Nurses don’t always have to venture beyond the bedside for unique career change opportunities. Always innovating and evolving, the profession identifies new roles for clinical practice nurses to meet patients’ needs.

Historical and structural racism is a huge barrier to quality health care that has created two tiers of access to care and a lack of understanding of the healthcare system. Government health agencies and leaders, such as the U.S. Agency for Healthcare Research and Quality (AHRQ), are tackling racial disparities in health care directly to change the dynamic to equality for all Americans. AHRQ says it is assessing its own agency and examining how professionals can make the health services research field more diverse and inclusive by building on a foundation that includes producing and promoting the annual National Healthcare Quality and Disparities Report and AHRQ’s social determinants of health database. By recognizing disparities related to race and ethnicity, income, and other social determinants, the organization plans to further address historical racism in health care.

Achieving health equity tops the list of the Patient-Centered Outcomes Research Institute’s (PCORI’s) newly updated National Priorities for Research, which the institute released on June 24, 2021.

As Americans reduce tobacco use and treatment and diagnosis advance, lung cancer survivorship rates are improving; however, it still remains the second most common type of cancer. The growing population needs appropriate survivorship care.

Emerging healthcare technologies require a significant investment in time, money, and training. It starts with ensuring that quality improvement efforts are consistent to support positive clinical and patient outcomes, which is why clinical and information technology (IT) representation is critical in making decisions and exploring solutions. Nursing informatics bridges that gap.

As a nurse, you have a diverse arsenal of skills, from clinical competencies and leadership to problem-solving and interprofessional communication. That skillset easily transfers to a variety of careers outside of direct care.

On July 26, 2021, the American Nurses Association (ANA) signed onto a statement released by a large group of healthcare systems and other associations in support of healthcare employers mandating nurses and all healthcare personnel be vaccinated against the COVID-19 coronavirus. This is in response to increasing circulation of COVID-19 variants and lagging vaccination rates. Although ONS was not listed on the statement as a supporting organization because of a late request, ONS agrees that vaccinations are critical for healthcare providers, particularly those caring for immunocompromised patients.

On July 28, 2021, the U.S. Food and Drug Administration (FDA) reported that a clinical trial (OCEAN, Study OP-103) evaluating melphalan flufenamide (Pepaxto®) with dexamethasone to treat patients with multiple myeloma showed an increased risk of death. 

As of July 2021, more than 159 million individuals in the United States have been fully vaccinated against the COVID-19 coronavirus, totaling about 48.1% of the U.S. population. However, approximately 173 million others have not, or suggested they will not, receive the vaccination. President Biden’s goal of having 70% of Americans receive at least one vaccine dose and 160 million adults to be fully vaccinated against COVID-19 by July 4, 2021, fell short.

On July 21, 2021, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda^®) in combination with lenvatinib (Lenvima^®) for patients with advanced endometrial carcinoma that is not microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR), who have disease progression following prior systemic therapy in any setting, and are not candidates for curative surgery or radiation. 

On July 19, 2021, the U.S. Food and Drug Administration (FDA) reported Pfizer’s voluntary recall of two lots of varenicline 0.5 mg tablets, two lots of varenicline 1 mg tablets, and eight lots of a varenicline kit of 9.5 mg/1 mg tablets to the patient level because of the presence of N-nitroso-varenicline, a nitrosamine, above the Pfizer-established acceptable daily intake level. Varenicline is a treatment to help patients quit smoking and is intended for short-term use. To date, Pfizer has not received any reports of adverse events that have been related to the recall.

On July 1, 2021, the U.S. Food and Drug Administration (FDA) reported Teva Pharmaceuticals’ June 30, 2021, voluntary recall of lot 31328962B of topotecan injection 4 mg/4 ml. The recall was based on a report that a single vial contained a glass particle, a grey silicone particle, and a translucent, colorless cotton fiber.

