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Session Sneak Peek: The Psychiatric Patient With a Cancer Diagnosis: Dual Diagnosis Strategies

March 24, 2021

Jeanette Pretorius, BSN, MBA, RN-BC, NE-BC, OCN®
Content Planning Team Member

The effects of cancer are not limited to the cells and organs in our body; cancer can also have a deep and lasting impact on our mind—the type of impact that cannot be seen on an MRI or CT scan. Sadly, many patients struggle with mental health after receiving a diagnosis of cancer. It’s estimated that one in three patients in the United States will report the onset of a mental health issue before, during, or after treatment. 

This is probably not new information for most oncology nurses; we have known about and addressed the mind–body connection with our patients for decades. Tools such as the Distress Thermometer are commonplace in our setting, and we routinely include mental health professionals as part of the patient’s care team. To say we are “experts” at addressing and treating the emotions brought on by a cancer diagnosis may be a bit of a stretch, but overall, as a profession, most would agree that oncology nurses are comfortable, even proficient, at managing this aspect of our patients’ care.

But, how comfortable are we treating a patient with cancer who has a clinically diagnosed preexisting mental health disorder? How much do we really know about depression, anxiety, bipolar disorder, schizophrenia, substance abuse disorder, or psychotic disorders? What is the difference between bipolar I and bipolar II disorder, and did you know there is a third type of bipolar disorder called cyclothymic disorder? 

What about all those psychiatric medications? We think that we give a lot of complicated and dangerous medications in oncology, but psychiatric medications, or psychotropic drugs, have their own unique system for classification based on site, goal, and method of action. Plus, there is an added classification layer of “levels” and separation defined by “generations”—and before you know it, learning to pronounce the latest “mab” is not so difficult after all.

Are you starting to feel a little outside of your comfort zone? That’s not surprising, given that most nurses spend just one semester in nursing school studying the specialty of psychiatry and then file the knowledge and experiences gained in the “nice-to-know” section of their nursing skills toolbox. However, given the rising prevalence of psychiatric disorders in the United States, especially in the form of substance abuse and anxiety disorders, we really do owe it to our patients to refresh our understanding of this specialty.

Maybe you’re not sure you’ve even cared for a patient with a bonafide psychiatric diagnosis. 

If so, ask yourself these questions:

  • How many times have you walked away from a strange or concerning interaction with a patient and thought to yourself, “What the heck just happened?” 
  • How many times have you worried about a patient’s irrational or erratic behaviors affecting their cancer care and ultimate outcome? 
  • How many times have you wished you understood some of your patients better? 

If any of these sound familiar, then chances are you’ve cared for a patient diagnosed (or undiagnosed) with a mental health or psychiatric disorder.

Exploring the intersection, and entanglement, of treating patients with both a psychiatric disorder and a cancer diagnosis is the focus of the two-part intensive session titled The Psychiatric Patient With a Cancer Diagnosis: Dual Diagnosis Strategies. Join Barbara Henry, DNP, APRN, a board-certified psychiatric mental health clinical nurse specialist with a clinical focus in psycho-oncology, as she reviews and analyzes the complicated connections (and disconnections) of treating a psychiatric patient with a cancer diagnosis. This two-part series will be presented on Thursday, April 22, from 10:15 to 11:15 am and on Thursday, April 29, from 10:30 to 11:30 am.

Join your colleagues at the most comprehensive virtual conference for oncology nursing. Register today.

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