“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.

Emily manages a rural clinic associated with an academic cancer center. Patients initially have an in-person consultation with their treating oncologists at the main campus but then use telehealth for subsequent visits. To support patients during teleoncology visits, Emily wants to initiate a plan to collaborate with the clinic staff to identify and address the ethical principles for oncology care using telehealth.

“How are you doing?” We ask this question of our patients repeatedly: at diagnosis, during treatment, throughout survivorship, and at end of life. However, studies show that patients often give inaccurate answers to that direct question.

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.

Some people may be overjoyed at the prospect of completing their cancer treatment and returning to normal life, but for many others, fear and anxiety can overshadow feelings of elation. The survivorship phase of a cancer journey can be confusing and uncertain. Comments like, “I don’t know what is next” and “The responsibility for care is now up to me” can alert oncology nurses that patients need additional communication and strategies to transition into healthy survivorship.

Communication is central to an oncology nurse’s role—with patients and families, within the unit, and across interprofessional teams. The Joint Commission identified poor communication as a causative factor in 80% of medical errors, particularly during caregiving handoffs. Effective communication skills are both a science and an art, but oncology professionals can use a variety of tools and techniques to enhance their practice.

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.

When hearing results from blood work or repeat imaging—regardless of whether they are “good” or “bad”—patients want and deserve to be given information truthfully and objectively. Oncology advanced practice providers are often the bearers of bad news, which can be uncomfortable and stressful. But here’s how you can hold those conversations with finesse, empathy, and respect.

To confront the disparities that minority populations face in health care, organizations across the United States are recognizing that cultural humility is a clinical competency. Implicit and explicit bias are part of human nature, but prioritizing cultural humility as a foundation, diversifying the workforce, and engaging in education and training can help providers overcome those tendencies and achieve patient-centered care.

In today’s digital age of news, the public often struggles to decipher real science from misleading or incorrect information—and the COVID-19 coronavirus pandemic has only magnified the situation. Seeing a detrimental impact to the health of the nation, U.S. Surgeon General Dr. Vivek Murthy, MD, MBA, issued his first advisory report of the Biden administration on the topic of misinformation in public health.

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

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.

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. 

Nurses are a trusted resource for patient education and offer clarity during a crisis, whether it’s a cancer diagnosis or global pandemic. However, in a survey from the American Nurses Association (ANA), 30% of nurses said they have not received a COVID-19 vaccine, and a quarter of that percentage was still undecided about getting vaccinated. The two main reported reasons were fear of short- and long-term side effects (66%) and lack of information about the vaccines (50%). ANA’s new campaign educates nurses about those concerns.  

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.

Patients with cancer navigate many isolating experiences: treatment side effects such as alopecia, long stays in the hospital, loss of life’s normalcy, and limited time with friends and family.

Many older adults are continuing cancer screenings beyond the recommended upper age limits, which range from age 65–75 years depending on the type of cancer screening, researchers reported in JAMA Network Open.

While working in a palliative care clinic, I developed a connection with one of my patients through an unexpected medium: word search puzzles. She was doing one the first time I entered her exam room, so I introduced myself and asked if it was a difficult one.  

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.

The cacophony that echoes through the 24-hour news cycle can be heavy on an average day but overwhelming during a global health pandemic. That is why relying on a trusted voice is essential when attempting to understand how to deal with the voluminous information that bombards us through radio, television, emails, social media, and any other channels that deem themselves news outlets these days.

Oncology nurses use many tools to help our patients, but one of the most effective is our words.  However, our terminology may be overwhelming to patients and feel like medical jargon. We also often use terms to describe how a patient is experiencing cancer, reporting adverse events, noncompliance, failing treatment, and palliative care, which can be confusing and misleading.

The 2019–2022 ONS Research Agenda mentions LGBTQ patients with cancer among ONS’s research priorities for the very first time. A panel discussion at the 44th Annual ONS Congress focused on this underrepresented patient population, so we are making progress. In the past few years, our field has given a little more attention to LGBTQ patients with cancer, although I suspect that many of the issues are still pervasive.

Like most nurses, my shifts as a new nurse functioned as consistently as clockwork. I would begin my afternoon shift by reviewing the assignment list. The previous shift’s nurses would handoff the patients, and I would head out to the unit to report to my assistive personnel and review the patients’ medication administration records. Every hour was dedicated to a different task, including my dinner break. That is, until a monumental moment jostled me from my systematic routine.

Recognized by the National Academies of Medicine as a population vulnerable to health disparities, people who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) experience specific health disparities, including limited access to health care, increased risk for certain disease types, and an inherent bias in the health system.

