A note to oncology care providers….

A few months ago my staff and I experienced multiple losses in a short period of time of patients we were very close with. This is a note I wrote to them to remind them that while our job is not easy, it is so worth it. To all oncology care providers out there, remember you are making a difference.

It was a tough week last week… which got me to thinking…

Recently I sat down at my new church to learn more about the church and in return, they wanted to learn about me. Quickly into my career as an oncology nurse I learned to just say “I’m a nurse” leaving out the oncology/cancer/hospice part. The reason for this is because once you say the word “oncology” or “cancer” and especially “hospice”, people’s faces tend to fall and the next question is often “how do you do it?”. In this particular case I did say just nurse first, but they proceeded to ask the question of what type of nurse, so I answered. Then I heard countless stories of how other people in the field of oncology had touched them and their family through cancer battles.

Each of you are a part of this team who makes a difference day in and day out in the lives of these patients and their loved ones. You hold their hands when they are scared, you clean up their puke, empty out their urinals, help them to the bathroom when they are too weak to make it on their own, but they want the dignity of going in a real toilet, you educate them on safety and why you need to be there, and the list goes on.

Each of us got on this career path for different reasons and each of us will be here a different amount of time. For some, it is a brief stop in their career journey. For others it will be their life’s work. Others it is somewhere in the middle. Some people landed here because you yourself or a loved one was personally touched by the care other healthcare providers in the oncology field provided. There are those that just landed in this because it was the open position. And others have a heart for oncology just because. No matter the time frame or reason, you matter.

So as I reflect back on the losses that we all felt deeply this week. As I think of the countless times I’ve felt the grief of losing an incredible patient to the horrible disease that is cancer, I want to encourage each of you. I want to let you know that you aren’t alone. I want to let you know that there is room to grieve. Most importantly though, I want you to know that you matter. That the work you are doing day in and day out is changing the lives of people, many of who have a ticking clock over their heads on how long they have left on this earth.

Oncology nursing has been my career plan since I was 16, but nursing leadership/management was not in that plan, that is more something that transpired as my career has progressed. As a leader on this unit, I am honored to work alongside each of you. You all and the patients are the reason I am here. And every time I hear “exceptional plus” or “satisfactory plus” in response to the care you are providing, my heart swells with joy and pride. Thank you for being a team that listens and truly cares. Thank you for caring, even when the pain runs deep. Please know my door is always open for a place to debrief and I’m walking alongside each of you. Thank you for making this unit exceptional plus.

From grouch to grateful – a nurse’s attitude adjustment

I woke up this morning feel defeated. The last few weeks things have been a bit rough. On top of that, I woke up at 4:30 for no reason and couldn’t fall back asleep. I got up eventually, got ready for work, and went there frustrated and grouchy. If I was being completely honest, I wanted to crawl into a hole and not talk to people. We all know those days, right?

Grateful Heart

Before I even got to work it was clear that things were not going as planned for the day.  Commence tiny violins playing in my head and the desire to crawl into a hole growing even bigger. Throughout the day I’m holding back sassy and sarcastic comments and trying to adjust my attitude.

In the middle of the day I was doing a dressing change on one of my young adult patients. This patient is younger than me and has had an extremely rough year. We’re talking about a lot of different things and out of no where she dives into a short spiel that went something like this…. “Erica just in case you’re wondering you make a difference in people’s lives every day, don’t every doubt that. You’re one of my angels.”

With tears in my eyes I told her thank you and that some days I do wonder. Some days I wonder if everything I’m doing really does matter. And some days, even though I know and witness plenty of people who have it far worse than me, I wonder why some things happen to me. And one of those some days was today.

So as I reflect on this Thanksgiving week, I’m reminded of one main thing, patients may claim I’m their angel, but in so many cases, these patients (and their loved ones) are my angels. Thanksgiving this year just got a whole lost sweeter.

 

How Do You Do it?

How do you do it? It’s a question I get asked all the time about my job. Some days, on days like today, where I mourn the loss of a patient who was near and dear to my heart, I wonder. I wonder how do I continue to do this? But here’s the thing, even when my heart is laced in grief my response is this – how could I not do it? You see, the deeper I dig into the question, the longer I’m an oncology nurse, the older I get – the more aware I become of how things in life aren’t necessarily meant to be easy. Especially the best things in life.

Oncology Nurse

I still remember when I was 17 walking into a hospital and my thought was “this feels like home”. Sounds crazy, right? But there was something that drew me in, and continues to draw me in. The more I thought about and experienced the oncology field, the more I was hooked. I can’t explain it, and I’m not sure that any one of us can. This is what I do know though – you ask any of us who feel called to the oncology field and we can simply answer “I was made to do this”.

