Finding out what works and what doesn't work : caring for women with a fungating tumour of the breast : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University, Albany Campus, New Zealand
A fungating tumour of the breast causes distress to those living with the illness and createss many challenges to the nurses who care for them. Control of malodour. exudate, haemorrhage and cosmetic acceptability creates complex wound care problems. Managing to live and maintain a sense of normality must take account of the palliative and chronic nature of this illness. This study utilises the grounded theory research method to discover the main concerns of nurses who care for this group of clients and how they continually resolve them. Three women who have this condition have provided information that adds and lends support to how the nurses provide care. This thesis argues that finding what works and what doesn't work is the core process that resolves the main concern of striving to maintain a sense of normality in life activities. Problem-solving, wound care and wider psychosocial problems initiate the process of finding what works and what doesn't work. Through making sense of the situation by gaining an understanding of the women's situations, being non-judgemental and building trusting relationships, the ability to find what works and what doesn't work is more likely to be achieved. This must take account of the physical, cultural and professional considerations that impact on the nurse's ability to provide appropriate care. The consequence of finding what works and what doesn't work is that the nurses' practice has the capacity to be transformed. This study provides insight into the creativity and complexity that characterises expert community nursing practice in caring for this particularly challenging group of clients.