By Megan Murdock Krischke, contributor
September 12, 2014 – Pediatric hematology/oncology nurses serve children, teens and young adults who have cancer and blood disorders, and during Childhood Cancer Awareness Month, NurseZone is pleased to highlight these special nurses and their patients.
The work that pediatric hematology/oncology nurses do can range from providing inpatient bedside care to administering chemotherapy and biotherapy in outpatient settings, and serving as nurse navigators, triage nurses and educators for families and other nurses. Some of these nurses specialize in bone marrow transplants, surgery or specific types of cancers or blood disorders. There are also positions for nurses interested in quality improvement and nursing research.
Joan O’Hanlon Curry, MS, RN, CPNP, CPON, urges pediatric hematology/oncology nurses to do the best work they can for their patients and then to trust their colleagues to do the same when they go off shift.
“If you are a RN, you can go into pediatric hematology/oncology as a new graduate,” began Joan O’Hanlon Curry, MS, RN, CPNP, CPON, administrative nurse manager and pediatric nurse practitioner at Children’s Hospital at Montefiore in Bronx, N.Y.
“Most floors are going to give you the education you need to take care of the patients,” she continued. “There are things you can’t do until you’ve gotten more comfortable and confident. For instance, RNs typically can’t hang chemotherapy until they have six months of experience.”
“It depends on the institution, but typically nurses have to take a specific course before they administer chemo,” said Melody Watral, MSN, RN, CPNP-PC, CPON, immediate past president of The Association of Pediatric Hematology/Oncology Nurses (APHON). “The APHON pediatric chemotherapy and biotherapy provider program is commonly used, but some places will have their own training in place. Additionally, nurses can become certified in pediatric hematology/oncology nursing–I would encourage all nurses to pursue certification.”
Most pediatric hematology/oncology nurses are drawn to the specialty because they enjoy working with children and their families.
“I’ve been in this specialty for over 21 years,” remarked O’Hanlon Curry. “The real reason I can do this so long is that I feel like I am making a difference for patients and their families at a really difficult time in their lives. They have gotten what might be the worst news of their lives and I am helping them through that journey and supporting them.”
“I also enjoy that I really get to know the patients,” she continued. “Every patient and family brings something different that helps you learn, whether it is figuring out a better way to take care of patients or life lessons that they pass on to you.”
Melody Watral, MSN, RN, CPNP-PC, CPON, says pediatric hematology/oncology nurses help smooth the path for families facing extraordinarily difficult circumstances.
“The work certainly can be emotionally taxing,” reflected Watral. “You have to keep your wits about you when things are not going right for your patient and their family. People often say to me, ‘It must be so hard to work in that field.’ It isn’t an issue of being hard, it is just what I seem to be good at.”
“It is such an honor that the families welcome us into their lives for a period of time and trust us to take care of their children and act as surrogate family members and friends, but at all times as a nurse,” Watral added. “I love it when I get wedding invitations and baby announcements from my past patients.”
“It is important for nurses considering the specialty to understand that there is going to be an emotional component to your job and to think ahead about how you are going to deal with that. You are going to work hard and do your best and sometimes patients aren’t going to have the outcome that you hoped for,” remarked O’Hanlon Curry.
“I find that it is sometimes more challenging to work with patients who have a blood disease than those who have cancer,” she added. “With cancer, we have a good chance of curing people and that they can go on to lead a normal life. With a chronic disease like sickle cell anemia, it can be really devastating and affect both the quality and length of life.”
In addition to the emotional component, O’Hanlon Curry says the job is physically and clinically demanding. A patient’s clinical condition can change quickly and even a small mistake in dosage of medications can have very serious consequences.
“A pediatric hematology/oncology nurse needs to have a good sense of self and a core strength,” commented Watral. “People will be leaning on you–families, your staff and everyone who is involved. But you also need to recognize what the professional boundaries are. You want to be involved but you don’t want to be immersed.”
“Figuring out how to set up a boundary so you don’t get too close takes some time to figure out,” added O’Hanlon Curry.
“The rewards far outweigh the stresses and strains of the job,” O’Hanlon Curry explained. “I think that a lot people believe that working with kids who have cancer and other blood disorders is depressing–but it isn’t.”
“Kids are really resilient,” she continued. “They don’t have time to feel sorry for themselves and to lie around and feel sick. Most of the kids do great. The kids want to play and bring you into it and there is a lot of smiling and joking and laughing that goes along with this career.”
Additional resources:
Strong Is What Makes a Good Nurse – video from APHON
Helping Children Be ‘Brave’ During Treatment – NurseZone article
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