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My daughter, Shanna (Shan) was diagnosed late with metastatic breast cancer in 2005. Sadly, despite predictions of hope, Shan lost her life to the disease. Shan was only 24!
The oncology nursing staff assigned to Shan were second to none during her hospital stay. The nurses were both caring and thoughtful in their work. They advocated for Shan, provided the best possible care and ensured both her comfort and dignity. Their support also extended to family members and Shan’s friends.
On the occasion of Oncology Nursing Day 2017, I would like to thank all the oncology nurses whose skills and talents touch their patients and their circle of care in a very special and meaningful way. Patients, family members and friends, will always remember you.
In Shan’s memory, Team Shan Breast Cancer Awareness for Young Women (Team Shan) was established to make a difference for young women following in Shan’s footsteps. Team Shan, a national charity, reaches young women across Canada with their breast cancer risk and breast health information. As a nurse and a mother, I am proud that we are realizing our goals for earlier detection and improved outcomes for young women diagnosed with breast cancer.
On April 4th, I will celebrate Oncology Nursing Day 2017 by posting a special thank you to all of you. Team Shan will also be posting AYA cancer infographics to coincide with AYACancer Awareness Week. These are two very special acknowledgements that are both near and dear to me.
Virginia Lee, RN, PhD
Recipient of the 2016 Helene Hudson Lectureship Award
What does being an oncology nurse mean to you?
Although I had worked on other units early in my career, all roads always led me back to oncology nursing. I often refer to the butterfly effect – the idea that small changes have the ability to make large changes, and the ripple effect – the ability for each of us to profoundly affect or influence others at another point in time, often unknowingly, with or without intention. It is these metaphors that come to mind as I reflect back on my early days as an oncology nurse on the 17th floor of the Montreal General Hospital. I can still remember some of my conversations and the faces of particular patients, how we as a team felt genuine joy when a patient shared a personal or family celebration, or deep sorrow and pain when there was a funeral to attend. It was these early experiences that were pivotal in directing my practice and redirecting my transition from the bedside to clinical research.
I’ve since learned that anyone who works in oncology confronts mortality. Once you’ve seen death, it cannot be unseen. But by witnessing death and suffering, we also open ourselves to deeply valuing the transience of the other side to life. There is a quote by Irvin Yalom “The way to value life, the way to feel compassion for others, the way to love anything with greatest depth is to be aware that these experiences are destined to be lost.” I think what I am most grateful for as an oncology nurse is the privilege of caring for people who are caught in the liminal space between living with and dying from cancer. By virtue of this privileged role, I am fully aware that I am granted special permission to assess, intervene, and bear witness to a significant life moment in a complete stranger’s life. And hopefully, by the end of this clinical exchange, the person no longer remains a stranger but an individual with a story – a past, present, and future who is trying to work with us to accommodate the unwelcome presence of cancer.
Professionally, we give to our patients in many ways. We educate patients and family members about the disease and treatment of cancer. We administer anticancer drugs and supportive care treatments. We provide symptom management. We coordinate care. We offer compassion and a caring presence in the face of the unknown. Every shift, we try to go the extra mile to make more good days than bad days for our patients.
And in return, patients teach us about the fragility of life and the importance of routine, everyday moments that can be taken away in an instant. Patients teach us that hope and resilience of the human spirit can rise out of the adversity of cancer. Patients have taught me not to fear suffering and death but to harness its power to illuminate that which is most important in our lives. I continue to marvel at the wisdom that patients have to have to live in the face of uncertainty. I am grateful for the life lessons and the stories that patients continue to share with me. On a personal level, it is by virtue of my experience as an oncology nurse that I have been able to cope when cancer entered my own family.
One of the most rewarding aspects in my current role is the ability to spread the wisdom learned from past patients to future patients, so that the butterfly and rippling effects can live on. Oncology nurses have an ability to connect with patients that goes beyond words. We are connected by an understanding about the fragility of life and the desire to live more meaningfully in the present. The idea that we can leave something of ourselves that one day can help another, however casually or unknowingly, can offer a potent answer to the potential meaninglessness of cancer.
