Editorial

Oncology Nurse in the Making
Armando S. Panganiban, BSN RNC

“Please don’t transfer me to the oncology unit. I don’t want to see any more death. I’ve had enough already working as a critical care nurse for nine years.” With the numerous deaths that I have encountered, I had become calloused, numbed, and apathetic. I felt death was just a part of human existence and an ordinary thing that every individual should experience. I begged the director of nursing not to transfer me, but his decision was final. “Take it or leave it,” he said, “You either go to oncology or look for another place to work.”

I was a total stranger in a foreign land with nobody to turn to. I came from the Philippines not knowing what my life would be like in America, and here I am in a terrible dilemma. I was assigned in the vent unit and was oriented for a month. I enjoyed working there. I was beginning to feel at home after a month of orientation in that unit then the sudden change occurred. I was scared of not knowing what to do. Against my will and convictions, I was forced into the oncology unit. I was miserable for several weeks because death was eminent in that unit; they called it the “graveyard’ in the hospital. True enough, I wrapped three bodies in the first week that I was ready to pack up and go back home.

One day as I was carrying for a dying patient with metastatic liver carcinoma, I was touched with his welcoming attitude and bright outlook. He was very calm and friendly. “You are very different from all the patients I have cared for. You seem very happy and content despite of your terminal illness,” I told him. I still remember his distended abdomen, generalized jaundice, and shiny skin caused by anasarca. He had a small butterfly needle in his left though with a morphine drip via CADD pump. He was very comfortable. “I’m dying,” he said, “it won’t be long and this suffering will cease. I ‘m going to a better place where there will be no more pain and suffering. I’m ready to die any time now. I already arranged for my funeral. I have chosen the coffin that I like, even the color of the lining. I even chose the song that I want to be played in my funeral service.” I had goose bumps while attentively listening to his spontaneity. It was very touching and he truly brought me back to my senses. He revived my feelings. I finally grasped the normalcy of my emotions. I’m no longer calloused and numbed. I can feel the spirit within me as it brought me back to reality.

“What is the title of the song you want to be sung in your funeral?” I inquired. “How Great Thou Art,” he replied. “Why do we need to wait for your funeral when you cannot hear anymore? If you will allow me, I want to sing it for you,” I said. With a bright smile in his face, he nodded and said, “Would you please?” Tears ran down my cheeks and with a trembling voice, I sang that song with feeling like I’ve never sang it before. My patient died the following morning.

I knew he was in peace. He really touched me and changed my attitude toward death and dying. I became more compassionate, dedicated and more sensitive to the needs of patients especially to the dying ones and to their grieving loved ones. From this time on I had fallen in love with being an oncology nurse. I would not trade it for anything else.

Oncology nursing is not just chemotherapy, measuring BSA (body surface area), calculating the right doses, placing patients in neutropenic precautions, and calculating ANC (absolute neutrophil count); oncology nurses play a more important role that that. For me, oncology nursing is compassion, commitment, dedication, and giving yourself to the best comfort of the patient you are caring for. It means going beyond what is expected of you and walking a second or third mile just to meet the needs of the patient and the family as well. Patients deserve absolute dignity and respect especially in these situations.

I believe in each person’s spirituality no matter what religion they are. I believe that they need to be ministered to and redirected, if need be, to the giver of life. To me, this is the most important task and most challenging role in being an oncology nurse as well. My goal is to help the patients have peace during their limited time on earth and to make a final connection with whatever god they believe in. I discovered that in this moment in time, the patients and their families want to be reassured that death can be a nice experience and that it is not something to fear. They need to be told that there is a better place in which there will be no more suffering and pain, a place where they will be at peach with God.

The September 11 experience was very heart-breaking and everybody was devastated with such an act of terrorism. As a medical professional, I had a longing to be part of the ground zero effort; to help those who were giving their lives for the love of their fellow countrymen. I was hopeless. How can I go to ground zero when I am here tied up with my own busy schedule on the oncology floor? I finally came to my senses and realized that there is a ground zero right where I am. There are people here who need my care, my compassion, and my gentle touch, as I deal with them every day. I will always grasp the opportunity of helping others whenever it knocks on my door. I just thank the Lord for giving me the gift of music, which enables me to comfort others and to give them a sense of hope in life. I enjoy singing to my patients if they so desire because I want to give joy to the weary and give encouragement to those who need it. “You Will Never Walk Alone” and “The Lord’s Prayer” are my two favorite songs to sing as I minister to the sin-sick souls who want to rest in the Lord.

Oncology nursing: compassion, commitment, dedication, and service.