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February 2015, VOL 6, NO 1

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Evidence into Practice

Staci K. Oertle, ANP-BC, MSN, OCN

Staci K Oertle, ANP-BC, MSN, OCN 

As I embarked on my nursing career more than 25 years ago, I remember having feelings of both  excitement and anxiety. I had just graduated with a degree as a registered nurse at 19 years old when I went for my first interview at a local community hospital in southern New Jersey—it was for a position with a medical surgical–oncology unit. I was interviewed by the unit’s nurse manager.

She asked me if I had any experience in nursing school with oncology patients, and proceeded to explain how oncology patients and their families require “extra tender-loving care.” Helping patients through treatments could be quite complex and challenging, she told me, explaining that oncology was a specialty and that oncology nurses were, in fact, special: they cared for the mind, body, and soul of their patients, and frequently laughed and cried with patients and their families.

I shared with her an experience I had as a student nurse caring for a woman with metastatic breast cancer. I recalled how she looked anorexic and pale, and was in constant pain from bone metastasis. She was frail, and I gave her several injections for pain the few days I cared for her. I remembered how helpless I felt.

The idea of working daily with patients such as her was frightening, but I decided I was up for the challenge. In just the first month, I learned so much it was mind-boggling. I was in awe of the other nurses and how they combined professionalism and compassion while balancing chemotherapy administration, blood transfusions, pain medications, educating and supporting patients and their caregivers, and all of the other numerous nursing responsibilities.

I remember the first patient I cared for who lost his battle with cancer. This was the part of the job I had worried about the most: Would I know what to say to grieving family members? How would I comfort them? I was blessed at that time with a healthy family, and I feared it would be difficult for me to relate to them or know what to say. When the time came, though, I instinctively knew what to do. I hugged these family members who I had seen every day, and I cried with them; I did not have to give it a second thought. At that moment, I knew that I had made the right decision and found my specialty, and I never looked back. I have been working as an oncology nurse for more than 25 years and cannot imagine working in any other specialty.

I decided to pursue further education, first earning my certification as an oncology-certified nurse in 1992, then returning to college and graduating with a bachelor of science in nursing degree in 1996. At that time, most chemotherapy administration was moving from inpatient to outpatient settings, and I began work at a private oncology-­hematology practice. It was during this time that my mother was diagnosed with breast cancer. We were so lucky—it was stage I, and she underwent a lumpectomy followed by radiation. I was fortunate to have the knowledge to help navigate her through the process, but I often wonder how this experience may have been different for my mother and family if I did not have a background in oncology nursing.

Another 10 years seemed to fly by as I cared for my family and raised my son. I decided it was time to further my education once again. While in graduate school, I returned to the hospital setting (Inspira Health Network) to work as an oncology research nurse, and helped develop a survivorship pilot program for patients who were completing cancer treatment at the hospital. I met with patients as they finished therapy, completed a summary of care, reviewed possible late-term and long-term side effects, and gave healthy living recommendations for patients’ life after treatment.

Through this work, I noticed that many patients were experiencing severe fatigue after treatment. This prompted me to do additional research on cancer-related fatigue and open an institutional review board–approved nursing research study: The Impact of Exercise on Cancer-Related Fatigue. Patients who completed cancer treatment and experienced fatigue were accrued to participate in a 60-day, supervised, physician-referred exercise program at Inspira Fitness Connection, a certified medical fitness facility. Pretest and posttest exercise comparisons using the Brief Fatigue Inventory scale and a quality-of-life survey (QLQ-C30) revealed that study participants who completed the exercise program experienced a significant reduction in self-reported fatigue and a significant improvement in quality of life.

After becoming a board-certified nurse practitioner in 2012, I moved into a new position as the nurse practitioner and nurse manager of the outpatient infusion center at Inspira Health Network. Many of the patients who receive treatment at the infusion center are uninsured or underinsured. They have multiple social and financial issues, and they need to be navigated and supported daily. It is a team effort that includes oncology nurses, oncology navigators, an oncology social worker, medical and radiation oncologists, and me. Together, we care for our patients, and it is the most rewarding job I have ever had. I truly feel like I make a difference and help provide access to quality care for patients who need it most.

I attended the Academy of Oncology Nurse Navigators (AONN) conference in November 2013 to pursue my interest in cancer survivorship and meet other nurse navi­gators. I soon became a member of the AONN Quality, Outcomes, and Performance Improvement Committee. This is a great platform to share best practices, share resources, and mentor others to help provide the best quality care to all of our patients. I presented my study, The Impact of Exercise on Cancer Related Fatigue, as an abstract and poster at the 2014 Academy of Oncology Nurse & Patient Navigators (AONN+) conference, and I am very proud to have won the honor of first place in the category of Original Research on Survivorship Programs.

I have worked with many amazing nurses over the years who have become lifelong friends, and I have wonderful mentors who have continued to guide me throughout my career. I continue to meet outstanding nurses through AONN+ conferences and committees who make a difference in the world every day. I am honored to be part of such an amazing organization. My first nurse manager was correct when she said that oncology nurses are special—and I am extremely proud to be one.

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