Randi is a 57-year-old patient who identifies as female. She was diagnosed with clear cell metastatic renal cell carcinoma (mRCC), and her past medical history includes mild hypertension managed with amlodipine and a two-year history of transient musculoskeletal pain managed with tramadol. She reports a family history of cardiovascular disease and rheumatoid arthritis (RA). Her primary care physician suspects Randi is at the beginning stages of fibromyalgia but has not made a conclusive diagnosis because she hasn’t experienced additional symptoms.

On July 16, 2021, the U.S. Food and Drug Administration (FDA) approved belumosudil (Rezurock^TM), a kinase inhibitor, for the treatment of chronic graft-versus-host disease (chronic GVHD) in adult and pediatric patients 12 years and older after failure of at least two prior lines of systemic therapy. 

Hypercalcemia of malignancy (HCM) is a common paraneoplastic syndrome associated with poor prognosis that affects approximately 20%–30% of patients with cancer. It’s most often seen in patients with breast, lung, renal, or ovarian cancers; squamous cell carcinoma of the head and neck; multiple myeloma; and certain lymphomas.

More than 40% of patients with melanoma treated with nivolumab or pembrolizumab experience persistent long-term immune-related adverse events (irAEs) for at least 1.5 years, researchers reported in JAMA Oncology.

Research has identified an association between malnutrition and functional deficits in patients with cancer, regardless of age, and other studies confirm that malnutrition affects treatment tolerability, outcomes, and quality of life for patients with cancer. However, studies have also found that oncology clinicians do not consistently assess for malnutrition and functional deficits in clinical settings. 

Cardiac toxicities are associated with many types of cancer therapies, with both length of and time since treatment increasing a patient’s risk for the adverse event. Anthracycline chemotherapies are among the oldest agents still used for a variety of cancer diagnoses, and as cancer survivorship continues to grow, more patients are presenting with late-onset cardiac complications.

On July 9, 2021, the U.S. Food and Drug Administration (FDA) approved daratumumab and hyaluronidase-fihj (Darzalex Faspro^®) in combination with pomalidomide and dexamethasone for adult patients with multiple myeloma who have received at least one prior line of therapy, including lenalidomide and a proteasome inhibitor.

On July 9, 2021, the U.S. Food and Drug Administration (FDA) approved enfortumab vedotin-ejfv ([EV], Padcev®), a Nectin-4–directed antibody and microtubule inhibitor conjugate, for adult patients with locally advanced or metastatic urothelial cancer who previously received a programmed death receptor-1 (PD-1) or programmed death-ligand (PD-L1) inhibitor and platinum-containing chemotherapy or are ineligible for cisplatin-containing chemotherapy and have previously received one or more prior lines of therapy.

Historically, ovarian cancer is often diagnosed at advanced stages because of vague symptoms and presentation, but with new advancements in diagnosis and treatment options, patients with the disease are living longer than ever.

Companies marketing the tobacco brands Aspire, Joyetech, Vaporesso, and Voopoo, which were selected through a systematic process, must share information about social media marketing campaigns that target youth, the U.S. Food and Drug Administration (FDA) announced. The requirements include social media advertising documents and marketing plans, such as planned content to target specific audiences, cost of plans, use of partners and influences, and the number of followers and views broken down by age group.

MUTYH-associated polyposis (MAP) is an autosomal recessive hereditary cancer syndrome. It’s most commonly seen in people of northern European ancestry, where an estimated 1 in 20,000–40,000 have MAP (two pathogenic variants on opposite chromosomes) and 1%–2% have one MUTYH pathogenic variant.

Implementing a standard minimum nurse-to-patient ratio lowers mortality, readmission, and length of stay rates, according to findings published in Lancet. 

Because they often face nutrition challenges—such as nausea, taste alterations, difficulty swallowing, and altered gastrointestinal function—that develop during their journey and hinder their nutrition stability, patients with cancer have increased nutrient needs. Oncology dietitians are experts at guiding patients and caregivers through the nutritional process and developing solutions.