As early detection, treatment modalities, and symptom management advance in oncology care, we are seeing an increase in the number of adult and childhood cancer survivors. Added to the unique challenges of comorbid conditions in an aging population, oncology nurses have a lot to juggle in the spectrum of patient care. The relatively new role of the oncology nurse navigator was developed to enhance care coordination in patients with cancer.

Many say that love is the universal language. I agree, but I’ve found that care is also universal.   

We are oncology nurses. We don’t shy away from hard discussions. We have the skills and tools to help others. But this pandemic is different. The COVID-19 coronavirus has changed the rules. It’s ushered in social distancing, limited contact, and induced a new level of panic. COVID-19 doesn’t care if you are a nurse or a patient. It is an equalizer between us all. 

“I don’t want to die.”  “What is my prognosis?”  “Is this a death sentence?” 

As oncology nurses, heart-wrenching questions like these are part of our day-to-day work. So how do we address patient concerns in a compassionate yet professional way? How do we respond to a patient with stage IV cancer who exclaims they only have two more cycles of treatment until they’re cured? How do we explain to patients with cancer that their journey is not short term?  

“It’s going be okay.”

That common phrase is full of meaning, yet so vague. Often, it’s a patient’s response when they’re first diagnosed or are told that all of the treatments have failed and they only have a few months to live. Other times, a family member will voice the remark when holding a patient’s hand as they provide comforting hope or temporary relief from distress. Sometimes an oncology nurse shares the phrase in an attempt to calm the agony their patients face each day.

In nursing school I was always taught to maintain professional boundaries with patients, including never sharing any personal information like my address or contact information. No matter how many times faculty members said it, we never role played scenarios with that situation. I was unprepared for the moment, six months into my nursing career, when a kind, gentle, nonthreatening woman asked me for my address so she could send me a Christmas card.

I remember my first day as a student nurse technician at an academic medical center as if it was yesterday. It was a Saturday afternoon shift in May 1996 on 10 Green at Harper Hospital in Detroit, MI, on a hematology unit that cared for patients with either malignant hematology (i.e., leukemia and lymphoma) or benign hematology conditions (e.g., sickle cell disease).

At the heart of patient-centered cancer care is communication and understanding, and oncology nurses have a responsibility to ensure that their patients have all the information they need to successfully navigate their cancer journey. But what happens when language barriers inhibit the flow of information between patient and practitioner? 

As people age, their risk for cancer increases, and so too does the complexity of their cancer care. Older patients with cancer typically present with age-related conditions like comorbidities, functional problems, falling, and polypharmacy, which are not as widely discussed in the oncology space as they should be. Age-
related concerns can influence outcomes for patients with cancer and their caregivers, including treatment toxicity, hospitalization, and even early mortality. 

“Two heads are better than one” is an idiom so old and often used that it borders on cliché. But as with most colloquial sayings, a kernel of truth is buried underneath. Combining forces to solve problems, overcome obstacles, and coordinate efforts is the key to nearly every successful endeavor, and it’s especially true for patients and providers navigating the cancer journey. 

Genomic testing—identifying variants, like mutations, in tumor cells to inform patient treatment options—occasionally comes with unanticipated results that clinicians have to address with their patients. Clinicians and patients alike are often hopeful that tumor genomic testing will identify a personalized cancer treatment. Indeed, many patients have benefited from being candidates for new targeted therapies identified through genomic testing. 

A provider develops a partnership with a patient and negotiates behaviors to reach an agreement to adhere to oral chemotherapy medication. This is an example of which strategy?

a. Reinforcement

b. Operant conditioning

c. Motivational interviewing

d. Partnership   

Oncology nurses interact with other staff, patients, and families, each of whom have various cultural and personal preferences. A person’s culture encompasses race, ethnicity, spiritual practices, social habits, and so much more. 

When patients with cancer also suffer from psychiatric diagnoses, it can present unique challenges to healthcare professionals. Because oncology nurses build relationships with patients while addressing issues, understanding the obstacles to practice is key to providing the best possible care. By having a keen understanding of symptoms, assessment procedures, and necessary response skills, oncology nurses can work together with the mental health team to provide holistic care throughout the cancer journey. 

Nearly 20% of Americans experience mental illness in a given year, according to the National Alliance on Mental Illness. With diagnoses such as schizophrenia, bipolar disorder, or major depression, about one in every 25 Americans suffers from a serious mental illness that directly affects major life activities. The prevalence of mental illness in the United States can have a downstream effect on cancer care and patient outcomes, and with these statistics, oncology nurses may encounter patients with cancer who have pre-existing psychiatric disorders. Healthcare providers in fields outside of psychology need to be prepared to address the unique needs and individualized care required to support this patient population during and beyond cancer treatment.