THE BASICS OF ONCOLOGY
PEDIATRIC NURSING
By: Jessica Coates
SENIOR PROJECT
MR.COPELAND
May 2015
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Jessica Coates
Mr.Copeland
Senior Project
May 2015
Throughout history helping one another has been a major part of the society. One of the
newer fields of nursing is oncology. These nurses not only work as caregivers, but are the child
and their family’s support system. Oncology pediatric nursing can be very rewarding, but also
presents interesting challenges. It is still a young career field with very little history, but statistics
are showing new results every day. To best appreciate nursing today one most learn about its
history.
All throughout history many citizens have come together to help anyone in need.
Knowledge and technology advances every day in the medical field. Prior to the need of
oncology nursing, there was nursing. Because no formal education in the care of the sick was
available, the earliest nurses learned through traditions passed generation to generation and
observations of others with the process of trial and error. In many societies woman were given
the role of a caregiver because women normally provided nurturance to the family
(www.jblearnihttp://ng.com). The oldest description of cancer was discovered in Egypt and dates
back to around 3000 BC. An ancient Egyptian textbook on trauma surgery was called the Edwin
Smith Papyrus. It reports 8 tumors or ulcers, the writing states “There is no treatment.” Some of
the earliest evidence of cancer is found among fossilized bone tumors, human mummies in
ancient Egypt, and manuscripts. Growths suggestive of the bone cancer called osteosarcoma
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have been seen in Mummies. Bony skull destruction as seen in cancer of the head and neck has
been found (www.cancer.org). Oncology pediatric nursing is a young career field. The
Oncology Nursing Society was officially incorporated on July 17, 1975 in Illinois and was
accepted into the National Federation of Specialty Nursing Organizations.
(www.ons.org/about/history).
Because people didn’t have all the technology and knowledge back then that America
has now, people made up theories to try and explain the unexplained. Throughout history many
theories have evolved, some were proven true and some false. In 1838 a German pathologist,
Johannes Muller demonstrated that cancer is made up of cells not lymph this theory was called
the “Blastema Theory.” His student a famous German pathologist determined that cells are
derived from other cells. Another theory was called the “Chronic Irritation Theory”, Virchow
suggested that chronic irritation was the cause of cancer. Virchow thought incorrectly that they
spread like liquid. German surgeon, Karl Thiersch in the 1860’s discovered that cancer was
formed through the spread of malignant cells not through an unidentified liquid
(http://www.cancer.org). Since cancer is so complicated it is important to get a proper education
in medicine to learn what theories are correct and how to better treat the patient.
Oncology nursing is a nursing professional whose practice involves caring for patients
recovering or undergoing cancer treatments. The patients must be 18 years old or younger
(education-portal.com). A gratifying feeling is to wake up and know that as a nurse they will be
able to help many lives throughout the day. Any ones day that can be made by a smile or smirk,
which can also have the ability to ignore a crying child to put an IV in or perform a painful
procedure has the patience and potential to become a pediatric nurse. A certified speaking
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professional whose name is, Donna Cardillo travels around the world inspiring many
nurses once said, “When I think about all the patients and their loved ones that I have worked
with over the years, I know most of them don’t remember me nor I them. But I do know that I
gave a little piece of myself to each of them and they to me, and those threads make up the
beautiful tapestry in my mind that is my career in nursing.” (http://donnacardillo.com/) Oncology
pediatric nurses are impacting little lives in positive ways, which not only helps the patient but
helps themselves grow as better human beings and become more experienced.
To become a pediatric oncology nurse one has to obtain a licensure as a RN; registered
nurse, BSN; bachelors of Science in nursing, MSN; Master of Science in nursing. Depending on
what program a student attends, it may take up to three to four years to complete
(http://education-portal.com). Frequently, oncology nurses focus on an area of specialization
such as, cancer genetic counseling, chemotherapy, gynecological oncology, palliative care,
surgical oncology, bone marrow transplant, breast oncology, prevention and early detection of
cancer and radiation oncology (nursingschoolprograms.net). Typical work places are the
hospital, physician’s office or an outpatient care facility. Most nurses have personality traits such
as being compassionate, having the ability to adapt to technology, be patient and optimistic. The
primary goal is to cure cancer or to considerably prolong life. Improving the patient’s outlook on
life is also an important goal (www.who.int). Nurses must be able to provide knowledge and the
emotional support families and the patient need (www.citytowninfo.com).
It is said to be very rewarding. The most delicate part of their job is they have to be good
with children. Most personality traits these nurses have are compassionate, technical aptitude,
patient and optimistic. Most are drawn to this job because they love working with kids and it
feels like their making a difference for the patients and their family in a time of need. A child and
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family brings in something different that helps nurses learn, whether its figuring out a better way
to take care of patients or life lessons they pass on to the nurse. Being a nurse isn’t all about
administering medication and doing what they are asked to, most nurses put their heart and soul
into this job. It is important to engage in their job when nurses are working with others,
especially when they are kids. Always, with rewards come challenges.
