The View from the Hall of the Oncology Unit

April 1, 2019
Debi Fischer, MSW, BSN, BA, LCSW, RN
Debi Fischer, MSW, BSN, BA, LCSW, RN

Debi Fischer is a nurse at the University of Miami surgical oncology step down unit. Prior to that she worked in orthopedics and neurology for many years. In addition to her nursing experience, she has earned a master’s degree in social work. Becoming a Licensed Clinical Social Worker was a lon-sought-after goal which she finally attained. She is a caregiver for her family and her dogs as well.

All too often, I get off the elevator to work on the surgical oncology acute care unit and am witness to an increasingly familiar scene.

All too often, I get off the elevator to work on the surgical oncology acute care unit and am witness to an increasingly familiar scene. I see relatives preparing to say goodbye to their loved one who have terminal cancer. This backdrop of death and dying extends to the corridors outside the hospital room. Big families have large groups meeting in the hall when. Smaller families, in contrast, have one or two relatives present. Also, there are patients suffering alone with their pain. All these scenarios are present in this extended canvass of death and dying.

Working as an RN on this 30-bed unit has given me a ringside seat to the random cruelties of this disease. I have seen the sadness and despair of patients facing their own mortality. I have also seen patients go home and continue their extended journey.

Older Relatives

The case of parents watching their adult children fight cancer is extremely difficult. I have watched older parents who might not be in the best of health end up caring for their adult children. This unfortunately has also become a common occurrence.

Giving an elderly mother reassurance or hope as she cares for the child who by rights should be on the other side of the bed is also stressful for the nursing staff. The thought usually crosses your mind that they, themselves, could easily become the patient if stressed to their breaking point. Figuring out how to support the relatives becomes a delicate balance between trying to pretend that all is well and helping them negotiate their “new normal.” Getting up in the middle of the night to monitor their son or daughter’s vital signs and taking their own medication while watching them decline has become a familiar scene.

The entire staff sometimes gets acclimated to a particular patient, and if they are on your floor long enough with multiple admissions, they become part of the fabric of the unit. Sometimes you admit a patient and the first thing out of their mouth is, “you were my nurse last year.” They remember you and your name even if you can't remember them at first.

Things Stay the Same

Cancer care has become more complex. This part of care has stayed the same. We sometimes know the probable outcome of this doomed boxing match. You cannot help but to wonder what is going on with the patient on your days off. I have learned that none of us come with a date stamped expiration tag.