The Value of Time in Cancer Care

From left: DAYNA HARDEE, RN, and ANNA JIMENEZ, M.S.N., RN, CCRN-K, CNML

PHOTOS BY JACKIE CEJA

As a child, Dayna Hardee, RN, understood the value of time. She frequented the convalescent home near her house to see if there were any residents who didn’t have visitors. Dayna spent time with those residents and helped brighten their days. She treated them like precious family members, consciously being present and just listening to them.

Dayna’s grandmother remembered how she always had an affinity for caring for others. In elementary school, Dayna spent her lunch time with autistic classmates, sensing their need for inclusivity and acceptance.

In the back of her mind, Dayna knew that she was destined to be a nurse. But she limited herself to what she felt she was capable of doing. She wasn’t good at math and knew that a health care career would require math courses. Dayna was fortunate to have people in her life who had confidence in her. She strongly feels that what is echoed in other people’s affirmations strongly impacts the trajectory of our lives.

When Dayna was a young adult, her father was diagnosed with emphysema. He was given weeks to months to live. Even though she was a newlywed, she moved in with him to care for him. She was blessed to be able to spend a year with him.

During countless hospital visits, Dayna developed a sense of when a great nurse came into the room, and what a huge difference it made. In the hospital, Dayna slept on the floor, but great nurses always made her feel comfortable. Dayna felt an overwhelming calling to make people feel loved, to dedicate herself to making people feel seen, heard and cared for.

When Dayna’s father was diagnosed, she was working at a doctor’s office. Her employer told her that her position would always be there for her whenever she returned from taking care of her father. The fact that this doctor valued Dayna as an employee had a tremendous positive effect on their clients. When she went back to work after her father’s death, her co-workers encouraged her to pursue a health care career. The words of the doctor pushed her to get through nursing school.

The exhortations of this early mentor convinced Dayna to become a nurse. She began an extensive career that spanned forensic nursing, cardiac transplant nursing, pediatric home health, hospice and, finally, oncology for the past 13 years.

She loves what she does, connecting with patients every day. She encourages patients, letting them know that someone has their back, someone is praying for them and someone is responding when they have a need. On her badge is a pin in the shape of a basin: This symbolizes her being a servant to her patients. She believes there is always an opportunity to make someone feel that they matter.

On her way to work, Dayna prays for opportunities to make patients feel like they are the only one being treated that day. She wants to be certain that patients know nurses especially feel for them when they are going through something scary, such as cancer. Patients leave an indelible mark inside of Dayna’s heart. She feels privileged to care for her patients.

Dayna has mentored numerous nurses and those aspiring to be a nurse. She has many conversations with nurses about their strengths and explores every nurse’s inner motivation, as this drive is what makes nurses capable of exceptional patient care. Dayna encourages others to follow their dreams and passions, to be the voice of encouragement for others, just as some people were for her.

Nurses are lifelong learners, constantly adding to their knowledge. Dayna is back in school at an accelerated online university so she can stay abreast of the rapid advances in science and evidence- based nursing studies.

Oncology is scary. Dayna feels that nurses must take time to listen carefully to their patients. The medical environment can be so fast paced. When patients face insurmountable obstacles in their prognosis, for example, another site of cancer popping up, Dayna offers to pray with them. For Dayna, holy moments are when time stands still in an exam room. A patient is vulnerable or tearful. Dayna is able to stop, be present and provide guidance for patients to tap into where they find their strengths, to find that secret strength within themselves in difficult times. Dayna opens windows of opportunity by asking her patients, “When you’ve gone through difficult things in the past, where did you draw your strength?” She cherishes the times when she provides patients with the confidence to fight their cancer.

Dayna has been a nurse for so long that nursing and all it entails has become second nature to her. The intensive listening, deliberate inquiries and utilization of all her senses toward the assessment of physical, emotional, spiritual and relational nuances happen simultaneously.

Dayna believes that nursing also involves the development of sharply honed time management skills to create space to respond to the stimuli around her. Body language, emotions, eye contact, tone of voice and demeanor are all clues to a person’s well-being, in addition to the vital signs, lab values and physical assessments medical professionals rely on. So much of what we learn and assess about a patient requires intuitiveness and sensitivity, and so much can be missed due to distractions, including rushing to get to the next patient.

