Nurses’ Personal & Professional Experiences as Cancer Survivors

As a cancer survivor, I had the opportunity to review a study that uncovered the dimensions of nurses’ experiences with cancer survivorship. When nurses are diagnosed with cancer, the process of their survivorship is one of living in two worlds -- that of the patient, and the provider. (DeMarco, 2004)

The study asks the question: “What is being a cancer survivor like, and what has the experience been like for you personally and professionally?” This phenomenological study, based on the theoretical framework of Watson and Newman, interviewed 25 RNs who had experienced cancer within the last five years.

The themes of personal experiences included the following:

Shock. Many felt unprepared for the feeling of vulnerability associated with the cancer diagnosis. Some participants verbalized that being an RN was an asset as they were able to access resources. Others stated it was a liability as they knew too much and had seen too many negative outcomes.

Time. Many verbalized the urgent need for expedient resolution of diagnostics.

Coordinating own care. Many conveyed information between each other another (i.e. when bloods needed to be drawn, or when to have CT scans).

Struggle to maintain normalcy. There was much effort to balance treatment, family, and professional commitments. Of particular challenge was the ambiguity in their relationship with family members. Instead of being caregivers, they now needed to receive care. Participants made great efforts to keep things as normal as possible for their families.

Experiencing caring and uncaring behaviors. There were mixed experiences here. Some coworkers provided post-op or home care, took nurses to appointments, or simply kept in touch through cards, letters, or email. Participants identified professionals as uncaring when they lacked compassion and did not treat them as individuals. Participants valued being fully informed about all aspects of their care.

Uncertainty. This was illustrated in the fear of cancer recurrence, and the worry of interpreting bodily symptoms as something more serious than they would have otherwise thought. Uncertainty drained the participants’ energy and created anxiety.

One RN likened cancer to a “pink elephant.” Initially, the pink elephant is right there in your face. As you get better, the pink elephant may move to another room, and as you progress, the pink elephant goes down the street. However, as you approach appointments and diagnostics, the pink elephant comes back into your living room again.

Non-clinical resources. Many participants discussed the importance of personal commitment to prayer and faith traditions. They appreciated prayers from others. Complementary strategies included yoga, therapeutic touch, meditation, and journaling.

Survivorship as an opportunity. Participants saw this as a “wake-up” call, an opportunity for change, for reflection, and for a shift in priorities.

The professional themes included the following:

Role ambiguity. The majority of nurses worked during their treatment to maintain structure and a sense of routine. Working meant feeling strong, competent, and in control of their professional lives. In retrospect, many nurses valued their professional role, but wished they had taken more time for themselves.

Deepening level of compassion for patients and others. Participants acknowledged that having cancer heightened their sense of compassion.

Self-disclosure as a therapeutic intervention. Many nurses shared their diagnosis with patients, either because they decided it was the right thing to do to help patients, or because colleagues suggested they do so.

Advocacy. Having cancer changed participants’ views of the healthcare system. They began to think of patient care from a wider perspective and took action to change policies, protocols, and the care environment.

Volunteerism. Most participants saw merit in sharing their expertise by becoming involved in volunteer groups.

Although nurse cancer survivors experience the same vulnerabilities as regular patients, nurses are often affected by their knowledge and what they know is at stake. Nurses can benefit from the support of colleagues and healthcare providers, and appreciate the challenge of being both a professional and patient.

References:

• DeMarco, R. (2004) Nurses Experiences as Cancer Survivors: Part I- Personal. Oncology Nursing Forum. Vol. 31. No3.
• Picard, C.(2004) Nurse Experiences as Cancer Survivors: Part II- Professional. Oncology Nursing Forum. Vol. 31. No 3.