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Marlon Garzo Saria is an oncology clinical nurse specialist and nurse scientist for the Inpatient Oncology and Caritas concierge suites at Providence Saint John’s Health Center in Santa Monica, California. He is an assistant professor of Neurosciences and Neurotherapeutics and Director of the Center for Quality Outcomes and Research at Pacific Neuroscience Institute and John Wayne Cancer Institute. Saria serves in the Nurse Corps of the US Air Force Reserve as a flight commander in the Aerospace Medical Squadron. He was inducted as a Fellow of the American Academy of Nursing in 2014.

Caregiver Chronicles: Work From Home, No Experience Necessary

In family caregiving, no amount of previous experience or academic degree can prepare individuals for the role.
Americans who are eager to land a first job or get their foot in the door to their dream career might find a job posting that does not require skills or degree requirements appealing. Sadly, some 40 million Americans will find themselves in a “work from home, no experience necessary” job that they did not apply nor will be compensated for. They are America’s family caregivers. Sometimes, they are referred to as informal caregivers, although there is nothing informal in what they do or are expected to do.

For corporate America, “no experience necessary” means that the employer is willing to train an employee; in family caregiving, no amount of previous experience or academic degree can prepare individuals for the role. In a Congressional Briefing on the challenges, rewards, and call to action for caregiving—hosted by the Gerontological Association of America in November 2017—US Representative Jacky Rosen from Nevada’s 3rd congressional district, shared the difficulties of being a caregiver to both her parents and in-laws. In nurse staffing jargon, she had a 1:4 ratio.

Rosen had yet to be elected to Congress at the time when her parents and in-laws were sick. She was a computer analyst, and her husband a physician. She had to quit her job as a computer analyst to assume the role of a caregiver to 4 individuals who “all got old and ill at the same time.” Navigating the healthcare system—including skilled nursing facilities, assisted living, acute rehabilitation, and even federal entitlement programs such as Social Security, Medicare, and pension plans—was one of the biggest challenges she had to deal with as a family caregiver… and she was married to a physician! it is not hard to imagine what challenges Jane Doe from Main Street, USA, will face when she reports on her first day at work as a family caregiver. It is also important to consider that her first day at work as a caregiver is the same day that she hears the patient’s diagnosis and learns about the plan of care.

Me with my mentor, Linda Gorman, RN, MN, PMHCNS-BC, CHPN, FPCN

Now Hiring. No Experience Necessary. Will Train!

Caregiver training: Does that happen? Most caregivers learn on the job. I have yet to meet a person who trained to be a family caregiver. Even professionals who have written papers and entire books on caregiving were inadequately prepared to take on the role when it was their time to provide care to their loved ones.

One of my mentors and a renowned palliative care clinical nurse specialist, Linda Gorman, who is co-author and editor for award-winning books on psychosocial nursing, end-of-life care, symptom management, and promotion of quality psychosocial and palliative care, said after hearing about my interest in cancer caregiving, "Caregiving is the hardest thing I have ever done. It doesn't matter how much you know. It just hits you."

What do you do when you find yourself being offered a job that you did not apply for? How would you react if you were to find yourself completing tasks that do not fit the job description you have on your resumé? Where do you turn for help?  Follow me in future blogs as we discuss the needs of family caregivers, America’s silent workforce.

Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
More from Marlon Garzo Saria, PhD, RN, AOCNS, FAAN
Caregivers of people with cancer should get flu shots.
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I was particularly drawn to Robert Pearl, MD's comments on Senator John McCain's decision to discontinue therapy—he called it "a service to his family and loved ones."
PUBLISHED: Thu September 06 2018
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