Ij

CJON BOOK EXCERPT SERIES
Continuing the Legacy:
More Voices of Oncology Nurses
Janice Phillips, PhD, RN, FAAN
on the fast pace, the diversity of
"To find out what one is fit-
This excerpt, chapter 19 from the book Continuing the
patient situations, and the col-
ted to do, and secure an op-
Legacy: More Voices of Oncology Nurses, edited by
laborative teamwork that was
portunity to do it, is the key to
exhibited on a daily basis. There
happiness."
Brenda Nevidjon, MSN, RN, is part of a series of clini-
was nothing more exhilarating
--John Dewey
cally relevant reprints that will appear periodically in the
than the thrill of performing
Clinical Journal of Oncology Nursing.
The Early Years
lifesaving procedures and mak-
ing every moment count during
The 1970s
upon an unbelievable journey of service and  a crisis situation. There is no place like an
It is quite amazing to me how I decided to  experience some of the most rewarding and  ER; "Ripley's Believe It or Not" could not
top those surroundings. I recall to this day
attend nursing school. All of my childhood, I  memorable times of my life.
My first stop after graduating from nurs-  one of the funniest yet most embarrassing
fantasized about becoming a schoolteacher.
I always admired my teachers for helping  ing school was the University of Chicago  moments of my life and times in the ER. An
me to learn subjects such as cursive writing,  Medical Center, where I was hired as a new  ER technician and I took it upon us to pro-
mathematics, Spanish, and even tap into my  graduate to work on a medical and clinical  vide further documentation that our patient
creative abilities and write poetry. For me,  research unit. I will never forget, in June  had died. Despite the very obvious rigor
teachers were the smartest people on earth,  1976, I was hired at $5.65 an hour, more  mortis and the physician's pronouncement
so it only seemed befitting that I wanted to  than twice the minimum wage of $2.20 an  of death, we decided to place our patient
be like them when I grew older. Aside from  hour. I still have very fond memories of  on the cardiac monitor, only to find normal
my grandparents and social worker, my  the university, where I launched my nurs-  sinus rhythm appearing on the screen--nice
teachers were among the most influential  ing career. It was during the late 70s that I  and steady beats. We were scared to death
people in my life. It was during my junior  learned to apply a wide variety of basic and  and immediately summoned the resuscita-
year in high school that I learned that a large  advanced nursing skills, prioritize heavy  tion team to assist with our revival efforts.
portion of my graduating class was going to  workloads, and collaborate with some of  Much to our embarrassment, the patient's
become teachers. I was quite disappointed  the finest healthcare professionals to pro-  pacemaker was still functioning, and right-
when someone cautioned me that the mar-  vide high-quality care to patients, families,  fully so. Embarrassed, humiliated, scared
ket would be flooded with an oversupply of  and communities. As a new graduate, I was  to death, you name it, all we could say was,
teachers and a limited number of teaching  introduced to the rigors of clinical research,  "He took a licking but kept on ticking." Talk
positions. I began to think about other career  the complexity of patient care, and the need  about quality assurance.
Even during the less hectic times, my col-
options that would allow me the opportunity  to engage in scholarly activity to advance
to help others. Nursing seemed to fit that bill  the profession. After two years on the unit,  leagues and I usually were very busy provid-
at the time, as nursing and teaching were  I transferred to the university's Class 1  ing patient education, locating resources for
among the two most popular career options  Trauma Center, where my career began to  our patients, and developing or evaluating
procedures to facilitate high-quality patient
for women during the 70s. With limited ex-  take shape.
While working for 10 years in the emer-  care. In fact, my first publication in nursing,
posure to nurses to help shape my decision,
thankfully for me, I made one of the best  gency room (ER), I assumed the roles of staff  "Emergency Nurses Thrive on Diversity,"
decisions that I have ever made in my life.  nurse and then assistant clinical manager.
