Running Head: PEDIATRIC ONCOLOGY

The Emotional Aspects of Pediatric Oncology Nursing

Celina Lackey

The University of Texas at El Paso

PEDIATRIC ONCOLOGY 2

Abstract

Pediatric Oncology Nursing is a heavy career to take on. Many wonder how

nurses are able to care for sick, terminally-ill children all day long. Both

parties, the patient and their family and the medical staff both suffer deeply

but very differently. At times, families seek comfort from the doctors and

nurses who are caring for their patient. At the same time, nurses can be

struggling to emotionally cope with the situation at hand and must remain

professional and neutral when presented to the patient and their family.

Emotional involvement in a department such as oncology is almost a given.

Nurses, are too human and it is only natural for them to find themselves

attached to their patients. However, emotions can eventually become a

factor that forms trust between a patient and their nurse which can build into

confidence in the nurse. In order for nurses to remain professional, when

assessing their patients, boundaries must set to balance objectivity and

emotion.
PEDIATRIC ONCOLOGY 3

The Emotional Aspects of Pediatric Oncology Nursing

Two main parties are involved when dealing with pediatric oncology: of

course, the patient and their family but also, the medical staff such as nurses

and doctors who get to know their patient and build a relationship with them

over the course of their battle. Nurses are much more present in the childs

life than the doctor because as their caretaker it is important for nurses to

stay on top of their patients vitals and comfort. This results in spending a lot

of time with their patient and getting to know them along with their family

which can eventually cause nurses to become emotionally involved with their

patients. Nurses are often expected to never get emotionally attached in the

first place yet, it still happens to many nurses especially when working under

pediatric oncology.

Below is a set of questions which helped look further into the emotional

aspects of pediatric oncology. Both parties are represented although, the

intended audience for this research is nurses who find themselves becoming

emotionally attached with their patients and wonder if they are right or

wrong to involve their emotions into their career.

1. How many children are diagnosed with cancer?

2. How can the emotions that are involved throughout Pediatric Oncology

affect nurses professionally and with their personal lives?

3. What are some benefits and/or disadvantages when families grant

permission to nurses to become emotionally attached to their

child/patient?
PEDIATRIC ONCOLOGY 4

4. Should nurses be allowed to become emotionally involved with their

pediatric patients?

How many children are diagnosed with cancer?

Cancer is the leading cause of death among children in the United

States. According to CureSearch for Childrens Cancer (2014), 43 children are

diagnosed every day with different types of the disease. There are many

forms of cancer that can begin almost anywhere in the body. Some forms of

cancer are treatable and some survival rates are higher than others yet,

there are some types of cancer that are terminal. Causes of cancer is still

unknown and unfortunately, there is not any preventions from the disease.

However, children exposed to radiation due to of Down Syndrome or other

genetic abnormalities, or children with AIDS have a stronger risk of

developing cancer.

The average age of diagnosis among children is age 6. Approximately

40,000 children endure treatment for cancer each year. Below is a graph

showing how many children are diagnosed with cancer each year. Roughly,

15,780 children are diagnosed with cancer per year.

PEDIATRIC ONCOLOGY 5

How can the emotions that are involved throughout Pediatric

Oncology affect nurses professionally and with their personal lives?

Pediatric Oncology Nursing is an emotion-heavy career that takes

plenty of strength and perseverance constantly throughout each day.

Patients impact the lives of nurses in both negative and positive ways.

Although nurses may suffer emotional pain because of their job, Pediatric

Oncology Nurses like Ali Alfaro insist that she loves her job and she does not

regret building relationships with her patients because it helps her do a

better job as their caretaker. In her journal, What Its Really Like to Treat Kids

Who Have Cancer (2014), Alfaro states, I love my job. I wouldnt trade it for

the world.
PEDIATRIC ONCOLOGY 6

Ali Alfaro explained to her readers her opinion on refraining from

becoming emotionally invested with patients, But you see, you cant really

be a pediatric oncology nurse without becoming attached; in a way you have

to give a little bit of yourself to your patients and their families in order to do

your job the best way that you can. She believes having a relationship with

her patients helps her perform better as a nurse which can ultimately help

get her patients on the road to remission.

Throughout her journal, Alfaro shared an experience she once had

when she lost one of her patients. She described how that certain patient

changed her both as a nurse and personally when she discovered that he

had passed away. Personally, she started coming to terms with her emotions

by accepting what she goes through on a daily basis. The patients death

deeply angered Ali as his nurse, in her journal she wrote, I didnt want to

accept it, I didnt want to believe it, I didnt want him to die. Alfaro was

upset because although her patient had poor chances of survival, she

believes lack of communication between other nurses played a factor into

losing her patient. His death greatly impacted her and because of him she

strives to be a better person and better nurse to her future patients.

What are some benefits and/or disadvantages when families grant

permission to nurses to become emotionally attached to their

child/patient?

Victoria Enmon was a young girl who was diagnosed with Leukemia at

age 11. (Victoria Enmons Story 2013 Video) Throughout her battle, Victoria
PEDIATRIC ONCOLOGY 7

received a lot of support from her family, friends, her coaches, and even her

medical team. She fought a unique battle with her cancer, relapsing three

times before she passed away. Victoria was always in and out of the hospital

which caused her medical team to get to know her pretty well. Victorias

family believed her nurses constant motivation and advice to Victoria played

a factor to Victorias outrageous amount of perseverance which led her into

remission three times. While in remission, her family invited her nurse to go

watch her cheer a few times and remained in contact with him. This shows

that Victorias nurse impacted her life in such a way that led her into

remission causing her to live longer than expected.

