Treatments such as surgery – removing tumour or cancerous tissue, radiation therapy – using high-energy radiation to kill cancer cells, chemotherapy – using drugs to kill or slow the growth, immunotherapy – boosting the body’s immune system to fight cancer, targeted therapy – specifically target cancer cells, and hormonal therapy – used for cancers that are influenced by hormones such as breast and prostate cancer.
Living with cancer presents a challenging journey, encompassing both physical and emotional hurdles. It involves navigating the disease, coping with treatments, and seeking ways to uphold quality of life. This experience is intricate, but with the appropriate support, resources, and care, many individuals find methods to manage the disease and sustain a meaningful life. The significance of a support network, transparent communication within the healthcare team, and encouragement and support for individuals cannot be overstated.
Learning Activity 2: End-of-Life Care
In this learning activity, I learned about end-of-life care in the context of a dying person’s last days of life. We discussed the importance of communication, recognising when a person is entering their last days, gaining awareness of symptom management, the role of NA and understanding advance care planning.
End-of-life care necessitates a comprehensive approach that encompasses the physical symptoms and the emotional, spiritual, and psychological needs of patients and their families. Having this understanding enables nursing assistants to deliver thorough care. Effective communication skills are vital in end-of-life situations, which frequently involve challenging discussions about prognosis. It is crucial to be proficient and empathetic, ensuring that patients and families are well-informed and supported. End-of-life care often entails intricate ethical considerations, such as decisions regarding life-sustaining treatment and patient autonomy. Familiarising oneself with these ethical considerations equips me to engage in ethical decision-making processes as an NA.
Advanced care planning (ACP) involves individuals deciding about their future healthcare, mainly when they cannot communicate or make decisions. ACP ensures that a person’s healthcare preferences and values are recognised, understood, and honoured by family members, caregivers, and healthcare providers.
KSB ADDRESSED:
Knowledge
| K1 | Understand the code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC 2018), and how to fulfill all registration requirements |
| K2 | Understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimise risks to health |
| K3 | Understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and well-being required to meet people’s needs for mental and physical care |
| K4 | Understand the principles of research and how research findings are used to inform evidence-based practice |
| K5 | Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care |
| K6 | Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice |
| K7 | Understand the importance of courage and transparency and apply the Duty of Candour |
| K9 | Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| K10 | Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes |
| K11 | Understand the factors that may lead to inequalities in health outcomes |
| K12 | Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being |
| K13 | Understand the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to mental, physical and behavioural health outcomes |
| K14 | Understand the importance of health screening |
| K15 | Understand human development from conception to death, to enable delivery of person-centred safe and effective care |
| K16 | Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care |
| K17 | Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care |
| K18 | Understand and apply the principles and processes for making reasonable adjustments |
| K19 | Know how and when to escalate to the appropriate professional for expert help and advice |
| K20 | Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met |
| K21 | Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care |
| K22 | Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health |
| K23 | Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| K24 | Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| K25 | Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life |
| K26 | Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld |
| K27 | Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies |
| K28 | Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions |
| K29 | Understand the different ways by which medicines can be prescribed |
Skills
| S1 | Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements |
| S2 | Keep complete, clear, accurate and timely records |
| S3 | Recognise and report any factors that may adversely impact safe and effective care provision |
| S4 | Take responsibility for continuous self-reflection, seeking and responding to support and feedback to develop professional knowledge and skills |
| S5 | Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018) |
| S6 | Act as an ambassador for their profession and promote public confidence in health and care services |
| S7 | Communicate effectively using a range of skills and strategies with colleagues and people at all stages of life and with a range of mental, physical, cognitive and behavioural health challenges |
| S8 | Recognise signs of vulnerability in self or colleagues and the action required to minimise risks to health |
| S9 | Develop, manage and maintain appropriate relationships with people, their families, carers and colleagues |
| S10 | Provide, promote, and where appropriate advocate for, non-discriminatory, person-centred and sensitive care at all times, reflecting on people’s values and beliefs, diverse backgrounds, cultural characteristics, language requirements, needs and preferences, taking account of any need for adjustments |
| S13 | Apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people |
| S14 | Promote preventive health behaviours and provide information to support people to make informed choices to improve their mental, physical, behavioural health and wellbeing |
| S15 | Identify people who are eligible for health screening |
| S16 | Promote health and prevent ill health by understanding the evidence base for immunisation, vaccination and herd immunity |
| S17 | Protect health through understanding and applying the principles of infection prevention and control, including communicable disease surveillance and antimicrobial stewardship and resistance |
| S18 | Apply knowledge, communication and relationship management skills required to provide people, families and carers with accurate information that meets their needs before, during and after a range of interventions |
| S19 | Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent |
| S20 | Recognise people at risk of abuse, self-harm and/or suicidal ideation and the situations that may put them and others at risk |
| S21 | Monitor the effectiveness of care in partnership with people, families and carers, documenting progress and reporting outcomes |
| S22 | Take personal responsibility to ensure that relevant information is shared according to local policy and appropriate immediate action is taken to provide adequate safeguarding and that concerns are escalated |
| S23 | Work in partnership with people, to encourage shared decision making, in order to support individuals, their families and carers to manage their own care when appropriate |
| S24 | Perform a range of nursing procedures and manage devices, to meet people’s need for safe, effective and person-centred care |
| S25 | Meet people’s needs for safety, dignity, privacy, comfort and sleep |
| S26 | Meet people’s needs related to nutrition, hydration and bladder and bowel health |
| S27 | Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity |
| S28 | Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain |
| S29 | Give information and support to people who are dying, their families and the bereaved and provide care to the deceased |
| S30 | Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed |
| S31 | Act in line with any end of life decisions and orders, organ and tissue donation protocols, infection protocols, advanced planning decisions, living wills and lasting powers of attorney for health |
| S32 | Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams |
| S33 | Maintain safe work and care environments |
| S34 | Act in line with local and national organisational frameworks, legislation and regulations to report risks, and implement actions as instructed, following up and escalating as required |
| S35 | Accurately undertake risk assessments, using contemporary assessment tools |
| S36 | Respond to and escalate potential hazards that may affect the safety of people |
| S37 | Participate in data collection to support audit activity, and contribute to the implementation of quality improvement strategies |
| S38 | Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members |
| S39 | Recognise when people need help to facilitate equitable access to care, support and escalate concerns appropriately |
| S40 | Support and motivate other members of the care team and interact confidently with them |
| S41 | Monitor and review the quality of care delivered, providing challenge and constructive feedback when an aspect of care has been delegated to others |
Behaviour:
| B1 | Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy and preferences |
| B2 | Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice |
| B3 | Be adaptable, reliable and consistent, show discretion, resilience and self-awareness |