Clinical Oncology Nursing: Will You Leave or Stay?

Anyone who works in clinical oncology care sees it, experiences it, or feels it on a daily basis: a real or perceived shortage of nurses and, specifically, experienced clinical oncology nurses.

Cancer nursing research priorities: A rapid review.

PURPOSE: Identifying cancer nursing research priorities is central to influencing the direction of cancer care research. The aim of this rapid review was to explore research priorities identified by oncology nurses for cancer care delivery between 2019 and 2022. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis informed the design of the rapid review. MEDLINE, CINAHL, PUBMED, Web of Science, and Cochrane databases were searched for studies published between December 1st, 2018, and September 30th, 2022. This timeframe was chosen to account for the latest relevant evidence synthesis, as well as changes in cancer care necessitated by the COVID-19 pandemic. The Quality Assessment of Diverse Studies tool was used to appraise quality. RESULTS: Four studies met the inclusion criteria. Many of the research priorities identified were influenced by the COVID-19 pandemic. The top cancer nursing research priority identified was the role of technology in improving patient and caregiver symptoms and health outcomes. Other most prevalent research priorities were focused on symptom management, culturally sensitive palliative and psychosocial care, early/integrated palliative care, financial toxicity, modifiable risk factors related to social determinants of health, public and patient involvement in research, and oncology nurses' well-being and scope of practice. CONCLUSION: The findings indicate a need to steer a strategic programme of cancer nursing research towards digitalisation in cancer care to meet the current needs of people living with cancer and their caregivers. However, cancer nurses' burnout, staff shortages and disparities in specialist education will hinder the implementation of certain models of care.

Pilot Testing of Virtual Simulation-Based Experiences in an Oncology Nursing Seminar.

BACKGROUND: The coronavirus disease 19 (COVID-19) pandemic challenged nurse educators to develop teaching strategies to engage students in a virtual classroom. This pilot study examined the effect of virtually delivered video-recorded (VDVR) simulation-based experiences (SBEs) with standardized participants on the management of clinical emergencies in patients and families affected by cancer on nursing student learning outcomes. METHOD: A pre- and posttest, one-group, convergent mixed-methods design with questionnaire variant was used. Data were collected before and after SBEs. RESULTS: Nineteen senior baccalaureate nursing students participated in this pilot study. The VDVR SBEs resulted in a significant increase in self-perceived competence. Participants had positive perceptions about the use of VDVR SBEs as a teaching strategy. Qualitative themes included realism, critical analysis, and preference for hands-on learning. CONCLUSION: The VDVR SBEs were well-received by prelicensure nursing students as a supplemental teaching strategy to enhance self-perceived competence. Additional research is needed about the effects of VDVR SBEs on learning outcomes. [J Nurs Educ. 2023;62(3):167-170.].

Influence of the COVID-19 Pandemic on Clinical Oncology Nursing Care.

Exactly where are we in the practice of clinical oncology nursing, now indelibly altered by the COVID-19 pandemic? Depending on the day or hour, experts in clinical oncology care claim that clinical oncology practice has stab.

Struggling, Adapting, and Holding Each Other Up: A Qualitative Study of Oncology Nurses During the First Year of the COVID-19 Pandemic.

PURPOSE: To explore the experience of oncology nurses during the first year of the COVID-19 pandemic. PARTICIPANTS & SETTING: 21 RNs, advanced practice RNs, and physician associates from inpatient and ambulatory care settings at a comprehensive cancer center in the northeastern United States. METHODOLOGIC APPROACH: A qualitative study using interpretive description was conducted through semistructured interviews. Data were recorded and transcribed verbatim, reviewed for accuracy, and coded into themes following an iterative process of analysis. FINDINGS: The theme of "Doing It Together: Struggling, Adapting, and Holding Each Other Up" describes the experience of oncology nurses during the first year of the COVID-19 pandemic. The following three themes provide further insight: "Struggling With Constant Change and Uncertainty," "Managing Workload Intensity," and "Experiencing Emotional Distress." As the year progressed, "Identifying Benefits and Finding Hope" began to emerge. IMPLICATIONS FOR NURSING: The findings suggest a need for programs to help nurses cope with the continuing effects of the COVID-19 pandemic, mental health and well-being resources, and nursing guidelines for telehealth and relocation to other units.

Palliative care delivery changes during COVID-19 and enduring implications in oncology nursing: a rapid review.

