Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.

This week, social worker Kelly Grosklags, LICSW, BCD, FAAGC, FT, founder of Conversations With Kelly, shared advice for dealing with difficult conversations and false hope in the care of patients with cancer.

The inspiration for her work, Grosklags said, comes from losing her mother when she was 11. While her mother, in her thirties at the time, suffered from heart disease, her young age caused clinicians to approach her care with an emphasis solely on lengthening her lifespan, rather than making the most of the reality her family was faced with.

“The whole goal was to keep her going, keep her going—and no one wanted to talk about the hard stuff,” Grosklags recalled.

Further, some patients develop what Grosklags referred to as “good patient syndrome,” where they fear exposing their care team to the emotional burden of difficult conversations around death and try to shield them from these by acting as if they don’t need them.

Grosklags stressed that hope is cyclical and can occur at any stage of a patient’s care, even at the end of life. The goal of care may not always be cure; it may evolve to become other milestones, like seeing a child graduate high school.

“Part of our job as social workers, as physicians—as anybody working in oncology—is to help introduce patients to that evolution-of-hope cycle.”

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers (formerly Jackson), DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.

This week delivers the second part of an interview with ethics expert Katherine Brown-Saltzman, MA, RN, president of Ethics of Caring, the organization behind the National Nursing Ethics Conference (NNEC).

Ethical concerns can grow into pressing issues, said Brown-Saltzman, when nurses don’t confront the concern early on, comparing these situations to the rapid spread of a forest fire.

“By the time you are outraged, you’re in moral distress,” said Brown-Saltzman. “To bring these issues up early really helps because then you aren’t completely locked down into conflict.”

In these cases, she said that the best thing a nurse can do to intervene early on is to simply ask a question.

“The wisest thing that I learned along the way was instead of pointing the finger…to put a question on the table,” said Brown-Saltzman. “’I’m beginning to have these ethical concerns and wondering, are we approaching this family in the best way?...I’m wondering how we can better approach them with questions about stopping treatment.’”