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    How Nurses Can ‘Curb the Spread’ and Support Themselves
    COVID-19
    How Nurses Can ‘Curb the Spread’ and Support Themselves
    June 05, 2020
    The Emotional Burden of COVID-19 Almost Made Me Leave Nursing
    Nurse self-care
    The Emotional Burden of COVID-19 Almost Made Me Leave Nursing
    May 29, 2020
    This Oncology Nursing Month, Access the Value of ONS Local Chapters
    ONS Leadership
    This Oncology Nursing Month, Access the Value of ONS Local Chapters
    May 25, 2020
    How COVID-19 Is Affecting Oncology Practice in South Korea
    COVID-19
    How COVID-19 Is Affecting Oncology Practice in South Korea
    May 08, 2020
    A Perspective on COVID-19 for New and Student Nurses
    COVID-19
    A Perspective on COVID-19 for New and Student Nurses
    May 01, 2020
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    The Case of the Medication Modification
    Treatment side effects

    The Case of the Medication Modification

    Doug is a 70-year-old man receiving treatment at the cancer center for metastatic renal cell carcinoma. He was initially treated with sunitinib, a tyrosine kinase inhibitor (TKI). He has been experiencing significant upper back pain and is having trouble with fine motor skills in his fingers. The oncologist, suspecting spinal cord compression (SCC), ordered a computed tomography scan, which confirmed metastatic lesions in the spine leading to instability and mild SCC. The oncologist refers Doug for surgery and advises him that a new medication, cabozantinib, will be ordered for after his surgery. The oncologist asks you, the oncology nurse, to instruct Doug on surgical preparations and educate him on cabozantinib.

    May 19, 2020
    The Case of the Cryotherapy Consequences
    Cancer treatments

    The Case of the Cryotherapy Consequences

    Janice is 32 years old and was recently diagnosed with triple-negative breast cancer. She is receiving neoadjuvant chemotherapy with doxorubicin and cyclophosphamide, followed by weekly paclitaxel. Janice is a nationally recognized performer (vocal and piano) and is distraught over the possibility of losing her hair or developing chemotherapy-induced peripheral neuropathy and mouth sores. She asks the nurse what can be done to prevent those unwanted side effects.  

    April 14, 2020
    Clear the Clutter With This Chinese Discipline
    Nurse self-care

    Clear the Clutter With This Chinese Discipline

    Physical and mental clutter can negatively affect your mood, productivity, and overall health. Think about how you feel when looking for a misplaced report on a disorderly desk covered with papers stacked atop magazines next to a conglomerate of used cups and scattered pens. Or observe your thoughts as they randomly shift from subject to object and back again. Being in a state of perceived chaos can stimulate feelings of anxiety and biologically increase cortisol levels. 

    March 19, 2020
    The Case of the CDK4/6 Inhibitors Checklist
    Immunotherapy

    The Case of the CDK4/6 Inhibitors Checklist

    Three years ago, Sarah, age 54, completed standard chemotherapy and radiation treatment for stage II, ER- and PR-positive, HER2-negative invasive breast cancer. A recent computed tomography scan, ordered to evaluate persistent hip pain, revealed bone lesions, and a biopsy and positron-emission tomography scan confirmed bone-only metastatic breast cancer. A CDK4/6 inhibitor, ribociclib, was added to the letrozole she was already taking.

    February 18, 2020
    The Case Supporting the Seasons of Survivorship
    Survivorship

    The Case Supporting the Seasons of Survivorship

    Jamie is completing her last cycle of carboplatin and paclitaxel for stage I ovarian cancer. The oncology infusion nurse notices that Jamie appears withdrawn and nervous, so he takes time to ask her how she is feeling about completing treatment. Jamie responds, “I feel as frightened about finishing treatment as I did when I was diagnosed with cancer.” She also shares that she doesn’t want to ring the cancer center’s bell to ceremoniously signify the end of her treatment because she doesn’t want to “jinx it.”

    December 17, 2019
    The Case of the Efficacy Explanation
    Treatments

    The Case of the Efficacy Explanation

    Jenni is an oncology nurse practitioner in an outpatient medical oncology clinic. She is meeting with 70-year-old Don after his first cycle of cabozantinib for treatment of metastatic medullary thyroid carcinoma when he asks why the oncologist put him on a pill instead of using IV chemotherapy. “Is it because I don’t have long to live?” Don wonders.

