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A Patient's Blog: What Makes a Good Oncology Nurse?

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Two weeks ago I had the opportunity to speak to a group of dedicated nurses at the 37th Annual Oncology Nurse's Society (ONS) Congress in New Orleans.

How do I know that the 200 nurses there were dedicated? Here's a clue: The program started at 6 a.m.!

I was barely there for two days, but I had the opportunity to meet some pretty amazing nurses. On the flight home, I had a chance to reflect on my trip--and to think back about some of the excellent nursing care that I have received since I was first diagnosed with multiple myeloma over five years ago.

A pair of local, small-town Wisconsin nurses, Dody and Cathleen, put up with me for two years while my doctors worked to stabilize my cancer--and  I tried to wrap my head around my difficult diagnosis.

I spent a lot of time at the Mayo Clinic in Rochester, Minnesota, early on. Teresa, Joan and Monica were three of the most helpful, caring and professional health care professionals that I have ever met. How fortunate I was to have their help throughout a complicated 15-day stem-cell harvest from hell. Ladies and gentlemen, I couldn't have made it without you!

And then there were the half-dozen or more BMT (bone marrow transplant) nurses who helped me through my stem-cell transplant last summer at Moffitt Cancer Center in Tampa. All things considered, the procedure went off without a hitch, courtesy of the bright and compassionate nursing staff. And trust me, I wasn't the easiest patient to work with.

I endured waves of nausea around the clock. My nurses worked hard to help me rest comfortably throughout. Heck, late one night my nurse even called a physician at home to get me the medication I needed to stop hiccupping!

More recently, the infusion nurses at Florida Cancer Research have helped make my ongoing therapy a lot easier to endure.

It probably won't surprise you to learn that the oncology nursing skill I value most is the ability to start an IV effortlessly, even in the most difficult-to-stick patients.

I have learned a lot about what makes a good oncology nurse from a patient's perspective over the years. And I'm convinced that while any type of nursing is difficult, oncology nurses handle some extreme challenges nearly every day.

  • For example, an oncology nurse needs to deal with the emotional challenge of sometimes losing patients who have become close friends. And that isn't getting any easier now that cancer patients are living longer. Sure, that means there may be a few more victories early on. But it also means more time to become close and emotionally attached to a patient, which can make it much more difficult if they do pass away.

  • Then there are the technical requirements of their craft. I have no idea how these skilled men and women keep chemotherapy dosing straight. It can't be easy working with so much toxic, dangerous medications day in and day out.

  • Most importantly, an oncology nurse needs to be a good listener. Getting to know and listening to their patients not only allows them to help keep a patient thinking positively, it also allows these nurses to make suggestions to the oncologist about things that they have noticed will help their patients get through each day.

  • Patient quality-of -life issues are also a primary part of an oncology nurse's job. By closely monitoring a patient's ability to deal with their medication, a well-timed nurse's suggestion to an oncologist can make a huge difference in a patient's quality of life while they undergo treatment.

All that's left to say to oncology nurses is thank you. Thank you for distracting me just before the needle goes in. Thank you for helping to keep me warm when the IV is cold. And most of all, thank you for being my friend.


Feel good and keep smiling!

Pat

13 Comments

I am scheduled for a stem cell transplant this month. I feel confident in my decision but get waves of fear that overtake me. Can anyone tell me a story about your transplant experience that will make be feel better and not so scared. What was it like - what can I expect? I have talked to 2 people so far but need to talk to some more individuals. My doctor said I am an excellent candidate as I am still fairly young (56) and responded very well to my chemotherapy and I have no other medical issues. Please help. Thanks. Michelle in Massachusetts

Michelle: I had my sct in 2009, I am 56 now. I will probably do an allo transplant in the future because my stem cells were not as "hardy" as we had hoped. BUT the experience of transplant was not that bad. Seriously. They kept me pretty doped up with every anti nausea drug you can think of etc before during and immediately after, that i really can't remember the total experience BUT it wasn't horrifying by any means. My advice is don't say no to anything offered :) I don't remember feeling nauseous though i do remember getting sick. But I did, it was over and then i would fall back to sleep. To me this was ideal. I had mine at Ucsf which involves in patient care for the whole experience... I always felt well cared for and the nursing staff was awesome. Because my white count took forever to recover (it wasn't great before i went in!) I was in the hospital for a month... much longer than most folks.. but it was still doable. I did not experience mouth sores, or constant nausea or diahrrhea. So don't plan on it. Go into it knowing that your experience WILL be different than others, and think positive.... attitude makes a HUGE difference.
Best of luck to you... you may get a long remission which makes it ALL worth while.

Aloha, Michelle
I'm a 63 year old oncology RN and I also was weak-in-the-knees from anticipation of my ASCT in July 2011. Maybe I was expecting an event similar to New Years Eve fireworks. My transplant reality was one of highly skilled professionals capable of guiding me through the process with minimal side effects. SUCKING MOUTHFULS OF ICE PRIOR AND DURING THE CHEMO INFUSION IS THE BEST advice. as a result, I had no mouth or intestinal sores. Antiemetics were effective for the nausea and also helped me sleep through the first week..
Lingering Fatigue was surprising. I'd never felt sheer exhaustion like that. Felt like trudging up Mt Everest without oxygen.
Now it's behind me. My cancer counts are imperceptible, lower than my oncologist dreamed possible. We're confident this was the right decision AND are prepared to do it again if ever needed.
Take care of yourself.
Hugs, Rose

