Finding Balance to Potentially Address Burnout Among Oncology Nurses

Doctor, laptop and neck pain at night in agony, stressed or burnout by desk at the hospital. Woman medical professional suffering from painful injury, ache or inflammation working late on computer | Image Credit: © C Malambo/peopleimages.com - stock.adobe.com

Oncology nurses face several challenges in their day to day including burnout, highlighting the importance of achieving a work-life balance to benefit not only oneself but also colleagues, an expert said.

Oncology Nursing News spoke with Dina O’Connor, APN, nurse practitioner for the GI Division at the John Theurer Cancer Center in Hackensack, New Jersey, to learn more about how oncology nurses and advanced practice providers can be proactive in preventing or alleviating burnout.

What are the some of the challenges that oncology nurses face in the workplace?

Aside from the fact that we are treating cancer daily, burnout and fatigue are a constant challenge. The job is never done; our hours may be 7:30 to 5:30, but we have to prep prior to our start, and leaving on time is a rarity. Often, even after our shift is done and we’ve left the practice, the work isn’t done. Emails and scans are still rolling in. It feels as though we’re always on call both physically and emotionally.

How do oncology nurses make that work-life balance happen when it seems like the work is never done?

Work-life [balance] is exactly as it sounds; the quality of one affects the quality of the other. While the work is never done, there are always new patients, but if you can maintain high-quality relationships with your colleagues, improving and maintaining your working environment will, in turn, improve your life outside of work.

It goes beyond caring for your patients; you have to also care for the people you work with. Having trust in your colleagues, knowing that you can support them, and they can support you is what makes for a cohesive environment. Having great relationships with your fellow nurses as well as your doctors is extremely important. You’re all in it together.

How can oncology nurses help prevent or alleviate burnout?

One of the problems with working in GI is that people with GI malignancies are very sick and symptomatic, and the treatments are difficult for the patients and their families. This only causes the burnout to be more prevalent, as it always feels as though you’re fighting an uphill battle.

So I believe this goes back to caring for each other. We have a great GI team here, and we share certain commonalities. We’re all nurses who chose this path, many of us are young mothers, and we’re all mentors. We are all people who have lives outside of work, and we’re not immune to dealing with life’s difficulties. So when I know one of my coworkers is dealing with something outside of work, I’ll offer to stay longer and let her go, which is offered by my colleagues in turn. Having that good working relationship and providing each other smooth handoffs allows us to deal with our daily necessities.

How can addressing burnout at the start potentially prevent a domino effect with high turnover rates and nursing shortages?

As with many things in life, it’s about realistic expectations. Knowing what you’re getting into helps you to manage the challenges. I knew choosing the path of oncology and treating cancer daily would be hard, not only at work, but that the hardship would follow me home. You can’t turn off what you go through daily, and it’s important not to, because your patients can see and feel that. Not to take anything away from an accountant, but this isn’t helping people file taxes, where you can assist a client, turn off, and go home knowing that you helped someone file their taxes. Our job can and will follow us home, and sometimes the concept of relief is foreign. Knowing you’re getting into that sort of career can help you manage it, and also improve your working relationships because you know your colleagues are going through the same. Empathy is a powerful emotion.

From experience, the people who have burned out did not know to expect the job to be so emotionally and physically demanding. The inability to turn off and experience relief of the day-to-day coupled with unrealistic expectations leads to that complete burnout. So I think it’s extremely important that these expectations are addressed early, let people know what they’re getting into, and offer best practices for dealing with the stress will help to alleviate downstream issues.

What do you find is the best thing for you to separate work from home?

My family. I have 2 young girls, 8 and 6 years old. They play sports all year long, but their favorite is ice skating. Whatever it is that they’re interested in, I try getting into with them. I’m an OK skater, but they’re amazing. I push myself to keep up with them so we can share those experiences together, and they can remember doing their favorite activities with their mom. This helps me to take my mind off of work. And on the flip side, while I’m struggling with things at work, they keep me grounded, knowing that I’m doing what I do to support my family.

I feel like kids are really receptive to, if you're feeling stress, they're going to know.

It’s important for all mothers, not only nurse practitioners, to cope with stress accordingly. Your kids are always watching and learning from you. While they might not say anything, they are very good at reading me, so it’s important that I teach them how to deal with stress in a healthy manner to promote their successes in life.

What advice would you give future oncology nurses?

I’ve always known that I was going to work in oncology. At 18, I found out that I have a genetic mutation that causes higher probability for breast cancer, a mutation shared by my mother and other women on my maternal side. My mother had breast cancer very young; she was 29 and I was 4. While thankfully, I have not been diagnosed, I have been very proactive in taking preventive measures, which has its own difficulties.

I have always wanted to give back, because I know many people who are diagnosed at young ages regardless of genetic mutation, so I look at myself as an advocate for the younger population, whether that be for breast cancer or other malignancies.

The best way for me to help or advocate was to work in oncology, and that was always my goal. It didn’t matter what cancer, I just wanted to be in the space and help those dealing with it. I began my career in breast cancer, followed by benign hematology, and eventually to GI malignancy, where I am today and have been for the past 8 years. I love it; it’s both rewarding and difficult.

What makes me better at my job is the latter that I climbed. Prior to college, I worked administratively in a doctor’s office and oncologist’s office, filing medical records when things were still on paper. I went to college in Boston, where I trained in various hospital settings. After becoming a registered nurse, I worked in the inpatient setting, while simultaneously attaining my masters.

I think the best thing that you can do is work in an inpatient setting, whether that be in oncology or in med-surge. Find out what interests you most. I happened to know that for me it was oncology. I gained experience working inpatient, overnights working in bone marrow transplants. I was able to shift towards days and towards outpatient at the Cancer Center, which is where I found what I love.

If you can find a natural progression and discover what suits you, you’ll set yourself up for long-term success. Once I moved to day shifts, I became an infusion nurse, a nurse that gives chemotherapy every day. I was able to learn all the treatments, all their side effects, and I learned what to talk to people about when they were sitting there for hours receiving their treatment. I heard what they were worried about and how to give them medication so they are more comfortable.

In becoming a nurse practitioner, I had to switch the way I was thinking, and I had great doctors who took me under their wing to help me learn new mindsets. While I was no longer giving the treatments, I had the experience in doing so. Having that experience in going through that progression, it makes me better at what I do.

In short, broaden your experiences early, discover what you want to do, and then follow a path to get there that allows you to experience multiple viewpoints of your chosen profession.

This transcript was edited for clarity and conciseness.