Convenience. Flexibility. Normalcy. Ambulatory oncology clinics deliver on those three crucially important aspects of treatment to many patients with cancer, offering expert care without a hospital stay or traveling far from home.  

With evolving treatments and novel approaches to care, outpatient oncology practice has grown exponentially during the past two decades. As a vital stop on the cancer journey for many patients, ambulatory clinics have seen a boom in acuity, patient needs, and staffing demands. ONS has been actively researching the growing staffing dilemma in ambulatory oncology nursing to help institutions understand and address nurse-patient staffing and which best practices can accommodate the varied challenges.  

P.G. is a 54-year-old woman who presents to the infusion center to receive her second cycle of chemotherapy for breast cancer. As her oncology nurse, you check the chemotherapy orders and patient history and are concerned to see that her weight has dropped by 10% from baseline, necessitating a change in dosing.

When cleaning patients’ skin in preparation for lumbar puncture procedures, oncology nurses must consider side effects from use of various germicide solutions. Chlorhexidine gluconate (CHG) solution has been considered the broad-spectrum germicide effective against most nosocomial yeasts and gram-positive and -negative bacteria. It’s available as 2% or 5% CHG in 70% isopropyl alcohol and is used as an antiseptic for skin preparation and central venous catheter dressings.

At the heart of patient-centered cancer care is communication and understanding, and oncology nurses have a responsibility to ensure that their patients have all the information they need to successfully navigate their cancer journey. But what happens when language barriers inhibit the flow of information between patient and practitioner? 

After the Institute of Medicine’s (IOM) 2010 report on the “Future of Nursing,” the nursing field made a concerted effort to encourage current and incoming nurses to achieve higher education through a Bachelor of Science Nursing (BSN) degree or higher. As lifelong learners, nurses are committed to providing the best care possible and consistently furthering their education is part of that commitment. According to a report from AARP and the Robert Wood Johnson Foundation, 56% of U.S. nurses hold a BSN or higher, an all-time high for the profession.

Most patients and practitioners associate chemotherapy with cancer treatments, yet the drugs are also used to treat a number of autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, antineutrophil cytoplasmic antibody–associated vasculitis, and systemic lupus erythematosus. 

Legislation ushering experimental drugs and treatments to patients without U.S. Food and Drug Administration (FDA) approval hit a snag on March 13, 2018, after it failed to garner enough votes in the House of Representatives. The right-to-try bill, a priority for the Trump administration, didn’t accrue the two-thirds majority vote needed to pass it along to the Senate. Lawmakers opposed to the bill had lingering questions about the safety concerns connected to bypassing FDA regulations for patients searching for new treatments. Patient advocacy groups have been speaking out against tenets of the bill, expressing concern for removing the FDA from the process.

Every job has its perils, and some of those perils are more pronounced than others. For nurses, professional hazards range from dangerous chemical exposure to workplace violence, to severe back and arm injuries, and everything in between. In fact, National Public Radio reported that more than 35,000 nursing professionals experience back and body injuries every year.

Between administering antineoplastic agents, monitoring patient vitals, and preparing patients for treatment, oncology nurses are required to balance their attention between many intricate tasks. Chief among the division of duties is that oncology nurses closely monitor their patients for hypersensitivity reactions (HSRs) to prescribed agents.

Advancements in medical records technology provide safeguards and contribute to overall patient safety. However, consider the following treatment scenarios and how they may present opportunities for error and jeopardize patient safety.

Candida auris is a multi-drug resistant yeast that is known to cause invasive infection and death. It first emerged in June 2016 and continues to present itself as a serious global threat. According to the Centers for Disease Control and Prevention (CDC), throughout 2017, healthcare facilities in multiple countries report serious illnesses caused by C.auris in hospitalized patients.

Mindfulness meditation is a popular topic in the media now. Research has already demonstrated the clinical benefits of mindfulness-based stress reduction for patients with chronic pain or anxiety disorders. Although there’s been limited research about the benefits of mindfulness stress reduction for oncology nurses and their patients, some evidence suggests that engaging in mindfulness exercises could lead to a safer environment.