During my senior year, my social worker  The ER is a tremendous place for develop-
from the Department of Children and Fam-  ing and using critical thinking and high-tech  From Continuing the Legacy: More Voices
ily Services began making preparations for  skills. Because of the diversity of patients  of Oncology Nurses (pp. 159 166), ed-
me to attend nursing school at North Park  that I encountered on a daily basis, I also  ited by Brenda Nevidjon, MSN, RN, 2004,
College in Chicago. Little did I know that  became sensitized to the need for commu-  Pittsburgh, PA: Oncology Nursing Society.
after completion of my bachelor's degree  nity outreach, public health education, and  Reprinted with permission.
from North Park in 1976, I would embark  patient advocacy. As an ER nurse, I thrived   Digital Object Identifier: 10.1188/05.CJON.94-97
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FEBRUARY 2005 VOLUME 9, NUMBER 1 CLINICAL JOURNAL OF ONCOLOGY NURSING
socioeconomic status, limited knowledge
University of Illinois College of Nursing, I
highlighted the diversity of skills and knowl-
about cancer and related resources, adher-
decided to leave my comfort zone again--
edge needed to survive in such an environ-
ence to follow-up care issues, and notions
Chicago--and pursue a teaching position
ment. However, despite all of the good times
of fear, fatalism, and silence. Notably, many
at the University of Maryland School of
that I experienced, I knew that at some
women were fearful about a diagnosis of
Nursing. This marked another pivotal point
point in my career I would need to move
cancer, losing a breast to cancer, the stigma
in my career and opened up unlimited op-
on to something less demanding in nursing.
associated with having cancer, not being
portunities to develop skill and expertise in
Nearly eight years after my near-death expe-
able to afford treatment, and the potential
oncology nursing.
rience (hard work as an undergraduate nurs-
loss of significant relationships. Some of the
At the university, I had the most incred-
ing student), I returned to school part-time
women held fatalistic perspectives regarding
ible time of my career working with Dr.
to pursue a master's degree in community
cancer and felt that they would die even if
Anne Belcher and other oncology faculty
health while remaining full-time in the ER.
the disease were detected early. Not surpris-
members on a number of oncology initia-
I knew then that I would be in nursing for the
ing though, many women within the African
tives ranging from developing oncology
long haul, so furthering my education was
American community were reluctant to talk
nursing curricula for undergraduate and
critical to enhancing my marketability and
about the "big C," thus creating another
graduate nursing students to implementing
personal satisfaction.
challenge for our outreach endeavors. Al-
cancer community outreach programs. One
though these issues challenged our efforts to
of the most significant highlights of my
"Know whence you've come. If you know
promote the early detection of cancer, they
career in oncology nursing occurred when
whence you've come, there is really no limit
also provided a tremendous opportunity to
Dr. Belcher nominated me to replace her
to where you can go."
dispel cancer myths and offer support to
as the ACS Professor in Oncology Nurs-
--James Baldwin
our targeted population. The idea that some
ing at the University of Maryland School
The Mid Years
women would not come for no-cost cancer
of Nursing. The professorship provided
screening services was quite perplexing
a unique opportunity to further develop
The 1980s
to me and, thus, provided the basis for my
the oncology nursing curricula, conduct
dissertation research. Returning to school to
more breast cancer research with African
The complexity and diversity of experi-
pursue a doctorate in nursing was never on
American women, and travel extensively to
ences at the University of Chicago Medical
my list of things to do; however, it became a
provide breast cancer education and share
Center enabled me to gain enough confi-
necessity for my future growth and develop-
my research findings with lay and profes-
dence and skill to handle just about any-
ment and ability to make a greater contribu-
sional audiences.
thing in nursing. The decision to leave my
tion to my community.
About the same time, an amazing thing
comfort zone marked a very pivotal point
happened. I received a phone call from
in my career. After receiving my master's
"The greatest achievements are those that
Dr. Beverly McElmurry, professor at the
degree, I moved on to my next adventure.
benefit others."
