CALGARY — When it comes to caring for patients, empathy is a desirable trait to have, and 25-year-old Matthew Frank has it in spades.
“I was diagnosed with cancer when I was 20,” says Frank, “I was in my third year of kinesiology at the University of Calgary when they found tumours in my brain.”
The experience of understanding a patient’s condition from their perspective, and being able to feel what they are feeling, is a major reason why Frank chose to become a nurse — and it’s also why he’s pursuing a career in oncology nursing.
“Having such a close connection to cancer, I have an intimate relationship with the disease and the pain it can cause,” he adds. “I feel very much connected to oncology patients — and I have a very strong drive to do everything in my power as a nurse to help them.”
Frank believes that, while there can be a great deal of suffering in a hospital setting, a nurse can greatly ease that suffering by providing excellent care.
“I want to be that nurse that made me smile while I was still in treatment,” he says. “I want to give oncology patients the same expert care I was given while I was so sick.”
Before his diagnosis, Frank enjoyed athletics as a national level white water kayaker — and always took an interest in the human body and how it works, but back then lacked a perspective on how he could capitalize on his interest.
“The idea of a gym teacher or a physiotherapist held little appeal, but after meeting so many amazing and empathetic nurses, I knew that nursing was what I wanted to do,” he says.
“Having a keen understanding of what it is like to be a patient, I wanted to able to pass on the tenets of patient-centred care as a nurse.”
After working as a Registered Nurse in Clinical Neurosciences at Foothills Medical Centre for the past year, Frank has now set his sights set on oncology nursing, where he can care for cancer patients and those at risk of getting the disease.
“Through my time as both a student and as a registered nurse, I’ve had the opportunity to meet a handful of cancer patients, with some cases presenting as very similar to my own,” he says.
“The teaching the nurses provided to both me and my family helped me to feel confident in what the next steps would be in a new and foreign process. I want to give that same help to patients who are in similar shoes now that I once was.”
Frank has also taken his experience as a patient and desire to help other patients one step further. He’s currently a Patient Advisor on the Calgary Cancer Patient & Family Advisory Council. Frank gives input on provincial patient-education programs and works with the Foothills Medical Centre (FMC) Quality Council to enhance patient- and family-centred capabilities in the delivery of care at FMC. As well, he attends events to speak about his experiences.
Now in remission and living with diabetes as a result of his bout with cancer, Frank is returning to climbing, hiking and kayaking — activities he enjoyed prior to his diagnosis — and is back to living what he calls a more normal life.
“In my time with these patients, I want to offer them the hope that a normal life can be found after a cancer diagnosis. As long as I provide empathetic and expert nursing care to a patient, whether in oncology or not, I’ve achieved my goal as a nurse.”
Oncology Nursing Day
This Tuesday, April 5, marks the 13th Annual Oncology Nursing Day, with events taking place across Canada to recognize the valuable role oncology nurses play in our provincial and national healthcare systems.
Frank says he’s also looking forward to attending the 28th annual conference of the Canadian Association of Nurses in Oncology, to be held Oct. 20-23 at the Hyatt Regency Hotel, here in Calgary. For more information on the conference, please visithttp://www.cano-acio.ca/conference-events
It is difficult for me to ascertain the reason why I am passionate about oncology. It could be a number of reasons. My mother had metastatic breast cancer when I was 15, and my uncle currently suffers from advanced multiple myeloma. But I wouldn’t attribute it to that. I think my passion comes from seeing the strength in people, helping them get the most valuable currency in the cancer journey – time. It is very rewarding work and strongly revolves around quality of life. I’d like to tell a short story about one experience as a new nurse that made me want to specialize in oncology.
In 2013, I was a new oncology nurse in Northern Ontario. I took a full time position on a medical oncology unit simply due to the vacancy.
Being a new grad, I took anything I could get. My patient was an extraordinary fellow- a tall elderly man who was very kind. He had a soft voice and was one of those patients who always thanked the nurses. He knew just how hard we worked on the unit. He had very little family. More specifically, he had one daughter who never visited. I’ll admit, the family dynamics from what I knew were a little different but I still had a soft spot for him. He lived in the
hospital long term because he had no where else to go, and that in itself is a long story.
