Cancer genomics influences all oncology nursing roles. Walking through the cancer care continuum shows how genomics—and oncology nursing—are involved at every level.

Patients throughout the United States still face persistent inequities across the healthcare continuum because of social determinants of health and inequity in research, Shannon N. Zenk, PhD, MPH, RN, FAAN, director of the National Institute of Nursing Research (NINR) recognized.

My role as a nurse navigator, for both patients with cancer and in the neuroscience arena, is the culmination of a 40-year career in oncology nursing. I got my start in nurse navigation 11 years ago. At the time I was working in Hoag’s brain tumor program and noticed that those patients had needs that we weren’t meeting. So, I shared my concern with the program directors and today Hoag continues to develop its brain tumor navigator role.

Nursing’s role in health equity, public health emergencies, and COVID-19 is a critical issue for updates to its Future of Nursing 2020–2030 report study, the National Academy of Medicine (NAM) said during a webinar on August 20, 2020, that sought public input on nurses’ roles in responding to the COVID-19 coronavirus pandemic.

In the 30 years since its inception in 1990, oncology nurse navigation has continually evolved and grown in response to patient and healthcare needs.

Seemingly overnight, many patients went from viewing telehealth as an intimidating frontier to embracing it with gusto. Fortunately, health care has prepared for years to put the infrastructure and people in place to support telehealth expansion.

Genomic testing identifies germline or inherited DNA changes that increase a person’s cancer risk, and it also can identify or profile the somatic or acquired changes in a tumor that guide selection of appropriate targeted therapies. The latter type of genomic testing is an analysis of DNA sequence information.

As groundbreaking yet high-cost cancer treatments make their way into clinical practice, the effects of financial toxicity can put a damper on the profound effects that new, lifesaving medications can have on patients with cancer. It’s a problem that even Washington, DC, hasn’t been able to address—so what can oncology nurses do about it?

Genetics versus genomics: Is there a difference? Does it even matter? There is, and it does. In our era of precision medicine, also referred to as individualized or genomic medicine, being able to differentiate the terms is a first step in establishing a foundational understanding of what they mean for cancer care from prevention to treatment.

Thanks to significant scientific and technologic advancements in the past 15 years, the majority of cancer care—an estimated 80% or higher—is being delivered in the outpatient setting.For patients, ambulatory oncology care offers comfort, flexibility, and a sense of normalcy during their difficult cancer journey while maintaining the highest-level treatment and care for optimal outcomes. Oncology nurses are key to successful outpatient care, serving as caregivers, educators, advocates, and patient champions from diagnosis through treatment and into survivorship.

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).

The Oncology Care Model (OCM) is a value-based payment system that the Centers for Medicare and Medicaid Services is piloting. OCM focuses on decreasing the cost of cancer care while continuing to provide high-quality care, including a high level of care coordination and navigation and adherence to national guidelines for care. Part of OCM requires implementing certain practice changes, including documenting a 13-point care plan for each patient.

You’re juggling three patients: one is nauseated and requesting lorazepam now, another’s blood transfusion is finished and the pump’s alarm is loudly chirping down the hall, the third has an order list coming in like rapid fire—and it’s only 8 am. In a blood and marrow transplant (BMT) unit, this sounds like a relatively calm morning.

Better care. Smarter spending. Healthier people. Those are the three hallmark goals of the Oncology Care Model, a value-based payment system developed by the Centers for Medicare and Medicaid Service’s Center for Innovation.

My charge nurse approached me and told me that I am getting an admission from the emergency department who presented with high blood pressure and shortness of breath. She told me that the patient is on concurrent chemoradiation therapy and has a rectal cancer.

Oncology care is one of the most challenging, yet rewarding, nursing careers that offers opportunities to care for patients in all stages of life. It’s a chance to help guide and support your patients through one of the most difficult times in their lives and be inspired by their determination, hope, and faith.

It’s more than just four walls and a roof. Home is where most people find comfort, solace, and a sense of familiarity. It’s where the heart is, and there’s no place like it. With advancements in cancer therapies, treatment care modalities, and technology, many of today’s patients are finding they can receive a large portion of their care in the home. Home care is not a new concept—rather it’s likely the oldest healthcare setting in human history—but it can be a complex and intricate care environment, especially when addressing specific needs related to cancer treatment. At its heart are expert oncology nursing professionals who safely deliver the best possible care for their patients—in the comfort of their own homes.  

Although the opioid crisis was formally labeled a public health emergency in late 2017, excess drug abuse beyond prescription directions has been a public health concern for much longer—since the 1980s, in fact. At the November 2018 Center for Advancing Palliative Care Annual Seminar in Orlando, FL, speakers Lynn Hallarman and Mary McPherson presented a session on how the opioid crisis came to be and what our role as nurses is in changing culture and ultimately addressing it.

When patients or loved ones receive a cancer diagnosis, they often experience fear, worry, and a desire to do everything possible to increase the chance of survival. It is also a pivotal time for patients to assess their well-being and lifestyle and make positive changes. For many, complementary therapies become part of their cancer care journey. Internationally, 40% of patients with cancer have reported using complementary therapies to address cancer-related symptoms, improve the effectiveness of conventional treatments, and provide hope.

Nurses can do it all. After all, the often-unsung heroes of health care use their unique skills to positively impact patients and their families in more ways than most people can ever imagine. Unfortunately, role confusion and a lack of awareness of a vital specialty have led to a dire need of nurses in clinical trials.

Because of immunosuppression from cancer or its treatment, patients are at a higher risk for viral, bacterial, and fungal infections. Patients who develop infections may experience dose delays or reductions that compromise optimal treatment outcomes, resulting in higher mortality rates, longer hospitalizations, and higher cost of care.

When the National Academy of Medicine, formerly the Institute of Medicine, released its 2010 report, The Future of Nursing: Leading Change, Advancing Health, it cited a need for improvement in nursing education and practice through the implementation of nursing competencies.