Maria Minjares is a Registered Nurse who graduated from the

University of Texas at El Paso, she was interviewed because she has

personally experienced a disadvantage of becoming too emotionally involved

with her patient, even with the families consent. Nurse Minjares had a

patient who would come in and out of the hospital constantly. After a while,

the family always specifically ask for Maria to take care of their patient so

ultimately she ended up close to the patient. She was the sweetest lady I

have ever cared for. Till this day, I still miss her jokes. Maria said.

Unfortunately, when the patient passed away her family became angered

with Nurse Minjares and looked to blame her for the patients death. Her

organs were failing there was nothing more I can do. They wanted me fired.

They told me they wish I wouldve been a part of her life. I felt like I failed her

and her family. Minjares said. Maria blames herself to this day for getting
PEDIATRIC ONCOLOGY 8

too emotionally attached to her patient. Although she always remained

professional, she believes if she wouldve detached herself from her patient

while she still had the chance, her family would have never blamed her for

their loved ones death. Maria said she feels she did everything she could for

her and does not regret anything except getting too personal with her

patient. She said she tries to stay away from putting too much emotion into

her job now but still cares deeply for each of her patients.

Should nurses be allowed to become emotionally involved with their

pediatric patients?

Although emotional management can be difficult for anyone, some

nurses like Theresa Brown R.N., believe emotions play a major role

throughout her career. She believes the compassion she has for medicine

does not only include medicine but also her patients and the different ways

she cares about each of them. In her blog, Can Nurses Care Too Much?

posted by The New York Times (2009), Brown admits, And because we know

them so well, in such an intense and intimate setting, we end up caring

about them. Along with Ali Alfaro she too, also agrees it is nearly impossible

for nurses especially those in the oncology department, not to get attached.

Without empathy and compassion, patients would not feel as confident

in their nurse compared to a nurse who is very caring and compassionate

about her job however, when dealing with patients, it is important for nurses

to remain objective. Jodie Price, Head Coordinator of Gap Medics, an

organization who helps students with internships within the medical field,
PEDIATRIC ONCOLOGY 9

wrote a blog, Balancing Empathy and Objectivity as a Nurse (2016)

explaining her perspective on what qualities nurses should have when caring

for their patient and how far empathy should be taken. Price understands

that being emotionally involved helps patients ultimately feel better but she

believes objectivity should remain prioritized above emotion. Jodi states in

her blog, Becoming too involved emotionally, interferes with your ability to

be objective.

While it can be hard to balance empathy and objectivity, nurses should

always remain professional. Nurses should care for their patients to the best

of their ability but never on a personal level. The patients decisions should

always be respected and nurses should always refrain from making biased

decisions. According to Jodi Price, The key is to find a balance between

empathy and objectivity. This way, nurses will not find themselves too

emotionally involved and always make the right medical decisions for the

patient.

Conclusion

Pediatric Oncology is a topic full of emotion coming from both parties.

Clearly the patient fights the toughest aspect of it but, also, nurses deal with

life and death situations every day. For nurses, the days may seem

impossible to get through at times but their compassion for their job is what

keeps them fighting hard for each of their patients.

Eventually, emotions are going to play an important role when caring

for patients, especially children, but that does not make for a bad nurse. On
PEDIATRIC ONCOLOGY 10

the contrary, research has proven being emotionally attached to patients

makes for a caring and passionate nurse. However, boundaries do need to be

set to refrain from becoming too emotionally involved. Objectivity is key to

helping a patient succeed and feel better and hopefully be on the road to

remission. The emotions involved with pediatric oncology can become

intense but the balance between objectivity and emotion is essential to

patient success.
PEDIATRIC ONCOLOGY 11

References
Alfaro, A. (2014). What it's really like to treat kids who have cancer. Thought

Catalog. Retrieved January 26, 2017, from http://tcat.tc/1xQoa05

Brown, R. T. (2009, February 04). Can nurses care too much? The New York

Times.

Retrieved March 01, 2017, from

https://well.blogs.nytimes.com/2009/02/04/can-

nurses-care-too-much/?_r=0

C. [CMN Hospitals] (2013, September 20). Victoria enmons story [Video File]

Retrieved

from https://www.youtube.com/watch?v=rHSZ_82wiJg

Childhood Cancer Statistics. (n.d.). Retrieved March 01, 2017, from

https://curesearch.org/Childhood-Cancer-Statistics

Hayward, R. M., & Tuckey, M. R. (2011). Emotions in uniform: How nurses

regulate

emotion at work via emotional boundaries. Human Relations, 64(11),

1501-1523.

doi:10.1177/0018726711419539

Price, J. (2016, March 02). Balancing Empathy and Objectivity as a Nurse.

Retrieved March 25,

2017, from https://www.gapmedics.com/blog/2015/01/20/balancing-

empathy-and-

objectivity-as-a-nurse/
PEDIATRIC ONCOLOGY 12

Sandgren, A., Thulesius, H., Fridlund, B., & Petersson, K. (2006). Striving for

emotional

survival in palliative cancer nursing. Qualitative Health Research,

16(1), 79-96.

doi:10.1177/1049732305283930

Williams, E. (2012, December 01). The disadvantages of being a pediatric

nurse.

Retrieved March 03, 2017, from http://work.chron.com/disadvantages-

being-

pediatric-nurse-14058.html

Zander, M., Hutton, A., & King, L. (2010). Coping and resilience factors in

pediatric

oncology nurses CE. Journal of Pediatric Oncology Nursing, 27(2), 94-

108.

doi:10.1177/1043454209350154