Sometimes, if I had the time, I would sit with him while he ate a meal just to give him company. He wasn’t the only one I did this for, but I particularly enjoyed doing this with him. He told me stories about the abuse he was subject to as a child, about running away from home, about being raised by Inuit people, about rebellion, and about the life of a professional artist. He spoke a lot about loss of independence and what it’s like to lose the ability to do what you love most. As time passed, he became increasingly frail. He had a debilitating disease combined with cancer, shortness of breath and frequent falls. He was eventually confined to a wheelchair. He spent his time writing (rather, typing) a book because even picking up a paint brush was painful. Sometimes if I was lucky, he would read or recite a passage to me while I provided him with care. He very proudly showed the nurses photos of his artwork – oils on leather canvas. Years ago, he had sold the entire collection to a Chinese collector for millions.
I always told him how much I loved his artwork and about my “lost creativity” which I described as having been artistic at a younger age only to have “lost it” somewhere along the way. And so one day, he gave me homework. He sent me to the dollar store to buy a pack of brushes, a canvas and some acrylic paints. He instructed me to set up and just begin painting, even with no ideas or guidance. I surprised myself with what I painted. I later learned that he was my guidance in my artistic journey and helped me find what I had lost. Years later, that inspiration sits upon my wall on a medium sized dollar store canvas. And today, I still paint.
Transitioning from active treatment to survivorship can be a distressing time for many people. Luckily several passionate oncology nurses that work in the Capital Health Cancer Care Program in Halifax were happy to become involved in a new patient education initiative called “Living Beyond Cancer- What Happens Now ”. The purpose of the monthly session is to help provide information to patients and families on what they can expect as they transition out of active cancer treatment and into recovery and survivorship. ask google . It provides opportunity for patients to learn more about what happens after cancer treatment, to ask the cancer team questions about their follow up care and to meet other cancer survivors.
The 3 hour session is held for registered participants in Halifax and streamed live via telehealth to hospitals across Nova Scotia. An oncology nurse helps facilitate the class and several oncology nurses take turns presenting on the late effects of chemotherapy and cancer treatment. Topics such a sexual health, brain fog and hormonal therapy are also covered by nursing.
The session is presented by a variety of health care providers including oncology nurses, radiation therapists, social workers, physiotherapists, dietitians and spiritual care providers… and is a true demonstration of people working together to help meet the needs of our patients and families!
In November 2014 it was announced that Mackenzie health hospital would be accepting nominations for the first presidents kudos award. So the physicians in our oncology clinic started the process of creating a nomination package. They each wrote a letter about the wonderful staff in our clinic as well as incorporating letters and comments from some of our patients. Much to our wonderful surprise the Kudos award committee selected our oncology clinic over 14 other units in our hospital.
Our oncology nurses are a very compassionate, dedicated hard working group and this was well deserved. Patients enjoy seeing the award and our photos displayed in the wait room.
Happy oncology nursing day to all, especially to Cheryl, Melinda, Marie Eve, Jessica and Robyn.
Over the past year I have had the opportunity to lead a research project as Principal Investigator. The entire research process has been an incredible learning experience. It’s amazing to know that a simple idea can possibly lead to a change in nursing practice.
A preliminary study was conducted to evaluate the potential ability of InterDry Ag to relieve discomfort from radiation skin reactions of the breast. Twenty eligible participants consented to wear the InterDry AG as advised. The effectiveness of InterDry Ag was evaluated every five days through a skin assessment as well as a participant questionnaire. A personalized skin care regime was developed during these appointments with feedback from the patient. Patient engagement provided a sense of empowerment as the patient became a partner in their care.
An unexpected, yet positive outcome of this study has been the emotional support these patients received during their skin assessments. A therapeutic relationship developed between the nurse and the patient through the research process. Patients shared their personal experiences in terms of their diagnosis and the unique impact on their lives.
