The roles of primary nurses were examined by reviewing the care provided to treat nausea in a cancer patient, Ms.‍ ‍A.

Regarding Ms. A’s nausea, the author experienced the following:

1) The author assessed the cause of the increased nausea and instructed the patient to take antiemetic drugs at appropriate times and perform her daily activities while resting.

2) After the author interviewed Ms. A about what kind of foods she could eat, Ms. A was thereafter able to eat food little by little. Although she could not eat sufficiently and thus received nutritional fluids in the early days of hospitalization, she was gradually able to eat normal foods and was discharged without the need to receive intravenous fluids.

3) When the author used a leaflet to support the patient to be discharged from the hospital, Ms. A said, “I never heard of such a method before.” The patient therefore better understood her needs in daily life after hospital discharge.

Primary nurses are required to collect information through daily conversations with patients and share such information with other professionals so that it can be used for future decisions regarding medical care.

Our hospital makes strenuous efforts to discuss the therapeutic policies and selection of sanatoriums by sharing information with a palliative care team and other professionals, and preparing opportunities to explain the disease state to both the patients and their families. The roles of primary nurses were examined with regard to support for the decision-making in one of our cases. In nursing care, the author made efforts to collect information from the patient and family to share it with other nurses. Through these efforts, the author could develop a good relationship with the patient and family in order to carefully respect their intentions. The patient could communicate with the medical staff and family members for one week before death, but such communication rapidly became difficult. The family felt responsible because they could not sufficiently confirm the intentions of the patient. As a primary nurse, the author considered it important to provide an opportunity to explain the disease state so that an elderly patient and family could communicate as much as possible because prognostic prediction is difficult in elderly patients. In the future, it will be necessary to continuously maintain an appropriate relationship with patients and their families in order to respect their intentions and to provide the necessary support for all decision-making.

A patient with bladder cancer and associated with severe pain due to bony metastasis and lumbar canal stenosis was admitted to a hospital for pain relief. After cardiac arrest occurred in the hospital, the patient developed a persistent disturbance of consciousness. As a primary nurse, the author provided care to family members who were shocked by the sudden development of a disturbance of consciousness.

The author made efforts to precisely inform the current state of the patient as much as possible, in addition to providing adjusted details of informed consent. To decrease the anxiety of the family, the author continued to listen to the worries of the family members attentively and regularly informed the family members regarding the patient’s medical state and appearance so that the family members could gradually come to accept the medical state of the patient. As a result, the family members finally were able to come to terms with their worries and consternation and finally accept the patient’s situation. Based on Fink’s crisis theory, which suggests the proper course taken by patients and their families who are shocked by a sudden change in a patient’s medical state, the changes in the attitudes of the family members in our case were examined.

Nurses should try to establish an environment where the family members can take sufficient time to communicate with the patients, express their thoughts, and thereby obtain a sense of relief, when worrying about a family member who is a patient in a crisis situation.

A patient with urinary bladder cancer and left renal cell cancer underwent a total cystectomy, total removal of the left kidney and left urinary duct, and urinary diversion. The author instructed the patient regarding the procedures for the exchange of devices for the treatment of a ureterocutaneous fistula on the right side of the abdominal part. As a primary nurse, the author collected information about the diseases that the patient had before hospitalization and the thoughts of the patient regarding the ureterocutaneous fistula. The author prepared a plan to prepare the patient to undergo the procedures for device exchange by using a checklist for uniform instructions to be provided by other medical staff. To support the daily life of the patient after hospital discharge, the author continued to provide nursing care intervention and support by sharing information with certified wound ostomy continence (WOC) nurses.

With this support, the patient could positively prepare for exchange of the devices by making mental and physical preparations before the surgery. In addition, organized instructions for the patient were effective for both the patient and nurses. The author could thus provide the patient with sufficient support so that the patient could comfortably resume his daily life after hospital discharge through continuous cooperation with the WOC and outpatient nurses before surgery, both during hospitalization and after hospital discharge.