Outlining Tiered Self-Care Plans for Oncology Nurses

At the Association of Pediatric Hematology/Oncology Nurses (APHON) 50th Anniversary Conference & Exhibition, pediatric oncology and palliative care leaders addressed the growing emotional demands facing frontline oncology nurses.

In an interview with Oncology Nursing News, Amy C. Haskamp, MSN, RN, PCNS-BC, CPON, CHPPN, FPCN, FAPHON, Clinical Nurse Specialist in Pediatric Palliative Care and Hematology-Oncology at Riley Hospital for Children at Indiana University Health, shared practical strategies for mitigating emotional distress and burnout in pediatric cancer care.

Following conference sessions on navigating difficult clinical conversations
and care transitions, Haskamp emphasized the necessity of structured, evolution-aware self-care regimens and professional boundaries for clinical staff.

Key Takeaways for Oncology Nursing Practice

• Tiered Self-Care Architecture: Establish short-term, intermediate, and long-term self-care strategies to sustain emotional resilience during acute clinical stress.
• Evolving Self-Care Needs: Recognize that personal self-care requirements change as clinicians mature and navigate different career stages.
• Workplace Boundary Management: Mentoring early-career nurses to mentally leave patient burdens at the clinical facility prevents secondary traumatic stress.
• Palliative Care Integration: Integrating structured palliative support helps streamline challenging conversations regarding prognosis and end-of-life care.

Developing a Tiered Self-Care Framework

Pediatric oncology nursing involves frequent exposure to high-acuity patient suffering and family grief. Reflecting on a challenging clinical period, Haskamp noted the importance of recognizing heavy emotional workloads.

"The number of really hard conversations I've had with families this week has been a little bit abnormal," Haskamp stated. "Having a good self-care strategy is really important to have and understanding kind of recognizing what is self-care to you.”

Haskamp stressed that effective self-care requires a three-tiered structure tailored to immediate, weekly, and long-term restorative needs.

"I always say have the quick things, have the intermediate things, and then have the big things too for self-care," Haskamp explained. "A quick thing might be on my way home from work I'm going to not listen to podcasts and things that are related to work, but maybe it's music, maybe it's something else.”

For intermediate care, Haskamp highlighted scheduled weekly routines. "I do cardio tennis once a week—that's my self-care and that's my every Wednesday event," she shared, adding that "big things" include planned travel and extended breaks to recharge.

Adapting Tactics and Setting Professional Boundaries

As nurses progress in their careers, self-care mechanisms must adapt to changing contexts. Haskamp noted that techniques effective early in a career may lose efficacy over time.

"Understanding that that also morphs as we mature and age and grow and develop, that things that were self-care at one point in your career and the things that might be self-care today may look different," Haskamp stated.

Establishing distinct boundaries between work and personal life remains pivotal for career longevity, particularly among novice nurses entering high-acuity pediatric oncology settings.

"I always advise new nurses, younger nurses, to try to find a way to leave work at work when you walk out, and understand that those are the burdens that other people carry, but it's not your responsibility to carry it when you leave work," Haskamp concluded. "You can leave that behind and say, 'I'm really sorry they have those burdens, but those are not my burdens to carry with me every day.'"