My Hardest Day as an Oncology Nurse: A Journey of Compassion and Resilience

Reflecting on my career as an oncology nurse, I often find myself revisiting the emotional landscape of my first year in the field. Although I now serve as a nurse leader, guiding and supporting my team through the complexities of oncology care, nothing quite compares with the raw, unfiltered emotions I experienced as a novice nurse. It was during this formative period that I encountered one of the most challenging yet profoundly impactful days of my career.

My journey into oncology nursing began in Detroit, MI. As a second-degree nurse, I had always felt a strong pull toward oncology. Before pursuing my nursing degree, I worked as a clinical research coordinator and later as a manager at a cancer institute. This experience solidified my calling, and I was determined to make a difference in the lives of cancer patients.

My first role as an oncology nurse was in an ambulatory setting, where I had the privilege of developing deep, meaningful relationships with my patients. In many ways, my role was akin to that of an oncology nurse navigator, guiding patients through the complexities of their cancer journey.

One family, in particular, left an indelible mark on my heart. For the sake of privacy, I’ll refer to the patient as “Tom.” Tom was newly diagnosed with pancreatic cancer and arrived at our clinic in a fragile state, suffering from hyperbilirubinemia. We quickly coordinated a biliary stent placement, and I found myself in daily contact with Tom, his wife, and their son as he started treatment. Tom’s treatment course was fraught with complications, necessitating ongoing communication and support.

I never anticipated forming such a close bond with Tom and his family, but through daily phone calls and clinic visits, a deep trust developed. I was committed to supporting them through every twist and turn of Tom’s often complicated treatment. When it became clear that Tom’s condition was deteriorating, we had a family meeting in the clinic to discuss the difficult transition to hospice care. I vividly remember that day, feeling a profound sense of empathy and questioning whether we had done enough.

During the meeting, Tom was not sure if he wanted to proceed with hospice. As I walked them out of the room, Tom and his wife turned to me and said, “We do not trust the MD like we trust you. Is this the right thing to do? Should I go on hospice? We only trust you.” Knowing that the patient and family would hang on my words, I felt an overwhelming sense of responsibility. I questioned whether I should be having this conversation and if I was qualified for it as a novice oncology nurse.

I told them that it was important for them to take the information given to them and then make the decision that is best for Tom. Continuing treatment could make him get sicker, and he might need to be admitted, so it was important for him to decide how he wanted to live his life. I allowed space for them to share their fears and hopes. In the end, they decided to move forward with hospice, which I arranged.

Tom passed away a little over a week after hospice care began at home. I learned that all his family members were able to visit him, and he had a sense of closure that he was hoping to have. His was the only funeral I have attended for a patient, a testament to the profound impact he and his family had on me. In the aftermath of his passing, I received heartfelt letters from Tom’s wife and son. As a new oncology nurse, I had often doubted whether I had done enough, but their words reassured me of the difference I had made in Tom’s journey. Their gratitude validated my nursing skills and confirmed the impact I had on their lives during such a difficult time, as well as the impact Tom and his family had on me.

This experience reinforced my belief that oncology nursing is not just a profession but a calling. The relationships we build with patients and their families are profound, and the emotional weight we carry can be immense. Yet, it is this very weight that fuels our compassion and resilience. As I transitioned into a leadership role in recent years, I carried with me the lessons I learned from Tom and his family. I strive to be a source of strength and support for my team, just as I was for Tom.

Oncology nursing is a journey of compassion, resilience, and profound human connection. It is an honor to walk alongside patients and their families during some of the most challenging moments of their lives. While the emotional toll can be significant, the impact we have as oncology nurses is immeasurable. I am grateful for the opportunity to serve in this capacity and to continue making a difference in the lives of those I care for.