Having remained in a specialty for so many years has given me the gift of living the evolution of cancer care over the past 40 years. The book “The Emporer of all Maladies” by Siddhartha Mukherjie was such a fascinating read for me as I could recall the various drug therapies that came to be such as Gleevac and how it revolutionalized CML; Herceptin for Her 2 positive breast cancer and ritux in lymphoma; new targeted therapies for renal cancer and other life saving treatments. This book so aptly described the challenges for oncologists and cancer team members in this very complex specialty of medicine. I have also witnessed my sister-in-law survive treatment and transplantation for ALL; watched her manage the long term side effects with such grace. Excellence in care now provides support to patients in the outpatient setting and for us in the interior the monthly interdisciplinary bone marrow out patient clinics has been a huge service.
Many of the standard drug cocktails administered back then are still being used. AC and FEC for breast cancer; carbo/taxol for ovarian cancer; CHOP in lymphoma; ABVD for hodgkins; chlorambucil, 5FU, methotrexate have been around for a long time; to name a few. However, what used to be a relatively few number of protocols has exploded into over 350 treatment regimens. This has afforded multi lines of therapies which keep lives extended and often suffering alleviated. I remember the days of nursing patients with distressing bowel obstructions; terrible suppurating breast wounds, cord compressions in prostate and renal cancer patients prior to the very important role of palliative chemotherapy and radiotherapy.
Karen Woodworth, Capital Health Cancer Care Program, Halifax
“I see myself as a patient navigator. My aim is to put my patients and their families at ease. I try to understand their expectations then offer front-line support. In the process I really see the value for the patients and their families of being actively engaged.”
Karen Woodworth, Capital Health Cancer Care Program, Halifax
Deborah McLeod R.N., Ph.D. Clinician Scientist, Psychosocial Oncology Team (NSCC) QEII Health Sciences Centre
“Patient-centred has been an ideal for oncology nurses for a long time . . . now we are seeing much more attention and direction about how patients can be engaged. Guidelines and policies are now designed to encourage us to do it. The patient’s experience is more of a priority than ever before.”
Deborah McLeod R.N., Ph.D. Clinician Scientist, Psychosocial Oncology Team (NSCC) QEII Health Sciences Centre
Before I retired from nursing, a job that I held for over thirty years, I was often inspired by my patients. I was rewarded in this way.
Liam was a middle aged breast cancer patient. Her cancer has spread to her bones, for which she was in the clinic for pain control. My colleague told me the paintings on the hallway wall were painted by her. The paintings were of green trees, birds singing and beautiful flowers that seemed to spread peace and joy.
One day while giving her a bath, I told her I painted water color paintings too. We shared our common interest. She told me, “I wasn’t so much into arts before. In fact, work has kept me busy, so busy I never had a quiet time for myself. Even if I did, I felt lost. Therefore I planned a busy schedule for myself, so I didn’t have time to think. About 10 years ago, I was given a diagnosis of breast cancer. Suddenly, as if the sky has fallen, I was spiritually woken up. I remember thinking life is so short. I could leave the world anytime, then what? What is the meaning of life anyway? After the treatment started, I felt so tired most of the time. All I could do was take walks. One day after the rain, a rainbow appeared, and I took a walk in our neighborhood. Passing my neighbors’ gardens, I could smell the beautiful flowers and I hear the birds singing. I took a deep breath, I felt blessed just being alive! Then I remembered the Hymn: This Is My Father’s World, and also Jesus’ saying: We are more valuable to Him than the flowers and birds! My heart was busting with joy and hope, and that was the time I started painting in order to keep this moment permanent.”
Later, while she slept I moved her paintings from the hallway wall, to her room, so when she woke up, she would be reminded of the beautiful world that God has created for us all! May her soul rest in peace forever!
As oncology nurses we are asked to play an intimate role in the lives of people who are struggling. These struggles are different for each patient, but the reality remains that most people living with cancer have to open up a part of their lives, which would normally remain private, to complete strangers.
