Oncology nurses aim to provide holistic care, alleviate suffering, and promote comfort for their cancer patients. However, their inherent intention to care for the sick makes them susceptible to experience psychological distress when they are not enlivened. They are committed to providing quality care, but they repeatedly witness their patients experiencing debilitating conditions, devastating symptoms, and adverse effects from aggressive interventions. Oncology nurses are therefore highly vulnerable to experience frustration and tension. These responses may further lead to negative outcomes, such as job dissatisfaction, compassion fatigue, burnout, absenteeism, and low quality of care.1,2
Caring is appraised to be a universal phenomenon in nursing. Its meanings have been widely delineated and discussed in the literature for decades. In the oncology setting, nurses and patients' perceptions toward caring have been explored in a number of studies. Cancer patients perceive that caring involves nurses being skillful in relieving physical discomfort and psychological distress and knowledgeable in providing informational support.3 Close monitoring of patients' conditions and meeting their various health and supportive care needs are ordinarily identified by both nurses and patients to be the most important caring behavior. In addition, such perceptions can result in nurses viewing caring behaviors as tasks or assignments. Consequently, caring practice is deemed a burden for nurses in fulfilling their caring role in a busy clinical environment. Indeed, it is not uncommon for some nurses to attribute the barriers to a caring practice to be heavy workload and shortage of nursing staff.4
The experience of emotionally immersing oneself into patients' illnesses enables oncology nurses to empathize with their patients. Nevertheless, continuous support to these nurses is essential to sustain their compassion. Oncology nurses, as carers of cancer patients, also need to be cared for. The sense of powerlessness resulting from compassion fatigue is related to the perceived lack of support to these nurses. They feel exhausted and inadequate when they are only involved in giving without receiving care. In a caring process, receivers refer not only to patients and their family members but also to carers. Nurses need to be cared for so that they can be empowered to pass on the caring to others.5
Despite the ever changing clinical environment, caring is affirmed as the essence of nursing that symbolizes the virtue of the profession.4 Caring is neither a task nor an assignment but an integral trait of nurses manifested in their interactions with the healthcare team, patients, and family members. Although caring is an innate attribute, cultivation of a caring culture in the workplace is necessary for nurses to enact caring. Nurses are intrinsically motivated to show their caring attitudes and behaviors in a clinical environment that has a caring atmosphere. Cultivation of a caring environment requires continuous efforts. Regular seminars and workshops sharing caring stories, caring acts, and updated research evidence can arouse and maintain nurses' awareness to a caring practice. A caring environment emphasizes the provision of quality care and the necessity of care for the carers. In the oncology setting, a caring culture supports nurses in relieving the suffering of cancer patients and reminds nurses of the significance of their presence in their patients' illness journey. A conducive environment enables nurses to reflect on their caring experience. They gain insights into the values of daily care and nursing profession, particularly as oncology nurses. Therefore, cultivation of a caring culture is not only therapeutic to cancer patients but also healing to oncology nurses.
Sincerely yours,
- Fiona W.K. Tang, PhD, RN
- Winnie K.W. So, PhD, RN
- Gigi C.C. Ling, PhD(c), RN
- Adela S.F. Lai, MHA, RN
- Sek-ying Chair, PhD, RN
The Nethersole School of Nursing
The Chinese University of Hong Kong, China
References