Peds Hem/Onc Nursing: How I Got the Job, Why I Never Looked Back

Two whole years as a pediatric hematology/oncology nurse this July. If my younger self could see myself now…see all that we’ve seen, the tragedy and the joy, the tears and the laughs. Being a nurse has brought every emotion out of me. It’s taught me to put aside my fears and worries going on in my own life, and step into someone else’s chaos and hardest days, to be whoever they need me to be, in order to carry some of the weight and help care for their child.

It's funny—looking back through all the blog posts I've written, I talk about hem/onc all the time. I write about the incredible kids I get to care for and the nurses I work alongside who keep me going. But I'm not sure I've ever really dove into why I chose this unit in the first place. Why I heard every concern from family and friends about going into such a difficult specialty...and did it anyway.

So for the nursing students and nurses who are curious about pediatric oncology, I want to share what getting this job actually looked like for me. The fears I had before starting, what surprised me once I got here, the little things that help me avoid burnout, and why, two years later, I can confidently say I haven't looked back on my decision once.

I first turned my head toward pediatric hematology/oncology during nursing school. One of my clinical instructors mentioned a former student who now worked on the hem/onc floor at the children's hospital in Birmingham, Alabama, and something clicked. As heavy as oncology sounded, it also checked every box of what I wanted in nursing—building close relationships with patients and families, working somewhere my calm and warm personality could maybe make a difference, finding purpose in my work, and honestly, I was fascinated by the science behind cancer and chemotherapy.

From there, I became a little obsessed. I told my parents about it, researched hospitals with pediatric hem/onc units, watched countless TikToks from nurses sharing day-in-the-life videos and advice on getting hired, and read about burnout and how to care for yourself while caring for children with cancer.

Eventually, I reached out to the very nurse my instructor had mentioned, and we talked about her role, what she loved, what was difficult, and what life as a hem/onc nurse really looked like.

What stuck with me most wasn't the conversation itself—it was what happened afterward. She checked in throughout the week, asked how she could be praying for me, gave me nursing school advice, and even sent voice memos celebrating when I eventually got my own hem/onc job. We'd never even met in person, but I remember thinking, I want to be that person for someone else one day.

A few weeks later, she helped me arrange a shadowing experience on her unit. I still remember it so clearly. I met a teenage boy who calmly told his nurse he was sure the symptoms that brought him back to the hospital meant his cancer had returned. Next door was a toddler struggling through severe chemotherapy-induced nausea. It was heartbreaking—but after spending those hours talking with the nurses, meeting the patients, and seeing the unit firsthand, I didn't feel discouraged. If anything, I felt more certain.

I remember calling my mom from the parking deck afterward and telling her, "I’ve got to be a hem/onc nurse."

About six months later, I started applying for jobs. As a brand-new graduate with a résumé full of restaurant jobs, summers working first aid at a youth football camp, and a medical mission trip through nursing school, I worried I wouldn't stand out without hospital experience.

I quickly realized the path to hem/onc would be through a nurse residency program. It meant spending my first year learning alongside a cohort of new nurses through classes, simulations, and specialty education. Looking back, I can't imagine starting any other way. It helped me build confidence, develop close friendships with coworkers, and ease into a specialty I knew I still had so much to learn about.

I had my heart set on one city and one specialty, so I only applied to two hospitals—which feels a little crazy now.

Then one day, I got the call. A recruiter told me the pediatric hematology/oncology unit at my top-choice hospital wanted to interview me.

Interviewing has always made me anxious, so I may have gone a little overboard. I made a ten-page document full of interview questions (thanks, ChatGPT), some general and some specific to pediatric oncology. For about three weeks, I practiced answering them out loud. I'd sit in the lounge of my Chi O house while my friends fired question after question at me.

Shoutout to them, they definitely earned part of that job offer.

On February 6, 2024, I walked into my interview. The very next day, I was tearing up on the drive back to Tuscaloosa after getting the call that I got the job.

