Oncology nursing workforce: challenges, solutions, and future strategies.

The global oncology nursing workforce is essential to achieving Sustainable Development Goals 3.4 (reduce non-communicable disease morbidity by a third by 2030) and 3.8 (universal health coverage). Unfortunately, challenges to a robust oncology nursing workforce include nursing shortages, recruitment barriers (eg, perceptions of a demanding specialty with complex care and hazardous work environments), and burnout. Innovative recruitment strategies, onboarding and continuing education programmes, occupational safety measures, and burnout prevention interventions are documented solutions. The long-term effect of COVID-19 on oncology care worldwide is unknown, but immediate therapy interruptions, workforce consequences, and threats to standard oncology nursing practice are addressed here. Retention of experienced oncology nurses is crucial for future cancer control in all countries and must be addressed, particularly in resource-constrained countries with few oncology nursing staff and continuing out-migration of nurses to resource-rich countries. As the cancer burden worldwide increases, the future of the oncology nursing workforce is reflected in the call from the International Council of Nurses, Nursing Now, and WHO for nurses to move to higher levels of leadership, advocacy, and policy making (ie, national cancer control planning) and assume responsibility for their key role in achieving global goals for cancer control.

Reflections on the Emotional Hazards of Pediatric Oncology Nursing: Four Decades of Perspectives and Potential.

THEORETICAL PRINCIPLES: Pediatric oncology nurses are particularly vulnerable to emotional distress. Responsible for the oversight of a child's care, these nurses sustain close interactions with multiple patients and families over time, many of whom are coping with life-limiting diagnoses. The world of pediatric oncology nurses is one where tragedy is routinely witnessed thus demanding self-care and healing across a continuum. PHENOMENON ADDRESSED: The aim of this article is to outline and review the emotional sequelae of pediatric oncology nurses' work and to suggest interventions to support well-being in light of prolonged caregiving. Three major categories that are addressed include the aspects of clinical practice that influence caregiving, the risks of burnout, compassion fatigue, moral distress and grief, and interventions to counteract these phenomena. RESEARCH LINKAGES: Future-nursing research should focus upon the development of validated, psychometrically sound measurement tools to assess nurse-specific variants of burnout, compassion fatigue, moral distress, and nurse grief. Qualitative research should investigate the relationship between personal variables, workplace and team characteristics, age and experience, and their influence on the predominance of burnout, compassion fatigue, moral distress, and nurse grief. Lastly, the phenomena of resiliency demands further study.

[The nurses involved in therapeutic innovation]. / Infirmière de recherche clinique en onco-dermatologie.

Clinical research nurses (CRNs) play an important role within the teams involved in the fight against cancer and in therapeutic innovation. In the dermatology department of the Gustave-Roussy Institute, patients treated for melanoma and taking part in clinical trials are supported along their care pathway by a CRN who, in addition to her clinical expertise, acts as a link between the different players concerned.

Acute oncology: a developing sub-specialty.

Patients with cancer frequently present to hospital as an emergency admission acutely unwell. Patients can suffer from complications of the cancer itself, or significant adverse effects/toxicities related to their cancer therapy. Alternatively, the initial presentation of the malignancy may be through a hospital admission, and the cancer can frequently be widespread and with a poorer prognosis. Patients are often admitted under general physicians, away from their comprehensive cancer care centre or oncologists. Without specialist input or staff adhering to most appropriate pathways, the management of these complicated conditions may be difficult, with patients sometimes having unnecessary and painful investigations and prolonged hospital stays. To address these issues the concept of an acute oncology service has recently evolved. This is a developing sub-specialty that aims to improve the care of cancer patients presenting acutely to hospital at a devastating time in their lives. This article will explore the literature to describe the recent development of the acute oncology model, and consider different methods for the delivery of this service.

Nurses' practices in targeted therapies in Turkey.

PURPOSE: The number of targeted agents has increased over the last years. The aim of this study was to explore the current practice and knowledge of nurses about targeted therapies and to identify the gap in their management in Turkey. METHODS: Nurses who attended to the oncology nursing educational programs organised by the Turkish Oncology Nursing Association were invited to participate. A total of 187 nurses from 29 cities responded. Data were collected via a 30-item questionnaire on demographics and knowledge and practices on targeted therapies. Following this survey nurses were invited to participate in "target" courses. RESULTS: More than half of them (57.2%) stated they were willing to receive information on targeted therapies, mostly through in-service education (32.7%). Also, most of them were partly (67.3%) or not satisfied (24.3%) with their knowledge. Only few explained what targeted therapies are and how they work. While most of them responded correctly about how and where to store targeted drugs, few (1.8%) wrote that these agents should be stored in freezer. The majority stated that targeted agents should be prepared like the chemotherapy drugs. CONCLUSIONS: Lack of knowledge may cause errors and influence drug effectiveness. Nurses need to be supported with information. This survey revealed the needs in nursing practice over targeted therapies, side-effects and management.