Working with kids is very difficult. Nurses have to come up with different methods when
trying to explain and administer medications. Also when telling them their diagnosis. These
nurses have to monitor patients constantly. Be able to act calmly and effectively in an emergency
situation. They have to feed, bathe, and clean after them. This job gets tricky when nurses are
working twelve hour shifts, due to fatigue (www.nursepractitionerschools.com). Nurses have to
be able to handle and deal with the emotional state within themselves. One of the hardest parts
about this job is that some children are dying. Nurses have to deal with their “inner critic”. Such
as them asking their selves; “What could I have done better?” “Was this my fault?” They have to
suffer the daily challenges that most humans don’t. Most children handle things differently for
many reasons.
When children have cancer it is very hard to explain what it is and how it will affect
them. When an infant, the baby’s siblings and older family will most likely feel separation and
anxiety. The nurse has to help them cope with their loss. When in their early childhood stage
they know the word ‘death’ or ‘dead’. The reaction depends on the parents. Its best to let the
family cope and child express their feelings. During their middle childhood they will understand
the meaning of death. Some may have fears of their parents dying, nurse will allow patients and
family to communicate if they feel like it. In the course of their late childhood the family and
Patient starts including religious beliefs about death. They will explore views of an “after life”
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and will continue to face reality. At this stage the nurse should allow the patient to discuss
feelings and how they feel about procedures. When an adolescence they have a grown
perspective and understand what is going on. Nurses should help them maintain and support their
self-esteem (Pediatric Nursing made Easy, Lippincott Williams and Wilkins). Cancer is very
deadly and there is a lot to learn research is showing new statistics every day.
Each year in the United States 13,500 children and adolescents 18 and under are
diagnosed with cancer every year (www.thetruth365.org). An average of 46 children are
diagnosed every day (www.nursing101). Approximately 20 percent of children with cancer will
die from their disease whether it is from a secondary cancer or complications from treatment.
The average age of death for a child with cancer is eight years old. Causing a childhood cancer
victim to lose up to 69 years of expected life years. It’s a remarkable loss of productivity to the
society. About one in 500 in young adults is a childhood cancer survivor nearly two out of three
of the survivor’s experience significant and chronic medical complications or develop secondary
cancers as adults that result from the treatment of their regular cancer. Incidence of invasive
cancer has went up 29 percent in the last twenty years. Among woman five of the most common
cancers are, breast, cervix, lung, colorectum and stomach. Male’s most common cancers are,
lung, prostate, colorectum, liver and stomach. To learn more about nursing one most know about
the roles.
There are many different roles in nursing. The oncology nurse’s role as a coordinator of
care discuss the best plain for the patient with team members to provide the required best care
possible. Advanced nursing practice in oncology as a direct caregiver demands mastery of this
field. They have the ability to provide, guide, and evaluate the practice given to patients and their
families. In the role of a consultant nurses provide their prowess about oncology to their
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colleagues, allied health personnel and healthcare consumers while as an educator. They also
design and perform patient activities. As a researcher the nurse identifies and investigates researchable problems, evaluates and applies research findings that could affect cancer care or
nursing. As an administrator or manager it is their duty to create a clean, respectful
environmentally friendly facility. It is their job to make sure everything is handled in a
professional manner and all precautions are taken with nurses and the patients
(www.nursesource.org). The medical field is changing everyday due to research. Nurses have to
be able to handle new crises.
The US cancer care delivery system is in crisis and changes all across the board are
urgently needed to improve the quality of cancer care. The IOM report presents six components
of high quality care that need to be addressed. These are in order of priority level. Engaged
patients and family should be provided comprehensible information about matters of cancer
prognosis, treatment benefits and harms, and palliative care. The workforce must include enough
clinicians with essential core knowledge for treating patients with cancer. The cancer care team
should work with primary care, geriatrics and specialist teams to preform patient care plans and
deliver comprehensive, efficient patient care. Clinical research should gather evidence of the
benefits and harms of many treatment options and the impact of the treatments such as, quality of
life, and the patients overall experience. Care in cancer requires an IT system. It can be learned
by enabling real-time analysis of the patient’s data. It will improve knowledge and help preform
medical decisions. Nurses should be given tools to help them incorporate new medical
knowledge into their routine quickly. HHS should try and develop a national strategy. One that
influences the nation to provide accessible and most importantly affordable cancer care. If
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specific payment models were publicized and demonstrated increased quality and affordability
payers will most likely adapt quickly (oncologynurseadvisor.com).
The medical field is a very demanding job. Nurses are taking lives into their own hands.
First it started with theories, as time developed and technology advanced there have been many
new tools and discoveries. Oncology pediatric nursing is delicate due to the fact their dealing
with kids that have cancer, but it is a very rewarding job to save lives. These nurses have to be
able to multi task smoothly and have appropriate education to do their job. This includes being
able to work with children and converse with their guardians. Nurses are the “backbone”, the
family and child’s support system. It is important for the nurses to be able to handle fatigue, and
their own emotions. Everyone handles things differently. Nurses have to handle it in a
professional manner. Throughout time research has developed as technology has and statistics
are showing new results every day. Organizations are always raising money and awareness to
everyone. The medical field is constantly changing throughout time.