University of Illinois College of Nursing,
My love for community health led me to
--Denis Waitley
inviting me to replicate portions of my breast
an administrative position coordinating
cancer dissertation research in Brazil. Well,
healthcare services at a large ambulatory
it happened within less than 10 months; I
healthcare center. Two years later, I went to
The 1990s
received a Minority International Research
the University of Illinois, School of Public
Training (MIRT) award from the University
Health, where my passion for oncology
Building on my interest in cancer control
of Illinois College of Nursing to conduct
nursing came into being. As a Clinical Nurse
issues and my experience with providing
research with breast cancer survivors resid-
Consultant for a National Cancer Insti-
breast and cervical cancer screening, my
ing in Brazil. The purpose of the MIRT
tute-funded intervention targeting African
dissertation, "Adherence to Breast Cancer
program is to advance primary health nurs-
Americans, I provided breast and cervical
Screening Guidelines Among African Ameri-
ing research to address the health dispari-
cancer screening, education, and referral
can Women of Differing Employment Sta-
ties among underserved populations in the
to underserved inner-city women. In this
tus," described African American women's
United States or in developing countries.
position, I had a tremendous opportunity to
adherence to the American Cancer Society's
The World Health Organization Collaborat-
provide lifesaving cancer information and
(ACS's) screening guidelines. Although I had
ing Centre/Nursing Research Development
promote the early detection of cancer. The
conducted research during my undergraduate
at the University of Sao Paulo College of
staff and research team were very commit-
years, conducting my dissertation research
Nursing at Ribeirao Preto, Brazil, served
ted to improving the cancer outcomes of the
was even more rewarding because I was
as the host site for me and my student to
African American community, a community
able to provide education, resources, and
conduct research and enhance our under-
noted for its high cancer mortality and poor
encouragement to women who had limited
standing of global health issues. Talk about
cancer survival. The commitment of the
knowledge about breast cancer. My disserta-
an opportunity! This invitation was not only
research team in many ways was infectious
tion research produced some very important
an honor but also provided confirmation
and inspired me to return to graduate school
insights regarding the low utilization of breast
that my dissertation was of fine quality and
to further develop my interest in oncology
cancer screening among low- and middle-
worthy of possible replication in a foreign
and behavioral interventions.
income African American women; however,
country. Thanks to my academic advisor
Although our clinic was located in a well-
it was not until my subsequent qualitative
and dissertation committee, the idea that I
popularized public health center and the
research that I began to more fully understand
had a polished product that could serve as a
services were free, our team learned early
the issues facing not just African American
model for advancing knowledge in another
on that we could not operate on the assump-
women but many women from all walks of
area was both humbling and exciting.
tion "if you build it, they will come." Rather,
life when dealing with breast cancer issues.
The experience of traveling abroad for the
many members of our targeted population
After obtaining my PhD degree with a
first time to work with noted Brazilian nurse
faced other urgent life issues, such as low
specialty in Public Health Nursing from the
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CLINICAL JOURNAL OF ONCOLOGY NURSING VOLUME 9, NUMBER 1 CONTINUING THE LEGACY: MORE VOICES OF ONCOLOGY NURSES
conducting international and collaborative
health care, and my next adventure in nurs-
scholar Dr. Marli Mamede, students, and
nursing research.
ing. I can only imagine and wish that my
women coping with cancer was a rewarding
After my trip to Brazil, I returned to
remaining years in nursing would be filled
and unforgettable experience. In the 1980s,
continue my work with African American
with as much passion and excitement as the
Dr. Marli Mamede had the remarkable vi-
women. Findings from my follow-up quali-
years to date. Each decade of my career has
sion to develop a breast cancer rehabilita-
tative breast cancer studies targeting African
been filled with increasing responsibilities,
tion center specifically targeting patients
Americans have been widely disseminated
challenges, and opportunities to work with
with breast cancer who had lymphedema.
and have helped to shape research and edu-
some of the world's finest nurses and health-
Breast cancer survivors from across the re-
cational initiatives targeting this population.
