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Hospitalization for a cancer diagnosis and treatment may trigger stressful experiences for patients and family caregivers.
Moral distress experienced by staff has been well documented in the intensive care work areas, but less described in oncology nursing. Factors that contribute to moral distress include ethical dilemmas, mismatched goals of care among patients and their families and providers, and perceptions of futility of care. This article describes recognizing the risk of moral distress in a newly formed medical-surgical oncology unit and steps taken to mitigate developing moral distress, illustrating that moral distress...
Melanoma incidence and mortality rates are predicted to steadily increase. Sun protection is important during early development because of the potential for overexposure to ultraviolet radiation while outdoors.
Patients are living longer with recurrent breast cancer, but survivorship programs for these individuals are lacking.
Futility in medicine has been defined as excessive medical intervention with very little prospect of altering the clinical outcome in a positive manner. If treatments fail to release our patients from the preoccupation with the illness and do not allow them to pursue their life goals, then perhaps that treatment is futile.
American Indians and Alaska Natives (AIANs) have been documented as a population with high rates of cancer mortality in comparison to other racial and ethnic groups in the United States. During a time when other populations in the United States are experiencing improvements in cancer outcomes, cancer disparities in AIANs persist. The disparities in cancer outcomes in this diverse population can be attributed to a complex constellation of factors, which include access-to-care, economic, medical, and individu...
This issue of the Clinical Journal of Oncology Nursing (CJON) contains the inaugural installment of STAT, a visually compelling one-page review about oncologic emergencies or other clinical care issues that require urgent nursing attention. The reasons for STAT are simple. The need for nurses to have accessible and timely references to support clinical practice is well established. Studies consistently confirm that time management is a core nursing competency. To best manage that time, nurses who have ready...
Sepsis has a higher incidence of hospital stays and poorer morbidity and mortality outcomes in patients with cancer. The development of infection in weakened immune systems and prolonged treatment courses increase the risk for sepsis in patients with cancer. The causes of infection that can lead to sepsis in patients with cancer are further complicated by disease- or therapy-related neutropenia. Early recognition of sepsis is critical for prompt treatment to prevent tissue damage, organ failure, and mortali...
The lack of coordination of care for complex patients in the hematology setting has prompted nurse case managers (NCMs) to coordinate that care.
Liquid biopsy is defined as the process of obtaining material for pathologic examination and analysis from body fluids. Liquid biopsy has been intensively researched for its clinical application in patients with solid malignancies, including melanoma and colon, breast, and lung cancers. This will become a standard and routine tool for the diagnostic and prognostic evaluation of all cancer types. This article provides an overview of liquid biopsy, its uses in cancer management, and its implications for nursi...
Advance care planning (ACP) is an ongoing process of communication involving patients, family members, and caregivers on one side and healthcare providers on the other to establish values, goals, and preferences for future care, along with discussions concerning end-of-life care options. Advance directives promote patient autonomy and provide written documentation of a patient's wishes for future care.
Hazardous oral anticancer agents (OACs) require the same safe-handling considerations in the home setting as in controlled healthcare environments. Effective home management strategies for OAC administration emphasize caregiver protections, proper storage, safe administration, spill management, and proper waste disposal to reduce the risk for hazardous drug exposure.
Caregivers of patients with cancer experience high levels of caregiver-related strain and burden (CGSB). Cancer caregiving is complex and can change dramatically depending on the cancer trajectory. Often, this experience leads to poor health outcomes for the caregiver.
Oncology care has made the shift to the outpatient setting. The authors' cancer center is a basic life support-certified facility using an affiliated hospital for emergent transfers. A nurse-led initiative was developed in response to expressed anxieties and lack of comfort by staff related to their role in emergency management. Mock drills help staff retain knowledge and skills necessary during an emergency.
I would like to thank Cantril, Moore, and Yan (2019) for their informative article on patient preferences for the disclosure of a breast cancer diagnosis in the December issue of the Clinical Journal of Oncology Nursing. The findings of Cantril et al.'s (2019) study suggest that patients prefer in-person disclosure. Additional patient priorities included knowing the results of tests quickly, having those results disclosed by an expert with a sensitive touch, and having a clear understanding of the next step...
Thrombosis is the formation of a blood clot, or thrombus, inside of a blood vessel. Pediatric patients with cancer are at a higher risk of developing a thrombus because of their underlying disease, as well as their treatment and supportive care. Thrombosis can lead to significant morbidity, such as pulmonary embolism, in pediatric patients with cancer.
Advocacy, an important component of nursing professional practice, is pivotal to ensuring that nurses' experience and insight influence public policy. Understanding how to become engaged and receive training to inform that process can support nurses' professional development. Such engagement ensures that nurses' unique insights inform the policies that affect patient care and professional practice in oncology and beyond.
Survivorship care and survivorship care plans have become integral components of comprehensive cancer care and national accreditation. An academic and community cancer network successfully pilot tested a new non-nursing role to support efficiency in case finding, staffing, and tracking patients throughout care delivery: the survivorship data coordinator (SDC). Key functions of the SDC role include abstracting data into survivorship care plans, scheduling survivorship visits, and tracking the number of compl...
With morbidity and mortality related to opioid use continuing to increase, clinicians need to better understand the risk for opioid misuse in patient populations. Screening for opioid misuse risk has not been routinely adopted as a standard practice in clinical settings. A pilot study was performed to determine the feasibility of screening for future opioid misuse risk using the Opioid Risk Tool (ORT) in an ambulatory oncology clinic. Twelve patients in this sample scored in the moderate- to high-risk range...
With increasing support for the integration of palliative care and standard oncology, communication training programs are needed to teach oncology nurses and other providers about palliative care communication.
A comprehensive cancer center in the midwestern United States implemented a stakeholder-engaged quality improvement process to extend its existing one-year advanced practice provider (APP) fellowship program consisting of general oncology education and clinical experience to include an additional survivorship clinical rotation. APP fellowship alumni and program stakeholders reported noticeable benefits and greater importance attributed to program participation, validating inclusion of a survivorship clinic ...
Receiving a breast cancer diagnosis can be traumatic and anxiety-producing. The way the diagnosis is disclosed to patients can affect their experience.
Intraperitoneal (IP) chemotherapy is often a preferred treatment for ovarian cancer because of its clinical benefits, but research on the experiences of patients receiving IP chemotherapy is limited.
Forty years ago, on a New Hampshire hilltop, I received my nursing pin as a new graduate from nursing school. A white dress, bright white stockings, and nursing shoes were the order of the day, along with a red rose. Despite the trend away from caps, I secretly loved my nursing cap with its blue velvet stripe. But, the nursing world moved on and, by the end of my first year in practice, nursing caps had become a relic of the past. Looking at a picture from that day, with my favorite professor on the chapel ...