An Oncology Nurse's Perspective on Cancer

Written by Em Jamieson, RN, BSN, CHPN, OCN / IG: @thatspitfirenurseem

I never thought I would end up in oncology – it’s a difficult field, because cancer is a beast of a disease, affecting anyone at any time for no fault of their own regardless of race, age, or social status. It takes a special person to work in oncology, and when I first started nursing school, I was far from that kind of person. I took a chance when I decided to go into oncology – when it was time to pick my specialty for my capstone, I was torn between oncology and the cardiothoracic ICU which is funny because I would have made a terrible ICU nurse. On the other hand, I didn’t think I had the heart to work in oncology, and I knew that this patient population deserved nothing more than the most compassionate, empathetic of nurses. I rolled the dice that day but the odds were in my favor, because they led me to find my dream job and the one thing in life about which I am truly passionate. 

As an oncology nurse, I have worked in many roles from bedside/inpatient, infusion, and clinic where I am now. Each role taught me valuable lessons about the strong yet vulnerable patient population that is oncology patients. I learned how to manage the myriad of symptoms that can occur as a result of cancer and its treatments while inpatient, how to administer and teach patients about the seemingly endless list of cancer drugs in infusion, and how to have difficult but important conversations with patients about how to navigate their lives with a diagnosis as complex as cancer while working in the clinic. 

Because cancer does not discriminate, I have had the privilege of working with adult patients from all walks of life. While I have taught these patients how to manage their cancer, in return, they have taught me the value of life and how quickly it can flash before your eyes. That’s what cancer does – it destabilizes lives, because no one is prepared for a cancer diagnosis and when it happens, patients have two options: let cancer be a part of their lives or let cancer take over their lives. For those that choose the latter, suffering is inevitable, and no amount of medication, treatment or emotional support will be enough to manage it. However, for those that choose the former, their diagnosis gives them a new perspective on life and shows them what aspects of life are truly worth living for.

As an oncology nurse, my job is to support both types of patients from time of diagnosis all the way to remission or, in unfortunate cases, death. I have had the pleasure of celebrating so many highs with patients whether it be completing their final round of treatment or, even better, achieving remission, but for every high, there is a low and this field is full of them. It’s just that nobody wants to talk about it. 

Oddly enough, the fragility that comes with a cancer diagnosis and the close relationship that cancer has with death was a huge draw for me when I originally decided to go into oncology. Nursing school teaches you a lot of things, but dealing with death and dying is not one of them. In school, you rarely see patients pass to the point where you are almost protected from it, but death is inevitable and shielding students from something that is guaranteed just because they might not be able to handle it does a disservice to their future patients. In my short career, I have found that cancer patients are more willing to talk about death and dying, because, for many of them, death is in their near future. Oh the stories you hear and the lessons you learn from patients who are forced to come face-to-face with their own mortality – It’s amazing, really.

Unfortunately, there are patients and providers alike who are not as accepting of death, which can lead to conflict among treatment teams, families, and even within patients themselves. As nurses, it is our job to advocate for patients and make sure their wishes are known, even if it means disagreeing with the treatment plan. I have fought countless times for patients who have been afraid to speak out against their providers or their families, because they don’t want people to think that they are giving up when, in reality, they are just tired of suffering.

There’s no shame in wanting to stop treatment and pursue palliative measures, but it’s hard to do so in an industry and a society that constantly promotes the concept of immortality and shies away from even mentioning death. That’s why I work in onco-palliative care at present, because as much as I love celebrating patients achieving remission, I also love the idea of patients passing peacefully in a manner that they choose. You can’t choose when and where you enter this world, but you can choose where you leave it, and it’s that belief that helps me cope with the “sadness” that most people often associate with oncology nursing. 

Cancer sucks, but cancer patients are the best in the world and working with them has helped me realize my God-given purpose on earth. I will be there for all my patients, holding their hands and supporting them from the time that initial blow is dealt all the way to remission or death. It’s not a glamorous job, but it is the best one, and I wouldn't trade it for the world.