care professionals. My years as a nurse have
gion came to the school of nursing for their
Perhaps most gratifying are the comments
been characterized by what I call the 4 Ps:
exercise and massage therapy, support group
that I have received over the years from
passion (for the work I do), people (men-
meetings, social services, and educational
the research participants themselves. Many
tors who have helped me along the way),
sessions that would assist them in coping
women have expressed appreciation for be-
persistence (when the going got tough), and
with their breast cancer diagnosis. During
ing able to participate in research that may
productivity (in scholarship and service). As
our three-month stay, our team conducted
be of benefit to other women and for gain-
I look back over my career, I can truly say
several breast cancer studies assessing both
ing additional insights about their personal
that I have enjoyed the roles of clinician,
women's and nursing students' knowledge
health and well-being. For some, discussing
consultant, academician, researcher, policy
and practices related to breast cancer screen-
their concerns and issues surrounding breast
regulator, administrator, mentor, and men-
ing. Findings from our research were im-
cancer has been therapeutic and enlighten-
tee. I have been blessed to incorporate my
mediately applied to develop a community-
ing. I have learned much from them as well.
interest in minority health, women's health,
based breast health education program and
For example, for many African American
oncology, and public health throughout all
to help shape the breast cancer content in
women, spiritual connectedness is central to
phases of my career.
the undergraduate nursing curricula. The
their responses to a potential threat or actual
Let me pause right here for a moment in
following summer, Dr. Mamede came to
diagnosis of breast cancer. Expressions of
case there is a new graduate or a more sea-
the University of Maryland School of Nurs-
letting go and letting God may very well
soned nurse out there reading this and saying
ing and collaboratively worked with me to
be an expression of one's faith in God to
to themselves, "Surely it's not that great!"
conduct her study on American women's
take care of the problem at hand rather than
Well, nursing has been good to me. I must
attributions of breast cancer, an extension of
what some may interpret as fatalism. I also
confess though, I too have encountered my
her work with Brazilian patients with breast
learned that despite some of their fears and
share of setbacks, disappointments, frustra-
cancer. My life has never been the same as
concerns, women are thirsty for knowledge
tions, burnout, and difficulties balancing
a result of the wonderful generosity that
and are open to participating in research. Fi-
work and personal life. Somehow, I have
I encountered during my first trip abroad.
nally, often the people we are trying to reach
managed to stay focused and surround my-
The love, sharing, and hospitality extended
have the answers themselves; as researchers,
self with very positive people, colleagues,
to me and my student was an unforgettable
we need only to ask them.
and mentors who have helped me to get
experience. Although my stay was limited
back on track. Each challenging situation
to three months (new and junior faculty had
"The future belongs to those who believe
has enabled me to gain renewed strength for
to get back to work), the experience was
in the beauty of their dreams."
the next experience. It is important to note
greatly enhanced by living with a Brazilian
--Eleanor Roosevelt
that I did not get to this point by myself. No
family and being immersed in Brazilian
way! Tennis champion Althea Gibson said
culture. The greatest challenge, however,
The Remaining Years
it best: "No matter what accomplishments
was the language. No falor Portuguese!
you achieve, somebody helped you." I have
Luckily, many people that I worked with,
The 21st Century
the Lord, many people, organizations, men-
including my student, Dr. Mamede, and
tors, supervisors, patients, research subjects,
school officials, were bilingual and more
Several years into the 21st century, I am
students, colleagues, friends, and custodial
than willing to assist me in communicating
still as excited about nursing as the day I
workers to thank for supporting me along
during my stay in Brazil. The people that I
graduated from nursing school in 1976. In
the way. The Oncology Nursing Society,
worked with were quick to teach me that a
my current role as a program director at the
in particular, has provided me with numer-
smile is the universal language. The breast
National Institute of Nursing Research, I get
ous opportunities to develop skill, interest,
cancer survivors and community-based
to interact with nurse researchers from all
expertise, and visibility in oncology nurs-
women were very warm-spirited women
over the country who share a common in-
ing. I am eternally grateful. I always have
who refused to take compensation for their
terest in health promotion, oncology, health
believed that belonging to and supporting
research participation. In many ways, they
disparities, and research in general.
