Oncology nurse-patient relationship
Clinician Biases Leave Patients Feeling Unsupported When Electing for Flat Closure Mastectomies
Although 74%–84% of patients with breast cancer who undergo mastectomies are satisfied with their bodies and outcomes after electing to have a flat closure, 20%–35% say that they felt unsupported by their cancer care team during the process. Patients report feeling marginalized or stigmatized, not being told that flat closure is an option, and even left with excess skin against their wishes because the care team wanted to give them “future options.”
Delivering Holistic Cancer Care Requires Oncology Providers to Weave Spirituality in Their Practice
Spiritual care is an essential component of cancer care. Representing an individual’s “sense of peace, purpose, and connection to others and beliefs about the meaning of life, spirituality is not synonymous with religion, which is “a set of beliefs and practices that center on questions about the meaning of life and may involve the worship of a supreme being.” Several healthcare organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Multinational Association of Supportive Care in Cancer, and the Joint Commission recommend including spiritual care in cancer care guidelines.
Add Meaning to Your Communication With This Key Element
Meaningful communication involves more than just words traded between people. By asking open-ended questions, affirming a person’s strengths, offering reflections, and providing a summary of the conversation, you can engage others in meaningful conversation.
Rare Cancer Survivor and Oncologist Speak About the Cancer Journey and Challenges in the Patient Experience
Deanna Fournier, a cancer survivor, and Eli Diamond, MD, a neuro-oncologist at Memorial Sloan Kettering Cancer Center in New York, NY, discussed Fournier’s cancer journey and the progress toward a better patient experience during a National Cancer Institute Office of Cancer Survivorship lecture. Communicating with patients throughout their cancer journey can help healthcare providers, including oncology nurses, support patients and advocate for their unique needs.
Transgender Patients, Deadnaming, and Patient Identification
Individuals who identify as transgender and non-binary may no longer use their birth or legal name but rather choose a new name that aligns with their identity. When they ask that you use their new name instead, calling them by their old name is referred to as deadnaming and can be a stressful and traumatic experience for the individual and is even considered an act of verbal violence.
Use Motivational Interviewing to Tailor Your Conversations to Your Patients’ Unique Needs
People encounter significant changes after being diagnosed with cancer. Oncology nurses can help patients and caregivers adapt by using motivational interviewing–based communication strategies.
Religious Fasting During Cancer Treatment
Many cultures and religions across the world practice fasting, or the absence of caloric intake for a few hours to several weeks, at different times throughout the year. Islam, Judaism, Buddhism, Christianity, Hinduism, and Taoism religions most commonly use fasting for various reasons, but the overall purpose generally is to demonstrate sacrifice or spiritual cleansing.
Precision Oncology Models Guide Tailored Nursing Interventions for Ovarian Cancer Symptom Clusters
Using the National Institutes of Health Symptom Science Model and Nursing Science Precision Health Model helps oncology nurses to recognize symptoms more promptly in patients with ovarian cancer and provide precision interventions that address racial disparities and foster equity in symptom-focused, patient-centered care, Mahoney and Pierce reported in the October 2022 issue of the Clinical Journal of Oncology Nursing.
AHRQ Recognizes Nurses’ Unique Contributions to Diagnostic Processes
Nurses bring unique but critical input to diagnostic processes in the emergency department, the Agency for Healthcare Research and Quality reported in August 2022. “Nurses have unique, valuable knowledge based not only on principles of science but also on holism and intuition,” the agency said.
Use Conversational Assessments to Deliver Whole-Person Care
Whole-person care involves evaluating a patient’s physical, emotional, spiritual, and social health. A conversational assessment can help oncology nurses foster an open dialogue about the patient as a person, not just their physical or health needs.
When the Provider Becomes the Patient: What I Learned From COVID-19
My world changed on December 22, 2021. It is a day I will never forget: the day I tested positive for COVID-19. For nearly two years, all while caring for patients with the virus, I avoided contracting it. I prided myself on mask-wearing, handwashing, and social distancing, but what we know all too well is that COVID-19 does not discriminate.
Connect With Your Patients on a Human Level as Well as a Healthcare Level
As a healthcare provider, I had been warned about getting too close to my patients. They told me that it was unprofessional, it would cloud my judgment, it would lead to emotional burnout, and various other reasons. For my first year as a nurse, I took that advice to heart and kept my emotional distance while still doing my best to provide care to the whole patient. Then one night I met Jeff, and everything changed.
