Written by Caleb Johnston BSN, RN, MBA

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Pediatric oncology?

You work with children who have cancer? 😞

"Oh, bless your heart. 💖
That must be so hard!"

Some form of this response is the reaction I get when people ask what nursing specialty I work in. I appreciate it. I do. 

It's a heartfelt response to someone who operates in a world that comes closer to death, and the death of children, than most people ever do.

Let’s Clear This Up

More often than not, we are saving kids’ lives in peds oncology. Yes, it can be really hard, but it’s also fantastic. But for nurses not familiar with this field, I wonder how many have a fear that keeps them away. I then wonder, what if some of those people are precisely the kind of people those who don't get to choose "pediatric oncology" need by their side? 💪🏽

Well, if you've ever thought about oncology or specifically pediatric oncology and wondered what it would be like to work in that world, by the end of this article, you will have a good initial sense of nursing in peds oncology. 

The Two Reasons

There are two reasons people come to see you when you work in pediatric oncology:

First - They had no choice. They didn't choose for this to be in their life. This is an essential theme that I will come back to later. 

Second - They chose to fight to get better. This might sound obvious, but those outside of oncology primarily think of it as a field providing some help to children bound to die. I won't sugarcoat it, sometimes this is true, but it is a small percentage (albeit a disproportionally weighty portion) of what we do.

So What Do We Do?

We use tools to help children get better. But, our tools have nasty side effects.

Chemo is a poison, but cancer is an even worse poison. We fight poison with poison because getting large amounts of cancer out of their system can make them start to feel like new again! So a majority of the time, this is what you are doing - helping people get better while making them feel worse. 🤒

One of the most amazing things to see is a kid who has been enduring the effects of cancer for weeks starts to feel like themselves again. 

This process of helping people battle cancer takes different forms that require ambidextrous skills, but that is exactly one of the reasons I've enjoyed pediatric oncology so much.

Pediatric Oncology is:

• Technical: What do I mean? Well, most oncology floors aren't ICUs, but they sure can feel like it at times. Transfusing blood, platelets, and even plasma are regular occurrences.

  Complicated chemo infusions and medication regimens running on several different pumps with what looks like a spaghetti mess of tubes (It's crucial to keep these organized).

  Accessing medical ports, frequent blood draws, drains, chest tubes and central line maintenance are part of the daily routine and need to be done with extreme care. All of those things are relatively minor in comparison to an immunocompromised patient going septic, which you are always on your guard for.

• Goofy: Yeah, it's quite a different sounding picture from what I was just telling you, but it's true. You need to create fun and hope. These kids live at the hospital. They are away from their siblings, friends, grandparents, and comforts of their room.

  The hospital becomes their life for weeks or even months at a time, and life needs some goofy fun. Some days this means learning to paint nails or helping to host a Hatchimals tropical island party. Another day it might mean creating a real-life Mario Kart race track in the halls - complete with bananas and shells to avoid. Life normalcy gets a whole new meaning for these kids, and it is a regular part of your day to help them envision what that can be.

• Educational: Cancer is a pretty dense subject. No matter how much I think I know, every year, I look back with some amazement about how much I didn't know. Aspects of jobs will always become routine, but if you find learning new things keeps you from letting a routine become dull, oncology is a place for you!

• Relational: Sometimes people feel like they live at work. Well, the interesting thing about oncology patients is they live where you work. This means the people you spend your days taking care of you get to know for months or years. The people you care for become a little like family.

• Hard: I told you I would come back to this part. Yes, while people do come to us to get better, there are times we can't make that possible, but it doesn't mean we stop caring for them all the way through. While it seems scary to choose to enter into a world where you might come face to face with death and suffering, those you are caring for didn't get that choice. A guy named Jesus once said, "Blessed are those who mourn, for they will be comforted." I've come to learn two ways what he said impacts my work. The first is, what those people need in their time of mourning is comfort, and it is a blessing to be that. The second is is that when we face that decision of choosing to move into a place that makes someone else's suffering a part of our life, there is reason to believe it is a valuable place of blessing for us to boldly step into.

It's a small piece of the picture, but hopefully, it pulls back a layer of the unknown - and the unknown is usually the scariest part.

Want to get a more in-depth picture of what pediatric oncology is like? Let the EARN team know you enjoyed this blog.

👨🏼‍⚕️Hi I'm Caleb; as an experienced BSN, RN, MBA, I'm excited to be a part of building a better way for RNs and NPs to be precisely matched with nursing positions that really fit them. I’m fueled by great coffee, am involved in startups, and love snowboarding.