Explore every episode of the podcast The ONS Podcast
| Title | Pub. Date | Duration | |
|---|---|---|---|
| Episode 388: ONS 50th Anniversary: Milestones in Oncology Advocacy and Health Policy | 07 Nov 2025 | 00:33:51 | |
"I think we really need to push more of our oncology nurses to get into elected and appointed positions. So often we're looking at health positions to get involved in, and those are wonderful. We need nurses as secretaries of health, but there are others. We as nurses understand higher education. We understand environment. We understand energy. So I think we look broadly at, what are positions we can get in? Let's have more nurses run for state legislative offices, for our House of Representatives, for the U.S. Senate," ONS member Barbara Damron, PhD, LHD, RN, FAAN, told Ryne Wilson, DNP, RN, OCN®, CNE, ONS member and member of the ONS 50th anniversary committee, during a conversation about the future of oncology nursing advocacy and health policy. Wilson spoke with Damron and ONS member Janice Phillips, PhD, RN, CENP, FADLN, FAAN, about how ONS has advanced advocacy and policy efforts over the past 50 years and its approaches for the future. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Phillips: "I think that there are so many pressing issues, but I'm going to start with any kind of threats or legislation that's poised to take away safety-net resources. It's really going to set us back because we all know that, particularly for minorities and certain other underserved populations, they have experienced poor cancer outcomes for a variety of reasons, variety of socioeconomic reasons, lack of access to quality screening resources—you name it. When you take away those safety net resources and take away resources for people who are already underserved, uninsured, or underinsured, it also jeopardizes their ability to get proper screening, get proper follow-up, have access to state of the art cancer services. I think the lack of affordability of health care is a problem that continues to challenge us, whether you on Medicaid or whether you have limited insurance." TS 10:16 Damron: "Because ONS is so grounded in science and research—we're not just a clinical organization; we're grounded in scholarship, science, research, and publication—we're able to take this vast network of strong clinicians [and combine it] with amazing scientists. … We've had some amazing scientists come out of ONS; some of the leading nurse scientists of all time were also oncology nurses. So by combining this, we're able to make a difference at the state and federal level. So the advocacy work that I've been involved in, state and federal levels, really involved working with the ONS staff involved with advocacy and those scientists and clinicians who brought that expertise." TS 18:19 Phillips: "I think expanding the work around multiculturalism in oncology will always be important. Are there any new partnerships or avenues that ONS can reach out to or explore? Maybe there are other specialty organizations or groups—and not always necessarily nursing— because as we think about the determinants of health, we think about things like health and all policies. Maybe there are other disciplines or other specialties that we need to embrace as we launch our agendas." TS 23:28 Damron: "As nurses, just our basic nursing training, we get these skills—we see a problem, we identify the problem, we assess what we're going to do about it, we do it, and then we evaluate what we did. Does that work or not? That's how you make policy. So we were all trained in this. Then what you bring on top of that are oncology nursing experience, whether it's clinical, whether it's research, whether it's teaching, practice, etc. Those continue to refine those skills that are basic to us as nurses. We have this built-in skill set, and we need to own it and understand it." TS 30:25 | |||
| Episode 387: Prostate Cancer Screening, Early Detection, and Disparities | 31 Oct 2025 | 00:16:28 | |
"[When] a lot of men think about prostate exams, they immediately think of the glove going on the hand of the physician, and they immediately clench. But really try to talk with them and discuss with them what some of the benefits are of understanding early detection. Even just having those conversations with their providers so that they understand what the risk and benefits are of having screening. And then educate patients on what a prostate-specific antigen (PSA) and digital rectal exam (DRE) actually are—how it happens, what it shows, and what the necessary benefits of those are," ONS member Clara Beaver, DNP, RN, AOCNS®, ACNS-BC, manager of clinical education and clinical nurse specialist at Karmanos Cancer Institute in Detroit, MI, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about prostate cancer screening, early detection, and disparities. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 31, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to prostate screening, early detection, and disparities. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "The recommendations are men [aged] 45 who are at high risk, including African American men and men who have a first-degree relative who has been diagnosed with prostate cancer younger than 65 should go through screening. And men aged 40 at an even higher risk, these are the men that have that one first-degree relative who has had prostate cancer before 65. Screening includes the PSA blood test and a digital exam. Those are the screening recommendations, although they are a little bit controversial." TS 3:42 "You still see PSAs and DREs as the first line because they're easier for primary care providers to perform. ... Those are typically covered by insurance, so they still play that role in screening. But with the advent of MRIs and biomarkers, these have really helped refine that screening process and determine treatment options for our patients. Again, those patients who may be at a bit of a higher risk could