During the morning shift change, Charlie, an RN, receives a report on Ellis, age 52, who was admitted three days ago for severe abdominal pain and persistent diarrhea after cycle 3 of high-dose ipilumumab and nivolumab.

When Charlie and the certified nursing assistant (CNA) enter Ellis’s room, the patient is sitting up in bed caressing hands with a woman of similar age. Ellis requests help getting into the shower, so Charlie says to the CNA, “Please, help him shower, and I will finish introductions.” 

Ellis interrupts Charlie. “I am not a he!” 

Practice reflection is a critical element of self-care for an oncology nurse, and one way to reflect is through storytelling. Whether it’s sharing your own stories or your patients’ stories, writing them down and speaking them aloud to yourself, your family, a small group, or more can be a healing self-care experience.

As a direct line to the oncology team, the phone conversations between nurses and their patients can help address symptoms, foster valuable patient education, provide useful interventions, encourage side effect reporting, and identify potentially life-threatening situations. Ultimately, successful telephone triage requires a unique skill set for oncology nurses to communicate with their patients and recognize underlying issues.

Advance care planning (ACP) is a process for patients and their families to discuss their wishes and goals of care for treatment and end-of-life care, clarify related values and goals, and state preferences through written documents and medical orders. In situations where a patient’s decision-making capacity is limited, healthcare providers turn to family members to make decisions. When no ACP conversations have occurred between patients and their families, family members are left to make decisions regarding life-sustaining treatment without input from the patient or with little knowledge of the patient’s wishes.

One of the biggest challenges in medical practice is finding a way to spend enough time with each patient amid all the regulatory paperwork. To streamline workflows and encourage better provider-patient relationships, the Centers for Medicare and Medicaid Services (CMS) proposed new reforms to roll back certain regulatory efforts that were saddling clinicians with cumbersome paperwork. As part of those efforts, CMS reevaluated some of its reimbursement methods to improve efficiency with its required paperwork.

The medical terms for living with and beyond a cancer diagnosis identify patients as entering the survivorship phase of their cancer journey. However, as science continues to develop new treatments responsible for extending patients’ lives, new levels of survivorship are being determined.

One of your patients is enrolled in a clinical trial and is scheduled to receive an investigational drug today. She reports a cracked tooth and asks if it’s okay to get dental work. What should you tell her? 

A. To Set up an appointment with her dentist between treatment cycles. 

B. To check with her research team before setting up a dental appointment. 

C. Not to have any dental work done since she’s on a clinical trial.  

D. Have her tooth fixed right away and let the research team know if you have any problems. 

On March 6, 2018, 23andMe—an at-home genetic testing company—announced their direct-to-consumer genetic test (DTCGT) would include DNA results for the three common founder BRCA mutations commonly seen in people with Ashkenazi Jewish ancestry. This was big news because DNA results for the BRCA mutations had been previously available on the 23andMe panel report until the U.S. Food and Drug Administration removed them in 2013.

Despite groundbreaking treatments, novel medications, fast-tracked drug approvals, and cutting-edge science, a terminal diagnosis is still a reality for many patients with cancer. Having end-of-life discussions with patients and their family members is a difficult part of oncology nursing, but it’s necessary to provide the highest quality of care and education possible. With more news reports emerging about states introducing—and passing—medical aid in dying legislation, oncology nurses will face questions about the process from patients and caregivers.

Imagine being in a hospital, unable to verbally communicate and having to find a way to get across your basic human needs. As oncology nurses, we take care of a variety of different patients: some able to make their needs known and some who unfortunately cannot.

More than 13,000 children are diagnosed with cancer every year in the United States. Because treatment options continue to improve, more than 80% of those children will survive at least five years after their diagnosis.

Roxanne, a blood and marrow transplant certified nurse, has been taking care of Jerome, a 20-year-old man diagnosed with acute myeloid leukemia. Jerome is the eldest of seven children; his mother works full-time, and with younger children at home has not been able to make the trip across country to be with her son.

Writing images from one’s memory and imagination can be a healing act. According to a recent study on expressive writing and patients with cancer, some individuals may benefit from participating in expressive writing as part of their supportive cancer treatment. The writing act can be a form of healing for patients struggling with their cancer diagnoses.  

Direct-to-consumer genetic testing (DTCGT) has entered the prime-time stage. It’s difficult to watch TV without seeing ads touting the simplicity of DTCGT and what it can tell you, and it even made Oprah’s 2017 Favorite Things List.

The MeToo movement, an online campaign where women from all walks of life shared their stories of personal sexual assault and harassment, went viral in October 2017. The goal of their stories was to demonstrate the prevalence of sexual misconduct, especially in the workplace. Victims of sexual violence and harassment often go unnoticed and unheard, even though the World Health Organization (WHO) estimates that it affects approximately one third of women worldwide. In a 2017 poll of American women, 54% reported “unwanted and inappropriate sexual advances” and 95% said it goes unreported.

Christina is a 29-year-old African American woman with a strong family history of breast and ovarian cancers and a personal history of benign ovarian fibroids. She was referred to your office because of a suspicious lump in her left breast. Because of her family history, Christina is especially worried. You are concerned that Christina could have a hereditary family cancer syndrome, and you know that a comprehensive family history must be obtained.

American author Kurt Vonnegut once wrote, “Laughter and tears are both responses to frustration and exhaustion. . . . I myself prefer to laugh, since there is less cleaning up to do afterward.” Humor has the ability to sooth and heal, and humor often makes grim situations feel brighter and less daunting. Moments affixed with tragedy, grief, loss, and terror can often soften in time, allowing for understanding, acceptance, and sometimes even laughter.

I just finished writing a sympathy card to the family of “Beth.” For the past five years, Beth was in a support group that I facilitate for individuals with advanced cancer. Beth is an example of why I am an oncology nurse. She was an amazing woman. A deliberate thinker, she collected information and made decisions about her health that fit her goals. She once asked me, “How can you continue to care for folks with cancer year after year? It must be hard.”

I arrived at work on Tuesday morning to find my charge nurse handing out blue ribbons, beads, and bracelets to staff.

"March is National Colon Cancer Awareness Month,” she said. “Put on the blue, we're promoting awareness and encouraging people to get their screenings!" I stared at some of my coworkers with ribbons tied neatly in their hair.

It’s important to know that I routinely have to field the question, "Are you sure you're old enough to be a nurse?" I had a feeling the ribbon wasn't going to help my credibility. This was also my second day of caring for a patient struggling to cope in a very tough fight against colon cancer. Would she mind? Would it be insensitive?