Personal Narrative Chemotherapy in Cancer Practice: Neutropenic Sepsis (Case Study Sample)

Personal Narrative: Chemotherapy in Cancer Practice: Neutropenic Sepsis
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Formative Assessment
Our societies have several people who suffer from various types of diseases and conditions. However, very few of them open up about it for fear of embarrassment. These diseases and conditions are acquired through different ways. As such, the impacts that they have on the patients also differ. Most of such patients prefer keeping their conditions a personal and private affair that they never discuss with anyone outside their family. On some rare cases, some respond to requests to share on their disease or condition. In most cases, they do so especially when there is a promise of medical assistance to follow their story. A similar case happened in the case of collecting data for this report. The patient was also assured that his identity would be protected as it would be kept anonymous throughout the compilation and presentation of this report.
The primary aim of this narrative was to identify a patient and interview them on their disease or condition. I was also required to collect data from the interview and compile it so that I would present it later. It was also necessary to ensure that the data collected could be used to help in improving patients of a similar disease or condition in the future. As such, I came across one patient who had acquired Nutropenic sepsis as a result of cancer treatment through chemotherapy. As such, she had been receiving home healthcare from her relatives who appealed for medical assistance.
I visited her home on a chilly Tuesday morning. I found that she had been left in the care of her granddaughter. Unfortunate, there was no other adult family member to authorize my interview with the patient. I did this because I knew it was illegal to interview her in the absence of the carer. As such, I left to return later.
In the evening, I found that the carer had returned from work. I introduced myself as a student and used my school identification card for proof. I also stated my purpose of the visit and why I wanted to interview the patient. After a few minutes, I was given the green light to continue with my interview. The carer offered to participate and help the patient respond to some of the questions.
The first thing I wanted was to know what the patient was suffering from. She explained that Neutropenic sepsis is a complicated type of anticancer treatment that is potentially fatal. The carer also added that doctors had informed them that mortality rates of chemotherapy ranged between 2% and 21% of the adult patients. However, the mortality and morbidity rates have been significantly reduced by the use of intravenous antibiotic therapy. That has reduced the need for intensive care management of the patients to around 5% in the case of England.
The only worry that patient had faced in the process of chemotherapy was that the bone marrow could be suppressed by the therapies used to treat cancer so that it responded to the infection. As such, it occurred as one life-threatening ordeal for the patient. However, from my knowledge in class, medical practitioners and researchers have proven that this case is common in the case of chemotherapy, although such suppression can still be caused by systematic radiotherapy. As such, I shared this information with the patient and carer and gave them hope that there was still a chance of survival for the patient.
The patient also explained that she had frequent cases of fever and potential sepsis because she was an outpatient. There is also need to explain to the patients who receive chemotherapy that there are several associated dangers that could rise after the therapy has been administered to them. The most common that each patient needs to be educated on is the risk of suffering from neutropenic sepsis. As such, they also need to be taught the symptoms and warning signs that they should watch out. There is also need to evaluate ways of improving the outcomes of chemotherapy. That can be done by establishing recommendations that are evidence-based on how the life-threatening condition of cancer treatment can be prevented, identified, and managed.
As the interview progressed, I inquired to know how the patient had acquired the condition. The carer explained that it all started as a case of cancer treatment using chemotherapy. The body of the patient had been forced to produce White Blood Cells at a rapid rate because they were replenished at a fast rate during chemotherapy. That forced the bone marrow to produce more of the WBCs to replace their level in the blood. Medical research studies have shown that the ability of the bone marrow to regenerate WBCs is affected by chemotherapy. That leads to a drop in the levels of neutrophil, causing a condition known as neutropenia.
It was also worth asking the signs and symptoms that the patient had developed that suggested that she could have been suffering from neutropenic sepsis. She explained that the initial symptoms of the condition had not been recognizable because they were mild. Some of these symptoms that she faced included malaise, fatigue, fever, sweats, urinary complications, and chills. She also complained that the condition had increased her chances of suffering other infections and fever. She was taking medicine to reduce fever at the time I carried out the interview.
