By Tara Sweeney, BSN, RN, OCN®, CHPN

As I walk into the exam room, isolation mask and eye protection on against the COVID-19 pandemic, my heart feels heavy with the reality of the day, of this moment, of these years.

Tara Sweeney, BSN, RN, OCN®, CHPN
Tara Sweeney, BSN, RN, OCN®, CHPN

Meeting you, behind a mask to protect each other from one another, with an empty chair between us to respect social distancing, seems far from a real moment in oncology care.

Throughout our careers, nurses hone our skills in nonverbal communication: posture, movement, facial expression, tone, tears, touch. Although these masks limit some of those nonverbal cues, they also emphasize our eyes: the windows to the soul.

As we discuss your cancer and treatment plan and what it means to have a metastatic esophageal cancer, I might not know what you look like behind your mask, but I see you.

I see the weight of this new diagnosis stopping you in your tracks.
I see the reality of the news trying to sink in.
I see the hope of a cure.
I see the fight, the fire behind your eyes.
I see the confusion as we discuss the names of regimens and medications, of plans for procedures and testing to complete before treatment begins next week.
I see the strength of a fighter as you talk about your two young girls and how you have to be there for them.
I see a tear beginning to form, holding realization and fear, just briefly in a moment of silence we share.
I see you and I am here for you, with you, together behind our masks.

As I go to the office and take a deep breath, the phone starts to ring. To be present is such a critical piece of the day. I exhale out into my mask, reset, and answer the call.

On the other line, the moment I hear your voice, I can immediately see your eyes—just prettier than the sunset. As we talk about Sunday's Eagles game and our team strategy for next week, our conversation turns from laughter to reality as you share your symptoms from the new radiation treatments to your spine for recently progressed metastatic breast cancer. I hear you.

I hear the sadness as you speak about how you can actually start to feel the cancer taking over.
I hear the pain as you describe the weight of this cancer on your body and your mind.
I hear the uncertainty as we discuss the plan to cycle to a different pain medication.
I hear the strength as you share your goals and plans to celebrate your favorite holiday early.
I hear the love as you talk about your family.
I hear the heartache as you ask how you can protect your children, your husband, your best friend.
I hear the peace in your voice as you talk about the legacy work you have done.

This is one of those moments that should just stand still, to have the time and space to openly discuss and explore your concerns and goals. Unfortunately, I am five minutes late for my next consultation, so we set a plan to connect tomorrow. I hear you, I am thankful for your openness, your courage, your strength, I am here for you.

As I walk out of the hospital at the end of the day, I remove my mask and take another deep breath, thankful for the moment of fresh air.

Monday through Friday, the clock has no meaning. The day ends when the needs are met. Health care is 24/7, inpatient and outpatient. It’s what our patients and caregivers deserve because there is no pause button or spring break in health—especially during cancer care.

I drive home with the radio on, but my mind is still reviewing the day. I spent it trying to help navigate patients and their families, attempting to convey a sense of calm and reassurance in this uncertain world.

I cannot help but wonder why, with all the cost savings measures and time spent educating and promoting proactive screening and disease management: Why isn’t healthcare doing better? With the continued changes and endless stressors in our daily practice—from staffing shortages, to supply chain issues, to increased burnout—where do we want to go from here? How can we strengthen together as a practice, a healthcare team, a nation, a global community to improve care for our patients, our caregivers, and ourselves?

As the medical oncology nurse navigator at a community cancer center during a global pandemic, my days are filled appreciating moments of pure inspiration and strength. Throughout a career molded in critical care and trauma, palliative and hospice care, and oncology nursing, I have had the privilege of crossing paths with the most incredible patients and families. To be present for someone as they face uncertainty about their future, vulnerability in emotions, and courage in strength is an indescribable gift.

My aim—my purpose—is to be present in the moment for each person I am honored to connect with during their cancer care journey. I am beyond grateful for those moments, those patients, and the inspiration from each path I cross.

Editor’s note: This story was submitted as part of the “Storytelling: What Keeps Us Going” session held during the 47th Annual ONS Congress® on April 28, 2022.