one's professional organization is an invalu-
considered it an honor to assist me in ac-
It is great to be on the inside to see how
able resource for professional growth and
complishing my research goals. In turn, the
things really work and to be of assistance
development. Nursing 101!
funds that were set aside for compensation
to so many dynamic and committed profes-
In looking back, I can say that I have had
were used to purchase T-shirts for a fundrais-
sionals. My passion for oncology nursing
the time of my life in nursing! I would have
ing activity as well as supplies for one of the
is still very much alive and well. I continue
never imagined that nursing had so much to
community-based clinics. This to me was
to seize and even create opportunities to
offer and that I would be able to seize and
even more gratifying because more people
promote breast cancer awareness and early
even create such opportunities for my pro-
could benefit from the monetary compensa-
detection. I continue to receive consider-
fessional development and personal satisfac-
tion regardless of participation. Since that
able recognition for my efforts, the work I
tion. I have never regretted my decision to
time, I have traveled to Africa, Canada, Nor-
love to do.
pursue nursing as my career versus pursuing
way, Taiwan, back to Brazil, and throughout
Boy, do I wish I had a crystal ball at times
a career in teaching. Nursing is filled with
the United States to share my experience in
to see what the future holds for nursing,
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FEBRUARY 2005 VOLUME 9, NUMBER 1 CLINICAL JOURNAL OF ONCOLOGY NURSING
Chang Chung Hospital in Taipei, Taiwan
with life-threatening illnesses, you name
opportunities to teach and make a differ-
(1997)*
it--nursing provides unlimited opportuni-
ence in so many ways. A wise person once
Delivering the Mara Mogensen Flaherty
ties to touch the lives of many people. Now,
said, "The reward for a job well done is the
Memorial Lecture to more than 4,000
mind you, the work is hard, sometimes very
opportunity to do more." I am excited about
oncology providers (1999)*
challenging, but the rewards are many. One
my remaining years in nursing and look for-
Being inducted into the American Acad-
reward is the diversity of things you can
ward to ways in which I can make a lasting
emy of Nursing (2000)*
do as a nurse. Imagine if you love caring
contribution. I would like to conclude with
Serving as one of the seven nurses nation-
for children or older adults or even help-
what I feel are the top 10 most memorable
wide in the national campaign "Nurses for
ing mothers in labor, then there's a role for
events in my career to date. Somehow, I still
a Healthier Tomorrow" (2001)*
nurses. Perhaps you like the excitement of
believe the best is yet to come!
* Denotes oncology-related
a fast-paced environment, then there's the
Receiving favorable state board results
emergency room or critical care unit. What
after my first try (1976)
"To whom much is given, much is re-
about your passion for teaching? There's
Receiving my first major nursing recogni-
quired."
a role for nursing no matter what the set-
tion, Nurse of the Year Ambulatory Divi-
--Luke 12:48
ting--nurses teach. Many nurses teach in
sion, the University of Chicago Medical
colleges and universities preparing the next
Center (1979)
generation of nurses. Some even work with
Receiving my doctoral degree (1993)*
Calling All Future Nurses
legislators to improve the healthcare system.
Constructing my first coedited book,
There is something for everyone depending
Women's Health Across the Lifespan: A
I certainly hope this message finds you
on the level of preparation and interest. Oh,
Comprehensive Perspective (1996)
doing well and seriously considering nurs-
and don't let nursing school scare you. Yes,
Receiving an American Cancer Society
ing as a career option. After 27 years in the
it can be demanding and sometimes over-
Professorship Award in Oncology Nurs-
profession, I am still excited about nursing
whelming, but at the end of the day, you will
ing (1996)*
but am anxious to find more caring, com-
develop character and determination that
Conducting my first international breast
passionate, and interested people who will
will take you far in your career. Hope you
cancer study in Brazil (1996)*
serve as the next generation of nurses. From
make nursing your choice!
Serving as a visiting professor at the
giving healthcare advice to caring for people
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CLINICAL JOURNAL OF ONCOLOGY NURSING VOLUME 9, NUMBER 1 CONTINUING THE LEGACY: MORE VOICES OF ONCOLOGY NURSES