PURPOSE OF REVIEW: A rapid review was conducted to synthesize evidence of palliative care delivery changes during the COVID-19 pandemic. Changes were synthesized according to the eight domains of high-quality palliative care and enduring implications for oncology nurses beyond the pandemic discussed. RECENT FINDINGS: The most significant changes occurred in the structure and processes of palliative care (Domain 1), where increased utilization of telehealth was critical in circumventing barriers imposed by COVID-19 mitigation. The suboptimal availability of community-based psychosocial supports for patients and caregivers and inadequate health system-based psychosocial supports for healthcare providers were highlighted (Domains 3-5). The pandemic also ushered in an increased emphasis on the need for advance care planning (ACP), where integrating its delivery earlier in the outpatient setting and shifting policy to promote subsequent virtual documentation (Domain 8) were essential to ensure care preferences were clarified and accessible before health crises occurred. SUMMARY: Continuing to embrace and sustain systems-level changes with respect to telehealth, psychosocial supports, and ACP are critical to bridging gaps in palliative care delivery underscored by the pandemic. Oncology nurses are well positioned to fill these gaps in care beyond the pandemic by providing evidence-based, palliative care throughout the cancer continuum.

Oncology Nursing Symptom Science: Overview of the NINR, ONS, and NCI Symptom Science Colloquium.

This article provides an overview of the process, development, and evaluation of the Symptom Science Colloquium sponsored by the National Institute of Nursing Research, Oncology Nursing Society (ONS), and National Cancer Institute. This colloquium was the first of its kind to leverage the common goals of these institutes to advance oncology symptom science. Specifically, this article will identify the goals of the agencies involved and synergy in forming this collaboration, review the ONS Research Agenda that provided the blueprint for the colloquium, and offer insights and lessons learned to be used for future planning. The colloquium engaged roughly 500 participants from all levels of clinical (RNs, advanced practice nurses), educational (undergraduate, master's, doctorate), and research (students, faculty, scientists) expertise. Six featured expert speakers and 115 poster presentations focused on the latest research in symptom science, cancer survivorship, palliative and end-of-life care, and hot topics (COVID-19, health disparities). Fourteen networking sessions fostered opportunities to engage with international experts. Special awards emphasized mentee-mentor relationships and exemplary midcareer faculty. Based on this emphasis, the authors provide themes from the successful award applications as exemplars. A summary of participant satisfaction and recommendations for future collaborations to enhance and advance oncology symptom science are provided.

How Do You Start an Oncology Nursing Career During the COVID-19 Pandemic?

My passion for oncology started when I was just eight years old. My mother sat with me and shared that my dad had cancer. I saw my father cry as I heard the news, so I immediately knew something was very, very wrong. My father was diagnosed with mantle cell lymphoma and was given only six months to live. He fought for five long years and left a legacy of love, laughter, and Kenny Chesney sing-alongs. Fast-forward 15 years, and I landed my first nursing job on an oncology unit. My dream of working with patients with cancer was finally coming true, or so I thought.

Patient Assessment: Using the Oncology Nurse Navigator Patient Assessment for Rural and Other Resource-Poor Settings.

Oncology nurse navigators (ONNs) rely on assessment tools to identify patient priorities so that care may be expedited along the cancer continuum. Few nonproprietary assessment tools exist for ONNs who work in rural and other resource-poor settings to reliably identify and track patient needs and barriers for seamless and timely oncology care.

Direction From Data.

This past summer, three pivotal trend reports were released that give direction to clinical oncology care and oncology nursing. After a tumultuous 2020, results from the 2020 U.S. census were finally compiled and reported in August 2021.

The Needs of Older Adult Cancer Survivors During COVID-19: Implications for Oncology Nursing.

OBJECTIVES: Older adults living with cancer have been described as more susceptible to coronavirus disease 2019 (COVID-19) and in need of special attention during the COVID-19 pandemic. For cancer survivors, the first year post-treatment is a critical time because many individuals transition back to their primary care provider and adjust to physical and psychosocial changes that occurred during their cancer treatment. In this longitudinal qualitative study, we followed a cohort of older adult cancer survivors through the first three waves of the pandemic to describe their experiences as a means for providing recommendations for how oncology nurses can tailor support to this unique population. DATA SOURCES: We conducted individual, semi-structured qualitative interviews with 24 older adults at three time points during the pandemic. Data were analyzed drawing from interpretive descriptive methodologies. CONCLUSION: Older adult cancer survivors' needs shifted during the pandemic from feeling confident and self-assured during the early days of COVID-19 to growing uncertainty and unease about their health and well-being. The main survivorship concerns included a preference for in-person appointments (as opposed to virtual), barriers to caregiver attendance at appointments, and diminished access to health care services. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses play a critical role providing care to older adult cancer survivors and are most familiar with unique patient needs and the gaps in services they face. We provide recommendations for oncology nursing practice that consider the shifting needs of older adult cancer survivors during COVID-19 and beyond.

Equity in Health Care.

The Oncology Nursing Society (ONS) has made marked contributions to the art and science of nursing, including establishment of resources and a community for oncology nurses across the United States. ONS's core values have evolved to innovation, excellence, advocacy, and inclusivity (ONS, 2021). While we know that these core values are, in virtue, admirable, there is a stark need to address another value-equity.