    November 19, 2019
    Harness Stress for Focus and Productivity
    Nurse self-care

    Harness Stress for Focus and Productivity

    Stress is generally associated with negative mental and physical consequences. But can it actually be a healthy, even sought-after phenomenon at times?

    October 29, 2019
    The Case of the Nicotine Nightmare
    Cancer risk factors

    The Case of the Nicotine Nightmare

    Jill works as an oncology nurse in a large community hospital. While attending a family gathering, her uncle proudly tells her that he and his 17-year-old son are using e-cigarettes to help them stop smoking traditional cigarettes. He comments that his wife now allows them to “smoke” in the house and car because the vapor is relatively odor free.

    October 15, 2019
    The Case of the Safety Session
    Safety

    The Case of the Safety Session

    Doug is a 48-year-old triathlete who was recently diagnosed with chronic myeloid leukemia (CML) after a routine blood test showed an increase in white blood cells and a subsequent bone marrow biopsy showed greater than 20% blast cells. The medical oncologist prescribed the oral drug dasatinib. Doug and his wife meet with Staci, RN, to receive oral therapy education. During the teaching, Doug says his wife will have no trouble dispensing the dasatinib because she already prepares all of their meals and nutritional supplements.  

    August 20, 2019
    The Case of the Explicit Exposure
    Clinical practice

    The Case of the Explicit Exposure

    Mr. Larsen presents to the clinic for his first dose of R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone) for a diagnosis of diffuse large B-cell lymphoma. Elizabeth, his oncology nurse, just started the cyclophosphamide when she is paged to the desk for a call from Mr. Larsen’s oncologist. She quickly removes her face shield and gloves as she hurriedly leaves the room to take the call. After completing the call, she returns to Mr. Larsen’s room to remove her gown.  

    July 16, 2019
    How Music Can Soothe Your Savage Beast—Stress
    Nurse self-care

    How Music Can Soothe Your Savage Beast—Stress

    Where you put your attention matters more than you realize. For example, when you are thinking or talking about work-life stressors, your ability to take in other sensory input is challenged. One way to break out of the mental stress loop is to listen to music. Music can divert the brain’s attention, giving you a break from repetitive thoughts and judgments. The variety of music genres to choose from when looking for ways to shift your attention and enhance mood is ever increasing.  

    June 11, 2019
    The Case of the Terrible Toxicities
    Adverse events

    The Case of the Terrible Toxicities

    After completing neoadjuvant chemotherapy for triple-negative invasive breast cancer, Madeline, age 32, had a bilateral mastectomy with reconstructive surgery. Final pathology showed residual disease in the breast and one lymph node, and her oncologist recommended adjuvant therapy with capecitabine (1,500 mg twice a day for 14 days, off for 7 days). Five weeks postoperatively, she started cycle 1. Eight days later, her husband called the cancer clinic reporting that over the past two days, his wife developed profound weakness, unremitting diarrhea despite using diphenoxylate and atropine as directed, and painful, red, swollen hands and feet. Her symptoms represented a drastic change from her usual routine and energy level.

    May 14, 2019
    Self-Care for the Soles
    Nurse self-care

    Self-Care for the Soles

    The twenty-six bones in the foot are always being stepped on. Getting on one’s nerves takes on a whole new meaning when considering that each foot contains an estimated 200,000 nerve endings. With health enthusiasts recommending 10,000 steps per day, which translates to approximately five miles, is it any wonder that the often-abused soles deserve a little self-care? 

    April 23, 2019
    The Case of the Belated BRCA Test
    Genetics & genomics

    The Case of the Belated BRCA Test

    Eighteen months after completing surgical debulking and chemotherapy for stage III high-grade serous ovarian cancer, 56-year-old Lily experienced a rising CA-125 level. At her oncologist’s recommendation, Lily started an aromatase inhibitor, but it did not stop the rising tumor marker. After she began experiencing symptoms of bloating and mild abdominal pain, Lily and her oncologist decided to proceed with second-line chemotherapy. As she left the office, Lily remarked that she did not complete genetic testing when she was originally diagnosed because she does not have any children or a family history of ovarian cancer and she was concerned that her insurance would not cover the testing.

