As a national nursing organization with a specialty in cancer care, ONS occupies a unique space in the healthcare public policy environment. When nurses speak, decision makers listen, because nurses are the most trusted healthcare providers. This is not an insignificant fact to those who decide how to implement health policy decisions through law and the regulatory system.

But as Spider-Man’s Uncle Ben is wont to say, “With great power comes great responsibility.” And that is the case when ONS joins a coalition, promotes an initiative, and helps to advance a congressional bill. This is a responsibility oncology nurses take seriously, because the weight of our organization can help persuade a lawmaker to support a pending bill.


For several congressional sessions now, ONS has joined an effort to introduce and pass H.R. 1676, the Palliative Care and Hospice Education and Training Act (PCHETA), defined as:

“This bill amends the Public Health Service Act to require the Department of Health and Human Services (HHS) to provide support for Palliative Care and Hospice Education Centers. These centers must improve the training of health professionals in palliative care and establish traineeships for individuals preparing for advanced education nursing degrees, social work degrees, or advanced degrees in physician assistant studies in palliative care.”

The bill is rather specific, narrow in scope, and broad in terms of the provision of care. Introduced by U.S. Representative Eliot Engle (D-NY) earlier this year, the act has wide bipartisan support, with more than 130 Republicans and Democrats already signed on to it.

Coming out of the powerful House Energy and Commerce’s Subcommittee on Health, the bill almost made it through the previous 114th Congress. But as we all know from School House Rock, once a session ends after an election, all bills that have not been passed die and must start all over from the very beginning. The current 115th Congress has until November 2018 to complete all legislation.

Although that may seem like a long time, in a contentious political environment, any number of minor or major incidents can stop a bill in its tracks. Sometimes it stalls for what appears to be no reason at all.

ONS Perspective

As it happens, palliative care is on the top of the ONS legislative agenda. ONS advocates every day for oncology nurses. Our busy agenda in Washington, DC, calls for progress on:

  • Improving cancer symptom management and palliative care
  • Advancing and ensuring access to quality cancer prevention and care
  • Strengthening nursing workforce contributions to safeguard public health.

Because oncology nurses are on the frontlines of patient care, they are keenly aware of the importance of palliation in survivorship. For this reason, it is imperative that ONS be an integral voice in the discussion about palliative and hospice care. In congressional meetings and with federal agency staff, ONS leadership educates elected officials on the process and the continued need for evidence-based research and patient-centered care, in coordinated teams.

Legislation has many versions on different topics from several committees by a lot of members of congress. Right now, know that oncology nurses have real authority on the subject of patient care, and promoting patient-centered care is why decision makers listen. As the U.S. Congress adjourns for the summer months, they have much to consider in how to approach an advocacy campaign before the next election. PCHETA is a powerful and potentially game-changing piece of legislation. But healthcare reform has a lot of string attached to it these days, and few are willing to get their hands dirty for fear of the wrath of constituents at the ballot box.

PCHETA may be a victim to its time. But it also may wiggle its way through. It takes effort and the support of many under the championship of just a few. But if the political stars are aligned, PCHETA has a very real chance of moving forward. And ONS will be a vital part of this process.