Caring for patients with cancer is a complex subspecialty of nursing. In most of their day-to-day work, oncology nurses function independently and require time management, communication, and prioritization skills in addition to extensive clinical knowledge and expertise.

A career of more than 40 years provides experiences and insight that can help nurses prioritize self-care, be more resilient, and stay positive during stressful times. During an on-demand session for the inaugural ONS Bridge^TM virtual conference in October 2020, Susan Childress, MN, RN, former director of nursing at Huntsman Cancer Institute (HCI) in Salt Lake City, UT, and recipient of the 2020 Mara Mogensen Flaherty Memorial Lectureship, offered advice for oncology nurses in maintaining compassionate care and resiliency in practice.

Nurses on the front lines of the COVID-19 coronavirus pandemic are at greater risk of infection than other clinicians, according to the COVID-19 Associated Hospitalization Surveillance Network, a Centers for Disease Control and Prevention report. Nurse-related occupations, including nurses and certified nursing assistants, represent the largest proportion (36%) of healthcare providers hospitalized with COVID-19. The national survey brought to light what many nurses may have already known: nursing as a profession bears the brunt of the pandemic.

Food connects us to other cultures, helps us celebrate life’s milestones, and nourishes our body. We spend hours of our day planning meals, cooking, and eating. With food at the center of our lives, a positive view of it promotes health and well-being, but many of us struggle with eating behaviors and weight management throughout our lifetime.

Current events have given us an opportunity, and sometimes even a necessity, to rethink our well-being approaches. But developing a self-care plan doesn’t have to be overwhelming when you use a familiar method like the American Nurses Association’s nursing process.

I was born in India but came to the United States of America when I was 16 years old to be with the rest of my family. Having been an American citizen for 20 years, I have called this country home for most of my life. However, I still feel like an outsider and the workplace is no exception.

The phrase “a new normal” is used in the oncology setting to describe the changes a person faces as a result of cancer and its treatments. Physical and emotional scars plus activity limitations are examples of adjustments cancer survivors make as they define what will be their new normal. But in today’s media, the new normal is being used to label the changes the world’s population is facing as a result of the COVID-19 coronavirus pandemic.

Almost 96% of nurses report experiencing at least one symptom of post-traumatic stress disorder (PTSD) and nearly 21% meet the criteria for a clinical diagnosis of PTSD, according to findings from a literature review published in the Journal of Clinical Nursing.

When it comes to the human brain, the ability to effectively multitask is a myth. Although computers can run two or more programs simultaneously, our brains must task-switch, and in the transfer of attention, time and productivity are lost. Monotasking, or single tasking, is now considered a way to increase productivity and actually maximize time.

Uncertainty prevails in times of crisis. Patients with cancer are all too familiar with the initial uncertainty surrounding a cancer diagnosis, treatments, and adjusting to a new normal. Oncology nurses are seeing parallels with the COVID-19 coronavirus pandemic as people worldwide face the unknowns of a health threat and the economic aftermath of the outbreak. Medical caregivers are confronting it head on as they work together to protect and tend to the physical and psychosocial needs of others.

Life can steer you down a road that changes your impressions and view of the world. Without conscious awareness, it distorts comprehension and challenges you to change or be a byproduct of the times. Fighting to go back in time can destroy your life, livelihood, and career.

A full night’s sleep is a necessity, not a luxury, yet many people place sleep at the end of their priority list. Rather than seeing it as restorative, they think it takes up precious time to be productive. Many proudly proclaim, “You can sleep when you’re dead,” but ignoring healthy sleep habits can actually bring people closer to that end. Insufficient sleep is so pervasive in the United States that the Centers for Disease Control and Prevention considers it a public health epidemic.

As the world embarks on unprecedented research efforts to prevent and treat the COVID-19 coronavirus, patients with cancer and healthcare providers alike may be interested in using herbal products to boost their immune system or relieve anxiety and stress. However, finding accurate information is challenging: no herbs have been scientifically proven to prevent or treat COVID-19, and some may even cause harm.

The concept of providing comfort is at the core of my identity as a nurse, and I have always been drawn to the palliative care component of what we do as oncology nurses. Because it wasn’t part of my roles, I was less confident in my knowledge and understanding of chemotherapy administration, but I often thought, “Palliative care, yeah, I’ve got this!”

And then I learned how little I knew.

The COVID-19 coronavirus is causing dramatic increases in anxiety and stress around the world, disrupting daily life. Healthcare professionals, including oncology nurses, are confronting enormous challenges as they struggle to deliver optimal patient care.

We are oncology nurses. We don’t shy away from hard discussions. We have the skills and tools to help others. But this pandemic is different. The COVID-19 coronavirus has changed the rules. It’s ushered in social distancing, limited contact, and induced a new level of panic. COVID-19 doesn’t care if you are a nurse or a patient. It is an equalizer between us all. 