Nursing science research must look at the whole picture of health, including health equity, social determinants of health, and the translation of science into policy and practice, the National Institute of Health’s (NIH) National Institute for Nursing Research (NINR) said in its approach to developing the 2022–2026 strategic plan.

Malnutrition affects 30%–85% of all patients with cancer, making it one of the most common symptoms for oncology nurses to manage. To help patients achieve the best outcomes, clinicians must understand how and when to screen for malnutrition and how nutritional status affects treatment outcomes and patients’ quality of life.

According to the U.S. Preventive Services Task Force (USPSTF), colorectal cancer is the third leading cause of cancer death for both men and women, with an estimated 52,980 individuals in the U.S. projected to die from the disease in 2021. After evaluating the current evidence and conducting a modeling study, USPSTF updated its recommendations on colorectal cancer screening.

On June 30, 2021, the U.S. Food and Drug Administration (FDA) approved asparaginase erwinia chrysanthemi (recombinant)-rywn (RylazeTM) as a component of a multiagent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) in adult and pediatric patients one month or older who have developed hypersensitivity to E. coli-derived asparaginase. 

Sofia is a 35-year-old patient who identifies as female who was recently diagnosed with breast cancer and is concerned with experiencing chemotherapy-induced alopecia (CIA) as an adverse event from treatment. She comes in for her first infusion of adriamycin plus cyclophosphamide and is using scalp cooling to prevent hair loss. She works as a project manager, which requires her to keep her camera on for her many daily video calls. She is very anxious about losing her hair and asks you if taking minoxidil in addition to the scalp cooling treatment would guarantee she maintains her hair. 

Patients with uveal melanoma who were treated with tebentafusp, an investigational immunotherapy, lived a median 5.7 months longer than those in comparison groups, researchers reported in study findings presented at the American Association for Cancer Research 2021 annual meeting. 

Tepotinib (Tepmetko®) was granted accelerated approval in February 2021 for mesenchymalepithelial transition (MET)-altered metastatic non-small cell lung cancer (NSCLC) based on overall response rate and duration. The drug is still under long-term evaluation and healthcare providers should report all serious adverse events that may be associated to FDA’s MedWatch Reporting System.

“Frontline healthcare workers have a nearly 12-times higher risk of testing positive for COVID-19 compared with individuals in the general community,” according to the results of a 2020 study. Although U.S. vaccination rates continue to increase and infection rates continue to decrease, national government entities such as the U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) are releasing new guidelines to help protect those who are putting themselves at risk for transmission so they can care for others.

On June 16, 2021, the U.S. Food and Drug Administration (FDA) approved avapritinib (Ayvakit™) for adult patients with advanced systemic mastocytosis (AdvSM), including patients with aggressive systemic mastocytosis, systemic mastocytosis with an associated hematologic neoplasm, and mast cell leukemia.

Nurses have an innate drive to improve healthcare delivery. When I was a unit director, I focused on nursing unit turnarounds to improve quality of care. I used mediation as the model for resolving long-time conflicts and provided training to effectively engage and communicate. I started my mediation practice in 2003 to help physicians, nurses, and administrators resolve the complex issues that get in the way of patient care and create stressful work environments.

In a May 2021 expansion to Section 1557 of the Affordable Care Act and the Title IX civil law, the U.S. Department of Health and Human Services (HHS), through the Office for Civil Rights, increased protections for lesbian, gay, bisexual, transgender, or queer (LGBTQ) people from discrimination. The revisions now prohibit discrimination based on sexual orientation and gender identity. 

More than 16 million people who identify as women and girls in the United States reported smoking in 2021, according to a May 2021 report from the Campaign for Tobacco Free Kids, of which ONS is an active member, who partnered with several leading women’s organizations on the study. Female smokers are also significantly more likely than men to use menthol cigarettes, and e-cigarette use among high school girls rose by 89% from 2017–2020.

