Chapter 02: Why Oncology Nursing is Unique
Ms. Houston describes how important a nurse is during the frequent “life ending” situations of cancer. She explains how a nurse gets to know patients and helps them confront all dimensions of their disease, though she also describes how uplifting it is to see patients beat cancer, as she was able to see when working with many lung cancer patients. She gives an example of a life-ending situation with a patient she particularly admired, and who spoke with her about how he could help his family during the rapid progression of his small-cell cancer.
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Tacey Ann Rosolowski, PhD:
That kind of leads to my next question, which is how and why is oncology nursing different from other kinds? I’ve started to get a sense of that, but I’m sure you’ve thought a lot about that.
From my perspective, I think, one of the things is oncology nursing is about the patient and their entire family. I’m sure pediatric nursing tells you that and other people will tell you that, as well. This is a life-ending situation for many, many, many of the patients that you will care for, so you have to get to know your patients and really understand what they need. When I first started working and really got to—had time to really start understanding what I was doing and learning, I worked on a surgical unit here. The patient’s would come in. They would have surgery. They would go home. We wouldn’t see them again. It’s like, oh, well, that’s not too bad. Well, then we kind of reorganized the care model, and I was over a unit that had medical and surgical patients with the same disease—with lung cancer patients, thoracic patients. It’s like they don’t do well. They come back fairly soon with metastatic disease or they need chemotherapy, and they don’t do well. It really made me realize that they’re coming in here, and this is something that may or may not go well for them. So how do you help them and their families prepare for that? When they do well and are cured and have long survivals, it’s fabulous, and when they don’t, how do you help them make that transition and make them as comfortable? It’s more about the quality of their life than the quantity of their life.
Tacey Ann Rosolowski, PhD:
Is there a particularly memorable case where you helped someone navigate through that—the difficult life-ending situation?
I remember a patient that was a—I think he was a judge from Georgia. I just remember he was a Georgia Bulldog fan. He was here during the fall, so it was football season. We would talk about football. He had small cell cancer of the lung, which is a disease that responds well to therapy, but if the disease doesn’t continue responding, it usually progresses pretty rapidly. He was a very, very intelligent man. His wife was very intelligent. They were a very loving family. He had children in Georgia. He was at the—he had his diagnosis. He knew he wasn’t going to be cured but took treatment, radiation, chemotherapy, but progressed pretty quickly and would come back in every month or so. After several months, he was back, and it was obvious he was not going to survive. He was someone that was like—he was just very open about it, and he wanted to make the right decision and wanted to talk about, “What’s going to happen if I stop treatment? How do I tell my family? How do I help my wife?” Those kind of things. Trying to make him comfortable, help him breathe as best as he could, positioning him so that he was comfortable, then at the end, making him comfortable so that he had a peaceful death with his family with him. It’s one of those—I think I related to the man, because he was from the south. My father was from the south. You know, he had an accent that just really drew you in and was one of the patients that I will always remember. There’s been lots of patients like that over the years of various ages from all kinds of places.
Houston, Deborah A. and Rosolowski, Tacey A. PhD, "Chapter 02: Why Oncology Nursing is Unique" (2012). Interview Chapters. 885.
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