A Letter to Myself - My first day on an Oncology floor

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    This was something that I wrote after experiencing my first day of a semester-long clinical rotation on an oncology floor. I wrote this to help me process the many different emotions that I experienced that day...there were many. I was going to keep it private, but then this might help other nurses or nursing students who go through the same things. My thoughts...

    Oncology. When she first said those words I immediately had two feelings: excitement, and oh-my-gosh-I-think-I'm-gonna-crap-in-my-pants-what-did-she-just-say? But the more I thought about it, the more I realized that this would be an experience unlike any other. One that could, if I let it, become a stepping stone to becoming a compassionate person and nurse...in all life levels.

    First day. Five patients. Five cancers. As I woke up this morning complaining about my early clinical and how bad my makeup looked, these five people woke up not knowing what their future would be. As I get my breakfast of coffee and cold toast, these patients get drips through their NG tubes. While I stress about my presentation of hypercalcemia in pre-conference, their family members stress about hospice care.

    I get on the floor. I greet the patients with my cheerful greeting and smile, but I see that the emotional status of each patient is so very different than the run-of-the-mill right knee replacements of last semester. I assess the patients for hygiene needs, immediately noticing that two patients had no need of hair care, since they had none. I watch my nurse give meds that I had never heard of, speaking amiably with the patient who had been here for two months battling rectal cancer. I give my bed baths, I chart, I speak to the patients, and I even gave a Lovenox injection. It was looking like a good clinical day. But as I continue through the day, a nagging thought slowly pushed to the surface...

    These patients have cancer.

    Perhaps I had never truly realized it before, in my excitement of getting the "nursing experience" I forgot that these lives meant something, and these lives were slowly being eaten away by a horrible clump of cells that we call cancer. I forgot that this mother in room 35 who was, to me, the "lady who doesn't speak English" was an individual watching her daughter die of pancreatic cancer. I forgot that the lady in 34 not only had abdominal surgery, she was fighting a disease that was fighting for her life. I forgot that the husband of the patient in room 37 was not only talking to a "nice lady" in the hallway, he was arranging palliative care. But how can I not? How can I function as a nurse thinking that, when I come next week this patient might not be here? How can I continue smiling at this beautiful woman when I know that she has days to live? How can I not hope to forget that this woman who is screaming during a diaper change may be soon to pass into eternity?

    But I can't.

    These people lived lives, made friends, fell in love, ate, drank, and hopefully learned many lessons. I cannot, as a 19 year-old college student, ever realize the impact of that. I cannot, in my 7 hours on Fridays, hope to grasp the influence of this person's illness on others. Yes, we all die, many before we have had a chance to live. But this is not our choice. We don't plan it, and nothing that we do will ever change it. It is set by a Being who, even in our pain and suffering, loves and suffers with us. Let me never forget it. Let me never forget that God, in His infinite wisdom, has set me here for a time and a purpose. And let me never forget that I am blessed.

    This is a letter to myself, help me to remember that I never have the right to complain.
    Last edit by Joe V on Feb 13, '17
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    About iwillnotwasteit, BSN

    Joined: Jan '11; Posts: 39; Likes: 16
    Registered Nurse
    Specialty: 2 year(s) of experience in PICU

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  3. by   rhondaa83
    It is good to be humble.... God in his infinite wisdom did not give these people cancer. You are born with genes, some are awesome with long lives ahead of them and some are short, due to who knows what?? Live life to the fullest everyday, be thankful and kind to everyone... Most of all, as you already know, be humble.
  4. by   CheesePotato
    The moment when the fog of task management breaks and you are able to see the person behind the diagnosis is a potent and powerful experience. I am glad to see you recognized this moment and wished to commemorate it to yourself.

    Through the years and as your practice grows, it is normal to slip and merely see the multi-trauma, the AAA, etc, as this is a normal sort of defense mechanism which allows you to suspend emotion in the face of much needed clear thinking. It never means you don't care, it just means that on Maslow's hierachry....well, let's just say stopping the bleeding outranks my feelings of empathy to the situation.

    And how do you come back each day? Because sometimes that is what the job is--providing healing, advocacy, and support one day, one moment at a time. And just as you, in your seven or so hours, can never hope to grasp the broad spectrum of each patient's circumstances and influence, so you can you never grasp how your presence in those seven short hours influenced and impacted the patient.

    May your faith provide comfort in your tough times throughout your journey. May it give voice to joy and praise in the good.

  5. by   iwillnotwasteit
    Thank you for your comments! I have learned so much since being on this floor, and I love it. I am privileged to have been given this opportunity! To help people at this time in their lives serves not only as a reminder to me of how good I have it, but also how rewarding it is to help those in need. It has also caused me to have great admiration for oncology nurses, and really all nurses in the field.
  6. by   Twinmom06
    I just started (permanently) on an Onc floor on Monday (I was previously float pool but enjoyed working on Onc so much that I bid on an open night spot and got it) and you're right - its amazing to watch the strength in these people and their families...and the sadness I feel when they go home just knowing that within a few short weeks to months I'll see their names in the obituaries...
  7. by   CWONgal
    Eloquent...it takes a special person to work in oncology. The very reason I went into nursing years ago was because I helped care for my brother who had cancer and felt rewarded by the little things I could do to make him more comfortable. After nursing school I found I couldn't do it...too many sad memories. Now, being a cancer survivor myself I can tell you it makes such a huge difference when you get that nurse who can care for you without having a constant look of pity. Keep it up!
  8. by   PaulaSullivan
    I'm on an oncology floor also for clinical this semester. I love it and I love the patients. What hit me the hardest was shadowing in the ED trauma wing the other day. A pt came in with thrombocytopenia and his labs came back with all answers pointing to cancer. We cared for him for four hours before doctors gave him the bad news. Those were the four hardest hours of my career knowing what I knew and he didn't....that soon, he would get terrible news that would change his life forever.
  9. by   smily11
    Such a nice words that encouraged me so much, am starting my nursing career in an oncology floor next week...now am recognizing that am blessed to be chosen to be in this place cause I have always want to be an ER nurse now am telling my self that maybe am meant to be in somewhere else... thank you