The experiences of nurses who care for patients with lung cancer

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Sarah I. Abrams (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Lynne Lewallen

Abstract: The purpose of this study was to convey the experiences of nurses who care for or have cared for patients with lung cancer in different settings and to discover how these experiences relate to the stigma associated with lung cancer. The study was conducted using a narrative approach. Two stigma theories were used to guide this study; Goffman’s theory, which describes stigma at the micro level, and Link and Phelan’s theory, which describes stigma process at the macro level. The main theoretical concepts used to guide this study are the stigma process as a downward trajectory for the disease and the people who have the disease, which begins with labeling, associating labels with negative stereotypes, separation, status loss, and structural discrimination. “Normals” contribute to this process and the “wise”, or nurses, counteract this process. Thematic analysis of nurses’ experiences caring for patients with lung cancer yielded four themes: addiction in action, cancer of a functioning organ, jumping through hoops, and securing the journey. The subthemes of addiction in action were stigma-related thoughts, struggle, and frustration; for cancer of a functioning organ the subthemes were dyspnea, sick, and secretions, for jumping through hoops the subthemes were push back, attitude barriers, and system level barriers; and for securing the journey the subthemes were progressing, following, connecting, and challenges to the journey. At the micro level of the stigma process, nurses are considered to be “wise” persons who have knowledge of the difficulties of people who have a stigmatized illness and are positioned to help the stigmatized counteract stigma, but the “wise” are also “normals”. Nurses’ experiences, communicated through narratives, further informed the characteristics of “wise” persons so that these qualities can be known and taught in nursing. This study added a more nuanced understanding of the experiences of nurses as the “wise” and nurses as “normals”, and the actions they take to help deal with struggles they have when caring for patients with smoking addiction, and lung cancer. Maintaining integrity of the nursing profession requires in depth knowledge of how nurses embody the expectations of their profession and the care they provide, and when they struggle to do so, or when they see the struggles of other health care professionals. Conditions that are commonly stigmatized, like smoking addiction, were at times transformed by the “wise” as something that can protect the person who has addiction from further judgement, which adds complexity to the identity of nurses and other health care professionals as “normals” and “wise”, and the process of labeling. However, nurses had a fragmented understanding of smoking addiction that contributed to their difficulties in witnessing smoking behaviors, and frustration with effectively addressing smoking cessation. This fragmented understanding allows for the continuation of extant negative stereotypes and labels in the health care setting. The “wise” thoughts and “wise” actions that nurses had and did can be used to build a framework for approaching patients with a stigmatized disease, and it also provides guidance for what additional research needs to be done.

Additional Information

Language: English
Date: 2018
Lung Cancer, Narrative, Nurses, Qualitative, Stigma
Lungs $x Cancer $x Nursing
Nursing $x Psychological aspects
Stigma (Social psychology)

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