Q&A with Jeannette Verkerk and Anneke Meerkerk

We have asked Ms. Jeannette Verkerk [MScN and RN] of the Groene Hart Ziekenhuis in Gouda (NL) and clinical nurse specialist Ms. Anneke Meerkerk of the Beatrix Ziekenhuis in Gorinchem (NL) about their roles and their perspective on  patient Quality of Life (QoL). This is to give us an additional insight on the care nurses provide regarding QoL.

Jeannette and AnnekeWhat are your roles as nurses  in terms of enhancing the patients’ QoL during treatment?
“We provide the patient information about the disease then we coach them in how to cope with it. We also give advice about treatment and alternative options so the patient can make an informed decision.”

What are your daily practices at work that contribute to patients’ QoL?
“It is important to talk to the patient about the disease and how it will affect his life and his family’s. We also check and observe if there are any side effects caused by his medication. Then we provide advice on how to perform ADL (Activities of Daily Living), and give them support by motivating the patient to keep moving/staying active.”

What are the common discomforts your patients experience?
“They generally experience urinary symptoms such as incontinence, side effects from bladder instillation, fatigue, blood in the urine, ED (erectile dysfunction), bladder pain, and pain from kidney stones.”

What kind of advice would you give patients and their families to improve their QoL?
“We provide them advice on alleviating the side effects of the medication and alternative treatments in addition to regular treatment such as PTNS (percutaneous tibial nerve stimulation). Then we discuss these, along with the patients’ complaints, with the physician. We also advise to take an anticholinergic in case of bladder pain, and cyproterone acetate (like Androcur®) in case of hot flashes in men with prostate cancer. Also, we recommend a balanced diet patients can follow or we search together.”

What is your role to better the patients’ QoL post-treatment e.g. improved mobility, discharge planning, etc.?
“We talk with the patient about the discharge during the early stage of hospitalisation. We inform them about daily practice; for example, when they are not allowed to drive or ride a bike after TURP (transurethral resection of the prostate). We provide them with a folder containing lifestyle advices, information on who to contact and in what situations should they call the hospital.

“We take care of the home care the patients need after the discharge from the hospital. We make sure they get the right incontinence material or stoma material, and guide them in coping with the incontinence or the stoma.”

Please describe a specific case(s) that you can recall which would be a good example(s) of your role as a nurse improving patient QoL.
“There was this woman with BPS (Bladder Pain Syndrome) and she had pain just above her pelvic bone. She had to run to the toilet because of urgency. She suffered from fatigue and experienced pain during sexual activity. Because of these complaints, she took special holidays and adapted her working hours accordingly.

“We gave her advice on how to adapt to her condition and to reduce her stress. Next to that, we recommended a diet plan (diet plans for patients with BPS differ because of individual reaction to food). We advised oral medications such as anti-cholinergic, anti-histaminic and painkillers. These helped cope with the pain and the urgency to a certain extent.

“When the medication didn’t help anymore, we advised the use of intravesical bladder treatment and taught the patient how to use it. And when she could administer it herself, she became independent from us, which is good.

“Another optional treatment is PTNS which the patient can also do on her own. Of course, we guide and teach the patient, taking into account the psychological and practical factors of using that treatment.”

Posted: 26/05/2016