The sliding glass doors open, the elevator hums and clicks floor by floor, footsteps are rapid up and down the hallway, and you can hear the infusion machines percolating like coffee makers. Walking into work on an oncology unit is never accompanied by the thought, “I wonder if I’ll be busy today?” There’s no question. It’s an absolute certainty.

More often than not, the question oncology nurses are asking themselves before every shift is, “Which treatments am I administering today, and who gets them?” As more new treatments enter practice—like immunotherapy, targeted therapy, and combination therapies—oncology nurses are required to be experts in every treatment they administer. They need to constantly walk a tightrope, balancing multiple medications for one patient then quickly moving to the next patient on a completely different treatment protocol.

ONS member Marianne Davies, DNP, ACNP, AOCNP®, administers a litany of different treatments to her patients. “I see several patients each day undergoing combination and immunotherapy. Several are on clinical trials that are evaluating the use of combination immunotherapy, combination chemotherapy and immunotherapy, and combination immunotherapy and targeted therapy,” Davies says.

“It is challenging to manage patients on new combinations of therapies,” Davies continues. “We might have a solid working knowledge of potential side effects and management issues with single-agent therapies. However, in combination, the effects may be synergistic.”

Science is advancing rapidly in many areas of oncology care. New immunotherapy indications are being approved quickly, traditional treatments are continuing to evolve, and symptoms for adverse events—and how they’re managed—can differ wildly from treatment type to treatment type. Oncology nurses are on the precipice of these changes and must be prepared to keep their patients safe from medication errors and adverse reactions.

A survey of ONS members to determine the extent and type of medication errors found that 63% of respondents reported evidence of medication errors occurring in their patient care settings. Errors included incorrect dosing, the wrong drugs being administered to the wrong patients, drugs being administered incorrectly, and errors in preparation. Staying educated and alert, along with performing institutional checks for multiple cancer therapies, can help oncology nurses reduce potential risks to patients receiving treatments.

Resources for Managing Multiple Treatment Plans

ONS’s new cancer therapies resource area was created to help eliminate the challenge of administering multiple treatments, combination treatments, immunotherapies, and more to different patients. By consulting a unified source for treatment information, oncology nurses can enhance their education on a number of topics, such as cancer-related surgery, chemotherapy, biotherapy, and hormonal therapy, complementary and integrative therapy, bone marrow transplantation, radiation therapy, and more. 

Remaining current with combination therapies and different treatment protocols is essential in practice. Communication with patients is also key to understanding any changes for patients, so they can be addressed quickly. “Clinicians and nurses must remain alert to potential complications and support patients to communicate any news or progressing symptoms,” Davies says.

Patients with cancer have unique treatment plans that create equally unique needs. Understanding the complexities of care can help nurses prevent safety errors and avoid potential adverse events while managing patients with differing treatment plans and protocols. Visit ONS’s cancer therapies resource area for more information.

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