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).

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.

Oncology nursing is an immensely rewarding calling, but the emotional burdens and stressors can feel overwhelming. Office politics, career changes, and providing end-of-life care are difficult to navigate alone, but partnering with mentors helps nurses work through challenges and grow as leaders. As I look back on my career accomplishments, I can’t deny the influence from several mentors sprinkled throughout that trajectory. Each one gifted me with the insight to develop specific skills that enhanced my practice.

Dedication to their patients and each other and an innate passion unrivaled by most other professions are two of the reasons why oncology nurses make great leaders—I know that from my daily work with colleagues both near and far as well as my experience as part of ONS’s Leadership Development Committee. 

For the past 15 months, healthcare providers across the country risked their lives to care for those who needed us most. After spending more than a year at the forefront of a global health crisis, many of us, naturally, harbor feelings of stress and anxiety. Now that the world is returning to something resembling normal, we can pause, reflect, and observe how much we’ve all grown throughout this experience.

With the aging population of clinicians and patients, nursing is in desperate need of a stronger workforce. To advance nurses at all levels of practice, on February 9, 2021, the U.S. House Committee on Energy and Commerce announced its plan to increase funding for the Nurse Corps Loan Repayment Program by $200 million through its section of the American Rescue Plan.

I believe that every nurse is a leader, and we need leaders in all areas of our profession, from academia and research to clinical practice. Nurses must lead from the future and reinvent themselves to achieve their desired career path. Practice in the now, but lead from anticipation of what will happen based on healthcare trends.

When you picture a nurse leader, what do you see? The thought of being a leader or taking on a formal leadership role can seem intimidating for so many nurses. But age, citizenship status, ethnicity, or gender are strengths, not obstacles. Every nurse enters the profession with the foundation to be a successful leader. 

Thrust into the mainstream in 2020, telehealth has transformed how patients with cancer receive some of their care, substituting certain traditional in-person office or clinic visits for phones, videos, and apps and devices that monitor patients’ health. It’s improved access to care in areas previously considered at risk for disparities: for example, patients in remote locations can be managed in an acute-care setting using television monitors, cameras, and call buttons to contact specialists. 

For a long time, like so many other nurses, I thought of myself as the “regular kind” of advocate for my patients, speaking out for their needs on an individual basis at the institutional level while supporting them as they navigate a cancer diagnosis. But I’ve more recently discovered an even more empowering role: I’m now a health policy advocate.

Three nurses serve in the U.S. Congress, and the profession briefly added one more federal representation at the agency level as well. President Joe Biden appointed Rear Admiral Susan Orsega, MSN, RN, FNP-BC, FAANP, FAAN, a nurse practitioner, as acting surgeon general while Vivek H. Murthy, MD, MBH, who served as former president Barack Obama’s surgeon general, was waiting for Senate confirmation. The position is often referred to as the “nation’s doctor,” although Orsega was the third nurse to hold the title before Murthy assumed his current post.

Contributing to the orientation and onboarding of new advanced practice RN (APRN) providers supports optimal patient outcomes, professional satisfaction, and nurse retention. Orientation involves working through the hospital’s training program, policies and procedures, organizational structures, and mission or vision statements, whereas onboarding builds engagement and relationships in the organization over many weeks to months. Some institutions have formalized, detailed processes for orientation and onboarding, but others may offer very little structure and support.

Guidelines give oncology nurses an evidence-based, standardized approach to cancer care. But guidelines are most effective used when they’re used as a regular part of practice—a process referred to as implementation. 
With several oncology societies releasing new guidelines in 2020 and 2021, including ONS and the American Society of Clinical Oncology (ASCO), the implementation process requires nurse managers and leaders to facilitate staff education, maintain a high quality of care, and answer the all-important question: “Why are we doing this?”

Nurses are selfless caregivers. However, compared to the average American, they are more likely to be overweight, have higher levels of stress, and get less than the recommended hours of sleep. Long shifts and work hazards only exacerbate nurses’ propensity for those factors. In response, the American Nurses Association (ANA) is raising awareness for nurses to think about themselves.

Most nurses can attest to the immense personal and professional growth that takes place during the first year of their nursing practice. When I graduated in May 2019, I began working on a blood and marrow transplant (BMT) unit. The BMT process is long and intensive, but it provides opportunities to develop strong connections with our patients. We often care for the same patient for multiple weeks or months and then again a year or two later if they experience longer-term complications. As a newly minted nurse, I had a lot to learn about my specialty and about nursing in general, but my fresh perspective made learning exciting.