Beyond the Chemotherapy Certificate: Building a Knowledge Base Virtually for Oncology Nursing Practice Across a Health System.

In a 51-hospital system serving seven states in the western United States, an organizational assessment in 2016 indicated critical staff shortages in one region for chemotherapy and immunotherapy-trained nurses. Leadership across the system was also concerned about nurse retention and turnover rates. Oncology nursing professional development practitioners designed and implemented a new multimodal oncology curriculum that utilizes a flipped classroom technique. Results indicate that first-year turnover rates were lower in nurses who participated. Healthcare systems are encouraged to invest in organizational infrastructure to implement nurse transition into practice programs to prepare, sustain, and stimulate specialization in oncology nursing.

Homecare Encounters: An Organizational Response to Innovative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation During COVID-19.

BACKGROUND: Healthcare delivery has been significantly changed because of the COVID-19 pandemic. Patients undergoing hematopoietic stem cell transplantation (HSCT) are vulnerable to infections because of their immunocompromised status. The risk of nosocomial infection may be reduced by providing care to patients at home. OBJECTIVES: This article describes one cancer center's approach for delivering safe patient care through homecare encounters, the benefits of home care for HSCT, and future directions. METHODS: Patients received detailed information on home encounters. Advanced practice providers visited patients daily and then returned to the clinic to formulate a plan of care with the interprofessional care team. Transplantation RNs visited patients on the same day to provide the prescribed care. FINDINGS: Based on evaluations from 32 patients and 12 providers, the results indicated that home care was safe, feasible, and beneficial for patient care post-HSCT during the COVID-19 pandemic.

What Lessons Did I Learn From My Experience With Cancer and COVID-19 During the Pandemic?

As a nursing student back in the late 1970s, I thought I would not work in oncology because it hit too close to home; my mother, my grandmother, my grandfather, and a college friend had all had cancer. Working with patients with cancer would bring up too many memories and worries to which I would never subject myself.

Pain Management Revisited.

Now that the SARS-CoV-2 virus and its variants have altered clinical oncology practice as we know it, let's return to a familiar focus from the Core Curriculum for Oncology Nursing-pain management. Much has happened during the past two years that influences the effective management of pain in patients with cancer-not the least of which is a clinical environment that has been changed by the COVID-19 pandemic.

Addressing Health Disparities From a Syndemic Perspective.

As we enter the second year of the COVID-19 pandemic, there is much hope about the eventual containment of the virus, leading to some form of a new normalcy. Multiple COVID-19 vaccines have proven to be effective, and the vaccination of individuals in the United States has reached several million per day, with an ever-growing percentage of the population having been vaccinated. However, there are stark reminders of the continued disparities that have been highlighted by the COVID-19 pandemic, with different levels of vaccine accessibility across states and communities. In addition, multiple countries have not begun any vaccination implementation. Case and death rates continue to be unevenly distributed, with higher death rates in minority populations, particularly African American and Latinx individuals. This pandemic has raised to a higher level of awareness the ongoing and multiple forms of disparity associated with health and illness. For oncology nurses and scientists, how do we look to the issues so starkly presented by the pandemic and raise our awareness that the issues are not specific to COVID-19?

The COVID-19-Cancer Connection.

I recently completed work at a large-scale, drive-through COVID-19 vaccination initiative and was immediately struck by its military parallel in mobilizing this emergent medical response. Federal personnel were deployed quickly to assist the local workforce untested in a public health domain. The expansive integration of technology was at a level I had not previously witnessed. Computerized algorithms organized the flow of cars through a huge fairground (think Disneyland Park). Databases were created to register the public, make appointments, and document the specifics of vaccination administration. From day one, the pharmacy tent was in constant overdrive to ensure vaccine supply was in sync with hourly demand. The interface of all these platforms vaccinated 2,300 people per day.

As an Oncology Nurse, What Does It Look Like to Be a Well-Being Clinician?

For me, becoming a well-being clinician required a journey that does not end. I discovered four relationships to pay attention to as an oncology nurse, and each requires care. They are self, colleagues, community, and patients and families. My journey to becoming a well-being clinician meandered through a variety of clinical practice, educational, and leadership opportunities. At each stopover, I developed knowledge, skills, and abilities in caring relationships. Three in particular were pivotal in my well-being practice development: my first nursing job as a float nurse in a small community hospital, a therapeutic communication class in my BSN completion program, and my Master of Arts in Lay Ministry (MALM) degree.

The Nazareth Community Oncology Unit: The Oncology Nurse's Role to Provide Care in the Environment of COVID-19.

The Community Oncology Unit (COU) in Nazareth, Israel, provides complete medical treatments to patients who live in the rural area of the country. During the COVID-19 pandemic, oncology nurses face additional challenges in facilitating cancer care. Pertinent adjustments are being made at the COU to maintain patients' safety and enable continuous oncology therapy by coordinating patients' COVID-19 testing and vaccination program.