They didn't teach me that in school

weirdscience · Jan 2, 2014

Also newish, also hem/onc, also lost a parent to cancer prior to nursing. May I ask how long it has been since yours passed? The residual grief may be compounded as patients pass on the same floor your folks did. I can't imagine how hard that must be.

Is a change of floor out of the question? Or oncology at another facility? At the bare minimum, maybe talking to a therapist (or EAP, or even a chaplain if yours is a hospital that provides their services to employees) can help you get some coping strategies in place.

Ruby Vee, BSN · Jan 2, 2014

I'm guessing that if you've worked on that floor as a CNA, seeing patients pass on the same floor that your parents did has already happened to you and, as a CNA, you dealt with it. It seems that the problem you're having is a transition from student to nurse. You have so much more responsibility than you expected, and part of you feels responsible for not being able to save patients even though, in your head, you know you can't.

I started on an oncology floor 35 years ago, in the same unit where my grandfather died.

You have to LEARN to leave your work at work. That takes time, and two and a half months is just a little speck of time. Share your feelings with your husband. He may not have the same job and the same responsibilities, but it may give him some perspective to know where your distress is coming from. He may also be able to provide some much-needed emotional support. That wasn't possible for me -- my husband at the time was a lying, cheating douche. I bonded with another nurse who started at the same time I did, and we held each other up. We each understood exactly what the other was going through.

Make sure you take good care of yourself. Eat right, exercise and get enough sleep. For years, I found that walking the dogs after work helped me to decompress and transition from being at work to being at home. Some days the walk was just long enough for the dogs to do their business, other days I'd walk miles and miles before I was ready to be home. Others find that running, books on tape, a hot bath, a glass of wine or a long commute does the trick for them.

Give yourself permission to stress/worry/think about your patients for a limited time after work. When that time period is up, move on. It's difficult at first, but it gets easier.

Getting attached and mourning is a part of oncology nursing. I know nurses who have done it for decades. I lasted five years, and then all of my primary patients, my cousin and another cousin's best friend all died in a time span of about six weeks. Just like that, I was done with oncology. I don't for a minute regret the time I spent with those oncology patients, though. Getting to know them and helping them through the end of life with all of it's emotions and issues was a privilege. You've chosen to do one of the most difficult jobs in nursing, and you're asking good questions. I think you'll make it. Still that first year is miserable. the only way to get through it is to GO through it. Good luck!

Emergent, RN · Jan 4, 2014

Your past experiences can be your strength, if you are able to bridle them for good. Maybe get some help from a counselor or clergy to help you come to terms with your own grief. Ultimately, your ability to feel should make you a more empathetic nurse. Take it from me, I've dealt with these feelings too.

One thing I know about myself, though, I could never work oncology. That's something you can sort out with a counselor. It may be just too close to home.

God Bless you, you sound like a good and caring nurse and human being!

ceebeejay · Jan 4, 2014

I had to do a clinical on the floor that my MIL passed away in. Everytime I passed that room, I had to choke down tears. But, the other posters are right - you have to teach yourself to let it go. Allow it its time, and then make a conscious choice to say "enough". A seemingly silly thing, but it works... Everytime you have a thought that you do not want to give attention to, say "delete" out loud. Your brain associates the word with being gone because of your experience with computers. And, when you try to get the thought back, you will actually have a little trouble. Silly, but it works. It's a way to train your brain to focus on something else. Hope it helps.

Kipahni, RN · Jan 6, 2014

I was in oncology right out of school too. It. Was. Rough. I took a break for 2 years and did some other nursing opportunities. Learned boundaries and found a grief counselor. Learned to turn to my husband for comfort (a phrase that helps is, "This is not a fix it moment, just listen, let me cry and talk and rub my back) Went back to Oncology for two years and was in a lot more healthier place to "handle" the emotional strain. Eventually I left it though due to poor management and surviving my own cancer made me re-evaluate my desires in life.

Long story short, You have to tell yourself at the end of the day you did your best. Surviving isn't the only kind of healing a pt can have.

LuckyRookie · Mar 19, 2014

A very belated reply here...

Good research exists on compassion fatigue and resilience in oncology nursing. After six years on an oncology and hospice unit I can emphathize with your experience.

Here is an article that you may find of interest:

Countering Compassion Fatigue: A Requisite Nursing Agenda by Deborah A. Boyle, MSN, RN, AOCNX, FAAN This was published by The Online Journal of Issues in Nursing in January, 2011.

You can retrieve it from

Countering Compassion Fatigue: A Requisite Nursing Agenda

Especially useful, if you have it available in your area, may be the Accelerated Recovery Program (ARP). Hang in there!

