heme/onc/bmtu --can I do it??


Out of nursing school I worked for 1 year in the PICU at a large teaching hospital (and a year before that as a tech). Very stressful, but I loved the patients and the families. I only took care of maybe 1-2 oncology kids and I just remember feeling so sad for them (MUCH more so than any of my other PICU patients for some reason; but I also really cared about them). I remember the families being *very* involved in their care and having a LOT of knowledge of their childs cancer and treatment and very demanding in their care (which I totally "get" but a lot of my fellow nurses in PICU really had a hard time with those parents--I think maybe they are just used to being in more control of their patients or something, Im not sure....). I also remember every one of them to this day.

This friday I have an interview in the heme/onc/bmt unit and the general medical floor. I honestly dont know if I got offered both jobs (which I believe I have a good shot at with my PICU background...though its been 1.5 yrs since Ive done that, Im doing child psych right now which is not a good fit for me) which one I would take. I worry about the emotional aspect of the heme/onc floor but I also think I would like the challenge and the learning opportunity. Right now I work in child psych (1.5 years) and it is NOT for me so Im going back into peds medical nursing.

Any advice, anything for me to ask about during my interview or think about??

Pediatric Critical Care Columnist

NotReady4PrimeTime, RN

16 Articles; 7,358 Posts

Specializes in NICU, PICU, PCVICU and peds oncology. Has 25 years experience.

I think you're leaning toward the heme-onc-BMT side, aren't you? (I think you'd probably find the medicine unit boring.) Remember that more children with cancer survive than don't. But death is always a posibility for them, so you need to take stock: How did you deal with deaths in PICU? Will you follow the families' lead when their children are nearing death? Heme-onc families do become very knowledgeable about their child's disease, treatment and prognosis. They also tend to have a deep well of strength that grows over time. They're never passive in the process of caring for their child so they'll start giving off signals when they know the day is near. What they need more than anything else is someone who will view them as a partner, who will help them maintain their family connections while allowing them some leeway in the care of their child, and respect them the way they deserve for the knowledge and skills they have as experts in their child. Solid nursing skills and superlative organization are paramount for the nurse. Do you have all that? (I think you do.)

When you interview, ask the manager how the unit supports the second circle of grievors, the nurses, physios, OTs, teachers, child life and so on who are often left out of the picture when a long-term patient dies. Ask what resources are available for staff to help them keep their emotional equilibrium. These questions will reflect well on you and the answers will tell you a LOT about how you'd fit in with the culture on the unit.

25 years ago today I became an oncology parent. I didn't know it then but that fact would shape almost everything that would happen to me since. It changed me in ways I'm still discovering, and when I look back on it, the prevailing emotion isn't the sadness you'd expect (although there is that!) but a sense of accomplishment. My child survived despite a only a 5% chance at diagnosis, he's healthy and happy now, my other children not only survived but turned out to be very wonderful strong people, our marriage is still intact and I'm the kind of nurse I so admired while we were on our journey. (I hope!!) Imagine how good it would feel to be part of something so life-affirming!


238 Posts

Specializes in peds palliative care and hospice.

I would suggest that you try it, mostly because its seems that you are already leaning that way.

Also...Find a way (and even plan it) to deal with the saddness that comes with working with hem/onc kids. I know that I interveiwed on a floor and they had a ceremony and released balloons. I have not done peds oncology (yet!) but I have worked with children that are terminally ill...Find your "space" for greiving them and it will help vs. having it all build up.

Good luck with your interveiws! I hope they go well!!! :)


1 Post

I so appreciate this. I am looking into a Heme/Onc job, as my heart really connects with children and I have a personal experience with chronic Leukemia (with my mother for the past 10 years). I feel I would do well at this, seeing as I worked in the PICU during school and after for almost 3 1/2 years. I got so burnt out on the PICU so I have been doing more of a "desk job" in the Neonatology department at my hospital. My heart yearns to go back to bedside and utilize my degree more and also learn more. This encourages me to go for it. I am nervous to do something new and that I don't know too much about in my nursing career, but it's also exciting. I also have been torn between heme/onc outpatient or bedside. I hope to apply for both and then be able to choose :) Thanks for your post!!