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Pediatric oncology nurses embrace a unique role

Their enthusiasm and love of the job — and their patients —makes all the difference.
Laura Hacker of Georgia Urology says “I think we make quite a difference in the lives of pediatric patients, as well as the parents.”

Laura Hacker of Georgia Urology says “I think we make quite a difference in the lives of pediatric patients, as well as the parents.”

This story was originally published in August 2017.

Emily Hawkinson was 9 when she settled on a career in nursing.

Her 6-year-old sister was hospitalized with a brain tumor at Children’s Health Care of Atlanta at Scottish Rite.

“Seeing what she went through and seeing the great care the nurses gave her made me want to do that, too,” said Emily, who is now 25 and a third-year pediatric oncology nurse at the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, the same place her sister beat cancer.

Pediatric oncology is a highly specialized and emotionally challenging field of nursing. In broadest terms, a pediatric oncology nurse works with patients who are 18 or younger, but can be as old as 21. All of their patients are dealing with cancer, with some of the most common being Leukemia, brain and spinal cord tumors, Lymphoma and bone cancer.

Marguerite Majcher has worked exclusively in pediatric oncology for 25 of the 28 years she’s been a nurse. Like Emily, she had a strong personal draw to the field: her mother was a labor and delivery nurse.

Marguerite always wanted to work in pediatrics and decided to focus her life’s work on oncology after visits to a summer camp for children with cancer, she said.

“I really just fell in love with that patient population,” said Marguerite, who began work at the Aflac Cancer Center in April.

The emotional challenges of working with young cancer patients are likely obvious and part of the daily life of a pediatric oncology nurse practitioner.

“The most challenging thing is seeing kids hurt and in pain and the parents stressed because of what they’re going through,” Emily said.

Yet these nurses speak with enthusiasm and love for their work. Both Marguerite and Emily said that they make it through some of the toughest days in part because of their supportive teammates and administration.

Oncology nurses often hear that it takes a special person to work with a child who is dealing with a cancer diagnosis, Marguerite said. She doesn’t agree.

“If I can make something easier for somebody during the worst days of their lives, I have always found it very rewarding,” said Marguerite, an RN who is certified as a pediatric-hematology-oncology nurse.

Pediatric oncology nurses perform a wide variety of procedures in both inpatient and outpatient settings. Assessments have to be made to determine whether a child is healthy enough to tolerate chemotherapy or other treatments, some of which the nurse administers under doctor’s orders. During treatments, the nurse performs more assessments looking for potential side effects, including life-threatening reactions. They’re also dealing with the child’s family, likely at one of the worst times of life.

At Aflac Cancer Center, where Emily works with

patients who need hematology and oncology services, as well as

those requiring transplants, the nurse-to- patient ratio is low.

Rarely will Emily be caring for more than three patients in a shift, she said.


That’s why the patient-to-nurse ratio in childhood cancer is usually low. For instance, at Children’s, where Emily works with patients who need hematology and oncology services, as well as those requiring transplants, she usually sees no more than two or three patients during her shift.

In many cases, the patient-nurse relationship can go on for weeks or months, not days as is the typical hospital stay for other patients, Emily said.

“I’m a strong believer we work as hard as any nurse in ICU,” Marguerite said.

Most pediatric oncology nurse practitioners, such as Marguerite and Emily work at a hospital in a specialized pediatric oncology unit – typically either a children’s hospital or a hospital with a general patient population that has a wing dedicated to children’s cancers.

But there are exceptions, such as Laura Hacker, a registered nurse who works with Georgia Urology. She isn’t officially a pediatric oncology nurse, but she works in pediatrics and is involved in treating young patients who are battling cancer.

Recently, she was part of a team treating a teenager who had gone to his primary care physician after noticing a testicular lump. The boy was referred to Georgia Urology and was set up to have a mass removed the next day, Hacker said.

The tumor had metastasized and was much worse than originally thought, she said.

“As a mom myself I felt pretty bad giving that kind of news to a mother and son. Nonetheless, we helped them and referred them on for the appropriate treatment,” Hacker said. “I think we make quite a difference in the lives of pediatric patients, as well as the parents.”

Hacker worked in primary care pediatrics for many years before joining Georgia Urology nine years ago.

“It is certainly rewarding to be able to help someone overcome a diagnosis, such as cancer,” the mother of two said.

The first step to becoming a pediatric oncology nurse is to complete a registered nursing program, which usually takes between two and four years. Once through the program, the next hurdle is to obtain a state nursing license.

Emily found that her courses at nursing school focused more on adult s than pediatrics. Built into her first year at

Aflac Cancer Center was plenty of training classes to fill in the gap, she said.

Childhood Cancer Statistics

  • The parents of about 15,700 youngsters hear the words "your child has cancer" every year
  • Cancer remains the No. 1 cause of death by disease in children
  • New diagnosed cases have not declined in nearly 20 years
  • 12 percent of children diagnosed with cancer will not survive
  • The average age of the children being diagnosed with cancer is 6
  • More than 40,000 children undergo treatment for cancer each year

Source: CureSearch for Children’s Cancer, a national non-profit foundation that works to accelerate the search for cures for children’s cancer. See: https://curesearch.org/

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