Having high expectations can motivate you to achieve your very best. In the extreme, however, aiming for perfection can be dangerous to your mental health. In a 2015 TED Talk, self-proclaimed perfectionist Petra Kolber passionately revealed that despite being at the top in her field in the fitness industry, she felt her best was never good enough and she lived a joyless life. 

Oncology nursing awakens a sense of purpose that drives us to be true patient advocates. As chair of my institution’s shared governance committee, I have found that being conduits for our patients empowers nurses to find solutions that take care to the next level. It’s driven me to find better outcomes, care, and treatment for my patients simply because their health is important to me. I am at the bedside for my patients’ entire cancer journey.

After a contentious election season, U.S. Representative Lauren A. Underwood, RN, (D-IL) returned to Capitol Hill as a new subcommittee chair and the same drive to push forward on healthcare issues, most recently with an open letter to President Joe Biden.

Watching patients—or even colleagues—suffer or die, not being able to protect yourself with the right personal protective equipment, worry about exposing loved ones, and the challenge of balancing it all contribute to an immeasurable psychological burden for nurses and other healthcare professionals during a pandemic. Studies show that the effects are serious, leading to post-traumatic stress, anxiety, depression, and, in some cases, suicide among providers.

Imagine this: You are working toward a leadership position and have all the necessary qualifications and experience, but you are also shy. You’re in a brainstorming meeting with your department and have an idea that would solve the problem, but it’s totally different than what has been proposed so far. Do you speak up or stay quiet? Do you even have a chance at that leadership position if you are too shy to share your idea?

Quick: what’s your first reaction when you hear the word criticism? Do you brace yourself for feelings of failure and put up a defensive wall? It’s hard to respond otherwise, but try to look at it differently. Criticism can be positive if we accept it with class and let it help us gain knowledge about ourselves.

Wonder Woman, Superman, the Flash! Characters like those have superpowers and save people, but they are limited by fiction. Nurses are real people doing superhuman achievements every day, often with little recognition. To pay homage to the most trusted profession, Allegheny Health Network in Pittsburgh, PA, partnered with Marvel to produce a comic book worthy of real heroes. The Vitals: True Nurse Stories (2020), includes three stories based on personal accounts from the children of nurses on the front lines of the COVID-19 coronavirus pandemic.

Caring for patients with cancer is a complex subspecialty of nursing. In most of their day-to-day work, oncology nurses function independently and require time management, communication, and prioritization skills in addition to extensive clinical knowledge and expertise.

The November 2020 presidential election saw a historic turnout at the polls. Before election day, more than 99 million of the 240 million registered American voters had already cast their ballots, and some predicted that as many as 155 million voters would exercise their constitutional franchise to make their voices heard, a record 65% of the electorate. The distinct differences between the two major presidential candidates indicated that people were engaged and took to heart the grand idea of participatory democracy.

A career of more than 40 years provides experiences and insight that can help nurses prioritize self-care, be more resilient, and stay positive during stressful times. During an on-demand session for the inaugural ONS Bridge^TM virtual conference in October 2020, Susan Childress, MN, RN, former director of nursing at Huntsman Cancer Institute (HCI) in Salt Lake City, UT, and recipient of the 2020 Mara Mogensen Flaherty Memorial Lectureship, offered advice for oncology nurses in maintaining compassionate care and resiliency in practice.

Food connects us to other cultures, helps us celebrate life’s milestones, and nourishes our body. We spend hours of our day planning meals, cooking, and eating. With food at the center of our lives, a positive view of it promotes health and well-being, but many of us struggle with eating behaviors and weight management throughout our lifetime.

Legislation aimed at reducing health care insurance premiums, introduced by U.S. Representative Lauren A. Underwood (D-IL), is included as part of the Patient Protection and Affordable Care Enhancement Act.

Up to $85.3 million of the U.S. Department of Health and Human Services’ (HHS’s) $107.2 million in funding awards is earmarked for nurses. The agency bestowed the awards in June 2020 to 310 recipients across 45 states and U.S. territories to increase the healthcare workforce in rural and underserved communities.

Does lack of inclusion in areas that are important to us affect how we see ourselves overall? Can someone amplify their voice without being represented in an authority position? Should leadership reflect the population that it’s leading? More and more medical organizations are publishing formal and informal position statements on diversity and inclusion, which is a great start, but the next logical step is bringing those beliefs and concepts to our institutions and communities. Here are some of the issues and the ways that any nurse can take action.

Current events have given us an opportunity, and sometimes even a necessity, to rethink our well-being approaches. But developing a self-care plan doesn’t have to be overwhelming when you use a familiar method like the American Nurses Association’s nursing process.