Structural racism is repeatedly linked to health disparities, but a new agency report outlines plans to address discrimination and improve patient outcomes. In a special 2021 supplement to the journal Ethnicity and Disease, “Structural Racism and Discrimination: Impact on Minority Health and Health Disparities,” the National Institute on Minority Health and Health Disparities published a series of reports exploring the relationships between policies, practices, and health. It also included recommended solutions, including outcomes from interventions in a school district and a local health department and future research directions (e.g., examining ways racism embedded in online systems can contribute to health disparities).

As the number of cancer survivors continues to grow in the United States, so too does the need for cancer survivorship programs. Oncology advanced practice RNs (APRNs) are essential team members as institutions develop and deliver comprehensive and holistic programs to meet survivors’ needs.

My team’s current project to understand communication in ambulatory oncology settings stems from more than a decade of research (Kamimura et al.), in which we have tried to uncover the factors that facilitate high-quality cancer care for patients and a satisfying practice environment for care teams (Friese).

Introducing palliative care from the moment of diagnosis is an essential component of comprehensive care, but it becomes even more critical when patients contract the COVID-19 coronavirus during treatment.  

In nursing, we talk about progressing from novice to expert. I remember my feelings as a new nurse, of being overwhelmed by the many things that I didn’t know. Over time, I became comfortable in my growing knowledge. I developed skills, learned about diseases and treatments, and adapted to the politics of my particular unit and the people in it.

Prostate cancer is the most common cancer among those assigned male at birth, with one in eight diagnosed during their lifetime. But with five-year survival rates of 90%, it’s also one of the most successful cancers to treat, making survivorship care even more important.

On May 28, 2021, the U.S. Food and Drug Administration (FDA) granted accelerated approval to infigratinib (Truseltiq™), a kinase inhibitor for patients with previously treated, unresectable locally advanced or metastatic cholangiocarcinoma with a fibroblast growth factor receptor 2 fusion or other rearrangement as detected by an FDA-approved test. FDA also approved the FoundationOne^® CDx as a companion diagnostic for infigratinib. 

Effectively treating a cancer diagnosis requires an immense amount of collaboration. Clinicians are equipped with the clinical knowledge to provide the best care possible, and sharing that crucial information with each other and patients is essential for optimal patient outcomes. 

On May 28, 2021, the U.S. Food and Drug Administration (FDA) granted accelerated approval to sotorasib (Lumakras™), a RAS GTPase family inhibitor, for adult patients with KRAS G12Cmutated locally advanced or metastatic non-small cell lung cancer (NSCLC), as determined by an FDA approved test, who have received at least one prior systemic therapy.

On May 27, 2021, the U.S. Food and Drug Administration (FDA) approved piflufolastat F 18 (Pylarify^®), a drug for positron-emission tomography (PET) imaging of prostate-specific membrane antigen (PSMA)-positive lesions in patients with prostate cancer.

On February 12, 2021, the U.S. Food and Drug Administration approved trilaciclib (Cosela^TM), a parenteral inhibitor of cyclin-dependent kinase, to prevent myelosuppression when administered prior to chemotherapy administration. The approval is currently limited to the use of trilaciclib before treatment with platinum- and etoposide-containing regimens and topotecan-containing regimens for treatment of extensive-stage small cell lung cancer.

On May 21, 2021, the U.S. Food and Drug Administration (FDA) granted accelerated approval to amivantamab-vmjw (Rybrevant™), a bispecific antibody directed against epidermal growth factor receptor (EGFR) and MET receptor, for adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by an FDA-approved test, whose disease has progressed on or after platinum-based chemotherapy. FDA also approved the Guardant360^® CDx as a companion diagnostic.

Dance/movement therapy is a complementary modality that may help patients manage cancer and its treatment-associated symptoms. Based on the concept that mind, body, and spirit are interconnected, it combines the communicative elements of dance and movement with other body-focused activities—such as guided imagery, mindfulness, breath awareness, and play—to create an emotionally inviting environment where participants can share feelings and experiences.