Pediatric Oncology Nursing: Interview with Shannon Martin, RN, BSN, CPHON
Providing care for cancer-related illnesses and bone marrow transplants
Tell us about your position at City of Hope in Duarte, Calif.
I am the pediatric clinical nurse manager for the 18-bed pediatric oncology and bone marrow transplant unit.
What types of patients are treated on your unit?
It’s all oncology-related, including osteosarcomas, post-op care for orthopedic cases, leukemia, sickle cell disease and bone marrow transplant. Our patients range in age from toddlers to people in their early 20s.
What is your professional nursing history?
I’ve been a nurse for 16 years. I started my career in pediatric oncology at St. Jude Children’s Research Hospital in Memphis, Tenn., specifically on the bone marrow transplant unit. After leaving Tennessee, I was employed at UC Davis in Northern California in an outpatient pediatric infusion room.
When we moved to Southern California, I came to City of Hope. This year is my eighth anniversary at COH. For the first five years, I worked on this same unit as a staff nurse. Three years ago, I moved into a management position.
How did pediatric oncology come to be your specialty of choice?
I’ve always enjoyed working with children. As a teenager, I babysat for a child with a chronic cardiac condition. After she died, I found myself wanting to know more and made a point of learning as much as I could. I was just fascinated by how the body works.
When I graduated from nursing school, a position at St. Jude’s was open and I jumped on that opportunity. I basically fell in love with pediatric oncology nursing. I’ll never do anything else. It’s such a rewarding field.
What’s it like working with families and children who pass through your unit?
We deal with children of all ages and spectrums. It’s often fun to take on that challenge, especially with teenagers. Some of our patients are very compliant, listening to their parents and the nurses. Some can be challenging. They may even spit their meds at you, so you have to be creative. You have to ask yourself, “How can I get this child to take his meds? What can I do differently?”
We have a great interdisciplinary team, including a child-life specialist, a psychiatrist, a psychologist, doctors and nurse practitioners. We all work collaboratively in the best interests of our patients. We also have an adolescent and young adult program, so we can tailor our care to patients’ very specific needs.
Pediatric oncology involves a great deal of patient and family education. For instance, leukemia is now approximately 85 percent curable. It’s about a three-year process of consistently taking medications.
What are some of the challenges of working in this area?
The psychosocial and spiritual aspects require special attention, so we have a chaplain who is available to all of our staff, patients and families. He knows us well and can be called upon to help with specific cases. Depending on what spiritual needs a family has, he will bring in local faith leaders who can assist.
We have various services that we offer our patients to support their needs. There are video games available in all of the patient rooms. We also have teen rooms, recreational therapy and special meetings where outside speakers and former patients can provide teaching and peer support.
When a patient dies, we get together, review the case and generally debrief. These deaths can be difficult for the staff. It’s sometimes like losing a family member.
The chaplain will periodically hold a “tea for the soul” for the nurses. He’ll bring in tea and massage chairs, dim the lights and provide a space where we can debrief and process our feelings.
There are many types of interventions that can be helpful for staff. Surprisingly, we have found that peer-to-peer debriefings are one of the most effective tools we have. Peer debriefing is immediate and it gives everyone an opportunity to talk about their feelings and hear what others have experienced.
What are some of the joys of your work?
One of the things I love is a new practice that we’ve recently initiated when one of our patients leaves the unit after a bone marrow transplant. We put on music chosen specifically for the child we’re celebrating and the staff stands in two lines facing one another, forming a tunnel with our arms. The child walks through the tunnel as we all hoot and holler, celebrating the patient’s accomplishment in being discharged from the hospital.
It’s such a joyful moment shared between the staff, our patients and their families and it’s so much fun. This tradition just started about a year ago and it has a very positive effect for everyone.
I also love that we work collaboratively. My colleagues’ passion for pediatric oncology is both wonderful and exciting. Everyone is so enthusiastic and passionate and that’s reflected in the longevity of our staff. Recently, a nurse retired after 40 years on our unit. These nurses who stay for a long time get to make a difference in the lives of many patients.
We have 54 nurses staffing our unit 365 days a year, so that’s a lot of passion and professional excellence.
What do you recommend for nurses interested in this specialty?
There are various conferences, local association chapters and other opportunities to learn more about this area of nursing, including the Southern California Association of Pediatric Hematology and Oncology Nurses (www.scaphon.org).
For new nurses who may be interested in this area of practice, I recommend arranging an internship during nursing school if possible. Once you’ve graduated, pediatric and related experience are definite pluses.
At City of Hope, we’re looking for nurses who are willing to make changes and be proactive in their practice. We don’t want nurses who just do things the same way they’ve always been done. We want nurses who think creatively and critically.
This specialty isn’t for everyone. Even seasoned nurses who come to pediatric oncology may not be right for it. It has to be a good fit. Also, if you’ve recently experienced a loss yourself, it can be very difficult.
What certifications are recommended for pediatric oncology nurses?
In order to sit for the exam to become a certified pediatric hematology oncology nurse (CPHON), you need one and a half years of experience, so finding a facility where you can work and log those hours is a necessity.
Nurses interested in this area can also pursue a chemotherapy and biotherapy certificate. Many nurses are trained in these areas once they’re hired and most facilities actively support their nurses in seeking such certification.
What are your professional goals?
I just finished my master’s degree in leadership and organizational studies at Azusa Pacific University. I was the only nurse in the program.
While I had originally considered pursuing a master’s in nursing, the program at Azusa Pacific University gave me the foundational tools to learn about the business of healthcare. I studied skills for becoming a better leader as well as skills and techniques in process improvement.
I was recently Green Belt certified within the Six Sigma Green Belt certificate program, which is a business-oriented technical certification that uses analytical, statistical and problem-solving techniques for process improvement in any industry.
In terms of my continuing work at City of Hope, I want to attract nurses who are interested in accelerating the excellence of care at COH. We’re now in the midst of seeking Magnet status so that our facility can deliver the best possible care to our patients and their families.
Keith Carlson, RN, BSN, CPC, NC-BC, has worked as a nurse since 1996 and has maintained the popular nursing blog Digital Doorway since 2005. He offers expert professional coaching for nurses and nursing students at www.nursekeith.com.
This article is from workingnurse.com.