Registered Oncology Nurse, Croatia
Oncology nursing is really specific. I’m not saying this because I expect understanding but because it’s simply the way it is. Working with patients who are sometimes really on the edge of life and death requires complete dedication, concentration and, above all, professionalism at a certain level. Working in the department means working in 12-hour shifts, i.e. 12 hours of continuous contact with people who have just arrived at the department, those who have been treated for years or those who are in the terminal phase of a malignant disease, and each of them requires a different approach.
As a nurse, my task is to admit a patient to the ward, take a medical history, set up an i.v. line, draw blood for the laboratory and prepare premedication and apply chemotherapy. But my work does not end there. My job is to educate the patient about the type of therapy they will receive, what they can expect and what the side effects are. Should someone do it before me? Maybe. Should I know all that too? Of course. The problem is that we are understaffed, one nurse for ~6-7 patients, all of whom should start chemotherapy at the same time. I simply don't have enough time to dedicate myself to each patient and explain to him or her what to expect, and then I feel like I didn't do my job properly. Doctors should, and they do talk to each patient and refer them to the therapy they will receive, but they are also understaffed, so a big part of it is up to the nurses, and sometimes we are really working under pressure.
In our department, most of us have bachelor's – or master's degrees that are not appreciated and are underpaid. When I first started working, no one explained the specific chemotherapy protocols to us, so we had to learn it ourselves, along the way. The constant influx of new drugs in oncology requires the education of not only doctors, but also nurses.
Young nurses who come from school do not have enough knowledge and as such are not competent to do the shift themselves, and this is exactly what happens. We are overwhelmed with paperwork, irrelevant forms that in the end no one even looks at, we do everything around the patient, but if one piece of paper is missing, all our work goes down the drain. But then I remember that what I do, I do for those who need me the most - for my patients, for their smile when it's the hardest for them. Overtime work, stressful situations, lack of staff and other situations lead to burn out syndrome, which then destroys us and our psychophysical health.
Sometimes the patient can have an allergic reaction to chemotherapy when no doctor is around, and we still have no competencies to administer “anti-shock” drugs even though we know it all. This needs to change in the near future. In the meantime, we have to wait for a doctor to come, while we’re both praying the patient will be alright.
When I look at the situation in Croatia, I am a little sad and disappointed, working in such a difficult department requires complete commitment, because even a small mistake can be fatal. We constantly educate ourselves, attend congresses and so on, but sometimes this “everything” seems a very little. Doctors also complain. The government should increase salaries, improve working conditions, enhance coefficients, and then we will have what we all wish for; medical workers who are satisfied with their work, and health care at a level that should essentially help our patients. I really do this work for love, but sometimes love is not enough.
