'If only I'd known you were in'

How it changed my practice

I am now more confident that I am aware when patients with a diagnosis of lung cancer are admitted. I do not always review the patients. Sometime they are discharged before I can review them, sometimes I can see that it is not appropriate or that another colleague has seen them. However, there are occasions when being able to get involved in someone’s care in a timely manner has evidently been helpful; whether it has simply been to provide a friendly face or expedite review by the wider oncology team or reduce length of stay by working alongside the admitting team.
Case study
Grace was admitted to a surgical ward with acute abdominal symptoms. She was prepped for surgery but symptoms resolved with conservative management. In many ways, it was a straightforward admission. However, Grace had been discharged from another Hospital having had surgery for a lung lesion only a few days previously. Grace is an independent, feisty lady who lives on her own with no close family. Her home is more than an hour away from Inverness. She is also quite stoic. I had met her previously when referred as an ‘urgent suspected lung cancer’ with a solitary lesion in her right lung. Unable to get a biopsy due to its location, she went directly to surgery. At the time of this admission to Raigmore she did not know the outcome of the lung surgery – whether the lesion had turned out to be metastatic disease from a previous bowel surgery, a primary lung cancer or something else.
Learning of her admission, I went to see Grace. She was feeling pretty exhausted but trying to put a brave face on things. She seemed very grateful of a friendly face and someone who could explain a bit more what was happening. Furthermore, I had seen that her pathology results from her lung surgery were through. Having confirmed the ongoing management plan with our respiratory consultant and that Grace was happy to be informed of results, I was able to tell her that surgical biopsies had confirmed an early lung cancer, that it had all been removed and that she would not need further treatment for it. This was a huge relief for Grace.
Knowing of her admission meant that I was able to provide support at a difficult time. Furthermore, being able to tell her results from her surgery meant that she was informed as soon as possible by someone she knew and also that she didn’t need to have another trip at a later date to come back for results.