Regardless of the outcome of disease progression this intimate relationship leaves its mark on caregivers, providing us all with a mental scrapbook of bits and pieces of other people’s stories that we became a part of. It’s as though we are all guest actors appearing in many different life stories.
In my scrapbook I keep a few clips of one couple in particular that I go back to for solace in my more compelling career crises. When they arrived at the hospital they arrived as a team. Mike* might be receiving the treatment, but they were going through this together. I instantly took to these two and their sheer positivity.
They took on Leukemia with an ease I’d never really seen before. I remember Mike telling me that the fellow that had told him of his diagnosis was so positive about it that he left his office with a smile on his face. The two even decided not to postpone their wedding and ended up getting married on the unit.
It’s not to say the whole experience was ideal. Mike suffered some very serious side effects, but he way he moved forward through each challenge determined to not let it get him down was uniquely effective.
Things actually went quite positively for these two. Mike responded to chemotherapy and his bone marrow transplant and eventually they left the hospital together as husband and wife.
A year later after a few transplant complications, they had the wedding they truly had wanted to have.
Often reviewing our mental scrapbooks can be a painful experience that begs for existential re-evaluation and sometimes we get to see the lighter side. We get to bear witness to the beauty of the human spirit and a little something my niece would refer to, with eloquence beyond her 3 years, as Hakuna Matata.
I have wedding photos in my mental scrapbook and I ask you to consider what memories of success and survivorship that you keep close to you as well. We can tell ourselves that we chose oncology to help make the lives of those living with cancer more comfortable, but let’s promise ourselves to not forget the survivors.
These are the good stories, the heartwarming stories, and the stories that keep us believing. The next time you have a teachable moment, consider how you might promote a plan for survivorship into your practice.
I am a Pivot Nurse for patients diagnosed with advanced lung cancer and I have a rewarding and touching story to share. Last fall I met a young man in his late 30s with Stage IV lung cancer who was married with two adolescent children. When he accepted the initial concomitant treatment offered by the lung cancer team, I collaborated with the team to manage his symptoms and side effects. During that time his wife struggled with her interpretation that she would be managing his care for years. I had the challenge to clarify with her that we were facing months, not years. In the meantime her husband began to respond poorly to treatment and required increased home care and support. Eventually he was admitted and kept comfortable with palliative nursing care. He then disclosed to me that he did not wish to live any longer and that he felt ready to let go. This was a most difficult situation for his family who was not ready to hear this but eventually accepted his decision.
As I prepared to say goodbye at his bedside with what I knew would be our last encounter, he whispered in my ear to thank me for how much I helped him and his family. In my role I support many patients and assist them in their transition to end of life care. It is because of patient experiences like this that I see how I can help make a difference in oncology care.
Viviane Amos, RN, B.Sc.N, CHPCN(C)
McGill University Health Centre, Montreal General Hospital
Pivot Nurse in Oncology Lung Cancer
One rainy day, I was cleaning up my old greeting cards; I came across a thank you card from the daughter of a former client. Tears came to my eyes as I reflected on the story of Lilly.
During the disease trajectory, effective communication, collaboration, and advocacy can impact clients and their families significantly. Initially, Lilly and her family declined community nursing visits as they considered these visits were intrusive. When we established our therapeutic relationship, Lilly’s family was selective in which nurse could visit. To maintain hope, Lilly’s family advocated maintaining active treatment for her journey.
Meanwhile, a great deal of collaboration was needed to support Lilly with symptom management, psychosocial support, and care coordination. Near the end, Lilly was admitted to a hospice where she spent 2 nights. Lilly’s family preferred to take her home for end of life care without consulting the health care team.
One beautiful summer evening, Amy called my work cell and inquired when the community nurses could visit. We managed to arrange a Shift Care Nurse to provide end of life care at home. Lilly died peacefully at home when her family was reading “the Lord is my shepherd, I shall not be in want…Psalm 23” to her.
