Hem-Onc

There are a few things that make peds hem-onc different from general peds. One is that the kids are there for long periods and have frequent readmissions. You would get to know and care about the families far more deeply. More of these kids die. So the emotional aspect can be more difficult. The nursing can be quite challenging from a number of angles. The drugs administered are highly dangerous and have to be handled with great care and attention. In our hospital there is a special certification and annual recertification needed before one may administer chemotherapeutics or cytotoxics of any kind. The side effects of these drugs are often very nasty and cause comorbidities like nausea, vomiting, anorexia (and the accompanying malnutrition), skin breakdown, hemorrhagic cystitis, mucositis, infection, neuropathy, hearing loss, cardiotoxicity, bleeding and a host of others. The chemo protocols are very precisely timed so that the drugs work the way they have to. This may have changed since I did oncolgy, but the neuroblastoma induction protocol had four different infusion drugs that started at different times in the treatment cycle but all had to be completed at the same time. As in the doses had to be delivered in their entirety, including the flush, at precisely 1800 hours on Thursday.

On the other hand, the feeling that you've really helped a child and a family can't be downplayed. Many of the nruses I worked with would never want to do anything else. Kids are so much more resilient than adults. When you see a kid who has just had an LP in the treatment room riding around the unit on a kiddy car, or a bald teenager patiently showing a bald six year old how to make friendship bracelets, or watch one of your patients tenderly cradle their newest sibling, born months after the devastating diagnosis of thier cancer, it makes you feel that the world has a chance. There are many opportunities for teaching, supporting, nurturing and caring in this field. You know, the things we all became nurses to do. If you try it and don't like it, you can always move on. But you just might love it.