    April 16, 2019
    Cultivate Cultural Humility in Yourself and Your Practice
    Nurse self-care

    Cultivate Cultural Humility in Yourself and Your Practice

    Oncology nurses interact with other staff, patients, and families, each of whom have various cultural and personal preferences. A person’s culture encompasses race, ethnicity, spiritual practices, social habits, and so much more. 

    February 19, 2019
    The Case of the Gender Gaffe
    Clinical practice

    The Case of the Gender Gaffe

    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!” 

    January 15, 2019
    The Case of the Emotional Emergency
    Psychosocial issues

    The Case of the Emotional Emergency

    Sharon, age 40, was diagnosed with invasive ductal carcinoma. Pathologically, her tumor was grade I, estrogen- and progesterone-receptor positive, and HER2 negative. The mass measured 0.5 cm on ultrasound. Sharon has no family history of cancer and is devastated by the diagnosis. One of her close friends recently died from metastatic breast cancer, and she is certain will have the same fate. She tells Jennifer, an RN in the breast center, that she is going home to “get her affairs in order.”

    November 20, 2018
    Laugh Every Day for the Health of It
    Nurse self-care

    Laugh Every Day for the Health of It

    An uproarious guffaw, uncontainable giggle, or a hearty hoot often has a ripple effect, turning a quiet room into a cacophony of sounds collectively identified as laughter. Humor is generally considered a subjective experience. Laughter, however, can be spontaneous or consciously produced by going through the motions (fake it till you make it). Either way, the overall benefits associated with laughter make it a virtually priceless self-care strategy.

    October 08, 2018
    The Case of the CAR T-Cell Toxicity Test
    Clinical practice

    The Case of the CAR T-Cell Toxicity Test

    Wilson was diagnosed with B-cell lymphoma three days after his 63rd birthday. He underwent chimeric antigen receptor (CAR) T-cell therapy after his disease failed to respond to two lines of systemic chemotherapy.

    September 18, 2018
    The Case of the Coercive Consent
    Clinical practice

    The Case of the Coercive Consent

    Betty, age 70, was diagnosed with metastatic colon cancer and started treatment with FOLFOX. Her medical oncologist changed the treatment to capcitabine after Betty developed grade 3 peripheral neuropathy. Because of disease progression, bevacizumab was added to her treatment plan. She lives with her daughter, is insured by Medicare, and receives $800 per month from Social Security.

    July 17, 2018
    Writing for Wellness
    Nurse self-care

    Writing for Wellness

    No reliable method exists for determining how many conscious or unconscious thoughts a person has in a day; estimates range from 12,000–70,000 daily thoughts for an average of 52 thoughts per minute. Journaling your thoughts and feelings is a way of becoming an interested observer of your thoughts.

    June 25, 2018
    The Case of the Blurred Boundaries
    Clinical practice

    The Case of the Blurred Boundaries

    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.

    May 15, 2018
    Establish Healthy Boundaries by Using Your Inner Compass
    Nurse self-care

    Establish Healthy Boundaries by Using Your Inner Compass

    Eating a balanced diet, drinking plenty of water, and following an enjoyable exercise routine are all part of physical self-care. Along with caring for the physical self, emotional and spiritual self-care also play a significant role in living a healthy and satisfying life. Like physical health, emotional well-being has various components. This article describes how to tune into your inner compass and develop the skill of learning how to set healthy limits by using your yes’s and no’s wisely.  

    April 25, 2018
    The Case of the Pain Paradox: Follow-Up and Clinical Trial
    Pain management

    The Case of the Pain Paradox: Follow-Up and Clinical Trial

    The January 2018 case study introduced Vince, a 55-year-old man receiving chemotherapy and radiation for recurrent bladder cancer. He suffers from chronic back pain because of spinal stenosis and has been on opioid therapy for nearly two years.

    March 20, 2018
    The Case of the Pain Paradox
    Pain management

    The Case of the Pain Paradox

    Vince was diagnosed with non-muscle invasive, high-grade bladder cancer at age 54 and treated with intravesical Bacille-Calmette Guerin immunotherapy. He stopped smoking and began a consistent walking program. 

    January 16, 2018
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    Deborah Christensen MSN, APRN, AOCNS®
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