Stigma is a deep-seated social construct that “profoundly discredits an individual or a group from being whole, causing them to be viewed as less desirable, harmful, or weak.” It infiltrates all corners of society, but when experienced in health care, it can contribute to health inequities and poor health-related outcomes.

The latest in a line of legislation designed to promote health information technology interoperability and reduce information blocking, the 21st Century Cures Act began implementation in 2020. Since then, patients, nurses, and the entire healthcare team have appreciated benefits while also confronting challenges—namely with patients having immediate access to their health information and results before their nurse or other healthcare professional can explain the results in context.

Most patients with cancer experience at least one nutrition-related symptom in the outpatient setting but say they’re not having nutrition conversations with their cancer care team—yet providers think they are. The contrary reports came from study findings researchers published in the Clinical Journal of Oncology Nursing.

Patients from underrepresented groups who self-advocate, are actively involved in their care, and have strong social networks have better cancer outcomes, oncology nurse researchers reported in substudy results published in the Oncology Nursing Forum.

Lack of social connections has the health implication equivalency of smoking 15 cigarettes per day, whereas maintaining a strong social community can increase odds of survival by 50%, U.S. Surgeon General Vivek Murthy, MD, MBA, said in a 2023 report.

Given their work and involvement in an individual’s cancer journey, oncology nurses can help motivate and influence patients. Sometimes this motivation leads to particularly special circumstances. Whether you consider it a moment of luck or a chance of fate, everything can fall into place. That was the case for ONS member Robert Zamora, RN, OCN^®, a retired oncology and stem cell transplant nurse living in San Antonio, TX, when Linda Hart-Garrahan was put under his care in fall 2015.

Just as people of various ages have different cancer care needs and priorities, how a nurse communicates with patients of various ages should differ, too. For instance, communication for pediatric patients predominantly involves parents, whereas adolescents and young adults (AYAs) may require alternate approaches to meet their communication needs. Personalizing your communication for each age group ensures effective and meaningful communication that has the potential to reduce the inherent uncertainty in cancer care and enhance survivors’ quality of life. 

One in four U.S. nurses reported being assaulted during the past year—two every hour—and it is happening in oncology settings, too, authors wrote in the Clinical Journal of Oncology Nursing.

Burnout knows no borders. The nursing workforce crisis cares little about country lines or continents. Regardless of their time zone, nurses in all settings are leaving the profession. “Healthcare systems are ailing, and they are in urgent need of healing. [We] call to action health system executives and other leaders to support, promote, and enable bold experiments to avert additional personnel losses and improve patient outcomes,” ONS member Christopher Friese, PhD, RN, AOCN^®, and colleagues wrote in a July 2023 NAM Perspectives commentary.

Telehealth offers many benefits for patients with cancer, but it may present oncology nurses with unique challenges to maintaining effective and empathetic communication.  

Both collaborative and authoritative communication approaches have value in educating and engaging patients. When deciding which style to use with each patient, oncology nurses must evaluate the individual, situation, and decision-making dynamics. 

When Ethan was 15 years old, he was diagnosed with osteogenic sarcoma. He underwent chemotherapy and was deemed cancer free for nearly 10 years. Maria, an advanced oncology certified nurse, worked closely with Ethan’s healthcare team throughout his treatment. She got to know Ethan, his sense of humor, and his dreams of becoming a child psychologist.

Prepare for the silver tsunami—experts predict that the number of older adults with cancer, those aged 65 and older, will double by 2035. Oncology APRNs have a pivotal role in their care, understanding patients’ values and preferences to facilitate informed decision-making. But communication can be difficult when patients have comorbid geriatric syndromes such as cognitive deficits, delirium, and depression.

The physical and emotional side effects of cancer treatments can force patients to make undesired lifestyle changes. After treatment ends, their friends and family may expect them to resume their former roles and activities, yet long-term effects can leave patients discouraged. When compared with healthy peers, cancer survivors experience higher levels of pain, depression, and anxiety, which can decrease their motivation to make healthy choices. Culture, coping style, and socioeconomic status may further compound the issue.

Although 74%–84% of patients with breast cancer who undergo mastectomies are satisfied with their bodies and outcomes after electing to have a flat closure, 20%–35% say that they felt unsupported by their cancer care team during the process. Patients report feeling marginalized or stigmatized, not being told that flat closure is an option, and even left with excess skin against their wishes because the care team wanted to give them “future options.”

