Will this get any easier?

[MLMRN1120]

Hi I'm a new nurse (8months out of school) who went right to work on an Oncology unit. I am still coming to terms with losing patients. obviously i understand that many of my patients will be terminal, but this has been a rough week; 3 patients that I have cared for for weeks went to Hospice. (the hospice unit is upstairs from my floor, so i did get to visit them,) but 2 have already died and it has left me feeling very depressed, almost affecting my daily life outside of work.. I really love Oncology, and love my patients..I guess I am just looking for some guidance.

While I would never want to take someone's death lightly, will it always affect me this badly? Any input would be appreciated. I consider myself a strong person, but does anyone else take it this hard?

[iNurseUK, RN]

Hi there. Although I've been qualified many years I am new to Oncology and this aspect of the work can be distressing. I came from a very good surgical ward originally (plastics) where the work was very satisfying and emotionally straightforward (patient came in with problem, we fixed it, smiles and boxes of chocolates all round) I did work elsewhere for a time, almost making me quit nursing (but that is another story) before settling on oncology.

Whilst no nurse ever takes the death of a patient lightly I think that perhaps focusing on good end-of-life care can really help. We can't save every patient but we can do much to make patients comfortable and ease whatever physical, emotional or psychological distress they are experiencing.

I'm sorry that you are upset. It is totally understandable but what has worked for me is adjusting my thinking from "cure" to "care" which in this speciality is inevitable.

Hang on in there :)

[MLMRN1120]

Thanks for your response..it makes sense to look at it that way, will be less stressful on myself, I am confident that I gave each of those patients the best care that I could, so I will try to focus on that. Leaving Oncology is not an option, so changing my mindset may prove beneficial. Thanks again :)

[hav2nurse]

I agree that changing your mindset is a great way to start. I too am an Oncology nurse and I have worked on Oncology and BMT floors. I just want to mention that Oncology patients in the hospital are there because they are very seek or they are expected to get very sick from high dose chemo, but in the outpatient setting you get to see them a bit healthier. You may want to think about outpatient oncology after some more experience on the floor. You get to see your patients when they are well. They still pass away but you don't have to see the worse of it and the families usually come back and say thanks. Many patients become like family so I won't say that it gets easier but it becomes different when you know the patient had a loving family and they let you into their lives. Maybe it would be worse for you, but I find it comforting to know that I was able to part of my patients lives and help them and their family through a very challenging time.

[KMRNOCN]

Oncology is a strange place. Many many of the patient are going to die.... but ..... all patients are going to die. The difference is, many are terminal from the day we meet them. I look at it this way. I'm going to die, my family members are going to die and many of my patients are going to die. I, the nurse, am part of the journey. My goal is to give good, safe, compassionate care while they share their journey with me and their loved ones. It's the most holistic nursing I've ever done. When they ask me, "how long" I remind them that none of us have that magic number and none of us is in total control but I'll be with them every step of the way as long as they will have me. It seems to be a pact we've both made. I shed my share of tears but usually it's a quiet moment, a silent good-bye and a card to their loved ones that gets me through.

[SmilesoBright]

I am not a nurse but I have worked as a nurse aide on an oncology unit and I must say it does not get any easier. I completely agree with the others when they say you have to look at the "care" you give your patients.As you know most of the patients you come across become frequent flyers . . . I too became depressed while working on that particular unit because I cared for the patients as I would care for a member of my own family or as if they were indeed my family. I absolutely adored working on this floor because they patients taught me things I dont feel I would have learned about life on any other floor. The appreciation of the care given is extremely high on this floor but to me I appreciated them even more for allowing me to comfort them in their time of need. Just remember that even though you lose a life you have also "touched one or many"!! I believe working on the oncology unit I worked among the best of the best and it was caring nurses like you that kept me going and have since inspired me to get a degree in nursing. I am currently taking pre-reqs for the nursing program here in my area and hope to apply this fall so I can soon become a "soldier" in the field of nursing.

[Arievilo]

I understand what you are going through. I am 6 months out of school and I went directly into oncology because that's what was offered to me. I have a hard time disconnecting myself emotionally from all the sad stories. Just this week we have lost several patients.

The horrible thing about inpatient oncology is that you tend to see them from diagnosis to death. You get to know these patients looking perfectly fine with a new diagnosis of a new cancer like leukemia. You see them through their first chemo, then when they come back with neutrapenic fevers. Then more chemo when the first one doesn't take. Then their BMT, then for more chemo if their BMT fails. Then all of a sudden they take a bad turn and they are completely different from when they came in. And soon they make the decision to go on hospice, and some choose to die in the hospital. Or sometimes something horrible goes wrong and they die unexpectedly... You get to know their hopes, dreams, you become close with their families, and they tell you things they would never tell anyone else.

It helped me once when a co-worker pointed out to me that impatient oncology mostly sees the worst case scenario. We see the bad cases, the ones where everything goes wrong. We tend to forget the patient we saw once for impatient chemo and they go home and we never see them again. Outpatient sees the success stories, the healthy ones, the ones who beat their cancer.

It takes a special person to be an inpatient oncology nurse. Showing compassion to patients while at work and trying to let go of all the emotions at the end of the day proves difficult. I haven't figured it out yet how to not bring the emotional baggage home. I'm not sure if I'll last too long before I reach burnout and have to make a change...and I'm only 6 months in.

[Alloush, BSN, MSN]

Salam

i chose peds onco myself. and it was my first position. it broke my heart several times. and it will a lot more. but making this child smiles is my goal and seeing him happy is what keeps me going. someitmes i try not get attached to the babies. but who cant ? ? ? they are adorableeeeeeeeeee

[Alloush, BSN, MSN]

Salam

MartinaRN1120

[rn undisclosed name]

It is very tough. I have learned to focus on the positive outcomes. We have an excellent head and neck program. Many of these patients come back to visit us and are told they are cancer free. After seeing them at their worst they're looking pretty darn good when they come back. There are a lot of not so good cases. Some of the paients can be so inspirational. I know after seeing many of the cases I see I'm not so sure I could go through the treatments and I don't think they are real honest with how tough the treatments and after care can be. Maybe they don't hear everything and are holding onto the hope that they will be cured.