Physical and mental clutter can negatively affect your mood, productivity, and overall health. Think about how you feel when looking for a misplaced report on a disorderly desk covered with papers stacked atop magazines next to a conglomerate of used cups and scattered pens. Or observe your thoughts as they randomly shift from subject to object and back again. Being in a state of perceived chaos can stimulate feelings of anxiety and biologically increase cortisol levels. 

When the COVID-19 novel coronavirus pandemic hit the United States, in a matter of days clinicians were scrambling to find novel ways to screen, triage, and provide telehealth interventions to protect patients with chronic conditions who are especially vulnerable to COVID-19. As nurses, we are accustomed to helping patients in crisis acclimate to a changing environment, process large amounts of information, and have their psychosocial needs met.

The COVID-19 novel coronavirus pandemic is turning the world, inside and outside of the hospital, upside down. Not only are oncology nurses seeing high demands at work, but changes and restrictions are being instated at home as well.

Vacations can take many forms. Some are focused on pursuing thrill in far off places, whereas others are all about rest, whether at home or in an exotic locale. But all vacation takers are seeking the same outcome: better health and well-being when they return. This can translate into personal and professional benefits such as a better attitude, increased focus, and improved outlook on life. So why does the average American leave approximately four employer-paid vacation days on the table each year?

In a world where we are bombarded with too many attention seekers (e.g., activities, people, internet), we need to prioritize which stimuli are worth our immediate attention. Nurses are inundated with busy, fast-paced, and evolving roles, and 90% report that they do not have enough time to properly care for patients. The pressure to do so much in a limited amount of time increases stress levels and burnout and decreases our capacity for self-care. Prioritizing and devoting allotted time to our attention seekers may improve stress management, work-life balance, and overall self-care.

Ethical dilemmas arise more often than we realize: consider the patient you have been taking care of for three days telling you he wants no further treatment, but later goes along with family members when they push for more treatment. Moral distress occurs when nurses believe they know the correct action to take but are prevented from doing so. It may lead to a decrease in the quality of patient care and can be a causative factor when nurses leave their current job and sometimes even the profession.

Stress is generally associated with negative mental and physical consequences. But can it actually be a healthy, even sought-after phenomenon at times?

Oncology nurses at every professional level may encounter a variety of unexpected experiences, ranging from unkind words uttered by a patient or coworker to a medication error or the traumatic or untimely death of a beloved patient. Although the events seem like isolated, separate experiences, they can have a compounding impact on a nurse’s well-being.

How are you taking care of yourself? It’s a question I’ve asked many team members, including leaders I have had the privilege of serving, over the course of my career. I’ve even added this question into certain candidate interviews to assess resiliency in individuals. And of course I ask it of myself often. That’s because it is my professional responsibility to ensure I am caring for myself. Provision 5 of the Code of Ethics for Nurses says, “The nurse owes the same duties to self as to others, including the responsibility to promote health and safety.” 

Personal development is a lifelong process. It’s a way to assess our skills and qualities, consider our aims in life, and set goals to realize and maximize our potential. Part of personal development involves challenging ourselves to learn and master new skills. The more we put ourselves out there—away from our comfort zone to try new things—the more we learn about ourselves.

Nursing requires emotional energy and hard work to provide care to those we serve. However, there’s a dark side to the profession: workplace violence, or the exchanges perceived to be offensive or intimidating that can progress as far as homicide.  

RNs encounter workplace violence and abuse at a far higher rate than in any other profession in the United States. Although the topic is uncomfortable, it’s a very real aspect of health care for many professionals. Most nurses have likely experienced an abusive, dangerous, or violent encounter in the healthcare setting at some point in their careers.  

Where you put your attention matters more than you realize. For example, when you are thinking or talking about work-life stressors, your ability to take in other sensory input is challenged. One way to break out of the mental stress loop is to listen to music. Music can divert the brain’s attention, giving you a break from repetitive thoughts and judgments. The variety of music genres to choose from when looking for ways to shift your attention and enhance mood is ever increasing.  

Oncology nursing is a rewarding profession that offers nurses opportunities to build meaningful relationships with patients and families, manage complex patient situations, and provide compassionate care during a scary time in someone’s life. But what makes oncology nursing so special can also make nurses more vulnerable to occupational stress, which can lead to compassion fatigue or burnout.   

May is a month of celebration as we look forward to graduations, Mother’s Day, National Nurses’ Day, and Oncology Nursing Month. Many of us will celebrate with small gifts or trinkets, continuing education events, or treats like special breakfasts, donuts, or pizza parties from our employers. How will you celebrate your role in a profession that the public continues to describe as the most trusted year after year? How will you continue to nurture and protect yourself as one of nearly 4 million national treasures?  

