Clinical practice

Screen for Distress in Patients With Cancer

Living with cancer is much like a maze, Watson said. Even though cancer care is rooted in generalizable knowledge, including specific types of cancer, the stage and pattern of progression, evidence-based guidelines, and side effects and risk factors, a balance must be struck between the general and the specific by focusing on how each applies to the individual patient.

April 30, 2015

Adverse events

Reduce Complications in High-Risk Patients With Cancer

Emergencies in high-risk patients with cancer can lead to complications, and nurses are often the first line of defense to recognize signs and symptoms and initiate a therapeutic response.

April 25, 2015

Clinical practice

Heal Through a Remember Tree

We had a problem—we knew it, and we just couldn’t find the right solution. The problem was that we had no time or way to grieve patients' deaths in our outpatient clinic. When a patient would die, some of the staff members would not find out for days or sometimes weeks. This left staff members feeling angry, sad, frustrated, and embarrassed if a family member would call and that staff member did not know about the patient's passing.

April 16, 2015

Clinical practice

Crush Constipation With This Old-Time Recipe

Constipation is no fun for anyone, but for patients with cancer this all-too-common side effect is especially troublesome. Oncology nurses need to know how to advise patients when they bring up this somewhat uncomfortable subject.

March 17, 2015

Cancer treatments

Outpatient Oncology Drug Series: Confidently Administer 5-Fluorouracil

5-Fluorouracil, or more commonly referred to as simply 5-FU, is a cytotoxic chemotherapy drug that is classified as an antimetabolite and, within that class, belongs to the pyrimidine analogue family.

February 23, 2015

Clinical practice

Educate the Public About Palliative Care

My community hospital serves patients from several, small rural counties and many of the patients that I meet do not have a clear understanding of what palliative care is. Many are afraid of this term and by mentioning it, I have turned the conversation into a negative.

December 23, 2014

Clinical practice

Palliative Care Is Not Just for the Dying

As a certified hospice and palliative care nurse, I was grateful to see the joint response from three nursing organizations that embraced the challenges presented in the IOM report, "Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life," and discussed how palliative nursing can address the key recommendations.

December 09, 2014

Clinical practice

Reference Tool Helps Nurses Monitor Patients Receiving Oral Oncolytics

As the use of oral oncolytics has increased in cancer care, so has the amount of time oncology nurses spend educating and counseling patients and caregivers on their use. Studies have shown that although it’s challenging for nurses to carve out, the time is well spent.

November 11, 2014

Cancer risk prevention

A Healthy Lifestyle Prevents Cancers

The importance of regular exercise and a healthy diet to maintain a healthy weight should not be underestimated. Healthy habits often need to be fostered. They need to be automatic and practiced consistently. The earlier they are developed, the bigger the benefits.

September 02, 2014

Clinical practice

How Do You Define the Role of a CNS?

Although I’ll soon be representing the CNS role, I still have trouble defining it, especially to my patients. This problem isn't unique to me, and it’s hurting the profession as a whole.

July 17, 2014

Clinical practice

How Do You Separate Your Personal Life From Your Profession When a Loved One Has Cancer?

When a family member or someone close becomes ill, it's hard for nurses to be objective. The problem needs to be fixed now because we have the tools. I think this is one reason why the nursing profession is so hard—we are always on call.

July 11, 2014

Clinical practice

Reduce Compassion Fatigue on the Unit

"Burnout is grounded in the work environment, whereas compassion fatigue is grounded in the clinical work." I don't know if I'd ever taken the time to think about the distinctions between the two, but they are important.

June 20, 2014

Clinical practice

What Is the Most Important Thing to Teach Patients About Infection Prevention?

During chemotherapy education, I tell new patients to treat themselves like a newborn. After each cycle of chemotherapy, the immune system, like that of a new infant, is beginning anew.

June 18, 2014

Clinical practice

Do You Prefer a 12- or 8-Hour Shift?

I recently participated in an online discussion that compared the benefits and disadvantages of the 12-hour shift to the 8-hour shift. Nurses were asked to give their opinions on their preferences for each shift and state their reasons for those preferences.

June 10, 2014

Clinical practice

Oncology Nurses Need Education About Survivorship Care Planning

Since the Institute of Medicine called attention to it in its seminal 2005 report, From Cancer Patient to Cancer Survivor: Lost in Transition, cancer survivorship has been a hot-button topic.

May 13, 2014

Clinical practice

The Case of the Lateral-Limb Lymphedema

Sally is a 62-year-old woman who had a mastectomy for stage IIB left-sided breast cancer. She had preoperative chemotherapy followed by the mastectomy, at which time she also had a prophylactic simple mastectomy of her right breast. She completed postsurgical radiation therapy six months ago and is in for a routine follow-up appointment.

March 18, 2014

Clinical practice

Have the Moral Courage to Do the Right Thing

Businessman W. Clement Stone opined, “Have the courage to say no. Have the courage to face the truth. Do the right thing because it is right. These are the magic keys to living your life with integrity.”

March 01, 2014

Clinical practice

What Is Your Level of Genetic and Genomic Competence?

As a child, I was fascinated by Gregor Mendel’s experiments with peas. In those days, dominate or recessive genes were touted as being responsible for eye color and other genetic characteristics passed from parent to offspring. Today we know so much more.

February 07, 2014

Clinical practice

We Need to Focus on Being With Our Patients

Recently, I was caring for a patient diagnosed with metastatic lung cancer. He was a young man with tattoos and a muscular frame whose strong body was just beginning to fail him. In the course of making my hourly rounds I asked if there was anything he needed that I could provide for him. "I wish you could just tell me I won't die."