I also learnt the challenges, effects, and ways of managing the condition. The carer explained that the condition had cost the family financially. The patient required special medication and diet to keep healthy. It had caused her trauma and depression because of losing her job and having to live with a fatal condition. She had also been put under special medical care as required by NICE guidelines. This management care was prescribed by qualified medical personnel.
Summative Assessment
This section presents a narrative on the journey of the patient. It was compiled using the data that was obtained from the interview. It was critical to understand fundamental knowledge before engaging in the review and analysis of the data obtained from the interview.
The National Confidential Enquiry conducted an investigation into the Patient Outcome and Death (Holmes, 2015, p. 207). The results were used by the National Chemotherapy Advisory Group to compile a report on the challenges that adult patients face in managing neutropenic sepsis when receiving chemotherapy at the same time (Holmes, 2015, p. 207). One of the primary problems associated with the condition is that it leads to unavoidable, untimely deaths of the patients. The report also revealed that there are no proper systems to conduct urgent assessment of the condition. Further still, most organizations lacked proper policies to deal with neutropenic sepsis (Holmes, 2015, p. 207). As such, this narrative also presents a summary of the recommendations and guidelines that have been issued by National Institute for Health and Clinical Excellence (NICE) on how to identify, prevent, and manage neutropenic sepsis in cancer patients undergoing chemotherapy (Kelly, Morgan, Ellis, Younger, Huntley, and Swann, 2010, p. 1056). The guidelines are the most recent and apply to all patients regardless of their age.
How Chemotherapy Causes Neutropenia
One of the lessons from the interview was how the patient had contracted neutropenia. White Blood Cells are constantly replenished because they survive for only three or four days in the blood circulation (De Naurois, Novitzky-Basso, Gill, Marti, Cullen, Roila, and ESMO Guidelines Working Group, 2010, p. 256). That bone marrow is thus forced to produce more of them to replace their level in the blood. The ability of the bone marrow to regenerate WBCs is affected by chemotherapy. That leads to a drop in the levels of neutrophil, causing a condition known as neutropenia (Freifeld, Bow, Sepkowitz, Boeckh, Ito, Mullen, Raad, Rolston, Young, and Wingard, 2011, p. 93). Neutropenia is a condition that is normally silent, but it is the most common condition that patients develop as a result of undergoing chemotherapy. The initial symptoms may not be recognizable because they are usually mild. They include malaise, fatigue, fever, sweats, urinary complications, and chills. Chemotherapy-Induced Neutropenia increases the patient’s chances of suffering other infections and fever (Aapro, Bohlius, Cameron, Dal Lago, Donnelly, Kearney, Lyman, Pettengell, Tjan-Heijnen, Walewski, and Weber, 2011, p. 31). These are the symptoms that the patient had been experiencing before she was di
Implications of Neutropenia to the Patient
There were several implications that the condition had on the patient. I noted that Chemotherapy-Induced Neutropenia had led to a condition that is known as febrile neutropenia (Bow, 2011, p. 545). Febrile neutropenia requires the patient to be hospitalized so that the condition may be evaluated and antibiotics such as broad-spectrum are administered if there is a need. The resulting conditions may be severe and sometimes lead to death. Individuals who have neutropenia also have to delay undergoing chemotherapy (Bow, 2011, p. 545). The clinical outcomes of chemotherapy may even be compromised if the treatment is not reduced. In such situations, medical practitioners can use the so-called Prophylactic Granulocyte-Colony Stimulating Factors (G-CSFs) to ensure that the dose of chemotherapy is maintained and that the severity and duration of neutropenia are reduced significantly (Lambertini, Del Mastro, Bellodi, and Pronzato, 2014, p. 118). These implications were evident on the patient. The patient was on a prescribed Prophylactic Granulocyte-Colony Stimulating Factors (G-CSFs) to manage the condition.
Identification/Recognition of Neutropenia
The interview revealed...