Pediatric Oncology Nurse: Sarah Cusick
Sarah Cusick came to pediatric oncology nursing by chance. A nurse at the Children’s Center was in her sorority at the University of Massachusetts and suggested she apply for a job after graduation. With no particular desire to leave Boston, Cusick did so on a whim and got the position, and she has come to know that this is just the right fit for her. “I enjoy the long-term relationships, and the longer I’m here, the more good outcomes there are for my patients. Kids who are chronically in the hospital are special. It keeps your own problems in perspective too!” As a student, Cusick also enjoyed working with geriatric patients. She found it profoundly affecting, talking to a woman in her 90s as a woman in her 20s. But with her pediatric patients, Cusick feels that she has to help them: “Cancer in a child is — how can I put it — it’s an ‘innocent’ form of sickness. It happened for no reason.”
Cusick’s first patient was 2 months old. Now she is 2 years old. Cusick was at her first birthday party; they are close and stay in touch when she comes for her outpatient visits. As part of the nursing team, Cusick is a source of consistency. Each pediatric oncology patient has a primary nurse and three associates on his or her team. Cusick learns what her patients need and tries to anticipate those needs, removing one more reason to worry. She has been challenged, too, in getting to know and understand patients who do not share her culture, religion, ethnicity, sometimes even her language: “You gain cross-cultural competence. You learn how to communicate in ways that are not always about the verbal. At the bedside, the patients find a way to tell you what they can handle, what they do or don’t like. In some situations, like rounds, for example, I need to be my patient’s advocate, her protector. The patients and their families look to us: We are not intimidating, not seen as a ‘white coat.’”
In late 2014, Cusick’s mother was diagnosed with breast cancer. Being a family member of an oncology patient has brought her a deeper understanding of her role as a nurse and the importance of communication. “It’s hard not knowing — the results of an MRI, for example. I understand the frustration better. As a family member, I want to know, to be able to plan, have a timeline.”
Sometimes Cusick can be quite outspoken: “I don’t take things too seriously, and I think that can be refreshing. I try to keep my sense of humor throughout the day. There is enough stress and sadness. I am a good help and resource to my colleagues, and I expect the same.” She enjoys working with the attending doctors and the fellows, and she sees how the residents often rely on the nurses to help them get to know and understand a patient.
Working with a team of nurses has been very helpful to Cusick. “We talk to each other a lot.” It helps when the patient is not doing well, and it is essential when a patient dies and the nurses must support the family and each other in their loss. “When a patient tries so hard, knows why he is taking his meds, keeps up with walking his laps around the unit because he understands why it will help: It is so hard when the outcome is not positive.”
Being new to Baltimore, most of Cusick’s friends are fellow nurses. “Many of us are of the same age, gender, have the same interests. We go to the gym, have dinner together. It’s important to have people who will listen.” Each nurse has a preceptor when they join the unit to give them a thorough introduction to how things are done. That preceptor then becomes the nurse’s mentor. “My preceptor knew how to do so much and how to be with patients. She is a good person for me to learn from.” Cusick will begin precepting this year for the first time. She enjoys teaching and finds that it reinforces what she knows. “Pediatric oncology is special. It brings people — patients, nurses and doctors — down to earth.”
As a member of the Compassionate Care Committee, Sarah has become more thoughtful about how death affects her and her colleagues: “Some nurses go to funerals, but some cannot. But we have to snap back to reality and look after the patients who need us. We are learning how to take a mindful pause. This work has made me more mature. You can see what can happen in life. I try not to take things for granted, as cliched as that sounds.”