Pediatric oncology is known to be a stressful work environment due to the difficult aspects regarding patient care. This known stress related to work and caring for pediatric oncology patients can negatively impact nurses, patients, and families. The purpose of this study is to examine: relationships between patient symptom management and nurse distress; strategies used by nurses to manage symptoms in pediatric patients with cancer; nurse perceptions of the effectiveness of non-pharmacologic or nursing interventions; and nurse distress related to managing symptoms in pediatric patients with cancer. Registered nurses (N=13) at a local children’s hospital participated in an online survey. The survey included the Nurses’ Distress and Interventions for Symptoms Survey (NDISS) and the Stressor Scale for Pediatric Oncology Nurses (SSPON). Descriptive and correlation statistics were used to analyze data. Results showed that the most commonly managed symptoms were pain (100%), nausea/vomiting (100%), hair loss (100%), fatigue (92.3%), worry (92.3%), mouth sores (84.6%), and trouble sleeping (69.2%). On average, participants reported using at least 10 strategies to manage these symptoms. The most common strategies included: active listening, encouraging family involvement, family support, and reducing sleep interruptions. Most participants felt like they managed the symptoms effectively. Overall, the most common stressors for pediatric oncology nurses were related to co-workers (71.8%) and system demands (68.9%). There was no statistically significant relationship between symptom management and nurse distress. Further research should be conducted on the relationship between nurses and significant stressors other than symptom management. Identifying these significant stressors, especially related to co-workers and system demands, would be the first step in the development of appropriate interventions, such as supportive programs, for decreasing nurses’ stress response.

Thesis Completion




Thesis Chair/Advisor

Loerzel, Victoria


Bachelor of Science in Nursing (B.S.N.)


College of Nursing



Degree Program



Orlando (Main) Campus



Access Status

Open Access

Length of Campus-only Access

1 year

Release Date

May 2018