One day, years ago now, my son and my daughter were listening to a bedtime story. My husband was reading them the Cat in the Hat, one of their favorite stories. And at the end, my son gave one of those happy little hops that kids give and said to my husband, "Dad you're so cool, you're like the Cat in the Hat." And I was walking by, putting laundry away or something, and I sort of turned and said, "If Dad is the Cat in the Hat, then who am I?" I was thinking I was the absent, completely irresponsible mother or Thing One or Thing Two.

“It takes 20 years to be an overnight success,” classical Hollywood era star Eddie Cantor once said. For many, “instant” recognition comes after a long preparation of methodical strategy and hard work. It is the story of nurses.

A single patient. A team of nurses providing compassionate, patient-centered care. A family so thankful that it had to give back. Today, it’s touched more than 177,000 nurses around the world in recognition of what they do every day: deliver high-quality, transformational cancer care.

As I begin my ONS presidency, I want to acknowledge the challenges and stress we have endured the past two years, which were most likely the hardest years in our careers. We need time to grieve for loss of patients; changes in the nursing profession, including equipment and personnel shortages; and the personal things we have lost that give meaning to who we are—graduations, weddings, memorial services, vacations. It all matters.

Governing ONS—including fiduciary oversight for all investments and budgets and strategic decision-making that secures the future of the organization—is the ONS Board of Directors’ primary role. In even the best of times, it is a serious commitment to govern our complex association, but the unpredictable environment we have experienced since early 2020 has increased that challenge.

Paper folding, also known as origami, has roots in several cultures, including Japanese, Chinese, and European. Origami’s exact origin is unknown. Although we have no concrete evidence of origami existing before 1600, a reference to origami butterflies in a 1680s poem suggests that it was an established art form with much older origins.

We must make a dedicated effort to increase diversity among nursing students at the college and university levels and support the inclusion of underrepresented minority, sexual minority, gender minority, and male student populations. Because of the country’s expanding immigration, increasing globalization, and minority population growth, we must have a diverse nursing workforce to meet the needs of patients and families from all backgrounds and communities.

To achieve health equity and improve health outcomes for diverse and marginalized racial and ethnic minorities, the nursing workforce must mirror the U.S. population. Yet despite decades of effort, the profession remains predominantly female and White. As the United States marches toward a minority majority, nursing diversity has never been a more critical objective.

In response to the 2010 Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, the Nurses on Boards Coalition launched an initiative to increase the number of nurses in decision-making leadership capacities with a goal to place 10,000 nurses on corporate, health-related, and other panels, boards, and commissions. Yet today, we still have more work to do to advance nurses into those positions and to educate the public about nurses’ role in providing high-quality, safe patient care.

Rewind. I adjust the strap on my mask and pinch it tightly around my nose and move it just under my lower eyelashes to prevent my goggles from fogging. These days, I am grateful for the face cover as it hides the pallor from six months in and the dark circles from long hours and anxious sleep. I wait at the valet circle for my team. Another SOS text out to them this morning. All hands on deck.

Six years ago, I signed up for the marrow registry through the German Bone Marrow Donor Center, also known as DKMS, which is an international organization that hosts stem cell registry drives. In late 2021, I received the call that I was a fully matched donor for a patient with chronic myeloid leukemia. As a hematology and oncology clinical nurse specialist, I have seen how valuable the gift of stem cells can be for a patient with hematologic disease. I didn’t think twice about completing the donation process.

Overall trust of scientists and their research during the COVID-19 pandemic has increased by nine percentage points between 2018 and 2020, according to the results from the November 2021 Wellcome Global Monitor 2020: COVID-19 report.

For better or for worse, the COVID-19 pandemic has affected nearly every aspect of life as we know it. As the virus evolves, so do we—from individuals to health systems, the country, public health policies, and more.

Nurses and other healthcare professionals persevered through 2021 and its obstacles, including the COVID-19 pandemic, staff shortages, and increasing rates of burnout, and their selflessness, drive, and honesty have not gone unnoticed by the American public, according to Gallup’s annual Most Honest and Ethical Professions Poll. In results released in January 2022, Americans ranked nurses as the most honest professionals for the 20th consecutive year on a list that also included physicians, grade-school teachers, pharmacists, and other professions.

Driven by evidence-based practice and patient-centered care, nurses have earned the faith of the American public. For two decades, nurses have been ranked the most trusted and ethical profession in the United States. Although trust is critical, what it lacks is support for the profession through federal investment in research, education, and workforce issues for long-term stability.

Oncology nurses must have effective communication and team-based skills to work across disciplines with other members of the care team. In an oncology setting, teamwork promotes safer, more efficient, and higher quality care, as well as a more positive and supportive practice environment. Dana-Farber Cancer Institute (DFCI) has used team training to develop those skills in our staff over the past 15 years.

Nurse burnout can only be addressed at the health system level, and beginning in your unit is one way to get that process started.

