Tuesday, June 24, 2008

never say never and how i got there

Warning! Nursey Content ahead...this post is part of a Change Of Shift Submission.

When I first made the decision to pursue nursing, I had a definite preference for pediatrics. I eagerly devoured my pre-requisite human development courses. Volunteering in the nearby pediatric ward at Swedish Medical Center seemed to validate both my decision to become a nurse and preference for children. I enjoyed the playfulness of working with children and was pleased to realize that they came with some practical benefits: they were smaller, easier to lift, and the results of their body functions were much tinier.

On my volunteer days I admired the brightly-clad nurses who deftly moved from room to room, soothing a feverish 2 year old while speedily drawing blood, educating parents of a new diabetic, and taking a few minutes to chat with a sulky teen. The stages of development and creativity in altering your approach to a child and his or her family fascinated me. It also satisfied that bit of artist lurking in my otherwise innately practical self.

I remember a conversation with one of my nursing school girlfriends where we decided we each had it figured out...I never wanted to work with adults, and she could never imagine herself as anything other than an oncology nurse. In fact, I think we also announced this on a video cam her auntie had brought to our pinning ceremony. Ah, relatives with videocameras...what's not to love?

I wound up taking a few detours along the way...that led me to a very different place: oncology nursing--initially in the inpatient setting and currently in the outpatient setting. It wasn't by any conscious design but a gradual set of circumstances and choices that eventually led me to where I'm at today.

1) In my junior year of college, I landed a Nurse Technician job in Post-Partum, the closest I could get to pediatrics. The nearby peds ward did not have Nurse Tech positions--so I had to settle for the next best thing.
2) Despite the fact that I scoffed at Labor & Delivery as not being 'real nursing' because I thought it didn't involve med-surgical skills, I eventually began to appreciate its complexities. Little did I know...
3) Had my senior practicum rotation in the anesthesia recovery room at Children's Hospital...Decided that it's really important to get young kids to brush their teeth and not live on sugary liquids so they don't need anesthesia to get dental work done at 3 years of age. These are the ones that wake up trying to kick and hit you. Nevermind that you're supposed to do Q 5 minute VS for 15 minutes. Try that for your next fat-burning work-out.
4) Realized I *really* liked Post-Partum and might want to start my career off as an L & D nurse-- this was despite the weirdness of figuring out to operate hospital contraptions otherwise known as breast pumps, those poor frazzled hormonal moms and downright horny dads. Yes--that's right. Sleep deprivation and lack of sex is a dangerous combination in the average male, my friends.
5) Even though I was really drawn to L & D, I then became worried about possibly not developing a comprehensive med-surg skill base and perhaps being specialized right at the get-go, so...
6) Decided to take a job on a floor specialized in Gynecology-Oncology, Urology, and Hematology-Oncology...it seemed to have a little bit of everything and everyone. I took this job with the thought I'd spend a few years there to solidify a general skill base and then transfer to the L & D.
7) Nearly 5 years later after orienting lots of new nurses, administering chemotherapy, doing complex wound care and end-of-life care... I traded in the hospital scrubs for a nurse case manager position at specialty oncology center.

It didn't take too long for me to realize that the inpatient oncology job I had selected as a graduate nurse was everything I was looking for in nursing. I was working with an outstanding group of folks who were capable of nurturing and gently introducing a newbie into the daunting task of oncology nursing. I began to appreciate that oncology nursing offered a satisfying array of clinical tasks and rapidly changing therapies and particularly an ability to develop a unique relationship with patients. Before I knew it I became OCN certified and was decidedly hooked. So much for pediatrics. So much for small poos. Apparently bigger is not always better.

One of the most frequent comments I hear after telling someone I'm an oncology nurse is...."That is so depressing. How do you do it? Isn't there a lot of death?"

Well, the answers are
1) No, it's not.
2) It's just what I do. I happen to like it.
3) And yes, there can be a lot of death. You have to be prepared for tough conversations and really be comfortable answering questions about death and dying. But there is amazing strength displayed by most patients despite being in the face of great adversity. Even while knowing that cure is sometimes not always possible, there is always hope, promising research, and the everyday business of life to attend to.

I think one of my patients expressed perfectly to me what makes working with the oncology population so unique and rewarding. He described his past 5 years living with colorectal cancer as 'the best of his life.' Before you start to think he's crazy or riddled with brain metastasis, ponder this...

A common sentiment that is frequently expressed by patients is that life becomes innately more valuable, more defined. This is not exactly what they say, but it is the general theme. True wishes, desires, and hopes surface. Relationships are renewed; people begin to act on or resolve their regrets .

The couple that never spent time together now does. And guess what? For the first time in their marriage, they genuinely enjoy being with each other. The estranged mother is reconciled with her daughter--and meets her grandchild. The work-a-holic now realizes there is more to life than constant work and rediscovers his love of painting. The husband who berated himself for not providing enough for his wife finally receives her affirmation that what he had given her was more than enough.

I've seen this sentiment manifest in hundreds of different ways, but the basic message is unchanged. Life goes on...But it does so with a remarkable sense of clarity and newly defined purpose.

As an oncology nurse, the opportunity to educate, to alleviate symptoms, and to celebrate victories both large and small, and most of all--to be present for that journey--is a gift. Never mind the detours--eventually you'll get to the right place.


Jaime said...

Thanks for sharing this!

Deanna said...

What a great story. I love hearing how people find their "calling" in life. Most often, you're right, it's by happy accident.

Cheryl and Greg Morton said...

wow. I always wondered why but I keep forgetting to ask.