My dream job.

To this day, I'm incredibly grateful that this is where I ended up. I wish I could tell you there was one thing that made my application stand out, but I honestly don't know. I prepared as much as I could, showed up excited to learn, and hoped they saw someone who genuinely wanted to be there.

What I do know is that every person who interviewed for that position probably wanted it just as badly. Many of them likely felt the same pull toward pediatric hem/onc that I did. Knowing that makes me even more thankful that I get to do this work every day.

As I prepared to start this job, sitting through weeks of hospital orientation before ever stepping onto the unit, I remember every fear that crossed my mind. I was afraid of how often I'd witness children dying. I wondered if I'd be able to carry that kind of grief. I questioned whether all the warnings from family and friends were ones I should have listened to.

Those fears didn't disappear overnight. But somewhere between a patient asking if I'd be their nurse again the next day and a parent telling me they trusted me with their child, I started to realize I was exactly where I was supposed to be.

Nursing will always come with fear. The question is whether it's the kind of fear that keeps you careful or the kind that keeps you from doing something you're called to.

I still get nervous every time I give chemotherapy with the potential for a severe reaction, no matter how much I prepare or how many resources I have at the bedside. And I hope I never lose the part of me that feels the weight of the hard days.

One of the things I never expected was how quickly the hospital becomes part of a child's everyday life. A port access isn't scary because it's unfamiliar—it's routine. A three-year-old instinctively lifts up their arm for a blood pressure cuff because they've seen one more times this month than they've seen their own sibling eagerly waiting for them at home.

If there's one fear I hope I never lose, it's the fear of becoming numb to those moments.

As I'm about to hit the two-year mark as an RN (can I still call myself a new nurse?), I've picked up a few little habits that help me through the rough shifts or the days when the emotional weight of the job catches up with me. They may not work for everyone, but they've made a difference for me!

The first is simple: I put on makeup before every shift and love putting together fun scrub combinations. It sounds small, but feeling put together on the outside helps me feel more awake, confident, and ready for whatever the day brings.

And then there are the patients. Building relationships with patients and families is what keeps so many of us grounded. On the hardest shifts, I've found that taking a few minutes to stop by a room that isn't even assigned to me–just to say hi to a patient I know will make me smile—can completely change my day. And it will most likely brighten theirs in return.

One thing that surprised me about pediatric hematology/oncology is that some of the hardest parts of the job are difficult to explain to people outside of healthcare.

But on the other side of that is something I'm incredibly grateful for. Very few people get to experience the kind of relationships we build with our patients and families. They're honest, vulnerable, and unlike anything I've experienced anywhere else. In pediatric hem/onc especially, we walk alongside families through some of the hardest seasons of their lives. We have these raw, heart to heart moments with patients that some people go their whole lives without experiencing. As nurses, we become deeply connected—not just to our patients, but to each other too.

So, why haven’t I looked back since starting this job?

What keeps me here isn't that the job has gotten easier. The losses still hurt, there are days I drive home emotionally exhausted, days when I question how many years it will be before my heart can’t keep making room for all of it.

But I strongly believe God keeps opening my eyes to moments that remind me to stay. I smile at little hands reaching for mine before a procedure. The bell-ringing celebrations that make me tear up every time. The birthdays I get to decorate posters and patient rooms for. The ordinary conversations that become unforgettable.

Friends and family asked me before I started if I was sure I wanted to work in pediatric oncology. But what I've learned is that this specialty isn't defined by cancer. It's defined by people.

It has taught me that joy and heartbreak often exist in the same room, and courage I could only hope to have can come in the form of a three-year-old walking onto the floor with a superhero backpack. 

So, two years later, would I choose pediatric hematology/oncology all over again?

Without hesitation.

Because somewhere between the fear that almost kept me from applying and the families who have forever changed me, I found exactly where I was meant to be.