Returning to work after a cancer diagnosis is difficult for any survivor, but oncology nurses who have cancer may face nuanced challenges. Although nurses with cancer say that they can apply their firsthand experience as a patient to their clinical practice, nurses with cancer need role adjustments and organizational support to remain in the profession, researchers reported in a scoping review published in the Oncology Nursing Forum.

The oncology nurse research team, which included ONS members Kai-Lin You, MSN, RN, Meredith H. Cummings, BSN, RN, OCN®, Catherine M. Bender, PhD, RN, FAAN, Laura A. Fennimore, DNP, RN, NEA-BC, Margaret Q. Rosenzweig, PhD, CRNP-C, AOCNP®, and Teresa Hagan Thomas, PhD, RN, identified 11 studies from four countries published in 1996–2020 describing the concerns of nurses with cancer returning to work after a diagnosis. Sample sizes ranged 1–130, were predominantly female, and mostly diagnosed with breast cancer and thyroid cancer, typically in early stages. 

Across the studies, the researchers identified two common challenges and two common opportunities:

  • A need for professional and interpersonal role adjustments
  • Cancer’s negative effect on work
  • The value of employer and peer support
  • Ability to apply insights from a personal cancer experience as inspiration and growth

Role adjustments: Going back to work created a sense of normalcy for the nurses in the studies and served as a distraction from their cancer. However, they “struggled to maintain a sense of privacy and composure with their dual roles as nurses and as individuals with cancer,” the researchers wrote. “Simultaneously being individuals with cancer and healthcare providers confused some nurses and made it difficult for them to stop acting like nurses when receiving cancer treatments, which caused emotional and physical distress.”

Oncology nurses said that their particular work setting often triggered uncomfortable memories of their own cancer experience. “However, some nurses viewed their nursing background as a benefit because it allowed them to quickly understand their disease, treatments, side effects, and prognosis, even if their professional experience could not fully prepare them for the challenges of being a patient with cancer,” the researchers said.

Effect on work: Cancer- and treatment-related symptoms and side effects affected nurses’ ability to fully function, and some experienced post-traumatic stress disorder or worsened quality of life. Nurses with cancer reported making emotional, physical, and work adjustments to manage the impact of cancer treatment on their work. “Some nurses decided to resign, take a short break, or stay in the nursing profession but change their positions or career paths,” the researchers found.

Employer and peer support: The researchers found that sufficient organizational support could motivate nurses to return to or stay at work. Nurses in the studies reported the value of gestures such as the ability to modify hours or take time off for cancer treatments and colleagues who donated their time off or shared responsibilities.

Inspiration and growth: The nurses said that their cancer experience “deepened their compassion, disclosure, advocacy, and understanding,” “improved their ability to advocate for patients and communicate with patients and their families,” and “empowered them to become active listeners when patients and their families were expressing their needs.” The studies reported that many nurses took extra action after a cancer diagnosis, including conducting cancer care research, advocating for changes in patient care, negotiating safe work environments, creating patient resources, volunteering for fundraising activities, running patient support groups, or serving as counselors in cancer care organizations.

The researchers said that the current evidence base for nurses’ experience with a personal cancer diagnosis is sparse and that their findings “underscore the need for additional research to support nurses in addressing their cancer symptoms at work, helping with role adjustments, ensuring that appropriate and adequate work accommodations are provided, and engaging in reforming quality patient care.”

“Illuminating the challenges and additional support needs at work for nurses with cancer will help ensure that their health and well-being are proactively managed so that they can fully reintegrate into the nursing profession,” they concluded.

As an oncology nurse, you may experience a situation where you are caring for a colleague during their personal cancer experience. Get insights into the ethics of caring for someone you know personally on the Oncology Nursing Podcast Episode 253.