PracticeUpdate: What advice would you give nurses just starting their careers from your perspective as an oncology nurse?
Lillie Shockney: I think that television shows have steered nurses toward the emergency room and the ICU—what people will sometimes refer to as the “sexy” areas of a hospital. The ER is considered a very sexy area. Everything's fast, and life-threatening, and what I see on these TV shows is usually just that. A young woman in nursing school will think, "That's what I want to do." And I say, broaden your horizons, broaden them, because, quite frankly, when you're in the ER or you're in the ICU, you see a patient for a snapshot of time, and to really get the full experience of nursing, as I have, you need to pick up the patient at the point of diagnosis. I am with the patient across every phase of treatment into short- and long-term survivorship or into the end of life. That is incredibly rewarding.
People think that oncology is a sad area to work in. Maybe they don't know that the majority of people are going to survive their cancer. (I personally am 29 years out from my first cancer.) It’s very satisfying to be able to celebrate with patients when they have finished their treatment, to be part of their extended family. To keep them on track for the milestones in their lives. To make sure that cancer takes away no more of them than is absolutely necessary.
We ask patients with advanced disease a series of questions. We may start with, "How much do you know about your cancer? How much do you want to know about your cancer?" Because, frankly, not everybody wants to know things. Some people want just-in-time information because it's just too overwhelming. And we ask, "What are you hoping for? What are you most worried about?” And, “Tell me three things that bring you joy." We want to preserve those three joys; that's really important. And, usually, we can in some way. Then, later, we ask her these questions again, because what she's hoping for and what she's most worried about are going to change over time.
I don't want people to see oncology as a depressing field because, believe you me, it's not. I would not ever have found as much joy as I have in my career if I had chosen to go into another field. I know it.
PracticeUpdate: Why is work–life balance important to maintain for providers in this field?
Lillie Shockney: We do need work–life balance. I have a tendency to not practice what I preach, and I will admit that. However, we need to teach ourselves that we need to maintain a life outside of work. One of the ways to do that is to change clothes when you get home. If you're going to stay in your scrubs, or whatever it is that you wear to work, you haven't disconnected from work, you still look like you're at work, and you might still feel like that you're at work. Also set some boundaries on how available you think is realistic for you to be. If I give a patient my phone number, I say, "Please don’t call me on the weekends unless something really bad has happened and I need to get you into care somewhere. I try to hold my weekends for my family.”
Also, it’s important that we find our own joy. I ask myself, “What am I hoping for today? What am I most worried about right now? And what are three things that bring me joy?" And I want to make sure that I am experiencing those three things. If I'm not, then I need to hit the pause button, "Okay, what am I doing that I'm losing those things?" It's probably that I'm losing time, that I've shifted more time over to my patients and made less time for myself and my family. That doesn't mean that the balance has to be 50/50, but you can’t devote all your time to work and have none for yourself and family because you'll burn out, you will burn out, and then all those people who you could have helped and really done a phenomenal job in supporting will miss out.
PracticeUpdate: You mentioned setting that boundary of emergency-only calls on the weekend. Do you have any other strategies for maintaining personal and professional commitments?
Lillie Shockney: I think it’s important that people have a calendar and plan events for themselves. "I want to go to the autumn festival." Make that happen. "I am going to take Tuesday off next week to go to school and see my grandson read a poem." If we don't proactively add these things to our calendar, then we'll let work take that time. We will; it happens. So, we have to be proactive for ourselves, and that’s not being selfish. I'm now 67 and, years ago, I thought it was being selfish; but, no, I’m preserving my mental health is what I’m doing. I cannot take good care of patients if I am not healthy, including emotionally healthy, myself. I'm going to let them down, and that's not right; I have control over that.