So instead of looking for ways for it to be easier, I’m looking for ways to walk through it well.

So as I have thought through and continue to think through the question “how do you do it?” I still keep coming back to, how could I not? I mean, I could not. I could walk away and enter another field of nursing and some day I might. But as for now, this is my calling, and I know this with my whole heart. So instead of looking for ways for it to be easier, I’m looking for ways to walk through it well.

I’m making a conscious decision to every day develop who I am and my coping mechanisms. I’m choosing to surround myself with community that will walk through life with me. I’m digging into who I am, how I was created, and working on making myself the healthiest I can possibly be.

Most importantly though, I’m choosing to focus on the things that make me love my job. I mean, for a science nerd, to be in one of the fastest advancing medical fields is incredible. The amount of new drugs coming out is breathtakingly awesome. Not to mention I work with some of the best doctors, nurses. CNAs, midlevels, and other office staff around. They are like family to me.

I wish that just for a moment you could get a glimpse into the incredible people’s souls who entrust me to walk with them through the hell they are living in.

The best part though? The patients and their loved ones. The fact that because of my job, I have met some of the most amazing people is enough, but it doesn’t stop there. I wish that just for a moment you could get a glimpse into the incredible people’s souls who entrust me to walk with them through the hell they are living in. I have witnessed what true love looks like in all sorts of relationships. It’s in the husband who still finds his wife beautiful, even when all her worldly beauty is gone. It’s in the son who makes his work schedule around when his mom has chemo treatments. It’s in the friend who cancels her plans on spare of the moment to take their very sick friend to treatment. It’s in the adult kids who take care of their dying father in his final days so he can be at home.

So instead of asking me “how do you do it?” Ask me “how can I help you do this?”

These people, the patients and their loved ones, challenge me to be a better person. To love deeper. To live well. To embrace all emotions – both the good and the bad.  To be the best me I can be.

So instead of asking me “how do you do it?” Ask me “how can I help you do this?” Because that is what we need. Any of us in fields that are as emotionally tough as the oncology field need the cheerleaders on our side. Walking with us, crying with us, listening to us. This is the best thing you can do for us, so that we can continue to do what we were made to do, and do it well.

 

 

Nursing: I Didn’t Choose it Because it Was Easy

As a nurse, there are weeks of work where I don’t sit longer than to quickly shove down my lunch down and to speedily chart. There are times I end a day with my legs aching and barely the strength lift  open my eyes and all I can think is “my brain hurts.” But even in those moments, I can sit and say I love what I do. I didn’t choose it because it was easy, I chose it because I care.

Oncology Nurse

I’ve written about my job often, about how it isn’t easy and why I love it. This isn’t anything new. But every day I discover something new about why I love what I do. I love that my friends have different interests and passions. Hearing about what other people do for their jobs is one of my favorite things. We were all created differently and with a separate purpose. Even within my field there are many different types of oncology nurses and I get to learn how to be a better nurse through each of them.

There is one thing that is in common though with each oncology nurse I know. They care and they care deeply.

I don’t know what your passions are. I don’t know if like me you are a nurse or if you like economics or if you get how computers work from the inside out or if you create the most beautiful things. But I hope you love what you do. Or have something in your life that you love what you get to do there.

I can say even in the toughest moments of my life when I know I’m hugging that young mom for the last time or I’m speaking to the family member as they look at me and ask me if their loved one is dying I love what I do. Because I know without a doubt I was created to do this.

 

Note: this post was originally published on November 10, 2014.

I Wouldn’t Change a Thing

Recently I was talking with someone who doesn’t know me very well and they asked if I see myself in oncology nursing for the rest of my career. I answered honestly – I can’t imagine my career without working with cancer patients in some way, shape, or form. I truly do love what I do. Even when the world seems to be crashing, I can’t catch up, my feet ache, my brain hurts, I’m sobbing over exhaustion, or I’m sobbing over grief. I was made to do this. I’m not exactly sure when cancer patients became a passion of mine – it was more something that seems to have been weaved into the soul of who I am made to be.

WorldCancer

It’s World Cancer Day. So what does World Cancer Day mean to me? Continue reading “I Wouldn’t Change a Thing”

Oncology Nursing Chose Me

This is a guest blog from Erin E. She currently resides in Grand Rapids, MI with her family where she works on an inpatient oncology unit. I (Erica) am honored to call her not only a colleague but one of my dear, dear friends. Your heart is an inspiration, Erin!

I didn't choose to bean oncology

People often ask how I chose to work in oncology. I usually tell them my story and what brought me to Grand Rapids and my oncology patients. The truth is, oncology chose me. As a new nurse, I was hungry to work. I was yearning to put all my nursing skills from school to use. Every area in nursing was new and exciting. I wasn’t fully sure where I would thrive and which area I would enjoy best.

