Nurse experiences as cancer survivors: part I-personal.

PURPOSE/OBJECTIVES: To uncover dimensions of nurses' personal experiences of cancer survivorship. DESIGN: Interpretive, phenomenologic. SETTING: Metropolitan area in the northeastern United States. SAMPLE: 25 RNs diagnosed with cancer. Average age was 50 years, and 20 participants were less than five years from initial diagnosis. METHODS: Interviews. Analysis using methodology of Newman (1994, 1999) and Van Manen (1990). MAIN RESEARCH VARIABLES: Nurses' personal experiences of cancer survivorship. FINDINGS: Themes of the nurses' personal experiences of survivorship included the shock of becoming a patient and multifaceted dimensions of the treatment experience, including time, coordinating their own care, the struggle to maintain normalcy, uncertainty, nonclinical self-care strategies, and encounters with caring and uncaring providers. Participants identified the need for supportive relationships both in personal and professional arenas throughout the survivorship process. The cancer experience became an opportunity for change in priorities. CONCLUSIONS: Although nurse cancer survivors experience similar personal vulnerabilities to those of non-nurses, their vulnerabilities often are affected by their knowledge of the healthcare process and content of care with which they are most familiar. They also are affected by what they know is at stake. This particular insider vulnerability is not cited often in research literature and, therefore, is not recognized as a particular type of need that should be addressed in cancer survivorship. IMPLICATIONS FOR NURSING: Nurse patients need providers to be sensitive to their information and support needs, which may vary because of their professional experiences and personal resources. Findings suggest that nurse patients may need supportive approaches that target their unique vulnerabilities.

Nurse experiences as cancer survivors: part II--professional.

PURPOSE/OBJECTIVES: To uncover dimensions of nurses' professional experiences of cancer survivorship. DESIGN: Interpretive, phenomenologic. SETTING: Metropolitan area in the northeastern United States. SAMPLE: 25 RNs diagnosed with cancer. Average age was 50 years, and 20 participants were less than five years from initial diagnosis. METHODS: Interviews. Data were analyzed using the methodology of Newman (1994, 1999) and VanManen (1990). MAIN RESEARCH VARIABLES: Nurses' professional experiences of cancer survivorship. FINDINGS: Professional experiences of cancer survivorship fell into five themes: (a) role ambiguity, (b) a deepening level of compassion for patients and others, (c) self-disclosure as a therapeutic intervention, (d) becoming an advocate for change, and (e) volunteerism. CONCLUSIONS: Cancer survivorship was a factor in reshaping participants' clinical practice. Experiencing the role of the patient affirmed the necessity of compassionate care for these participants. Nurses experienced a deepening level of compassion for patients and used self-disclosure as a therapeutic intervention. During and shortly after treatment, role ambiguity (being both patient and nurse) could cause difficulties. Nurses took action to change their clinical environment through their influence on colleagues and the healthcare system and by working through other organizations to improve patient care. IMPLICATIONS FOR NURSING: Nurse cancer survivors can benefit from the support of colleagues and healthcare providers and an appreciation of the challenge of being both a professional and a patient. The invitation for dialogue as they return to work may help with the challenges of role ambiguity as nurse cancer survivors. Based on this study, nurses value the opportunity to enhance care environments with their two-world knowledge through compassionate care, disclosure, advocacy, and volunteering, and coworkers need to appreciate each nurse's unique response to this potentially life-changing process. Nurses in all settings can learn from their cancer survivor colleagues who have been the recipients of care to reflect on their own clinical practice in the areas of advocacy, sensitivity to patient concerns, and care experiences.