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Cancer education in the workplace
Lessons about diagnosis help co-workers respond
Education about a cancer diagnosis and the impact of treatment is not limited only to patients and family members treated at OhioHealth Cancer Services in Columbus, OH. Cancer education sometimes extends to patients' colleagues in their workplace
Staff can go into the workplace to educate colleagues of cancer patients who are returning to their job following an extended absence during treatment. Also, they can address the concerns of co-workers of cancer patients being treated while they continue to work.
The co-worker education program was initiated after cancer patients expressed concern about returning to the workforce, says Mary Szczepanik, RN, BSN, MS, a breast health specialist at OhioHealth Breast Health Institute.
"Our mission is to improve the lives of those who are touched by cancer," says Szczepanik.
While OhioHealth performs market research and follows national standards for cancer treatment and cancer survivorship, the staff listen to the individuals and groups in the community, who express their needs and opinions about how the health care institution can help, explains Szczepanik. For example, an employee of a large local bank died of breast cancer, and the administrators at this business asked for a series of classes for their staff.
Cancer diagnosis impacts not only close family members and friends of the patient, but also all who have a relationship with him or her, including co-workers, she adds.
Therefore, it is important to help cancer patients through the treatment process while in the work force or transitioning back into the workplace after time off, says Szczepanik. The diagnosis of cancer alone hearing the words: "You have cancer" is often devastating for an individual. While each person adapts to a cancer diagnosis differently, there are some consistent themes that can be discussed in classes.
People diagnosed with cancer often feel they have lost control over their lives, and the fear of recurrence is ever-present. They often express the desire to "get their lives back to normal" and want to be treated the same way they were before they were diagnosed.
At the same time, they may be experiencing some changes in their thoughts, feelings, and even physical abilities that they want others to understand. They don't want to be talking about cancer all the time, and yet they don't want others to be afraid to talk to them or ask questions, explains Szczepanik.
Tailor information to group
During a class, OhioHealth instructors suggest ways to introduce the subject of cancer; explain how to follow up on hints from the patient about whether to talk about the diagnosis; give tips on how to help the patient adapt if he or she does have a deficit, such as problems concentrating; and provide information on how colleagues can advocate for their co-worker.
The presentation should be tailored to the audience, says Szczepanik. This can be done by asking those attending the class what they want to know. The curriculum should also include basic information about the diagnosis and treatment for the type of cancer in which the audience expressed interest; psychosocial effects of a cancer diagnosis on the patient and family; cancer survivorship; and effective means by which individuals and groups can help a returning cancer patient.
The purpose of the lesson is, first, to educate the public, says Szczepanik. "We have found there is a general lack of accurate information about cancer circulating in the general public. It is often driven by the media or experiences of others who are being diagnosed or treated for cancer," she explains.
The lesson also provides reassurance to co-workers who are uncomfortable thinking about a colleague, who is often a friend, coming back to work. This reaction can be prompted by a personal experience with cancer or that of a family member or friend. In such cases, their impressions are at least partially based on the outcomes of that experience, such as whether the person survived or was physically changed. Or the co-worker may feel he or she failed a colleague with cancer in some way during diagnosis and treatment, notes Szczepanik.
A third purpose for the class is to assist the returning co-worker in the transition back to work. "A cancer survivor returning to the workplace can have an easier transition if his or her co-workers have a realistic idea of what to expect, how to interact with the individual, and what is most helpful," says Szczepanik.
The majority of employed patients at OhioHealth continue to work throughout treatment. Some can take certain days of the week or month off when they know symptoms and side effects will make it impossible to work, says Szczepanik. For example, they can take a day for chemotherapy treatment and the day after to help recover. With this form of treatment, they often have physical side effects and extreme fatigue, which affects their work, she adds.
Others, such as patients receiving external beam radiation therapy, often use their lunch break for therapy and return to work. These patients may have fewer side effects, theoretically making it easier to work during treatment, says Szczepanik.
"Keeping the work environment as normal as possible depends on the patient's response to treatment, both physically and mentally... [as well as] co-workers' level of anxiety and concern regarding their colleague," says Szczepanik.
It's easy for co-workers to understand that a person may have a hard time adjusting to changes in physical appearance, such as hair loss, loss of a body part, weight loss or gain, peripheral neuropathy, and pain. What most people don't understand is the fatigue that accompanies all types of cancer treatment, including surgery, chemotherapy, and radiation, explains Szczepanik.
The fatigue is not something that is resolved with a nap or a long night's sleep. Patients express significant frustration with this side effect, she adds.
Therefore, instructors in the classes not only talk about the obvious, but they also emphasize the invisible side effect of fatigue, says Szczepanik. Also, they talk about other physical and emotional side effects that may not be obvious to others.
Initiating a program
When setting up outreach classes to businesses who have employees undergoing treatment for cancer, choose a clinician with an education background to teach it, advises Szczepanik.
This instructor also should have good presentation skills, good listening skills, and a broad knowledge of cancer. In addition, an oncology social worker or licensed counselor who works with cancer patients regularly is a great co-presenter, she says. This combination is especially helpful during question-and-answer periods.
The program can be promoted in many ways, says Szczepanik for example, during face-to-face contact with individual patients, especially those who are seeing an oncology counselor or art therapist. A short description of the program can be included on print pieces describing services, which are mailed to patients and handed out at community events, presentations, classes, and support groups.
Patient education managers should not have a problem creating a curriculum and lesson plan, because the cancer-specific information provided in the workplace is relatively basic, says Szczepanik. However, there are budget considerations, as well. For example, class materials must be produced, and staff members are pulled out of their normal roles to conduct the programs. It is also helpful to have portable audio-visual equipment in case the business does not.
For more information, contact:
Mary Szczepanik, RN, BSN,MS, Breast Health Specialist, OhioHealth Breast Health Institute, 376 Blenheim Road Columbus' Ohio 43214. Telephone: (614) 268-3547. 614 566 5000. E-mail: email@example.com.