February 04, 2014

Clinical practice

Make Time for Healthy Eating With These Helpful Tips

It doesn’t take any longer to eat healthy food, but it does take extra planning and time to prepare healthy meals. Over the years I have come up with some time-saving tips and tools that I think you will appreciate.

January 30, 2014

Clinical practice

The Case of the Pyrogenic Platelet Product

Jackie is administering six units of pooled random donor platelets to Stuart, a patient with myelodysplastic syndrome. The transfusion was started at 120 ml per hour, per hospital policy. When Jackie rechecked Stuart’s vital signs at 15 minutes, she noted that his temperature had increased from 37.1°C to 38.1°C. In addition, Stuart was chilling. What would you do?

December 17, 2013

Clinical practice

The Case of the Mind-Altering Mineral

Hal is a 73-year-old patient with refractory multiple myeloma. Florence, his wife, calls the hematologist’s office and asks to speak with the triage nurse. She says she is worried about her husband and that “he’s just not himself.” What would you do?

November 19, 2013

Clinical practice

Telephone Reporting Identifies Symptoms Most Important to Patients

As oncology care continues to move toward delivery in the outpatient setting, the number of patients reporting symptoms by telephone also continues to increase. Unlike face-to-face symptom reporting, telephone reports are initiated by patients or caregivers.

November 12, 2013

Clinical practice

The Case of the Severe Sudden-Onset Swelling

Gina is filling in for the triage nurse at her facility’s outpatient solid tumor department. She receives a call from a patient who reports severe swelling in her left arm after returning from a trip on the opposite side of the United States. She says the skin in her arm and hand is quite tight, and that her hand was throbbing when she woke up this morning. What would you do?

October 15, 2013

Clinical practice

The Case of the Hyperthermic Hypodermic

Erin arrives in your injection clinic for her monthly injection of fulvestrant. She tells you that her regular nurse always warms the drug before the injection by wrapping it in a warm pack because it lessens the discomfort during the injection. She says her nurse also told her it makes the medication easier to administer. What would you do?

August 20, 2013

Clinical practice

Cultural Barriers Keep African Americans From Using Palliative Care

Although use of hospice services continues to increase across the United States, with more than 1.5 million Americans receiving services in 2010, only 9% of hospice recipients are African American.

August 13, 2013

Clinical practice

The Case of the Suspicious Sunburn

William calls your office complaining of painful redness and blisters on his chest. He admits that during the recent warm weather, he hadn’t been wearing a shirt while working in the yard. He initially thought it was a sunburn, but the symptoms continued to worsen and were unrelieved by typical sunburn remedies. Upon reviewing William’s chart, you see that he recently received radiation and chemotherapy therapy for Hodgkin disease. What would you do?

June 18, 2013

Clinical practice

FDA Approves Xofigo for Castration-Resistant Prostate Cancer

On May 15, 2013, the U.S. Food and Drug Administration (FDA) approved radium Ra 223 dichloride (Xofigo Injection, Bayer HealthCare Pharmaceuticals Inc.) for the treatment of patients with castration-resistant prostate cancer, symptomatic bone metastases, and no known visceral metastatic disease.

May 21, 2013

Clinical practice

Ineffective Communication Is a Barrier to Patient Care

I was spoiled with several plane trips in the month of April, which I always enjoy because it allows me some reading time. My recent trip to Boston and its subsequent layovers allowed me time to read ANA’s American Nurse Today and The American Nurse, and ONS’s Clinical Journal of Oncology Nursing. The latter had a great article, "Oncology Nurse Communication Barriers to Patient-Centered Care."

May 13, 2013

Clinical practice

The Case of the Compacted Colon

Bob, a 61-year-old man with multiple myeloma, calls his hematologist’s office complaining of worsening constipation despite increasing his fiber and liquid intake. Yesterday, he stopped taking his ondansetron because he remembered that it can cause constipation, but now he’s nauseated in addition to being constipated. What would you do?

May 07, 2013

Clinical practice

The Case of the Out of Order Chemotherapy Order

April is car­ing for a patient with bil­iary can­cer. She receives a new chemother­apy order for cis­platin fol­lowed by gem­c­itabine on days 1 and 8 every three weeks. The stan­dard sequence in April’s hos­pi­tal is to admin­is­ter plat­inum agents last. How­ever, the order clearly states to admin­is­ter the cis­platin first. What would you do?

April 23, 2013

Clinical practice

The Case of the Irradiated Red Cells

Xaviar, a newly diagnosed patient with acute myelogenous leukemia, is receiving his first packed red blood cell (PRBC) transfusion.

January 22, 2013

Clinical practice

The Case of the Sour Saline

After William had blood drawn through his tunneled central venous catheter

December 04, 2012

Adverse events

The Case of the Vexing Vesicant

Ursula arrives in her physician’s office to receive doxorubicin and cyclophosphamide

October 04, 2012

Clinical practice

Top 10 Reasons I Chose to Pursue a DNP

10. To demon­strate my com­mit­ment to prac­tice.

February 22, 2012

Chemotherapy

The Case of the Painful Port

Louise arrives in your office for her chemotherapy treatment with doxorubicin and paclitaxel.

January 03, 2012

Adverse events

Symptom Clusters in Women With Lung Cancer

Symp­toms of lung can­cer rarely occur in iso­la­tion

January 02, 2012

Adverse events

Nursing Care of Tenckhoff Catheters for Malignant Pleural Effusions

Malignant pleural effusion is a frequent and often morbid side effect of advanced metastatic disease, and its symptoms may cause anxiety and emotional distress for patients as well as their families.

March 01, 2010