Helena Akrigg, RN BSN CON (C) CHPCN (C) MA (Ed)
Vancouver Coastal Health Authority
Community Health Nurse, Evergreen Community Health Centre
I am a clinical nurse specialist in psychosocial oncology with a memorable inpatient success story. I once overheard a discussion between two colleagues about a 56 year old patient with metastatic disease; they wondered if she should be able to get out on a pass, as she was neutropenic and possibly suicidal. I decided to meet with the patient to do a depression screening and suicide assessment. She appeared relaxed, smiled regularly, and maintained eye contact. She described herself as “happy”, and well supported by family, friends and her religious faith. She stated, “I don’t regret the choices I’ve made. I’ve had a good, life. I’m at peace.” When I asked about suicide she stated, “No one’s hands will take me from this earth but God’s.” When asked about her wishes, she said, “All I want to do is get out of this place, to do something normal”.
I presented my assessment to the doctors, noting that she was neither depressed nor suicidal, and advocated for her to go out on a pass. The doctors agreed to a brief pass, which the patient used to see a hockey game with her brother that night. She was overjoyed to go. The patient died three days later. At her bedside, her grieving brother described the happy moments they were able to share at that hockey game, and his gratitude that it had been possible. This story emphasizes the importance and impact of the nurse’s role in patient assessment and advocacy.
Nancy Lee Brown, RN, MSc(A), CON(C)
McGill University Health Centre
Clinical Nurse Specialist, Psychosocial Oncology Program
When I decided to write this story I took into consideration patients whom I have nursed over the past five years as a bedside nurse. There was the man who, while on a morphine infusion for pain, informed me of all his deepest, darkest secrets – for which I am sworn to secrecy. I vividly recall the women who apologized for crying more while I shaved off her long dark hair than when she received her diagnosis of leukemia. I remember the husband who would sit with us in the nursing station on nightshift, huddle around the teapot and talk about celebrity gossip. I later found out that this was a distraction that enabled him to endure the hard times during his wife’s bone marrow transplant.
Though I have stories I cannot choose one because they are not only mine to tell. They are part of a bigger story – the nurses I work with. These memories stem from the patients and live collectively through nurses. In times of sorrow, laughter, embrace and tears I see the reflection in their eyes. These are the nurses who provide the most palpable care and have taught me everything I know. I realize now my memories cannot stand alone. Every heartache and hope is what keeps all of us whole.
The Oxford Dictionary defines Nurse as both a noun and verb: As a noun: a person trained to care for the sick; as a verb: to take special care of; to promote well being or development. I personally prefer the latter.
Jennifer Fahie, RN, BScN, CON(C)
Capital Health – 8A/BMT Hematology, Oncology and Bone Marrow Transplant (BMT)
Halifax, Nova Scotia
I am a Nurse Practitioner in Hematology/Oncology on an in-patient oncology unit at London Health Sciences Centre in London, Ontario with a rewarding experience in mentoring. Over the past 3 years I have worked with and encouraged several staff nurses to submit abstracts to CANO. They have been successful in their efforts and were able to give oral presentations in St. John’s and in Edmonton that were very well received. Their experiences have encouraged them and other staff to join CANO(!) and to participate in our local chapter activities.
I have worked for 12 years as a Nurse Practitioner in Hematology /Oncology in the same setting as above; this experience has been so very rewarding as I am privileged to work with patients and their families over time, to provide continuity and consistency as they move through various stages in their cancer journey. An unfortunate aspect of acute leukemia is that the risk of relapse is high and when this happens, I will work with them once again. I will be familiar to them and they to me and this is invaluable.
I am an Oncology nurse with a rewarding educational success story.
The education isn’t mine, but those of my students. I love working Adult Oncology at London Health Sciences Center, Victoria Hospital. But I also have the honour of teaching (in the role of clinical instructor) for the University of Western Ontario in this same clinical unit. There is something valuable and rewarding about teaching on your home unit; being able to share your passion and love for the area of nursing you choose to work in. By being able to show passion for work in Oncology nursing, I can show a whole new generation of students not only what it is to be a nurse, but how truly amazing it is to be an Oncology nurse. When a student remarks that your passion for Oncology nursing has made them consider it as a career, it’s worth it. When you can share that Oncology, though an emotionally hard place to work is also a very rewarding one, it’s worth it. When you can make education exciting, rewarding, and leave a lasting impact on students, it’s worth it.
