Learning Objective #1: the learner will be able to identify the categories necessary to care for head and neck cancer patients.

Learning Objective #2: The learner will be able to identify 3 ways nurses identidy patients needs.

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Making a Difference in Small Ways : Nursing Head and Neck Cancer Patients Abstract This study investigated nurses perceived challenges, strategies and processes when caring for head and neck cancer patients. Head and neck cancer is only 3 % of all the cancers in the United States but it creates permanent changes in facial appearance. The most basic functions like eating, breathing are changed, and many of these patients are voiceless. Voiceless ness creates difficulties in patients getting their needs met. Many of these patients have pain throughout their illness. This study used grounded theory to interview thirty nine interviewees with experience with head and neck cancer patients in one east coast eye, ear nose and throat specialty hospital and two other east coast medical centers. In-depth audiotaped interviews of one and one half hours were audiotaped, transcribed, and inputted using Ethnograph v.5. The interviews were listened to again, compared to the typed version and corrections were made when needed. Data collection, coding, and analysis occurred simultaneously. The findings revealed that nurses initiating communication is the key to assessing patients needs. Nurses use connecting or distancing behaviors depending on the level of comfort or discomfort with the situation. Nurses use the following strategies to understand the needs of these patients who frequently cannot speak. The core category Reading the Patient encompasses all of the other themes. The categories include Giving Voice, Being There, Giving Control, Saving Face, Normalizing, Giving Comfort/Relieving Pain, and Giving Hope are designed to “make a difference in some small way”. The results of this study reveal the need for further exploration of these patients clinical needs, patient and health care professional education, and areas of needed research.