Through a combination of expert clinical knowledge, relationship-building skills, and routine selection as the most trusted profession in the United States, nurses are one of the most impactful healthcare professionals when it comes to addressing patient issues. Challenges—like financial toxicity and limited access to care—are central to nursing advocacy efforts, and oncology nurses know firsthand the negative impacts they have on patients with cancer.

The twenty-six bones in the foot are always being stepped on. Getting on one’s nerves takes on a whole new meaning when considering that each foot contains an estimated 200,000 nerve endings. With health enthusiasts recommending 10,000 steps per day, which translates to approximately five miles, is it any wonder that the often-abused soles deserve a little self-care? 

Five years ago, I was consulted, as a mental health clinical nurse specialist, by a nurse manager seeking assistance in determining an appropriate response to a bullying situation on one of her units. That was the first time I learned that our profession has a longstanding and significant problem with incivility and bullying from within. 

Oncology nurses interact with other staff, patients, and families, each of whom have various cultural and personal preferences. A person’s culture encompasses race, ethnicity, spiritual practices, social habits, and so much more. 

Practice reflection is a critical element of self-care for an oncology nurse, and one way to reflect is through storytelling. Whether it’s sharing your own stories or your patients’ stories, writing them down and speaking them aloud to yourself, your family, a small group, or more can be a healing self-care experience.

Nurses spend an average of 2.5 hours per day on drama per staff person, according to Cy Wakeman, the opening keynote speaker at the 2018 American Nurses Credentialing Center’s Magnet Conference in Denver, CO, in October. That’s right, take 2.5 and multiply it by how many staff are working that day. 

An uproarious guffaw, uncontainable giggle, or a hearty hoot often has a ripple effect, turning a quiet room into a cacophony of sounds collectively identified as laughter. Humor is generally considered a subjective experience. Laughter, however, can be spontaneous or consciously produced by going through the motions (fake it till you make it). Either way, the overall benefits associated with laughter make it a virtually priceless self-care strategy.

Reading is essential to growth—both professionally and personally. Unfortunately, reading for enjoyment rapidly declines after age eight, and one in four Americans say they haven’t read a book in the past 12 months.

No reliable method exists for determining how many conscious or unconscious thoughts a person has in a day; estimates range from 12,000–70,000 daily thoughts for an average of 52 thoughts per minute. Journaling your thoughts and feelings is a way of becoming an interested observer of your thoughts.

Animal-facilitated therapy (AFT) programs have been shown to promote a healing environment and reduce certain psychological symptoms for patients with a variety of diagnoses, including cancer. Its use was even recommended by the founder of modern nursing, Florence Nightingale, who wrote about the benefits of animals in patient care and recovery: “a pet is often an excellent companion for the sick, for long chronic cases especially.”

Eating a balanced diet, drinking plenty of water, and following an enjoyable exercise routine are all part of physical self-care. Along with caring for the physical self, emotional and spiritual self-care also play a significant role in living a healthy and satisfying life. Like physical health, emotional well-being has various components. This article describes how to tune into your inner compass and develop the skill of learning how to set healthy limits by using your yes’s and no’s wisely.  

Adverse events and traumatic moments send shockwaves through the entire care team. As families grieve the loss of a loved one, providers can often suffer from feelings of overwhelming guilt, remorse, or helplessness. When clinicians struggle with the aftermath of a tragic care event, they become known as second victims. Second victim experiences can lead to lapses in safety and care and could be potentially dangerous for future patients.

Do you consider sleep to be part of your self-care regimen? Does a spinning wheel of thoughts keep you from restful sleep, or do you consciously sacrifice sleep time? If so, you are not alone. The Centers for Disease Control and Prevention (CDC) declared that insufficient sleep is a public health epidemic with an estimated 25% of the United States population suffering from some type of sleep disturbance.

Oncology nurses are generally compassionate people and dedicated to helping others live the best they can while experiencing a life-changing illness. Over time, such dedication can lead to compassion fatigue, especially when others suffer.

Twenty-five years ago, you could be flying at 39,000 feet and still be inhaling cigarette smoke. Smoking’s pervasiveness in U.S. culture was far and wide, and it wasn’t until cancer research findings—coupled with public policy and healthcare education—that the dangers of smoking caught on with the general public. Since then, smoking rates have declined.

When I received an offer for a position on the stem cell transplant unit at UPMC Shadyside in Pittsburgh, PA, I had no question about whether to accept it. It was, and still is, my dream nursing job. I started in August 2015 and have since grown as a healthcare professional and as a person. This setting is challenging physically, mentally, and psychologically. My undergraduate education prepared me well for the technical aspects of nursing, but I had little training in managing the emotions that would come with this job.