Reflection on Caring for Ellie- The Emotional Labor of Pediatric Oncology Nursing
Grace Burke
In the book Critical Care, Theresa Brown introduces us to Ellie, a lively and intelligent teenager who is undergoing treatment for leukemia. Initially full of life and hope, Ellie’s sudden decline and death had a powerful emotional effect on Brown and, through her narrative, on me as well. Ellie’s story reveals the emotional toll nurses go through when they work with dying children, especially in oncology wards where emotional burnout is always a risk. Brown’s story shows precisely how difficult it is to stay empathetic when faced with prolonged loss, and it made me reflect on how I can deal with the same kind of grief in my own professional life.
Ellie was a teenage patient with leukemia in the oncology unit. Despite her age, the disease course and chemotherapy worked rapidly on her body. She was cheerful and upbeat in her first few days on the unit, greeting staff warmly and developing a bond with her nurses. Ellie’s health rapidly deteriorated, and she died much faster than anyone expected. This rapid change from being stable to dying was clinically and emotionally challenging for the care team. Brown, like most oncology nurses, was emotionally invested in Ellie’s case, and her death therefore came as such a shock.
Leukemia, particularly in children, is intensive and complex to manage. It may involve long-term hospitalization, high-dose chemotherapy, and vigilant monitoring. Ellie’s case shows how quickly the patient’s state can change, and the need for strong communication, clinical vigilance, and emotional resilience. According to Ramdaniati et al. (2023), leukemia patients suffer from anxiety and emotional distress, and play therapy has been found to be a productive nursing intervention for supporting their mental well-being. This is evidence of the nurses’ double role of fulfilling medical as well as emotional requirements, a duality that was observed during Brown’s encounters with Ellie. Psychologically, Brown felt powerless and traumatized following Ellie’s death. I was moved by her vulnerability and honesty in explaining how the experience stayed with her. As a nurse major, it made me think about how I would manage such a loss. Would I be able to remain calm yet be respectful of the emotional connection I have with patients? I think Brown’s shows strength not weakness. If I were her, I think I would have reacted the same way, and I hope that I would receive the same level of support from my peers.
One nursing practice concern that particularly stood out in Ellie’s situation is emotional burnout, especially in oncology. Treating daily patients with pain, loss, and death, especially young patients, can lead to compassion fatigue and long-term mental health effects for nurses. Sullivan et al. (2019) surveyed inpatient pediatric oncology nurses and found that evidence-based interventions emphasizing resilience and coping could reduce burnout and increase compassion satisfaction. Their study suggests that emotionally supporting nurses is not just a good idea, it’s required to ensure quality care.
Brown’s story of nursing Ellie made me remember why I want to become a nurse in the first place. To walk beside patients through all of healing or dying with presence and compassion. It brought home the heavy emotional toll this can take. Burnout is not a failure of a person, it’s a sign that nurses require care as well. Knowing this makes me realize what kind of nurse I want to be, and what kind of healthcare facility I want to be in, one that cares for its healers just as it cares for its patients.
CITATIONS ON NEXT PAGE
Ramdaniati, S., Lismidiati, W., Haryanti, F., & Sitaresmi, M. N. (2023). The effectiveness of play therapy in children with leukemia: A systematic review. *Journal of Pediatric Nursing, 68*, 1–9. https://doi.org/10.1016/j.pedn.2023.102206
Sullivan, C., King, M., & Hutton, A. (2019). Reducing compassion fatigue in inpatient pediatric oncology nurses. *Oncology Nursing Forum, 46*(3), 338–347. https://doi.org/10.1188/19.ONF.338-347
