Oncology nurses face some uncomfortably common truths when treating patients with cancer. Invariably—no matter how hard certain patients fight—some will die from their diseases. Patient death is a part of oncology care, and no nurse would tell you differently. But accepting and dealing with loss and grief is sometimes pushed aside in favor of stoic attitudes that some may equate with professionalism.

From the day you began your career as an oncology nurse, it is quite likely that two main principles were ingrained into every aspect of your training and practice: infection prevention for our very susceptible patient population and using safe handling to reduce the risk of exposure to chemotherapy and other hazardous agents.

Mistakes happen. Unfortunately, there’s no avoiding it, no one is above it, and I'm sure we can all think of a time that we made a mistake in our nursing practice. The events following a mistake in patient care can be chaotic and emotional. But after the dust settles, what’s most important is learning how to avoid the same mistakes from occurring again, and doing all you can to prevent your fellow nurses from making mistakes in a similar situation. Think of it as primary prevention.

During a session presented at the 2016 ASCO Annual Meeting that discussed team-based oncology care, ONS member Wendy H. Vogel, MSN, FNP, AOCNP®, an oncology nurse practitioner at Wellmont Cancer Institute in Kingsport, TN, discussed how advanced practice providers can be involved in the care team process.

Have you ever made a mistake in nursing? Well, I have and want to share my experience, feelings, and outcome. When this happened, all that I kept thinking was, “Did I harm my patient?” Maybe that sounds familiar to you. I think we can all say that we went into nursing to help others, not harm them.

A recent article on the Scrubs website, “Chemotherapy Drugs are Killing Nurses” shared important facts and concerns regarding the handling of hazardous drugs. It also highlighted the need for comprehensive education and collaboration to establish a culture of safety around the use of these drugs by building respect, not fear, for hazardous drugs in the workplace.

Great catch, near miss, smart catch—they all mean the same thing: someone protected a patient from harm during care. These healthcare gems happen 24 hours a day, 365 days a year by every discipline in every healthcare setting, yet we rarely celebrate them. Why? Because health care is supposed to be safe. We're supposed to be highly reliable. We are supposed to heal and not harm. It's a must.

It has been a little over a year since cardiologist Dr. Michael J. Davidson, 44, was shot and killed at Brigham and Women's Hospital in Boston. He was murdered during the day by the son of a patient he treated who had died a few months prior to the shooting. I remember that day well. I was working in my clinic and all of us wondered, “How could this happen? And could it happen in our clinic?” I like to think that all of our patients and families are thankful and appreciative for all we do for them, but unfortunately that isn't always the case.

Clinical environments demonstrating a strong culture of safety have optimized communication and teamwork among front-line staff, physicians, and leadership. A safe work environment is one in which the physical health and well-being of all staff are considered prerequisite for safe patient care. Consider for a moment the ways your workplace supports healthy behaviors on the part of employees.

There is currently a huge focus on patient safety. It's not just in the news and literature. It pervades the clinical environment. I'm currently spending my days between two major teaching hospitals and an outpatient cancer institute, all in Boston, MA. Some of the safety concerns I have encountered just in the past week include 

“Hey, you didn’t dress up for me today. Where’s your pretty blue dress?”

At first I wasn’t sure what the patient in the chemotherapy chair was talking about. After a moment, I realized the patient was referring to the blue safety gowns we wear. I heard the infusion nurse respond as she removed the chemotherapy from the hazard bag, “Oh yeah, I’m kind of in a hurry today.”

While the patient could possibly benefit from the chemotherapy, for the nurse that same drug posed a serious hazard.

Change is constant. Change is challenging. Some changes, like the five rights of medication administration, surgical timeouts, and clinical pathways, are compulsory. Changes are often identified when something fails. A traffic light becomes a permanent fixture at an intersection where accidents or a loss of life happen. A new protocol is enacted when a fatal error occurs. Awareness drives change and safety initiatives in health care.

Because oncology practice settings are often are chaotically busy with the need to deliver complex care, high-risk treatments, and psychosocial support, oncology nurses are key contributors to the assurance of safe and high-quality care. Patients expect to receive safe care provided by competent staff, and oncology nurses must be aware of the magnitude and significance of safety-related risks.

During a patients’ initial visit, they’re asked to fill out a screening tool that helps provide a clearer picture as to what their home life is like. This tool addresses important information that helps to dictate our care. Though patients may feel like this is “just another piece of paperwork,” it is crucial to helping us understand their needs and to begin planning for special precautions we many need to take going forward.

Darker lenses do not necessarily provide more protection from harmful ultraviolet rays—consumers need to check the label to be sure the pair blocks 99%–100% of both ultraviolet A and ultraviolet B radiation or say “UV absorption up to 400 nm."

I saw something recently that made my alarms go off screaming "Med error! Med error!" I was about to get medication for my patient when a nurse jumped in front of me. I didn't mind; I had enough time and figured that he must be in a hurry. I saw him get medication out for his patient. Then, I saw him get medication out for a second patient.

Recent studies show that approximately 41,000 patients in the United States alone develop central line-associated bloodstream infections (CLABSIs) annually and that CLABSIs are one of the most deadly types of healthcare-associated infections.

Can you answer the fol­low­ing ques­tion correctly?

In 2011, a work­group con­sist­ing of Amer­i­can Soci­ety of Clin­i­cal Oncol­ogy (ASCO) and ONS mem­bers was con­vened to review feed­back received since pub­li­ca­tion of the ASCO/​​ONS Stan­dards for Safe Chemother­apy Admin­is­tra­tion in 2009 and to clar­ify the stan­dards as needed. The most sig­nif­i­cant change is the deci­sion to extend their scope to the inpa­tient set­ting. This