Mrs. Jones Gave Me the ‘Ah-Ha’ Moment That Guided My Entire Nursing Career
After years of hard work, Mrs. Jones and her husband had what seemed to be an idyllic life traveling and enjoying their life together. As a newly minted nurse on the medical/surgical unit, I got to know them over the months I cared for her during repeated admissions for melanoma. At each admission, they would be side by side, inseparable and so in love. I was just a new bride, and I wondered if my marriage would be as magical as theirs.
After Two Decades of Trust, It’s Time for Action
“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.
Use the Evidence to Integrate Ethics in Teleoncology Care
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.
Don’t Ask Patients About Their Symptoms—Have Them Tell You
“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.
Patients and the Public Recognize and Thank Dedicated 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.
Anticipate and Address Anxiety in Survivorship 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.
Master the Essentials of Effective Communication
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.
I’m a Match: My Journey From Advanced Practice BMT Nurse to Stem Cell Transplant Donor
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.
Global Report Indicates World's Trust in Science, Scientists Rises Amid COVID-19 Pandemic
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.
Break Bad News to Patients With This Step-by-Step Guide
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.
Cultural Humility Is a Nursing Clinical Competency
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.
Nurses Can Help Patients With Cancer Manage the Complexity of Comorbid Psychiatric Disorders
When a patient’s behavior is different than what would be expected, swift identification and treatment can be critical, if not lifesaving when it comes to psychiatric disorders or symptoms, Kathleen Murphy-Ende, PhD, PsyD, AOCNP®, PMHNP, from the University Wisconsin, said during a session September 16, 2021, for the ONS BridgeTM virtual meeting.
U.S. Surgeon General Issues Report on Dangers of Health Misinformation During the COVID-19 Pandemic
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.
HHS Solidifies Protections for LGBTQ Patients
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.
Big Tobacco Continues to Target Female Smokers, but Oncology Nurses Can Help
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.
Maximize Your Words’ Healing Power
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 Have an Ethical Responsibility to Speak Up and Advocate for Patients
“Ethical issues and dilemmas are inherent in the care we provide to our patients and their families across the life span,” Joyce Neumann, PhD, APRN, AOCN®, BMTCN®, FAAN, from the University of Texas MD Anderson Cancer Center in Houston, said during a session on April 22, 2021, for the 46th Annual ONS Congress™. “We have a responsibility to speak up and speak out individually, through our professional organizations like ONS and the American Nurses Association (ANA), and internationally, when possible, to advocate to resolve ethical issues.”
Here’s Why Advanced Practice Nurses Are Ideally Suited to Manage Telehealth Programs
As use of digital health or telehealth has grown, healthcare providers have had to address challenges and get buy-in on multiple levels. Will patients feel comfortable and heard during a phone call or video chat? Will staff still be able to provide optimal care? Advanced practice RNs can apply their skills and experience to create a supportive telehealth environment for patients and families as well as for professional staff.
ANA Launches Nurse-Specific COVID-19 Vaccine Campaign
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.
Empower Recent Graduate Nurses to Be Patient Advocates
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.
Always Search for Ways to Connect With Patients
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.
Nurses Help Patients Weather the Storm of CAR T-Cell Therapy
Chimeric antigen receptor (CAR) T-cell therapy is at the forefront of care for a specific subset of patients with cancer. However, the severe side effects of this highly specialized treatment require unique management. During a session for the inaugural ONS Bridge™ virtual conference, Kathleen McDermott, RN, BSN, OCN®, BMTCN®, of Dana-Farber Cancer Institute, discussed how oncology nurses can temper the storm of CAR T-cell therapy.
The Case of the Delicate Discussion
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 Public Trusts Nurses’ Voices During Health Emergencies
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.
Word Choice Matters When Caring for Patients With Cancer
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.
Nurses Improve the Care Experience for Bone Marrow Transplant Recipients
Patients who receive bone marrow transplantations require vigilance for complications such as graft versus host disease, opportunistic infections, and febrile neutropenia. During a presentation for the inaugural ONS Bridge™ virtual conference, Barbara E. Wenger, DNP, APRN, AOCNS®, CRNI, of UCHealth Metro, and Stephanie Armstrong, DNP, AGNP, NP-C, of Froedtert Hospital Clinical Cancer Center, described interventions to improve care quality in the BMT population.
Nurses Can Provide Safe Spaces for LGBTQ Patients With Cancer
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.
Oncology Nurses Have a Special Power of Presence
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.
LGBTQ Patients With Cancer
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.
Unique Roles in Oncology Nursing: Oncology Nurse Navigation
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.