Given the inherent nature of caregiving, burnout has been part of the nursing profession since the beginning. As the complexities of the profession increase, so do nurses’ vulnerability. Oncology nurses have multiple physical, emotional, and mental demands, which, if left unaddressed, can lead to burnout, compassion fatigue, and moral distress.

As we turn the calendar to the new year, it feels a bit like the film Groundhog Day. Information about the COVID-19 pandemic—and related topics like masks, vaccination, and protecting ourselves and our patients from infection—still dominates the news and the literature. Many areas are struggling with surges in winter cases, and we all feel the personal loss of friends and family, colleagues, and patients and the toll it has taken on our profession. It is, without doubt, a constant presence in our lives.

Embracing—not judging or hiding—our flaws and vulnerabilities makes us happier and more relatable, a research-supported concept called the beautiful mess effect. What we think are negatives or weaknesses, others see as courageous. Showing vulnerability can lead to stronger relationships, increased self-esteem, and better mental health.

As nurses, the inclination to nurture and care for others is in our nature, yet sometimes we forget to care for ourselves. That’s an easy routine to fall into, but optimizing our mental well-being improves both the quality of care we provide and our overall health. So today, right now, is all about you. Here are four simple, sustainable ways you can safeguard your mental health, which includes your emotional, psychological, and social well-being, amid the ever-present chaos.  

Although you may not always believe it, living a balanced life is not out of reach. Nurses have a variety of ways to achieve daily balance and well-being, both informally and through dedicated programs. Today, institutions and nursing organizations alike are prioritizing initiatives to support and strengthen nurses’ well-being.

In addition to her daily practice as a nurse practitioner at Memorial Sloan Kettering Cancer Center in New York, NY, ONS member Naomi Cazeau, RN, MSN, ANP-BC, AOCNP^®, is using her leadership skills to make a difference in advocating for patients on a broader level. In October 2021, the Sepsis Alliance appointed her to its advisory board to help guide the organization’s mission of improving awareness and care.

A balanced life allows us to function at our best. Our bodies do that naturally through homeostasis, a familiar term from nursing school, by self-regulating physiological processes to ensure equilibrium and optimal functioning. But our brains sometimes need help to self-regulate, and one way to do that is to practice silence. After a day of noise and action, silence and solitude can calm and restore you.

ONS member Christopher R. Friese, PhD, RN, AOCN^®, FAAN, oncology nurse researcher and professor at the School of Nursing in the University of Michigan in Ann Arbor, was named one of seven researchers and clinicians that President Joe Biden appointed to the National Cancer Advisory Board on September 15, 2021.

Stress is a normal and necessary part of life. However, prolonged emotional tension takes stress to a new level for many people, including oncology nurses. But what is the antidote to cumulative pressure? The evidence for compassion’s benefits during stress is compelling.

The nursing shortage has reached dire proportions and more needs to be done to ensure the United States has the nurses we need to care for the public, particularly during the COVID-19 pandemic, the American Nurses Association (ANA) said in a September 2021 letter to the U.S. Department of Health and Human Services (HHS) urging the agency to declare the shortage a national crisis and to take action against it.

Are you at—or well over—the brink of burnout? Do you feel like you give, give, give and cannot find the time to refill? Those are common feelings for nurses, whose profession is a service to humanity. Although our work is rewarding, it’s also physically, emotionally, and mentally draining. Never feel guilty or judge yourself for stepping away and taking time for yourself—it’s essential to maintain the high level of care you provide every day.

Nurses’ skills, experiences, leadership, and voices are more relevant than ever before, and more and more ONS members are sharing their knowledge and expertise beyond the bedside to improve health throughout the community.

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.

Oncology nurses have a responsibility to continually enhance their career and practice—for their patients, for their profession, and even for themselves. Two strategies for doing that are certification and mentorship. Combining the two is an even more powerful approach.

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.

Nursing is a calling, but sometimes the profession takes nurses into careers that are an opportunity to serve others without direct patient care. In a recent blog post, Patricia Flatley Brennan, RN, PhD, director of the National Institute of Health’s (NIH) National Library of Medicine, looked back at the roles she’s held. Brennan considered herself a “mother-daughter-sister-aunt-friend, and an advocate for self-care management education and support for all people.” But on top of it all, she is a nurse.

Social distancing was never intended to be social isolation, but many of us have struggled to maintain relationships in today’s world. Human beings are built to be social, and science has shown that building strong, meaningful relationships can get us through tough times, provide physical and mental advantages, and make us happier. Perhaps a silver lining of the pandemic is a newfound appreciation for social connections with friends, colleagues, and community.

ONS Director-at-Large Anne Ireland, MSN, RN, AOCN®, CENP, and executive director of City of Hope’s Clinical Network and Outreach Nursing Department in Duarte, CA, was among the 12 San Gabriel Valley, CA, women on the frontlines of the COVID-19 coronavirus pandemic to whom U.S. Representative Judy Chu (D-CA) dedicated the 2021 Congressional Woman of the Year award. The recipients were nominated for their extraordinary community service and leadership during the pandemic.

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?”