Recipient of the 2016 Lymphoma Canada Award of Excellence in Honour of Estéphanie Jemus-Gonzales
My first experience with cancer was as a young child. My Uncle Lloyd was in the hospital and all of our family went to visit him. I was shocked. I had never seen anyone as thin as he was and I recall thinking to myself that I didn’t know he was sick until that very day. It was Christmas Eve and we took presents to him. He told my grandmother “I don’t know why you brought these. I won’t be able to use them”. As I listened, I wondered how my Uncle knew what his presents were, when he hadn’t even opened them, and I wondered why he and my grandmother were upset with each other. After a short visit my grandmother rushed me out the door and home we went. The phone rang before the sun came up the next day -my Uncle had passed away. I was sad that I didn’t understand his illness or what he went through. But mostly I was sad that I didn’t get to say goodbye to him.
This experience compelled me to go in to nursing. I wanted to talk to people about their illnesses and I wanted to be able to understand their experiences.
Nurses care for people when they are in their most vulnerable state. It is both a privilege and a huge responsibility to care for a patient newly diagnosed with cancer. We listen to their stories, help them understand their cancer, teach them about their treatments and how to care for themselves. Most patients initially struggle to find meaning in their cancer diagnosis, “Why me? “ -and for this, there is no answer. Mostly nurses help patient understand that they are not alone and that if others have gotten though this journey then they can too.
Nurses in oncology care for patients but we also care for their families as well. Every day in the waiting room I see family members offer their strength and compassion to their loved ones and I feel lucky to be able to see this side of people. Caring for these caregivers is intrinsic to caring for our cancer patients.
Cancer patients have taught me life’s most valuable lessons. For instance, our patient Sarah, who was also a mother. She took the bus home from the hospital after her chemotherapy treatments so she could be there when her son returned home from school. She taught me what strength was and that mothers never stop putting their children first.
There was a young man I met on my 40th birthday. Scott was diagnosed with a very aggressive lymphoma and was so sick he could not even raise his head off his pillow. He asked me how old I was and when I told him he said “I hope I get to turn 40 someday” He taught me that every year, every day is a gift to celebrate and one day we celebrated his 40th birthday. That was a great day.
I have seen a lot of bravery. Anyone who comes back to the treatment area for multiple cycles of chemotherapy is amazingly brave. I have seen hope spring from places where I didn’t think there would be any to find. I have witnessed patients cope with the deepest of faith and some who sometimes lose their way. But I have also seen the lost find the strength and resilience they need to conclude their cancer journeys in exactly the way that is most meaningful to them.
I have celebrated many milestones and anniversaries with my patients and have experienced great joy in my career. Conversely I have learned that I cannot always take away a patients suffering and that some illnesses cannot be cured. As I nurse, I can always listen, witness, touch, hold hands, cry, laugh, and learn with my patients throughout their cancer journeys.
4th year BScN Student, PEI Cancer Treatment Centre
OND Story: A Student Perspective
When choosing my final clinical placement in nursing school, many of my classmates questioned my interest in oncology nursing. They asked questions regarding their presumed assumptions of why I would want to work in such a sad and challenging environment. It was not until I was a few weeks into my preceptorship that I was able to answer that question with an honest response.
I always knew that I wanted to be a nurse, and I thoroughly enjoyed all of my clinical rotations. However, it was not until I was a third of the way through my oncology rotation that it all came together. I had finally found an area of nursing that I was truly passionate about. I was able to go home each day with a new sense of knowledge and appreciation. I have been very fortunate to learn and grow from such an inspiring group of nurses.
So, in response to the frequently asked question of why oncology nursing, I have realized that my response would be because of the patients. They are the most appreciative people you can work with, which makes it so rewarding. I have witnessed first hand from experienced oncology nurses the relationship that you can build with these patients. There is great satisfaction in providing dignified care to those who need it the most. Although I have witnessed some emotionally challenging days, the success cases definitely outweigh the bad days. I am grateful to have found an area of nursing that I truly enjoy and I am looking forward to furthering my education in oncology nursing!
