19.1The Role of the Nurse in Pediatric Oncology

19.1.1 Direct Care

•Taking care of children with oncological illnesses presents a major challenge to nurses

•The patient enters the hospital not only for chemotherapy but also for the treatment of complications and side effects such as infections, stomatitis, transfusions, and blood count checks

•Nonmechanical intensive care has psychosocial consequences such as pressure on the family, absence from school, limited social contacts, and short or long hospitalizations

•Involvement of the entire family from the outset is crucial and represents a focal point in care of the patient

Eight features of holistic care for oncological patients (modified from I. Bachmann-Mettler):

1.Ongoing information and instruction (initial information is given by the physician, the nurse, as the key carer, checks the understanding of conveyed information and refers observations of the patient to the doctor)

2.Establishment of a durable relationship with the patient and their entire family (nursing measures become effective through the quality of the nurse’s relationship with the patient, and the patient needs to be convinced by professional nursing skills)

3.Knowledge of the treatment plan (induction, consolidation, and maintenance phase; simultaneously the nurse has to be informed about the course of illness as well as the aim of the current treatment with chemotherapy)

4.Knowledge about mode of action (alkylating agents, antimetabolites, mitotic inhibitors, chemotherapeutic agents, antibiotics, etc.)

5.Safe handling of chemotherapeutic agents (we need to be aware of the fact that these drugs, when wrongly administered or given in an incorrect dose, can lead to life-threatening complications)

6.Knowledge of side effects

7.Formulation of goal and planning as part of the nursing process (the first part of nursing care strategy is collection of information about the needs of the patient; the concept of nursing care is designed for everyday use, particularly in oncological nursing care planning; determination of goals and the knowledge about the effects of specific measures for the prevention of side effects is of great importance

8.Close, respectful cooperation between nursing staff, physicians, and other personnel

Parents of children with cancer contribute significantly to comprehensive care. Holistic care demands involvement of the sick child and their entire family, which includes showing empathy toward them. Family members who are listened to and supported become a valuable resource for the patient as well as the nurse.

Children have inquisitive personalities, they are able to assess themselves well and only do or permit what they can tolerate. The nursing care regime has to take into consideration the ability of the child and the parents to cope with the oncological illness: