- This topic has 24 replies, 25 voices, and was last updated by vccpsychologist.
January 9, 2020 at 9:14 pm #16851
At my facility, we have historically not done a great job of discussing fertility issues with patients. The floor and clinic nurses tend to leave it up to the physicians or the nurse navigator, when it should be everyone’s responsibility
The video gives us a good starting point and a great example of how this provider did not focus on the negative (no one had discussed fertility with this young man prior to his treatment). Instead, she focused on options to assist him and organizations that might be helpful for him and his partner as they made decisions about how to pursue fertility options. She did not appear embarrassed by the topic, which made the young man more comfortable.
I think that role playing and watching videos such as this would be very helpful for those practitioners who hesitate to bring up this very important topic with our patients.
DarlaJanuary 10, 2020 at 11:21 am #16870
I agree. I think the provider did a great job of stating the facts and positive options on the table instead of focusing on the negative past. I appreciate the fact that she mentioned the percentage of individuals that struggle with infertility that have never been treated for cancer. I think this may have helped the patient feel less like an outsider and more like part of the “non cancer survivor” group. If I had to choose one thing that I would change that the provider did during the conversation, I would change the comment that she made at the beginning about how unfortunately this lack of education happens often. I’m not sure if that comment was helpful or necessary, but overall she did a great job.January 10, 2020 at 1:39 pm #16881
I agree that the video does a great job, prompting us as caregivers, to initiate a viable conversations around a sensitive issue. In general, I think that there is a lack of understanding surrounding fertility.January 12, 2020 at 1:57 am #16914
I also do believe that this is a great learning tool as a role playing activity. It would be helpful to include various team members interacting with one another to see the education and communication processes that can and should be set up within a cancer care hospital with the multidisciplinary team as well.January 12, 2020 at 1:45 pm #16915
I agree this video does an excellent job of showing social workers how to open up a discussion about a very sensitive topic. I like that the social worker does not overstep any boundaries and does not impart information that is not within her scope of practice. She is confident in the information she is providing and is obviously knowledgeable and sensitive to the patient’s feelings. I too have experienced patients being uninformed about fertility and their options. I am always very careful not to take a session into an area that I have not been properly trained in and have always been honest with patients regarding my lack of knowledge in the area of fertility and have referred them out, which they greatly appreciate. Hopefully, after this training, I will be educated enough to add another layer to my interaction with my patients as this social worker does so eloquently in the video.January 13, 2020 at 9:50 am #16929
I do agree that social worker was knowledgeable and comfortable talking to the patient about fertility options. However, I feel that she could have given him more space to talk about his feelings and concerns.January 13, 2020 at 1:11 pm #16942
Hi. Just joined discussion. The SW appeared supportive and knowledgeable. She discussed what we heard in a positive and hopeful manner. One thing I noticed was that we didn’t hear much from the young man. Don’t know where he’s coming from at this point.January 13, 2020 at 2:56 pm #16950
I appreciated this example of how to begin a discussion of fertility issues following treatment and thought the social worker did an excellent job of normalizing fertility as a concern both for survivors and people who haven’t had cancer. She also opened the possibility of discussion with his current partner, which addresses fertility as an issue that can affect multiple people within a situation – their relationship, goals and vision for the future, etc. I also thought she did a good job of sharing hope by explaining that even if he discovers he has fertility challenges, there are ways to deal with this and still become a parent if that is his goal. Others are absolutely right that we didn’t hear much from the patient. Perhaps we will see more of that perspective in future modules?January 14, 2020 at 12:44 pm #16970
This video was a good example on how to approach this difficult discussion of fertility concerns after treatment. I appreciated how the SW acknowledged the patient’s frustrations with lack of information prior to his treatment. She did a great job in validating his concerns and bringing up the fact that even men who were not treated for cancer have issues with infertility. She spoke to the patient in a way that was easily understood. We did not hear much from the patient other than his frustrations. I wish we could’ve heard more from the patient on his current place in life in regards to pursuing fertility evaluation and treatment. I also wish the SW would’ve discussed some treatment options/referrals a little more in detail with the patient as well. She did a good job in giving basic information on options moving forward.January 14, 2020 at 3:06 pm #16973
I think the SW did a great job for initially broaching the topic of fertility with the patient. It would be good to have some feedback from the patient and get his thoughts.January 14, 2020 at 3:23 pm #16974
I agree with the consensus that the SW did a great job handling the situation, and seems well versed in situations like these. I would be interested in seeing a session where she has invited back Jose’s partner, and the discussion had between the three of them. I would think that it is important to see where they are at in building a family, if they are considering it now or already trying. Some other things to consider, like she said, is that there is a population that has difficulty with fertility regardless of cancer treatment. Which seemingly takes some responsibility or maybe even guilt off of him. Building a family takes two people, and assessing the partners fertility as well has value to it. Apart from discussing what could happen just naturally, I do like that she gave him all the options up front. So if for some reason or another natural conception is not in the cards for this couple, he knows there are other viable options.January 15, 2020 at 12:06 pm #16986
I agree that the SW did a great job discussing these issue with the patient. This is an extremely tricky topic to navigate and I think being able to see conversations like this give us a better idea of how to do that. Even if a nurse or provider has extensive knowledge about oncofertility, this shows the importance of having an honest and open discussion rather than just providing facts and data to patients. The patient’s emotions and thoughts on this topic are just as important as the science and process behind it.January 15, 2020 at 2:37 pm #16987
I think this was a good example of how to start discussion. It is thoughtful to apologize for and acknowledge the lack of pre-treatment discussion. I also liked how the conversation led to talking about fertility as a couple and the generalized statistics on infertility (to normalization sub-fertility). Lastly, I liked how she referenced other resources so the AYA could seek out information on his own.January 15, 2020 at 2:37 pm #16988
The social worker in the video did an excellent job of acknowledging and validating the frustration around lack of education and options; I believe this helps in developing rapport and showing empathy. I appreciate seeing her providing concrete information and potential options without being too technical and medically focused as well as addressing the needs of the couple by inviting his partner to be present at future sessions.
I cannot recall if this was displayed in the video but the only thing that I may have included at the start of the discussion is asking the patient what his current understanding of fertility options might be so there is a baseline. I have had patients in the past who have had a fairly broad knowledge of these topics and therefore I would not want to assume that they are not familiar with this subject. As others have said, I’d like to hear more about his feelings and help him to process in future videos.January 15, 2020 at 3:25 pm #16990
I too think the social worker seemed at ease with this discussion and did provide some valuable information for him to consider. I agree with others that the patient was not asked what his feelings were about not having the fertility discussion prior to treatment and what questions or fears he currently has, or what he already knows about viable options. I wonder at what age he had received cancer treatment as he is only 25 now. For all we know he may have had treatment as a child and did not have a voice or even an idea that this would become an issue for him. I also liked the fact that the social worker offered to have a further discussion with the patient and include his girlfriend once they had had time to talk about the situation. Regardless of what happened in the past, the present and future should be the focus for further discussion, options and resources.
This was interesting and helpful and I look forward to further discussions and videos.
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