APRN Roles Evolve to Address Cancer Screening, Treatment Adherence, and Public Health
Responses to pandemic-related screening and treatment delays have created new opportunities for oncology advanced practice RNs (APRNs), too. In both their institutions and communities, APRNs are guiding patients and providers to reverse the increases in late cancer diagnoses, morbidity, and mortality—ultimately improving outcomes.
Screening and Diagnosis
For several months in 2020, the number of screening endoscopies dropped (https://www.nature.com/articles/s43018-020-0074-y) by 90%. Oncology APRNs have a new role in patient and public education, awareness, and advocacy, communicating the current evidence-based cancer screening recommendations. They’re also advising about new and alternative screening options such as noninvasive imaging.
The face of surgical cancer treatment has also changed: in response (https://ascopubs.org/doi/full/10.1200/GO.20.00632) to medical societies’ guidelines and recommendations, oncology APRNs are now developing tiered levels of urgency or priority for patients with cancer, identifying opportunities to delay selected low-risk patients to prioritize resources for high-risk patients, and improving population-level outcomes.
Approaches for other types of therapies evolved to protect patients at high risk for infection. Decisions to use systemic therapy now factor the higher risk of immunocompromise and potential for worse outcomes. And because it can replace or delay other treatment options or shorten time on treatment for patients at high risk for infection, radiation therapy’s use is expanding (https://www.nature.com/articles/s43018-020-0074-y).
Oncology APRNs are consulting on the cancer care team to individualize treatment strategies based on patients’ age and comorbid conditions, potential for home administration, and need for frequency changes.
APRNs are still involved in patient management, shared decision-making, and psychological support, including symptom management, monitoring adherence, survivorship care, and advanced care planning. But as illustrated in the sidebar, they are increasing (https://www.nursingoutlook.org/article/S0029-6554(21)00097-X/fulltext) their public health outreach, using creativity and innovation, and further supporting interprofessional collaboration.