Oncology Nursing for the Future: Multisector Planning Is Needed.

Assessing the landscape for oncology nursing of the future, the biggest problem that faces the specialty is that of workforce shortages. On the practice side, nursing turnover, resignations, and early retirements have contrib.

Oncology Nurse Navigation in Underserved Communities: Opportunities and Future Directions.

OBJECTIVES: Provide an overview of navigation in three disparate populations: rural, Native American/Alaska Native, and low- to middle-income countries. Discuss gaps in care and opportunities to improve cancer care. METHODS: A literature search was conducted in PubMed and on Google Scholar using search terms, nurse navigation, cancer, disparit*, low- to middle-income countries, Native American, American Indian, and rural. Peer-reviewed research studies, review articles, databases and websites of professional organizations, and historical books were reviewed to provide an overview of oncology nurse navigation in underserved communities. Experiences in working with these populations over the past 30 years were also provided to support current literature. RESULTS: Forty references were included in this overview of nurse navigation in underserved communities. Nurse navigation in these disparate areas is in its infancy. While some programs exist and outcomes have been positive, their dissemination is sparse. A need exists to expand nurse navigation into these areas to provide care for these underserved communities. CONCLUSION: Oncology nursing navigation for each of these underserved communities requires a culturally sensitive approach. Many of these approaches are universal to cultural competency and can be applied to most disparate populations. IMPLICATIONS FOR NURSING PRACTICE: Nurses comprise the largest workforce around the globe and are well-equipped to develop navigation programs in some of the most disparate communities around the world. To do so, it is important to use a foundation of building trust, embracing individual differences, providing culturally sensitive education and resources for growth, and good communication.

A pilot study of satisfaction in oncology nursing care: an indirect predictor of quality of care.

PURPOSE: Although "satisfaction" is not easy to define, excellence in health care is impossible without professional/patient satisfaction, so this paper aims to report on a pilot study designed in order to evaluate the degree of nursing staff satisfaction with the implementation of measures to improve quality of care. DESIGN/METHODOLOGY/APPROACH: The project consisted of several phases: writing protocols of care; training of nursing staff in their management; and a cross-sectional study to evaluate nursing staff satisfaction with them. The design of the survey consisted of a 16-item Likert scale, which had to be auto filled. A factorial analysis to simplify and validate the tools was used, using statistical analyses with SPSS software 8.0. PRACTICAL IMPLICATIONS: The results are applicable to young small oncological units with high degree of variability in patient care. The study showed that nursing staff satisfaction with new improvement measures taken improves safety and finally quality of care. FINDINGS: The study obtained four dimensions (D) explaining 100 percent of variance. Each dimension with several items: D1: "Nursing job quality" explaining 48.4 percent of variance; D2: "Satisfaction with the knowledge"; D3: "Nursing job feelings/perceptions"; D4: "Nursing communication with doctors/patients". It provided a direct point of view of each nurse, knowledge about problems encountered daily and demonstration of how a simple/convenient method is useful to engage the staff in decision-making-process and implementation of new strategies or to promote the integration of basic aspects of health management in daily clinical practice. ORIGINALITY/VALUE: This is the first study evaluating nursing staff satisfaction with new improvement measures taken in a small medical unit, aiming at quality of care benefits. Very promising results were obtained although the sample size was small.

Nurses' knowledge about end-of-life care: where are we?

BACKGROUND: During the end-of-life stage, patients suffer from multiple symptoms or impairments of altered body systems. This study examined nurses' knowledge of end-of-life care and also the relationship between the nurses' knowledge and their characteristics. METHODS: This was a descriptive, correlational study using a convenience sample of 368 Korean registered nurses working in cancer units, general wards, and intensive care units of a university health system. Twenty questions of the Palliative Care Quiz for Nursing (PCQN) were used to examine nurses' knowledge of end-of-life care. RESULTS: The mean score on the PCQN was 8.95 of a possible 20. Participants who had the end-of-life care education (M = 9.57, SD = 2.19) tended to score higher than those without this education (M = 8.47, SD = 2.34), and the difference was statistically significant. CONCLUSION: Comprehensive continuing education programs on end-of-life care should be provided to fill the gap in knowledge and skill of staff nurses.

[Breast care nurse. A new specialist in the multidisciplinary care of breast cancer patients]. / Az emlorák-terápiás novér. Új szakember az emlorák multidiszciplináris ellátásában.

The uniform European structure and professional standards for high quality breast cancer care were established in conjunction with the European Organisation for Research and Treatment, the European Society of Mastology and the European Breast Cancer Coalition with the support of the European Parliament. Well-prepared professional teams including a new member called the breast care nurse serve as ground for special breast cancer centers with international accreditation that provide modern, evidence based, patient centered multidisciplinary oncological care. The responsibilities of the new qualified professional staff member include the psycho-social support of the patient and carers from the moment of diagnosis throughout the whole oncological treatment, the fostering of delivering information and communication between patients and specialists. As a result of the curriculum founded by the European Oncology Nursing Society, breast care nurses have become key members of the practice of holistic breast cancer care in countries where the European recommendations have already been implemented. Considering the expected rearrangement of national oncological care, the new sub-specialty is outlined for the first time in the light of the experiences gained at the National Institute of Oncology, Budapest, a comprehensive cancer center.