Spiritual care is an essential component of cancer care. Representing an individual’s “sense of peace, purpose, and connection to others and beliefs about the meaning of life, spirituality is not synonymous with religion, which is “a set of beliefs and practices that center on questions about the meaning of life and may involve the worship of a supreme being.” Several healthcare organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Multinational Association of Supportive Care in Cancer, and the Joint Commission recommend including spiritual care in cancer care guidelines.

Meaningful communication involves more than just words traded between people. By asking open-ended questions, affirming a person’s strengths, offering reflections, and providing a summary of the conversation, you can engage others in meaningful conversation.

Deanna Fournier, a cancer survivor, and Eli Diamond, MD, a neuro-oncologist at Memorial Sloan Kettering Cancer Center in New York, NY, discussed Fournier’s cancer journey and the progress toward a better patient experience during a National Cancer Institute Office of Cancer Survivorship lecture. Communicating with patients throughout their cancer journey can help healthcare providers, including oncology nurses, support patients and advocate for their unique needs.

Individuals who identify as transgender and non-binary may no longer use their birth or legal name but rather choose a new name that aligns with their identity. When they ask that you use their new name instead, calling them by their old name is referred to as deadnaming and can be a stressful and traumatic experience for the individual and is even considered an act of verbal violence.

People encounter significant changes after being diagnosed with cancer. Oncology nurses can help patients and caregivers adapt by using motivational interviewing–based communication strategies.

Many cultures and religions across the world practice fasting, or the absence of caloric intake for a few hours to several weeks, at different times throughout the year. Islam, Judaism, Buddhism, Christianity, Hinduism, and Taoism religions most commonly use fasting for various reasons, but the overall purpose generally is to demonstrate sacrifice or spiritual cleansing.

Using the National Institutes of Health Symptom Science Model and Nursing Science Precision Health Model helps oncology nurses to recognize symptoms more promptly in patients with ovarian cancer and provide precision interventions that address racial disparities and foster equity in symptom-focused, patient-centered care, Mahoney and Pierce reported in the October 2022 issue of the Clinical Journal of Oncology Nursing.

Nurses bring unique but critical input to diagnostic processes in the emergency department, the Agency for Healthcare Research and Quality reported in August 2022. “Nurses have unique, valuable knowledge based not only on principles of science but also on holism and intuition,” the agency said.

To improve cancer care and lower costs, the Centers for Medicare and Medicaid Services created the Enhancing Oncology Model in June 2022.

Whole-person care involves evaluating a patient’s physical, emotional, spiritual, and social health. A conversational assessment can help oncology nurses foster an open dialogue about the patient as a person, not just their physical or health needs.

My world changed on December 22, 2021. It is a day I will never forget: the day I tested positive for COVID-19. For nearly two years, all while caring for patients with the virus, I avoided contracting it. I prided myself on mask-wearing, handwashing, and social distancing, but what we know all too well is that COVID-19 does not discriminate.

I found a card from him the other day and my breath hitched. Then I remembered how annoying I thought he was the first time I heard him.

As I walk into the exam room, isolation mask and eye protection on against the COVID-19 pandemic, my heart feels heavy with the reality of the day, of this moment, of these years.

As a healthcare provider, I had been warned about getting too close to my patients. They told me that it was unprofessional, it would cloud my judgment, it would lead to emotional burnout, and various other reasons. For my first year as a nurse, I took that advice to heart and kept my emotional distance while still doing my best to provide care to the whole patient. Then one night I met Jeff, and everything changed.

After years of hard work, Mrs. Jones and her husband had what seemed to be an idyllic life traveling and enjoying their life together. As a newly minted nurse on the medical/surgical unit, I got to know them over the months I cared for her during repeated admissions for melanoma. At each admission, they would be side by side, inseparable and so in love. I was just a new bride, and I wondered if my marriage would be as magical as theirs.

“It takes 20 years to be an overnight success,” classical Hollywood era star Eddie Cantor once said. For many, “instant” recognition comes after a long preparation of methodical strategy and hard work. It is the story of nurses.

Emily manages a rural clinic associated with an academic cancer center. Patients initially have an in-person consultation with their treating oncologists at the main campus but then use telehealth for subsequent visits. To support patients during teleoncology visits, Emily wants to initiate a plan to collaborate with the clinic staff to identify and address the ethical principles for oncology care using telehealth.

“How are you doing?” We ask this question of our patients repeatedly: at diagnosis, during treatment, throughout survivorship, and at end of life. However, studies show that patients often give inaccurate answers to that direct question.