Recipient of the 2016 CANO/ACIO – Amgen Award for Innovation in Oncology Patient and Family Education
Oncology nursing reflections
With Oncology Nursing Day coming up on April 4 this year, I was asked to share some thoughts, as a recipient of this year’s Innovation in Oncology Patient and Family Education award. After accepting, I sat staring at a blank page. What does it mean to say “I’m an oncology nurse”? What, if anything, sets us apart? It’s not every day we sit down to reflect on why we love what we do, or why we identify with being an “oncology nurse.” By definition, an oncology nurse is a nursing professional who specializes in caring for people with cancer. Okay, well that’s me. I’m a nursing professional and I care for people with cancer. What I love about this definition is its expansiveness. It encompasses a variety of positions – any nursing role that touches a cancer patient or families’ life as they go through the experience of cancer.
I was introduced to the idea of oncology nursing through a family member working in the area. She loved it. I mean, really loved it. The effect was inspiring. At the time, I was working on a unit I did not love – or even like! To hope that I could feel that love also was motivational. When a position opened, I applied and started a few months later. I too, loved it – the staff, the patients, the families. Working in systemic treatment, giving chemotherapy to patients – I felt it a privilege to be involved in what I consider to be an intimate experience for patients and their loved ones.
People always asked me if it was hard. Some days were, no doubt about it. But I was inspired by the patients themselves – their courage and often their heart. Sometimes just an extra smile, or a conversation that was not about treatment or cancer had the needed effect. Patients would comment on how meaningful that was – to have a focus outside of their diagnosis, for just a moment. Obviously, given the setting in which I worked, many of the conversations were about treatment, or side effects or things like that. But being able to go beyond that, was meaningful for patients and families. Perhaps it was the normalcy of the area we worked in and all of the different people I saw. I would say all of my colleagues in treatment were professional but able to make the environment a warm and welcoming one.
I began my career in patient education by volunteering to update our chemotherapy patient teaching class. Working with patients and families, giving them the information they needed to start their treatment safely and being present to answer questions was reassuring for them, and rewarding for me. While I do not teach this particular class now, I currently work in developing our provincial patient education program. It is not clinical work, although I am still afforded the amazing opportunity to work with patients and families. It is very rewarding, in a different way. Patient and family education provides so many things, from the tangible, practical information a person might need to navigate their way to a building or providing a phone number to call, to helping them manage their side effects, understand better and more fully their treatment, disease or symptom management, to helping them feel more connected and less alone.
As oncology nurses, we are unique in our roles but bonded in the experience of working with patients and families experiencing a cancer diagnosis. I believe it is our passion which sets us apart. We are a part of one big team…whether it is the team within our own cancer centres, hospital units, home care, or palliative/hospice care, or our team of oncology nurses that spans the country. We are united in our work, with a common goal of supporting our friends, colleagues, family members, loved ones and strangers in living with, fighting against and managing this disease. We should all be proud of the work that we do, in whatever capacity or role we do it. Each small thing is a part of something much bigger and even a simple smile can have the most profound effect.
Be proud, colleagues! Happy Oncology Nursing Day everyone!
Recipient of the 2016 Pfizer Award of Excellence in Nursing Education
Read why Barbara Hues became an oncology nurse, what makes her proud to work in this setting, why she is passionate about what she does, her most memorable moment and what it means to her to be an oncology nurse!
Why did you decide to become an oncology nurse?
My first nursing job in 1979, was on an inpatient oncology unit in Toronto. I hadn’t thought seriously about oncology during my university years. Oncology only grabbed my attention once as a student; when I cared for a 5-year old with leukemia. During that first year of working though, I grew to appreciate how difficult life could be for people with cancer. What really impacted me, was realizing that I could help make life less difficult for them!! I fell in love with oncology.
What makes you proud to work as an oncology nurse?
