Everyday life of a nurse in the children’s cancer ward

SZ-Magazine: Mrs. Ruf-Büttner, even before Corona there was a nursing shortage in Germany. Why did you choose nursing anyway?

Sophia Ruf-Büttner: When I was doing my social internship in the hospital in the 11th grade, it was already clear to me after five minutes: This is what I want to do. After graduating from high school, I completed my training as a pediatric nurse.

Today you work in pediatric oncology. Why this station?
I was trained in the children’s ward of a small hospital. Since the children there were not seriously ill, they could usually be released after just a few days. After the training, I wanted to learn new things and look after children with more complex clinical pictures. In oncology, I can accompany children over a longer period of time.

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Is there a case that you particularly remember?
Many cases touch me in different ways. But what has kept me very busy over the last few months is the case of a small child. He came to us last April with leukemia and received his first chemotherapy regimen. At first everything went well. The child was bright and talkative. But then the girl fell ill with Covid, which led to severe pneumonia. Eventually, it was transferred to the intensive care unit, where it had to be ventilated for several weeks. It looked very critical several times. A stressful and traumatizing time for the whole family. When the child finally came back to us in the oncology ward, it was physically severely marked and weak from the long ventilation period. Nevertheless, it started babbling again immediately. His happy nature hadn’t changed. We didn’t expect that. Eventually it was released and has continued to develop well since then. Since then it has also visited us once and shown what it is already capable of. That was so nice to see and touched me deeply. The family bond was also very special.

How would you describe the solidarity of this family?
Very tight. The child was never alone. His mother was there every night and his father also during the day. In this way, they were able to take on tasks and relieve each other. Every morning his father would bring him obazda or other of his favorite dishes.

How is the child today?
Unfortunately, his treatment was delayed due to the Covid infection. But now the intensive therapy on the ward is done. At home, the child currently still has to take tablets. It’s really on the right track.

The families are sometimes on the ward for months. How is your relationship with them?
I would call it a close relationship. We have one big goal: to make this difficult situation as pleasant as possible for the child and parents. However, I also have to keep a certain distance. That’s part of the job. But of course I think about some cases longer or sometimes even dream about them.

Do you have any other examples?
At the beginning of last year we took in many families of children with cancer from Ukraine. They arrived at the clinic at the beginning of the war after a two-day bus journey. Several days and nights lay behind them in the basement of a Kiev hospital. Some children were in a very unstable condition. They were malnourished, dehydrated and some had infections. There was also trauma from the days under the siren alarm in Kiev. Some of these children are still being treated by us today. Although I always got along very well with the work and the emotional stress, these cases took a toll on me and often didn’t let me go even after work was done. On the one hand, I admire the strength of the families who handled this terrible situation so well. On the other hand, I was often very sad because I just couldn’t understand why things like this happened.

Then how do you distract yourself?
I do a lot and like to travel. But actually I don’t have to distract myself much, because I connect the children primarily with their joy and less with their suffering.

The children on your ward often have a long road ahead of them. How are their fears expressed? How can you take care of them?
At first the children are often very shy, speak little and cry a lot. They are almost “overwhelmed” by the examinations and therapies and first have to learn how to deal with the new situation. Over time, however, I get to know how some children react to certain things and what then helps them in particular. For example, the child in the case I described was very afraid of changing the dressing. So we agreed with him when exactly we would change the bandage, namely when he felt ready. This way the child could see that we are responsive to their needs. However, we also have offers such as occupational, art or music therapy and clinic clowns who help the children to cope with their fears.

Flu, RS virus and Corona: Many children’s hospitals are repeatedly overloaded, especially in the winter months. Your clinic also reported bottlenecks. Are there days when you are at the limit yourself?
Last winter was very intense for us nurses. Especially when team members were ill themselves and we had to fill the shifts quickly. Nevertheless, these bottlenecks are nothing new. I can’t remember when we last operated our ward with the actual maximum bed capacity. The lack of staff is a constant problem. It’s not uncommon for me to cry after a shift: because I’m overworked, couldn’t eat anything and hardly had time for my patients and could only do the bare essentials. Then there is the emotional burden. This combination is sometimes difficult to digest. In the short term, an appreciative conversation with my colleagues from the team helps me. In the long term, however, real change is needed. Caregivers from abroad often wait more than a year before they are recognized and allowed to work here. I know of one case that even took three years to be recognized. In addition, the working conditions of the nursing staff must be improved.

Do you feel sufficiently valued with and in your work?
No, unfortunately not. Some think we only carry out doctor’s orders, but care is much more than that. I also think that people in social professions give more of their own accord and help each other. How often do I get called in my free time and asked if I could step in? When I have time, of course I do it too, for my team and the children. If politicians don’t act, we’ll just have to help ourselves.

Again and again one hears: »Care? I could not do it”. What do you say to such statements?
I think these people have a completely wrong image of the nursing profession. I always tell them how enriching my work can be. The parents of the child I told you about with leukemia once said to me, “Your work will make you happier in life than many others.” I think that sums it up pretty well.

How can more people be attracted to this profession?
A one-time 500 euro Corona bonus does not bring much. We simply need more caregivers so that we can give children and parents more attention and time. This is so important to build a relationship of trust.

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