The revolutionary declaration written 244 years ago, proclaiming that “all men are created equal,” maintains that a true democracy must be based on an individual’s right to vote and the freedom to exercise that power at the ballot box. Since 1998, women voters have embodied that concept, achieving a majority vote with higher rates than men. Of registered women voters, 55% went to the polls in 2018, compared to only 51% of registered men. Yet today women account for only 23.2% of the members of the U.S. House of Representatives and 26% of the U.S. Senate.

As we enter the final few months of 2020, the World Health Organization’s (WHO) International Year of the Nurse and Midwife, I find myself thinking about the theme that we had for our 45th Annual ONS Congress^TM: Purpose, Power, Passion. WHO’s intent in designating the year was to elevate nursing globally and showcase the many roles that nurses have in health care. In the United States, Gallop surveys consistently rank nurses as the most trusted profession, but our colleagues in other countries do not have a similar means of recognition.

Understanding correct coding strategies is an important skill that affects billing and reimbursement for value-based cancer care. Meeting the requirements for complete and accurate documentation is critical to support healthcare claims. Both nurses and advanced practice providers have responsibilities in this work.

The phrase “a new normal” is used in the oncology setting to describe the changes a person faces as a result of cancer and its treatments. Physical and emotional scars plus activity limitations are examples of adjustments cancer survivors make as they define what will be their new normal. But in today’s media, the new normal is being used to label the changes the world’s population is facing as a result of the COVID-19 coronavirus pandemic.

Over the past three years, Sharon, age 38, has been intermittently receiving treatment for ovarian cancer. She was initially treated with carboplatin and paclitaxel and remained in remission for 20 months. She responded well to second-line therapy (carboplatin, gemcitabine, and bevacizumab), remaining on bevacizumab maintenance until she experienced a relapse eight months later.

Almost 96% of nurses report experiencing at least one symptom of post-traumatic stress disorder (PTSD) and nearly 21% meet the criteria for a clinical diagnosis of PTSD, according to findings from a literature review published in the Journal of Clinical Nursing.

Nurses are experts in advocating for their patients’ care. Taking those skills to Washington, DC, and speaking out for changes in federal health policy can have just as much impact. Even in an era of social distancing and travel restrictions, oncology nurses can bring their message to the local, state, and federal leaders to bring about change.  

Oncology nursing is a complex world that continues to evolve rapidly. However, one challenge that remains consistent is the ethical dilemmas nurses face when caring for patients with cancer. Complex care needs and lengthy hospital stays are common in our patient population and allow opportunity for nurses to develop relationships with patients and their families. Over the course of treatment, various ethical issues may arise, which nurses are at the forefront of identifying and acting on.

What does the future of nursing research mean to you? How can nurse scientist-led studies provide information you can use in your daily practice? What gaps do you see in evidence to support nursing care?

When it comes to the human brain, the ability to effectively multitask is a myth. Although computers can run two or more programs simultaneously, our brains must task-switch, and in the transfer of attention, time and productivity are lost. Monotasking, or single tasking, is now considered a way to increase productivity and actually maximize time.

Nurses have been advocating for increased personal protective equipment (PPE) long before the COVID-19 coronavirus pandemic. Last year two clinicians published a book that reported on their five years of research into trauma in nurses. Their findings showed that lack of PPE, along with a multitude of other factors, led to a variety of traumas in nurses, all of which has been ignored for decades.

Healthcare institutions have used care delivery models to guide practice for years. A care delivery model provides a structured system for work assignments, responsibilities, and authority to provide optimal patient care.

The media fails to represent nurses as leaders in health care. Only 2% of health articles included nurses as sources, Diana J. Mason, PhD, RN, FAAN, and colleagues reported in a 2017 study. In a June 26, 2020, opinion piece published in USA Today, Mason called on universities and medical institutes to offer more nurses as sources for journalists, rather than just physicians.

New nurses are a lot like new drivers: they know just enough to pass the test but lack the experience to influence critical decisions. Those who understand the importance of continuing education in various formats have an advantage in today’s competitive job market.

A multitude of factors influenced by institutional inequality, such as underlying health conditions and employment opportunities, are to blame for the COVID-19 coronavirus’s disproportional effects on African Americans, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said. His remarks were part of a June 23, 2020, testimony before the House Energy and Commerce Committee.

“There’s no way you can extricate what’s been going on and the outcomes of the (COVID-19 coronavirus) from the basic racism and social injustice and inequities that have existed in this country for so many years,” American Academy of Nursing Living Legend Catherine Alicia Georges, EdD, RN, FAAN, said in a June 17, 2020, podcast. “The chronicity of racism is the issue.”