Pediatric Oncology Nurse: Kailea Conley
Before Kailea Conley was born, her older sister had cancer. “It was always in my life too. She was treated and her treatment was over, but the surgeries, occupational and physical therapy were there, and it interested me.” In middle school, a friend had osteosarcoma that resulted in a limb being amputated. “It was a big event in all our lives, at a time you don’t usually think about death or disease. We were determined to make her life more fun: We took her to the pool, to parties. When she passed away, it was my first experience of a person close to me dying, and I knew that I wanted to stop this happening again, that it is not OK.”
Initially, Conley thought she wanted to be a doctor, but as she got to know herself better, she was increasingly drawn to nursing. She earned her associate’s degree in nursing at Howard County Community College and found her way to The Johns Hopkins Hospital in an unorthodox way. “I was recommended to Johns Hopkins by a patient,” she says. A friend from college was having his annual follow-up appointment at the pediatric oncology clinic. He had been impressed by her excitement and passion when they talked about his journey as a cancer patient, and he told his doctors about her. That sparked a series of conversations between Conley and nurse manager Lisa Fratino, and after graduation, Conley began working as an inpatient pediatric oncology nurse. “I love working with children, and having a relationship with their families. The long-term care and primary nursing is brilliant.”
Conley finds she has a special affinity and interest in her teenage and young adult patients. “It’s a different dynamic. They are processing more of what’s going on, have more abstract thought, understand the gravity of their situation.” The care team needs to pay special attention to these patients’ wishes, particularly those who are now old enough to consent to their medical care and make their own decisions. “We have be sensitive about when to bring in the parents. At 16, a patient has a voice, needs to be heard.” Conley remembers a teenager of whom she was particularly fond. “We read the same books, enjoyed hanging out.” She had relapsed and her prognosis was not good. “Hope has more than one path, even at the end of life: palliative care, or to keep fighting. The patient and family must make the choice, and we then support it.” That support can come in all sorts of guises. For this patient, it was about helping her fulfill her dreams and wishes. “She wanted to take a cruise, to take a trip to Paris, get her driver’s license.” When she was too sick to leave her hospital room, Conley helped her go places through pictures pasted up in her room, keeping her spirits lifted. “And she got to do all she wanted to before she passed away. It was powerful.”
Conley has seen how teenage patients can help each other too. A group of older patients were inpatients at the same time. All of them had relapsed and needed a bone marrow transplant, and all had gotten to know each through Camp Sunrise, the Johns Hopkins camp for cancer patients and survivors. They made each other paper chains, one loop for each day pre- and post-transplant. “As you ripped off the loop for that day, there was a quote or message of encouragement inside.” She adds: “I love camp. When you are dancing like a crazy fool with your patients around the campfire, you know that sometimes, we win!”
As a young nurse concerned about the issues of palliative care and the end of life, Conley sees the importance of reveling in her patients’ stories of success. “We have a scrapbook of notes, letters and holiday cards. They help with the bad days, when I don’t understand why this happens to people. But I have my faith to fall back on.” Conley is a member of the Compassionate Care Committee and values the work she and her co-workers to do look after each other. “It is important to be allowed to leave the floor to visit a patient who is not doing well in the pediatric intensive care unit, and know that your colleagues will help with your other patients while you do. At other times, we have fun together; we are friends outside of work. We have our own problems, but it’s important to have safe places for talking, for crying. I look back and laugh about moments, then realize how far we have all come. The first time I took out an IV, my patient was screaming so loud you could hear him in the hallway. I was overwhelmed at the time!”
Conley’s place on the team has changed in the three years she has been a nurse. “I am more assertive now. I just hunted down the fellow to talk about my primary patient. Our relationship is synergistic — we can’t do what they do, and vice versa.” Conley enjoys being a charge nurse and is about to begin as a preceptor, responsible for the orientation of a nurse new to the pediatric oncology unit. “At first, you are learning how things are done here — tubing, medication schedules. Now my role is more global.” Conley continues her own studies too: She will soon graduate with a bachelor’s degree in nursing science from the Johns Hopkins University School of Nursing and is already looking ahead to a master’s degree.