One of the things I love about blogging is conversation through comments on posts with people I may not otherwise meet. I learn as much from the comments as I do writing the posts.
I received a comment from a nursing student, quoted in part:
I am finishing up my RN degree and so want to go into oncology, but I fear that it will turn into nothing more than a loosing battle. A battle that I lose almost every day. Do you ever feel this way and do you ever wonder if the chemo is worth the pain your patients suffer through sometimes?
I think this sensitivity makes her an excellent candidate for oncology nursing. I wanted to answer her honestly. After taking a few days to consider, I responded:
You must have done some clinical rotations in oncology if you have interest in it. I’m wondering what experiences led you to believe it will turn into a losing battle? As a cancer survivor, and a nurse, I would answer, “Yes, the chemo was worth it.”
I suspect the question you might really be asking is, “When should curative treatment be withheld or stopped?” and that is the big question in any nursing or medical specialty. I’m sure you are aware that some chemo, surgery, and radiation are done to control cancer symptoms when cure is not possible, and that is different.
Doctors and nurses do not have crystal balls. The best we can do is listen to our patients, offer advice when asked, and respect the decisions they make. Nurses are patient advocates. We cannot control outcomes, only do our best for each. Every nurse must find a way to reconcile this.
Perhaps I could have/should have added at the end, “in order to survive our profession.”
I thought about this nursing student’s question while sitting on the rolly stool gently pushing chemotherapy into the side arm of IV tubing connected to a patient. She asked how long it would be before her hair fell out.
There and then, I wanted to apologize for being the nurse dealing this blow to her self-image, but I did not. Instead, I reminded myself that the chemo might very well save her life. The blow I administered was to her tumor. Her hair will grow back.
This is how I have to look at oncology nursing for my patient’s survivorship — and my own.
Do you feel nurses face a losing battle? How have you reconciled the harsh realities of treatment with your desire to help others? How would you advise this student?
Whenever I feel I am facing a losing battle I remind myself of my role as a nurse. I am there to support my patients, sometimes through their final hours; to offer comfort for their families, sometimes through their most difficult times. I am there to offer my hands, ears, heart for whatever time we have together.
I do question treatment plans, last-ditch-effort protocols, options that disregard a quality of life. But it is not my job to eliminate a patient’s hope. Maybe they will be in that small percentage of positive outcomes. So I hold on to hope with them.
Yes, patients pass and I experience a sense of loss, but I do not feel I am losing overall. Reminding myself of the patients, our encounters, their incredible insight and stories left behind, help me to move forward and channel their energies. From them I am gaining insight, growth, and wisdom. My job can be heartbreaking but the payoff is humbling connections and lifelong insights.
I do not know if its possible, as a nursing student, to know how you will foster these experiences. They can break you down, make you jaded, depressed, and questioning the meaning of life. But they can also force meaning into your life. They can make you appreciate a walk to work, a breath of fresh air, your strong, healthy body. They can create passionate living and make you aware of life’s most simple pleasures. It can be a trying payoff but I am grateful to be an oncology RN.
So, to the student nurse on the oncology nursing fence, I believe time in the trenches is the best indicator of whether it is for you. Best of luck.
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