Continue reading “Oncology Nursing Chose Me”

Dear Breast Cancer Patient-Round 2

Dear Breast Cancer Patient,

Since I first wrote to you a lot has happened. New research is coming out every single day. Recently I received another e-mail about another genetic marker for breast cancer. But here is the thing. Since I first wrote to you, some of you have passed on for this earth. Some of you far too young. It wasn’t that long ago that I was first meeting one of you. You had been battling this awful disease for many years. You were fighting to have just a few more days with your young children. You were fighting until your very last breath. And when I said goodbye to you we both knew it would be the last time I saw you and you collapsed in my arms crying. I’ll never forget that day. I’ll never forget what you taught me about life, love, fight, and utter and complete strength.

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I’m so thankful for all the money that has been donated to help, but I still sit in awe as it often isn’t hard to figure out why a young woman is sitting in a chemo chair worried about her babies at home. Often it is breast cancer. Not always, but more times than not. 1 in 8 women will get breast cancer in her life. That is 12%! (Source). And this is something I am not okay with. Not at all. Lung cancer is the first leading offender in cancers causing women to die followed by breast (Source).

I’m so incredibly thankful for those of you I have had the privilege to rejoice with as we dance around celebrating your last chemo. I’m so glad to know that thanks to the money that has been donate to research deaths caused by breast cancer have been decreasing since 2000 (source). But my heart continues to break every single time a women sits in that chemo chair and I talk with her about her cancer.

Breast cancer patient, seriously, you have made my life so much richer. Every. Single. One. Of. You. I’m blessed to get to work with you and I look forward to fighting for a cure with you.

Until then, thank you for the honor of getting to be one of your nurses.

With gratitude,

One of your nurses

Raising Awareness Month: Pediatric Cancer Awareness

I love what the ice bucket challenge did. I love that it brought so much awareness to a disease that has brought so much heartache to so many people. I did the challenge, but here is my challenge to all of you. Choose a disease or disorder every month to learn more about and even potentially donate to for the next year. If we all chose to do this, I think we would be a lot more aware and hopefully financially we as a whole could propel medicine and research along faster.

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We live in a world that is full of brokenness, hurt, and trials. 1 in 285 children before the age of 20 will be diagnosed with cancer (1). While less children than adults are diagnosed with cancer on average a child loses 71 years of life compared to an adult who loses 17 years of life (1). Worldwide on average each day 720 children are diagnosed with cancer and 250 die from cancer EACH day (2). In the U.S. childhood cancers is the leading cause of death by disease in those under the age of 15.. the LEADING cause (2). The average age of death for those kids who do die of cancer is EIGHT years old (3). And for those 80% that do survive, 2/3 of them will have chronic conditions related to treatment as a result (2). Chemo sucks. I know I give it 5 days a week and I help patients manage through symptoms 5 days a week.

So friends, let us ban together to help fund research. To help fund support for these children going through treatment. To help find better treatments that cause less side effects and work even better. Let’s work together to find treatment so less kids are doing early. Let’s fight for these kids and their parents. Let’s be aware of what far too many little ones and their families are dealing with on a daily basis. Because it isn’t just about survival statistics, but it is about quality of life and longevity after the 5 year survival mark. Together we can make a difference. Together we can help take back some of those years being lost by a war against cancer

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Resources:

1. http://curechildhoodcancer.ning.com/page/facts-1

2. http://www.alexslemonade.org/childhood-cancer-facts

3. http://www.kidsvcancer.org/facts/

Dying Well Means Living Well

I remember sitting there in a midweek service at my church as the speaker said “you young adults listen up… you don’t even think about death but you need to be aware it is real, it is very real.” I sat there as a young adult and wanted to yell.. heeey! not all of us.

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I haven’t ever died and I haven’t personally stared death in the face myself. But I have walked with a lot of patients in their final days. I have been the one to listen and hear no heart beat. I have managed medications as someone is in their last hours… even minutes to make them comfortable. I have cleaned up bodies and placed them in body bags. I have wheeled them on that cold metal cart down to the morgue. I have mourned more than anyone at the age of 28 would want to for patients and their families when lives were in our definition “cut short”. Oh and “The Fault in Our Stars”… yeah I sobbed like a baby but loved every minute of it.

Why are we as a culture so terrified of death? Why do we avoid talking about it? What about it is so terrifying to us? These are questions I’ve been mulling over and over. I personally am of the Christian faith so I have a confidence in a hope… but even some people I talk to who are of the same faith are utterly terrified of death.

Death is final.

In the last many months I’ve made it a point to research and truly figure out what dying well means. From the message at my church, to TED talks, speaking with others, and even some patients. After this thought process here is what I’ve come to conclude…

It is about LIVING WELL. And here are some things I’ve concluded about living well….