There is a distinct pleasure in feeling like you are in the right place at the right time. I feel this satisfaction and it makes me proud of the work oncology nurses do. Patients may express dissatisfaction with finding a parking spot or with long waiting room stays but rarely do we hear that there is anything but enjoyment in their relationship with their oncology nurses.
Why are you passionate about what you do?
I love learning, and problem-solving. When I can apply these innate appetites to improving the lives of cancer patients, it’s even better. In my role now, the impact on patients is less direct. It feels like an investment in the future of oncology nursing, to promote life-long learning and professional engagement. I could not talk about the passion I have for my career without mentioning the gift I had of working in Hematology/Oncology for many years. Oncology nursing in Hematology clinics brought my career to life; there was something new every day. My knowledge and understanding of “blood” grew and grew. It was so suited to my curious nature.
What is your most memorable moment working as an oncology nurse and why?
I sat through the night once with a dying patient. He was in a 4 bed ward and had no family or personal support. Being with him until everything was over was such a gentle and meaningful time– and dark in our little corner of the ward. I didn’t think the other patients were awake or paying attention. After the patient’s death and all the “hub-bub” that goes along with that, one of the other patients said; “I hope when I die, that you get to be with me too”. That meant a lot!
What does being an oncology nurse mean to you?
The meaning oncology nursing has for me have evolved over time. In the beginning it was the “aha” moment of discovering what I wanted for my career. Next it was gratifying to grow in expertise and the ability to meet patients’ need. Now, nearing the end of my career, I want to engage and encourage the next generation of oncology nurses. I want others to fall in love with oncology, as I did.
2016 Boehringer Ingelheim Oncology Nurse of the Year Award Recipient
I remember the stress of having to pick an area for my 4th year nursing consolidation placement, back in 1990. At that time, the focus for many classmates was picking a unit that provided the opportunity to hone any last minute technical skills that might be needed before graduating and entering the world of nursing without the back up of a clinical advisor, formal preceptor, or a 4’x6’ taped together, carefully crafted nursing care plan. Everyone wanted a medical surgical placement for the “technical skills”, so naturally, I chose a different path. No one signed up for any of the 5 open oncology placement spaces and that immediately made me very curious…so8West, at a local community hospital, it was…
Little did I realize at the time that I was about to embark on a 25 year journey as an oncology nurse. Oh, the technical skills were all there, but more importantly, so were the psychosocial skills, the skills that were not as strongly enforced in school (as they are today), but the skills that have always defined the importance of nursing. As a novice oncology nurse, I was launched into a multitude of intimate conversations with patients and their loved ones about what it meant to have cancer, the perils of coping while on toxic and invasive treatments, and the ultimate realization of having to face the possibility of death. This is where I fell in love and I knew I would never leave.
Before I officially graduated in 1991, I was hired onto the same unit (8West) and I continued to work there for 2 more years before relocating to Toronto, to a much larger academic health sciences centre. It was big leap and in order to get in, I nervously accepted a position on a trauma/neurosurgical unit, but before long, made my way back into oncology and there I have remained ever since fulfilling many different nursing roles.
Oncology nursing is grounding. It reminds you every day about how vulnerable we all are and how important life is. It has been a privilege to care for those with cancer – to have provided them with the education and support they needed to better understand the next steps in their plan of care.
I am proud to be an oncology nurse and I am thankful to still have the opportunity to influence nursing practice and key initiatives focused on enhancing patient care.
Photo by Doug Nicholson
Director of Communications, Greater Toronto Chapter of Oncology Nurses (GTCON)
As the Director of Communications for the Greater Toronto Chapter of Oncology Nurses, part of my role this year for Oncology Nursing Day was to apply to the various Mayors within our catchment area for an OND proclamation. One day when I was working on this task I contacted over 10 mayors. This included the mayor of Bolton, Ontario. A week later I received a lovely letter from the Bolton Mayor thanking me for my application but that unfortunately they were unable to provide proclamation. I suppose I wasn’t paying much attention because I had in fact contacted the mayor of Bolton, England not Ontario. The email, however, continued to wish all the best to CANO and luck in our quest for support because the Mayor herself is a retired RN.