Over the years, through many realms of nursing, Dayna has been blessed to walk beside the most exceptional people facing the most frightening things they have ever faced. As an oncology nurse, the experiences Dayna had prepared herself to be aware of are things that might ordinarily be missed. She has been recognized by multiple patients for the remarkable moments they shared with her.

Dayna recalls a tender, elderly man who came in alone. He was terrified of chemotherapy for reasons he could not articulate. Dayna pulled a privacy curtain around them in a busy infusion suite, and just sat with him as he cried and shook with fear. He needed space, he needed to be able to express himself in whatever capacity he could manage, and he needed to feel like he wasn’t alone. This man had endured a series of terrifying surgeries to remove parts of his face. Due to his subsequent facial disfigurement, he was accustomed to hiding and remaining unseen. He really needed someone to draw close and use soft eyes to see the inside of what he had gone through on the outside. Dayna felt it was a priceless gift that he trusted her in his moment of vulnerability.

Another special moment occurred when Dayna prepared a radiation patient for a consultation. When Dayna rolled up the patient’s sleeve to take her blood pressure, extensive bruising on the patient’s arm was exposed. The bruises looked as though they were caused by a hand. Dayna stopped her task and asked the patient questions related to her injuries. The patient started sobbing and shaking and shared that her adult daughter, who lived with her, had been abusing her for years. She said that her cancer diagnosis was bringing out the worst in her daughter, who drank heavily, and that her daughter was taking it out on her. It was a moment to put the brakes on, a situation that required unusual space involving multiple departments and law enforcement. Developing trust with this patient was essential for Dayna to ensure her safety at home.

Dayna believes that you cannot plan time for these things; you make time for them. You build teams around you so that when things happen, you have the ability to manage them correctly. Extreme sensitivity and the collaboration of multidisciplinary teams — both inside and outside of our facility —were needed in that situation. Without a collaborative team, the care and observation required for this circumstance wouldn’t have been possible.

Another patient shared a sacred time she was able to spend with Dayna. This patient was diagnosed with a rare and aggressive form of breast cancer. She was a medical social worker at a nearby hospital, but felt completely knocked down when she became a patient. She first met Dayna when she started her radiation therapy. Dayna sat with her, highlighted what she could expect and explained the importance of skin care. Dayna answered all her questions, but above all, made her feel comfortable about the treatment she would receive.

In the words of the patient: “My skin became extremely uncomfortable, and, finally, I was experiencing 10 out of 10 pain. Dayna became a daily part of my treatment plan. At first, Dayna had me try different over-the-counter products designed for the treatment of skin after radiation therapy. When that was ineffective, she recommended a topical antibiotic cream, which proved to be highly effective. Dayna started meeting with me after each radiation treatment, where she personally bandaged my skin so I could go back to work. She took pictures, coordinated with other radiation nurses and researched different treatments for my skin care. She took time out of her busy schedule to eagerly train my nursing friends on how to care for my skin in the evenings and weekends. When I finally finished all my radiation therapy, to my surprise and absolute amazement, Dayna insisted I come back at least three times a week so that she could dress my wounds and monitor my skin. Dayna made an extremely unbearable situation bearable. She gave me hope that everything would get better, and she was right. Dayna was there every step of the way. Dayna allowed me to believe I didn’t have to go through the struggle alone and allowed me to believe someone cared. I have never met a nurse who gives so much of herself or cared so unconditionally.”

Dayna extends her nursing career outside of her City of Hope oncology nurse role. For 15 years, she has served as a nurse on medical mission assignments to countries such as Vietnam, Laos, Myanmar, Thailand, India and Nepal. The agency she volunteers with trains people in local villages on how to provide basic medical and nursing care to their communities, as well as provides them with preventive health education classes and clean water initiatives. They perform medical and dental clinics, provide first aid, and help with sanitation practices to prevent food and water borne illnesses. Dayna has served on the board of this international ministry for the past four years. She also works with The Dream Center in local cities and the Bread & Water Ministry in Riverside, California.

Nursing is a way of life for Dayna, one that reaches far beyond the walls of City of Hope, crossing boundaries and borders locally and globally. Dayna loves what she does and loves the people she gets to meet and the time she gets to care for them. For Dayna, it is a privilege to be a nurse and an honor to be considered for the CURE Extraordinary Healer Award.

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