This isn’t a rewarding educational success story about me, but about those that I teach because I love what I do and I want to share it with others.
Jennifer Knoll, RN, BScn, CON(C)
London Health Sciences Center, Victoria Hospital
We are oncology nurses with remarkable oncology unit success stories. At the Cape Breton Cancer Center, we have a team of extraordinary oncology nurses. We use a holistic approach to caring for all of our patients, their families, and for our colleagues. Patients and families who visit our center are not only treated for their illness, they are cared for on a personal and emotional level. Our patients tell us that the caring and support provided by our staff is a source of strength to them and their families. This is evident in the rapport shared by patients, families and staff on a daily basis. Having a diagnosis of cancer is a very difficult time in most people’s lives. The atmosphere in the center is upbeat and positive. Patients and families become comfortable with staff and show appreciation with baked goods and treats, even after treatment or after the passing of a loved one who received treatment. One patient who was coming back for port flushes surprised the nurses one day by decorating himself in battery operated Christmas lights. A couple of patients continue the spirit they witnessed by dressing up as Santa and continue to visit the center. Cancer survivors often return to the center when treatments are completed to give back the care and support they received by volunteering their time. Some provide complementary therapy or participate in workshops and share their inspiring stories to help those going through treatment.
Oncology nurses provide ongoing education and support and work closely with other cancer team members to ensure optimal level of care. Staff members keep abreast of best practices and evidenced based care by attending education sessions and conferences. Our nurses treat the person, not just the illness
Lori Butts, RN
Clinical Nurse Educator Cape Breton Cancer Center
My patient, “Mr.D.”, had cancer and was referred to me for symptom control and was followed for 9 months as of March 2011. He was seen at least once each month and would regularly call whenever he had issues around his medications, his symptoms or just to be reassured. This reassurance allowed him to stay home longer and avoid unnecessary emergency visits. I once asked a CLSC nurse to verify his Oxygen saturation and then got oxygen installed at his home. During one visit we discussed the decision to sell his chalet and move to Montreal where he would be closer to his caregiver and his hospital.
During another visit, with his illness progressing, it became clear that we needed to find him a bed on the palliative care unit or in an outside palliative care hospice once necessary. There were unfortunately no beds available, however we sent him to emergency and informed the consultation team on his worsening status. Later on, I checked again the bed status. One had just opened on the unit, where he could finally be admitted. Finally, his family was able to gather around him, and he passed away that very same day. His family expressed their deepest gratitude for that last, cherished moment together.
Clémence Rheaume, RN, B.Sc., CHPCN(C)
McGill University Health Centre, Montreal General Hospital
Pivot Nurse in Palliative Care Day Hospital
I am a radiation oncology nurse with remarkable oncology nursing colleagues. Each nurse has brought their unique skills and knowledge gained from their previous experiences to the clinic. The team approach is encouraged in our clinic. We promote our strengths and assist each other with our weaknesses. Our goal is to provide good patient care that includes collaborating with all of the team members involved with the patient.
There are more than 200 patients circulating daily in the department where anything can happen. My nursing colleagues are resourceful, professional and make me want to come into work. Our days are varied with many tasks and situations. I feel incredibly supported by my oncology nursing colleagues as they are true team players. They always include and work closely with the patient’s family and friends. We all get involved when there is a complex case to assist with solutions in managing their care.
This is a time where many nurses are experiencing burnout and poor job satisfaction. I can honestly say I love my job and look forward to showing up to work. We laugh together we cry together, we remain together.
On a daily basis I meet incredible courageous patients that are battling cancer. They have so much to teach us if we just take some time to listen. I have the pleasure to work with a wonderful team that encourages these opportunities.
Kerry Jensen, RN, BSc,
McGill University Health Centre, Montreal General Hospital
Radiation Oncology Nurse Clinician