title: The hidden side of nursing: why caring for patients with malignant malodorous wounds is so difficult.
abstract: OBJECTIVE
  This cross-sectional qualitative study used semi-structured telephone interviews with palliative care nurses working in urban and rural settings in Australia to explore their experiences of dealing with patients with malignant, often malodorous, wounds.
  
  
  METHODS
  This paper was the second phase of a research project examining the care of patients with malignant wounds. Of 71 palliative care nurses in New South Wales invited to participate, 26 took part, 17 of them working in community positions. The data from the telephone interviews were transcribed and analysed, using content analysis, and coded for themes relating to the nurses' experiences of caring for this patient group.
  
  
  RESULTS
  Nurses working in this setting strove to do the best for patients and their families under circumstances that are emotionally and physically difficult. Some of them suffered personal distress as a consequence. Patient isolation and altered body image are significant challenges for these nurses.
  
  
  CONCLUSIONS
  The nature of the work these nurses do, in particular the fact that they are dealing with cancers, tends to push them into literal and practical silence. But the researchers question whether this is always the best option. They ask if hiding feelings could be bad for nurses and patients alike. In qualitative research it is not appropriate to generalize the results, although lessons can be learnt from the experience of this group.
authors.affiliation: University of Western Sydney/Wentworth Area Health Service Clinical Nursing Research Unit, Penrith, New South Wales, Australia. l.wilkes@uws.edu.au
authors.forename: L M
authors.initials: LM
authors.lastname: Wilkes
authors.forename: E
authors.initials: E
authors.lastname: Boxer
authors.forename: K
authors.initials: K
authors.lastname: White
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D003430:Cross-Sectional Studies; D006801:Humans; D008875:Middle Aged; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D009859:Oncology Nursing / Q000379:methods*; D010166:Palliative Care / Q000523:psychology*; D017064:Process Assessment, Health Care; D011368:Professional-Family Relations; D036301:Qualitative Research; D012878:Skin Neoplasms / Q000451:nursing