A single patient. A team of nurses providing compassionate, patient-centered care. A family so thankful that it had to give back. Today, it’s touched more than 177,000 nurses around the world in recognition of what they do every day: deliver high-quality, transformational cancer care.

Some people may be overjoyed at the prospect of completing their cancer treatment and returning to normal life, but for many others, fear and anxiety can overshadow feelings of elation. The survivorship phase of a cancer journey can be confusing and uncertain. Comments like, “I don’t know what is next” and “The responsibility for care is now up to me” can alert oncology nurses that patients need additional communication and strategies to transition into healthy survivorship.

Communication is central to an oncology nurse’s role—with patients and families, within the unit, and across interprofessional teams. The Joint Commission identified poor communication as a causative factor in 80% of medical errors, particularly during caregiving handoffs. Effective communication skills are both a science and an art, but oncology professionals can use a variety of tools and techniques to enhance their practice.

Six years ago, I signed up for the marrow registry through the German Bone Marrow Donor Center, also known as DKMS, which is an international organization that hosts stem cell registry drives. In late 2021, I received the call that I was a fully matched donor for a patient with chronic myeloid leukemia. As a hematology and oncology clinical nurse specialist, I have seen how valuable the gift of stem cells can be for a patient with hematologic disease. I didn’t think twice about completing the donation process.

Overall trust of scientists and their research during the COVID-19 pandemic has increased by nine percentage points between 2018 and 2020, according to the results from the November 2021 Wellcome Global Monitor 2020: COVID-19 report.

When hearing results from blood work or repeat imaging—regardless of whether they are “good” or “bad”—patients want and deserve to be given information truthfully and objectively. Oncology advanced practice providers are often the bearers of bad news, which can be uncomfortable and stressful. But here’s how you can hold those conversations with finesse, empathy, and respect.

To confront the disparities that minority populations face in health care, organizations across the United States are recognizing that cultural humility is a clinical competency. Implicit and explicit bias are part of human nature, but prioritizing cultural humility as a foundation, diversifying the workforce, and engaging in education and training can help providers overcome those tendencies and achieve patient-centered care.

In today’s digital age of news, the public often struggles to decipher real science from misleading or incorrect information—and the COVID-19 coronavirus pandemic has only magnified the situation. Seeing a detrimental impact to the health of the nation, U.S. Surgeon General Dr. Vivek Murthy, MD, MBA, issued his first advisory report of the Biden administration on the topic of misinformation in public health.

Implementing a standard minimum nurse-to-patient ratio lowers mortality, readmission, and length of stay rates, according to findings published in Lancet. 

In a May 2021 expansion to Section 1557 of the Affordable Care Act and the Title IX civil law, the U.S. Department of Health and Human Services (HHS), through the Office for Civil Rights, increased protections for lesbian, gay, bisexual, transgender, or queer (LGBTQ) people from discrimination. The revisions now prohibit discrimination based on sexual orientation and gender identity. 

More than 16 million people who identify as women and girls in the United States reported smoking in 2021, according to a May 2021 report from the Campaign for Tobacco Free Kids, of which ONS is an active member, who partnered with several leading women’s organizations on the study. Female smokers are also significantly more likely than men to use menthol cigarettes, and e-cigarette use among high school girls rose by 89% from 2017–2020.

Effectively treating a cancer diagnosis requires an immense amount of collaboration. Clinicians are equipped with the clinical knowledge to provide the best care possible, and sharing that crucial information with each other and patients is essential for optimal patient outcomes. 

Nurses are a trusted resource for patient education and offer clarity during a crisis, whether it’s a cancer diagnosis or global pandemic. However, in a survey from the American Nurses Association (ANA), 30% of nurses said they have not received a COVID-19 vaccine, and a quarter of that percentage was still undecided about getting vaccinated. The two main reported reasons were fear of short- and long-term side effects (66%) and lack of information about the vaccines (50%). ANA’s new campaign educates nurses about those concerns.  

Most nurses can attest to the immense personal and professional growth that takes place during the first year of their nursing practice. When I graduated in May 2019, I began working on a blood and marrow transplant (BMT) unit. The BMT process is long and intensive, but it provides opportunities to develop strong connections with our patients. We often care for the same patient for multiple weeks or months and then again a year or two later if they experience longer-term complications. As a newly minted nurse, I had a lot to learn about my specialty and about nursing in general, but my fresh perspective made learning exciting.