An Oncology Nurse's Mission to Teach

Back when we had a hematology/oncology fellow from Myanmar, we had the curious irony of a young woman from Myanmar winding up in our hospital with a new diagnosis of acute myelogenous leukemia. She knew almost no English and little of the official language of Myanmar but was very fluent in her own local language.

Substantial communication over the next several months could occur only on Saturdays when someone was available and fluent in both English and the patient’s native language. Far more common, however, is when I try to work with my “little bit of Spanish” and my patient’s “little bit of English” and manage to pretend that proper communication has taken place. All too often, of course, something is lost in translation.

Alicia Castanon, M.S.N., OCN, APRN, FNP-C, is an extraordinary person and an extraordinary healer who has opened the lines of communication between our patients and staff.

Over 45 years ago, I took Texas’ famous River Road from Presidio to Lajitas, and I still clearly remember the ups and downs and the unique wilderness beauty of the area. The Rio Grande is the 20th-longest river in the world, starting at the foot of some of those “fourteeners” in Colorado and going through a series of dams in New Mexico. There is usually no water at all from El Paso to Presidio, but there the mighty Rio Conchos from Mexico brings the water that gives life to the canyons of the Big Bend. On River Road is a small community called Redford, and Alicia grew up there with Spanish as her native tongue. Thanks to the river, her experiences were largely agricultural, with a diet supplemented by fish, chicken, hogs, goats and deer. Chasing chickens was fun, but Alicia had dreams of something else.

After working as a teacher’s assistant and striking that one off the list, she ended up with an associate degree in business and computers and was able to work in retail for a few years. Then something dreadful happened, and the painful memory lives on to this day. Alicia’s only son became ill in 2001, and soon the dreaded diagnosis of severe aplastic anemia rocked the family. There was a temporary ray of hope because her 8-year old daughter was a perfect match for a stem cell transplant, which happens in about 1 in 4 cases. However, her son died after the transplant due to lung complications, just two months after diagnosis at the age of 14.

Sometimes tragedy can be a catalyst for change. It was during this trial and afterward that the thought of being a nurse came into Alicia’s mind and heart. She had seen some good nursing and some not-so-good nursing and was convinced that she could become a good and compassionate nurse. According to Alicia, “God insisted to make me understand my mission, as painful as it was.”

She didn’t like to see pain or blood, and English was her second language, but she kept pushing herself, and that brought her to where she is today. Alicia became an oncology-certified nurse in April 2012 and has been a consistent presenter and participant at the annual regional Oncology Nursing Symposium since that year. Along with other oncology nurses, she served Thanksgiving and Christmas dinners to the local Hope Lodge residents from 2012 to 2019. Our Hope Lodge, sponsored by the American Cancer Society, provides lodging to a large number of patients with cancer and their families who live 40 miles or more from Lubbock, Texas.

She worked at the Covenant Medical Center in Lubbock for about five years, was involved with hospice nursing for about one year and came to the Southwest Cancer Center (SWCC; now UMC Cancer Center) and the University Medical Center, or UMC, in 2011. She has been a part of eight committees here and has received numerous awards, including the UMC All-Star of the Month, Guardian Angel Award and Employee of the Month, all in 2015, and the Guardian Angel Award again in 2016. Most impressively, she was named the SWCC Nurse of the Unit for 2014.

At our cancer center, she focused on chemotherapy administration for about two years, and then Alicia used her excellent bilingual skills as a patient and staff educator for about two years. In June 2015, she became our assistant director of nursing and a clinical educator. Two years later, Alicia became the community outreach coordinator for our center. In a curious life twist, she didn’t enjoy teaching at the beginning of her career and yet has been quite a teacher for the past six years.

What is it that she treasures the most about her nursing career? In Alicia’s own words: “When I teach Spanish-speaking individuals (about their cancer, treatments and side effects) and I see the light of understanding in their eyes, that is priceless to me.” Alicia has helped as a translator for me on multiple occasions. She speaks Spanish in a way that is effortless, emotional, expressive, thorough and accurate, and she looks into people’s eyes to see that they understand. About one-third of our patients are Hispanic, and half of those are quite fluent in English. But for the rest, Alicia’s skills are priceless.

Alicia pushed forward yet again to get her family nurse practitioner degree in May 2019. She has a new interest in cancer survivorship to add to the list of what she is already doing. On a personal note, she has been married for 33 years, and her daughter has continued the tradition of providing compassionate and excellent care as a nurse.

Alicia Castanon is always willing to go the extra mile, and for that she deserves recognition.

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