LevitateMe, RN · Jun 3, 2014

This is a great feed. I've been in out patient about 2years and handle it all better than I thought I would. I joke a lot with patients and I feel like that keeps everyone's morale up. Where I have difficulty is when after a patient dies and their family member usually a spouse comes back to thank us. I lose it every time. Sometimes this is ok because they are crying too and we are all crying and laughing but it's still makes it hard for me to control my grief for them. A nasty co-nurse recently said to a drug rep "no you can't be sensitive in this job" and I thought to myself, no! You should be! But I guess that's why the patients prefer me and another nurse over her snarkyness. But I'm ranting. My point was 2 years later I still have a hard time but I am realizing I love this field.

lookingrn · Jun 18, 2014

I've been a year and a half in oncology. I had a couple years experience when I started, and I think that helps. That first year of nursing is just so hard, and so scary, and you need to be very, very gentle with yourself. Hopefully the people you work with will be supportive and gentle as well, but if they aren't, you need to remember that you're doing your best, and you're doing good things and that it's ok to be a beginner.

As for the grief, I try to actively let it go. For me, this happens on a bicycle a lot, and sometimes running, but there are all kinds of ways that work. Meditation, if that's your thing. Prayer, if that's more comfortable. Talking to people who can listen, and that's probably not your husband, unfortunately.

I really think about letting it loose, sending out out away from me.

Beckyloo75 · Jul 7, 2014

I started on a med/surgical oncology floor strait out of school and that was 5 years ago!! I love oncology and I am sure part of my passion comes from the extensive cancer history in my family. I lost my mom at the age of 12 to colon cancer who was 30 at the time of her passing. Oncology nursing is a very rewarding/heartbreaking area of nursing. I do feel it takes a very special person to be a oncology nurse and unfortunately it is very hard not to become attached! The hardest thing to do some times is hang chemo for someone knowing they most likely will not live through the treatment. I think with every patient you just have to tell yourself you were meant to be here for this person and help them in any way possible rather that be to get them in remission or help them to pass over in the most painless way as possible. I myself have had to take breaks because it does cause so much heartache and grief and literally at times can emotionally drain you! I am lucky to work on a floor where we have neuro and surgical patients as well and I have a option to take a break from time to time but I also have for the most part a great team of nurses that I know I can talk to. Your family will always be there but your nursing team also becomes your other family because they of all people can relate to you and your feelings! I wish I knew the answer to how u can leave work at work but I myself have yet to figure that out. I have so many patients and family members though that I can truly say have became a part of me and for that I am blessed and wouldn't change for anything! I wish you the best in you oncology nursing career!

eagle78 · Jul 10, 2014

I did a year of clinical in radiation oncology and I understand your helpless feeling when it comes to the patients. It is not easy seeing someone who you want so very much to help, but cannot. As a former cancer patient I want you to know that your being there, caring, well the patient can tell. Sometimes when you are facing something so scary it just helps to see a kind face with a caring look in their eyes.

Most importantly you have to find an outlet for your self to relax and revitalize. You have gotten a wealth of wonderful suggestions, but in the end you have to find what fits for you. I realize this post is late but I hope you have found the peace you need to carry on, cancer patients need caring individuals such as yourself. Be blessed.

cancer.sucks · Aug 4, 2014

I have been an oncology nurse for 28 years. I know that I was called to be an oncology nurse straight out of nursing school. My plan was to go into labor and delivery and then become a midwife. So much for those plans. I have read every post in this conversation and I see repeatedly that you have to find your own way to let it go. That is true and no one can tell you that there is a right way and a wrong way to handle the grief that comes when your patients die especially when you have provided care for them for quite awhile.

As painful as it is, I ask you to remember your parents' experience on that floor and with the staff. Who was the person(s) that impacted your family the most? Who was the most helpful? Who are you most grateful that he/she was there? My guess is that the person or more that comes to mind are the nurses that supported your parents as they went on their cancer journey. Remember the behaviors that meant the most to you because those are the behaviors that you want to emulate.

I spent 16 years on the hematologic malignancy floor. Only 10% of the leukemia patients that I had would live more than 3 years unless they could get an allo transplant. I took care of many of them for years. I watched most of them eventually die of their disease. I was honored to be with them through their journey. I know that my presence made their life better however long or short it may have been. I am blessed to have a supportive family, but more than that I was blessed with the understanding that I had a gift to give.

You have not been a nurse for long, but you have natural talents and compassion that led you to become a nurse in the first place. Give yourself permission to recognize what you have to offer and it will give you a place to start. The more you recognize the gifts that your patients are giving you by allowing you into their lives, the more you will celebrate their lives with them and not dwell as much on the mournfulness of their passing. You make their lives and their deaths better by being the honored one to celebrate them.

You will never repay the nurses that made a difference in your parents' cancer journey. It is time to pay it forward.