Chapter 02: Oncology Nursing

Chapter 02: Oncology Nursing

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Identifier

HilkemeyerR_01_20000523_C02

Publication Date

5-23-2000

Publisher

The Historical Resources Center, Research Medical Library, The University of Texas Cancer Center

City

Houston, Texas

Keywords

Professional Path; Professional Practice; The Professional at Work; Understanding Cancer, the History of Science, Cancer Research; Overview; Patients; Patients, Treatment, Survivors; The History of Health Care, Patient Care; Cancer and Disease; Portraits

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Disciplines

History of Science, Technology, and Medicine | Oncology | Oral History

Transcript

Louis J. Marchiafava, PhD:

What I would like to do now is move into your main focus of interest. I have read through the materials, the background materials, and it didn't quite answer my question, so I am going to ask you: What drew you to nursing cancer patients?

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

Well, I got into cancer nursing by accident, really, by accident. I was in Missouri and I had worked with the health department. And I think I put your copy of that information in there. If not, I will give you a copy. Anyway, there was a new director of nursing at the health department, and by that time, I was over in the state Nurse's Association, and I was helping get a legislative program through, and I was working with the legislature and that kind of stuff. She called me one afternoon. She was big and burly. I mean, big and burly! She said, "Hilke, I've got a new job I am setting up over here and I would like for you to take it." And I said, "And what, pray tell, are you setting up?" "Well," she said, "I am setting up a program in the Health Department and I am hiring a consultant in nursing education, and I want the nurses from the hospitals and from the counties where we have public health nurses to come in and learn something about cancer." She said, "I want you to do the job." I said, "You must be crazy. I don't know the first thing about cancer." And she said, "Well, you are not too stupid to learn, are you?" I said, "No, I'm not." I took that job and I didn't know nothing. I'll tell you, for five years, I learned and I learned and I learned. So, I got accidentally .... I had no intention of going to take care of cancer patients. As a matter of fact, when I was a student, we had one ward that was called the tumor ward and it was mostly terminal cancer patients, and we all had to take a turn down there.

I didn't have any feeling one way or the other about it. But I did take that job, and it was a good program. And the more people tell me now what a really good program it was, because there was nothing out in the world like it. I set up the program. I had to learn myself. I had to learn to take care of the patients. I wrote all their policies. I wrote all of their procedures. I taught all their staff. I taught the public health nurses when they came in. And then, in the summer time, I could go out in the field and work with them out in the field. So, I had it both ways, and it worked out real fine.

So then, one of the people that came to visit my program was the Regional Public Health Service office, and they were quartered in Washington but they had regional district offices. And she came and she said, "I know our director is going to be very interested in this." Her director was Rosalie Peterson. The next thing I know, Rosalie is on my doorstep in Columbia, Missouri, and she says, "My dear, I have been looking and looking for some place that is trying to do some cancer nursing. Nobody wants to tackle it... I said, "Well, I've tackled it. I don't know how good it has been but I have tackled it at least and I know where I am." So, she visited, saw the program and so forth. The next thing I knew, she was putting me as a consultant on her staff to Washington. So, I am a consultant now. I am as green as brass. She says, "You've got more clinical than any nurse I've got on my own staff, so I am going to send all of mine down to go through your program for five days and see what you can teach them."

Louis J. Marchiafava, PhD:

Let me just interrupt you and ask you: You say, your program? Can you describe some elements of it before we move on?

Renilda Hilkemeyer, RN, BS, Dr.P.H.:

Yes, let me tell you what I did. I believe very strongly that the only way you are going to learn anything is to do it. And so, they had to fill out an application. I had to OK them. They came. They were prepared to come. I set up part of the program on teaching. I would have the doctors give the lecture, maybe. Part of it, I would go to the clinic with them, with the new patients coming in. What is wrong with this patient? What do you think about this patient? What do you think is going to happen to this patient? And how are you going to see this patient? And then I would make them put those same patients up on the floor and follow those patients, and make rounds with us, which we did very much. And then, every nurse who came through had two things she wanted: she wanted policies and procedures, because they didn't have any out in the area. If they had to irrigate a colostomy, for example, or if they had to suction somebody with a trach tube in, they didn't know how to do it because there wasn't anything...We didn't have books like that at that time. We made our own stuff up.

I made my own slides. They were pretty awful but they showed .... like, for example, we did radiotherapy at this place, and in those days, we had only the 250 kV machines. Not anything like the fancy. I didn't know anything about it but I cultivated the doctor in radiotherapy, and he would take me over and look. I had to because here are these people out on the floor after they had been treated and they didn't know what to do with them. So, I had to teach them how to do the dressings and how to change the dressings, and how to get the patients ready to go home, and how to feed them if they couldn't swallow, that kind of stuff. So basically, it was a combination of some show and tell but a lot of doing.

The other thing in those days, people were exceedingly concerned about cancer. Patients thought it was a death signal, and they thought they were going to die if they had cancer. And the nurses were just as bad because they didn't see anybody hardly who lived. Less than 20% of the people lived at that time. And so, I wanted them to learn to talk to people and to see what patients were really like, and not just, this fly by night business. So basically, that is what I had. I had five days and it was chock full. And they had assignments. And they had reading and things of that kind to do as well. But I had a lot of hands-on with patients. Sometimes, I would pair them up with somebody that was already working there. Sometimes, I wouldn't. Sometimes I would send them by themselves. And to show you how that worked, when I got down to Anderson, I did a program similar to that for the Southern Regional Education Board and I paired instructors with nurses from 20 colleges and universities in the south. And I did a 16 lot of the same kind of thing with them because I found they didn't know how to talk to patients. They didn't know what to do with patients. And so, I was trying to learn. And the other thing was that I had to learn myself. Nobody taught me. I would follow the doctors along. I would go out on the floors. If I wanted to see something that you were doing that morning, I would go and I would say to you, "Could I watch you today?" because I was not on their staff. I was on the Health department staff. As a matter of fact, I was kind of like an intruder, if you looked at me that way. The director of nursing was so happy to see me, she didn't even show up the day I came!

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