Development of palliative care in Israel and the rising status of the clinical nurse specialist.

It was in 2009 that the Ministry of Health in Israel issued unique recognition for registered nurses. Palliative Care has been recognized as a specialty for nurses, working already in different clinical specialties. By obtaining the qualification of a Clinical Nurse Specialist in Palliative Care, nurses obtained the de jure status of what they have been doing for years de facto.

Sleep-Wake Disturbances in Oncology.

Sleep-wake disturbances are common in patients with cancer. Despite the high prevalence of altered sleep patterns in oncology settings, there remains a gap in consistent assessment of sleep, leading to an underrecognized and undertreated condition. Provider failure in addressing sleep-wake disturbances can result in chronic issues with insomnia and has a negative impact on quality of life and cancer survivorship. Often sleep-wake disturbances present in symptom "clusters" including, anxiety, depression, and fatigue, which adds to the complexity of managing sleep disorders in oncology. Aggressive management strategies for managing underlying symptom burden from disease or medications effects is a priority.

Oncology Certified Nurse Specialist in Japan.

The purpose of this article is to review a historical perspective of the Certified Nurse Specialist role and current trends in nursing education and practice of the Oncology Certified Nurse Specialist. Since the initiation of Certified Nurse Specialist credentialing system in 1995, 193 Oncology Certified Nurse Specialists have practiced in clinical settings. The Oncology Certified Nurse Specialist credentials committee, the Association of Nursing Programs in University and the Association of Oncology Certified Nurse Specialists play the important part to maintain a high level of Oncology Certified Nurse Specialist competencies in Japan. The Oncology Certified Nurse Specialist should promote the outcomes research to assess the effectiveness of nursing intervention by the Oncology Certified Nurse Specialist, and participate in the interdisciplinary research by collaborating with other health professionals to realize the ongoing cancer reforms in Japan.

Factors influencing oncology nurses' approaches to accommodating cultural needs in palliative care.

AIMS AND OBJECTIVES: The purpose of this study is to explore the social construction of cultural issues in palliative care amongst oncology nurses. BACKGROUND: Australia is a nation composed of people from different cultural origins with diverse linguistic, spiritual, religious and social backgrounds. The challenge of working with an increasingly culturally diverse population is a common theme expressed by many healthcare professionals from a variety of countries. DESIGN: Grounded theory was used to investigate the processes by which nurses provide nursing care to cancer patients from diverse cultural backgrounds. METHODS: Semi-structured interviews with seven Australian oncology nurses provided the data for the study; the data was analysed using grounded theory data analysis techniques. RESULTS: The core category emerging from the study was that of accommodating cultural needs. This paper focuses on describing the series of subcategories that were identified as factors which could influence the process by which nurses would accommodate cultural needs. These factors included nurses' views and understandings of culture and cultural mores, their philosophy of cultural care, nurses' previous experiences with people from other cultures and organisational approaches to culture and cultural care. CONCLUSIONS: This study demonstrated that previous experiences with people from other cultures and organisational approaches to culture and cultural care often influenced nurses' views and understandings of culture and cultural mores and their beliefs, attitudes and behaviours in providing cultural care. Relevance to clinical practice. It is imperative to appreciate how nurses' experiences with people from other cultures can be recognised and built upon or, if necessary, challenged. Furthermore, nurses' cultural competence and experiences with people from other cultures need to be further investigated in clinical practice.

The Future of Immunotherapy in the Treatment of Cancer.

OBJECTIVES: To discuss future direction and present an overview of the evolution of immunotherapy long-term toxicity issues, financial toxicity, and new emerging survivorship considerations. DATA SOURCES: Peer-reviewed manuscripts, Web sites. CONCLUSION: Cancer treatments involving immunotherapy have had a major impact on long-term survival, toxicity, and survivorship issues. IMPLICATIONS FOR NURSING PRACTICE: Nurses play a pivotal role in the care of the cancer patient across the continuum. With the unique toxicities associated with immunotherapy, it is essential that nurses be keenly aware of all aspects of management, from physical to financial care.

Disparities in Hispanic Care.

Attendees at a 2019 ONS Congress session about disparities in clinical trials seemed to be aware that African Americans are underrepresented. But what about Hispanic patients with cancer? I sensed that some of my colleagues had not considered Hispanic recruitment before and were surprised to learn the facts about clinical trial disparities in this population.

Cancer nursing: past, present, and future.

This article explores the context and nursing care that was provided to people facing the challenges imposed by cancer diagnoses throughout history and issues that influence cancer nursing as it continues to evolve in the twenty-first century. Considerations and potential strategies for the nursing profession to address these issues are offered.