HI Michelle,
All best wishes on your upcoming SCT. Anyone who has gone through this procedure can understand your feelings. To add to Pat's comments I "was there, done that" in spring 2008--18 days at the Indiana University Cancer Center in Indianapolis--wonderful nurses,Pat!! Based on my conversations with people who have had an SCT as well as my own experiences the way one's system responds to an SCT can differ a great deal. I had few lousy side effects except some diarrhea. NO nausea at all. I felt pretty good throughout my stay--even reread most of Moby Dick--something I had promised my self I would do if I were ever in a situation like this. Also got on my computer a good part of the time and walked around the unit for exercise--ducky mask always on. I guess I post this because I had heard all sorts of horror stories about SCT and discovered it is not always like that. I should add that my case was also different since I'm a type 1 diabetic who uses an insulin pump so I had the attention of a lot of people in the endocrinology dept.--my question was how long can someone undergoing an SCT stay on a pump? Made it to the last day before I needed some injected insulin.
All good fortune to you....
Warren Vander Hill

I have been blessed with outstanding oncology nurses over the 11 years of multiple myeloma. I also have been through a year of colon cancer during this time. Maureen (Mo to her friends and patients) has provided excellent oncology nursing care for the 11 entire years, always cheerful and knowing exactly what is needed. Kristi was also a very fine oncology nurse for over 8 years at the same infusion center. Both of them have accessed my port and used butterfly needles to draw blood, flush port and infuse chemo that seemed effortless and painless. If you ever are treated by them in the Coachella Valley, you too will be blessed.

One of the most useful bits of advice I received before my two autologous stem cell transplants was to plaster my hospital walls with photos. For the two weeks I was in that room each time it gave me something to look at and think about when I couldn't read, watch TV or do anything due to the unrelenting nausea. I also asked my friends and colleagues to make something or send a photo no larger than a small letter envelope that would be in a forest so my partner could make a large poster sized forest for me. I looked at that poster of this forest made up of their objects and photos and borrowed the energy of these people and thought about them, their lives and how we have interacted over the years. The photos and the forest helped me "leave" the room and were a wonderful distraction. It gave the over 13 different medical people who came into my room each day something to look at and talk with me about too.

Some important things for me were to create distractions, try to find solutions to the nausea, and be in as good condition before hand as possible. If you will have fresh food restrictions for 100 days after, be sure to "pig out" before hand on your favorite items.

Be tough, you can do this! LiveSTRONG.

I, too, will be having my first SCT sometime in Augusut. I was diagnosed Dec 8, 2011. I have responded very well to my treatment also. Like you Michelle, I feel good about it, but yet think it is scary. I have read so much about SCT's. For now I am ok with it, but I am sure as it gets closer I will start to feel nervous. I hope I don't. My doctor told me she would give me phone numbers of people who have had theirs to talk to. I am not sure at this point if I will take her up on it. My husband and I attended our first Support Group last month. Several people talked about theirs. MM is different for everyone. Like you, Michelle, my doc feels I am a good candidate too. She considers me young (63 as of last month), healthy and caught it early. Good luck with yours and I hope to learn of your experience. Thank you, Pat, for your input and sharing your story with MM.

I underwent a stem cell transplant in 2007 when I was 52. It is very scary anticipating what is going to happen before it does. However, other than some discomfort for a short while, it is not a physically painful experience. I sucked on sucking candy while it was happening which was helpful. Ice chips are also helpful. I, as Pat, did suffer with nausea from the high dose chemo. However, I did not have much diarrhea nor did I experience mouth sores. As long as you follow the directions that they give you for rinsing your mouth frequently, you will be OK. I was diagnosed 9 years ago and I am still going strong, working 6 days a week. You will be OK. It's hard to see clear to the other side but you will get there! All the best of luck to you.

Hi Michelle,
Yes, the scariest part is definitely the fear of the unknown leading up to the transplant! In a way, it's just one of life's new adventures. Although not fun, crazy as it sounds, I do have some happy memories of that time. I had my auto stem cell transplant in 2004 at age 49 (now 57), so I've been fortunate enough to have had a vacation from myeloma for 8 years.
I remember one of my worst fears was loss of independence. Yes, you will be able to walk, take yourself to the bathroom, bathe and dress yourself daily. I did that even for the few days I was in the hospital. If your family or caregivers can find you some ginger beer (not ginger ale) it definitely helps with the nausea. Decide ahead of time about headcoverings - if you prefer scarves, hats, or a wig. If you have time before your transplant, the American Cancer Society offers a class called Look good...feel better. They have some great "beauty" tips! Keep a journal. You don't have to write in it every day - only when you feel like it, but you might want to look at it months or years later.
I was able to return to work (I have a desk job) 4 hours a day 2 and a half months after my transplant, gradually resuming my normal hours after my 100 day checkup. You will need a lot of naps for at least a year, but will gradually resume all of your normal activities.
I don't worry about relapse. I figure I'll cross that bridge when I come to it. (It does help to have faith). I would absolutely have another SCT. I love that I don't have to take any meds. other than my once a year IV bisphosphonate (bone builder).
Good luck! I'll be keeping you in my prayers! Feel free to e-mail me at angus6807@comcast.net

Thank you all for your comments to Michelle. I was diagnosed a few months ago and just finished my third cycle of frontline treatment. My doctor believes I'm a great candidate for SCT...I too am scared. Can anyone tell me about the catheter which is placed below your collar bone. Taking care of it seems scary to me...I haven't heard any talk about this procedure. I'd appreciate any feedback. Thanks, Marcia

Hi Michelle
I am considering a autotransplant this fall, about to due the collection mid July.
I would also love to talk to people about the process. The few things I could find were pretty scary.
I am in ma also email me at Jeaninetalks@hotmail.com

Good luck hope your doing well.
Blessings!

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