1. Make amends. Wherever you need to … make them. Leave nothing hanging.  You’ll have a lot more peace and those that are left behind will have peace as well. Even if its 50 years old, call that person up. You’ll feel a lot better. And this is not just for the people who know death is upon them. This is for EVERYONE.

2. Make a bucket list, but don’t just make it DO IT. Enlist one or two people to help you accomplish it.

3. Figure out what you believe and why about life after death. Don’t just leave it for tomorrow, because you aren’t promised tomorrow.

4. Don’t live like you have tomorrow. Live like you have only today. That means doing the things that really need done, but also leaving what doesn’t. It means spending time with your loved ones and not just working to excel at work. Truly LIVE each day.

5. Have it written down somewhere what you want if you become unable to speak for yourself. Do you want your organs donated? Do you want to be a full code? Do you want extreme measures taken? Have the tough decisions made for your loved ones. Trust me, this is a lot easier for them in times of trouble.

6. If you do know your life is coming to an end sooner than you had hoped, write letters, make videos… leave things to help those who are grieving your absence.  Let them know its okay to move on. Even if you don’t know this, start writing journals to those who matter most to you. Write them with plans to give them to them at a set time, but also know that that journal will be there if your life ends sooner than you expect it to.

7. Explore who you are. REALLY dig deep. Do some of those silly personality quizzes. Figure out your passions and what makes you tick. Learn to love the person you were created to be… because there is only one of you. There will only ever be one of you. Be the best you that there is.

8. Love deeply. Love hurts. It’s hard. But at the end of the day love as deep as you can so that at the end you know that you gave it your all.

9. REST. Don’t be afraid to take some breathers. To refresh yourself. Our bodies were made to require rest. Rest will help you to truly live.

10. Cut out the things that don’t matter. Focus on what really matters.

Friends, death is a hard topic. Not a fun conversation, but it is inevitable for every single one of us. Let us stop running away from it, but instead make the most of our run towards it, because that is in fact the direction we are all headed. Let us all make a point to not just live, but to live well. Live everyday with passion, purpose, integrity, and truth.  Truly LIVE each day. Each moment.

Tough Conversations; Through the eyes of an oncology nurse

I’m an oncology nurse. I knew when I signed up for the job that it was a tough one and that tough conversations was part of it. But some weeks the tough conversations are never ending. And sometimes the tough conversations rip my heart to shreds. And sometimes I want to hop in my car and drive for miles. Or put on my running shoes and run until it makes sense. But here is the thing; it won’t make sense. Cancer doesn’t make sense.

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Some weeks cancer pisses me off more than other weeks and this week was one of those. On Friday I opened my e-mail and had two e-mails of bad news from patient’s loved ones. I’ve said it often, but I think we need a punching bag in our office. A place for both employees and patients to take out some anger. And let me tell you, this Friday morning I needed it. 

Why? I sat there and asked… why? But here is the thing, I’m the nurse. I’m the supporter. And I had to get myself together and call these loved ones. I knew the status of one of these patients from the e-mail, but called to get the plan of care. The news kept being worse, but this patient’s loved one was so gracious. They were in shock and upset, but they graciously took the news and were taking the bull by the horns and ready to fight. And at the end of the conversation you want to know what this patient’s loved one said to me? Thank you. In the middle of their battle when all I can be is the communicator and the emotional support; when I have nothing else left that I can do at that moment and they are facing a huge new unexpected battle she stops and thanks ME. 

After this phone call I went back to speak with the PA. I told her I wasn’t ready to make the next phone call. After the news of the first two patients I was spent. I went to make the phone call anyways, because it needed to be done. My heart broke. It isn’t the first time and won’t be the last time that a patient’s loved one asks me to tell them what is really going on. What they really need to prepare for. But every time I have these conversations it hurts the same. 

I had this conversation twice that day with two different loved ones. And here is the thing that struck me yet again… both of them stopped and thanked me. After the phone calls were concluded and the rest of my day was wrapped up I got in my car and I sat stunned. It was a tough week and a really tough day, but yet again I was reminded why I do my job. Because even when I have very little I can do for patients and their families and even when I have to be the truth bearer, they teach me so many things.

The tough conversations will continue to come throughout my career. The days of needing a punching bag will continue. The days of wanting to run as fast and hard as I can until something makes sense will still occur. But this is what I was created to do at this time in my life. And those “thank yous” make it worth it. 

So to my patients and their loved ones. Thank you. Thank you for all you teach me through the tough conversations. Thank you for your thank yous. 

As we step into pediatric cancer awareness month let us all learn more about the tough conversations so many families are going through. And let us learn how we can help them as they walk through these tough battles. 

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