go for an MRI or have biomarkers completed. Or if they're on that verge with their Gleason score, instead of doing a biopsy, they may send the patient for an MRI or do biomarkers for that patient. ... These updated technologies put [patients] a little bit more at ease that someone's watching what's going on, and they don't have to have anything invasive done to see where they're at with their staging." TS 4:35 "Disparities in screening access exist based on race, socioeconomic status, gender identity, education, and geography. It's really hard in rural areas to get primary care providers or urologists who can actually see these patients, [and] sometimes in urban areas. So socioeconomic status can affect that, but also where a person lives. African American men with lower incomes and people in rural areas face the greatest barriers to receiving screening. It's also important to encourage anyone with a prostate to be screened and offer gender-neutral settings for patients to feel comfortable." TS 7:50 "I think a lot of men feel like if they have no symptoms, they don't have prostate cancer ... so a lot of patients may put off screening because they feel fine, [they] haven't had any urinary symptoms, it doesn't run in their family. ...With prostate cancer, there usually are not symptoms that a patient's having—they may have some urinary issues or some pain—but it's not very frequent that they have that. So, just making sure our patients understand that even though they're not feeling something, it doesn't mean there's not something else going on there." TS 12:53 "Prostate cancer found at an early age can be very curable, so it's really important for men to have those conversations with their providers about the risk and benefits of screening. And anyone that we can help along the way to be able to have those conversations, I think is a great thing for oncology nurses to do." TS 15:44 | |||
| Episode 378: Considerations for Adolescent and Young Adult Patients With Metastatic Breast Cancer | 29 Aug 2025 | 00:36:49 | |
"She's triple negative and has a very, very aggressive tumor. Instead of going on spring break that year, she sat in our chemo room and got chemo. Her friends from college are good to try to keep her involved and try to surround her and encourage her, but they're right now in very, very different spots in their lives. She's fighting for her life; her friends are fighting for the grade they get in a class—and that's different," ONS member Kristi Orbaugh, MSN, NP, AOCN®, AOCNP®, nurse practitioner at Community Hospital North Cancer Center in Indianapolis, IN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about metastatic breast cancer in adolescent and young adult patients. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 This podcast is sponsored by Lilly and is not eligible for NCPD contact hours. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "When we use 'adolescent and young adult,' we're really talking about age 19–35. Some groups will say 15–39, but right around that age. When we think about that age, think about what all could be going on during those ages. Late teenagers, they may be going off to college, they may be graduating high school, trying to set up their own life, trying to become independent from mom and dad. If you're talking about early to mid 30s, you could be talking about young parents, young career folks. So, just setting that into place makes you realize this can be a very tumultuous time for folks." TS 2:06 "Unfortunately, this group tends to have more aggressive subtypes. We see more triple-negative in this group. We see more hormone-negative, HER2-positive in this group. Normal breast cancer cells should be stimulated by hormone. They are stimulated by hormones. So when you have a breast cancer cell that is not driven by hormones, it's much more difficult to treat. We tend to see more aggressiveness in these tumors. We also see a higher incidence in non-Caucasian folks in this age group compared to the older age groups." TS 4:53 "I think we have gotten much better about understanding the importance of fertility preservation and getting reproductive endocrinologists in, sooner rather than later. If we have earlier-stage cancers and we have patients that want to try to preserve eggs, preserve fertility, sperm banking. … If you have that time to talk to them—maybe a 21-year-old—the primary thing on her mind is not how many children she wants to have one day. Maybe she's not even thought about having kids yet. It's still a question you need to [ask]. Do you want to try to preserve fertility? Do you want to try to harvest some eggs? That's a conversation that needs to be had and is very, very important for that age group." TS 10:35 "One thing that helps is if you can get them [into] reputable support groups with people their own age that are going through what they're going through. Someone else that doesn't have hair, someone else that isn't going to make it to the big board meeting or isn't going to get the promotion this year because they've had to take a medical leave. Someone else that understands it differently." TS 16:47 "In breast cancer, many of those biomarkers just get reflexed. And what I mean by reflexed is a breast cancer pathology comes through, or a breast cancer specimen comes through, and it just automatically gets tested for X, Y, Z. HER2 and of course ER/PR. Now we understand that we don't just need to know whether they're HER2 positive or HER2 negative. We need to know: What is the IHC score? And even if the IHC score is zero, is there any membrane staining? And then we need to know what's their ESR1, their PTEN, their AKT, their PIK3CA. Those are so important to know." TS 18:11 "I think it's important to try to remember what our priorities were when we were in our 20s—what our priorities were when we were starting out as young mothers or starting out our career. Because that's where these folks are. … I can't imagine in the midst of college, when I'm trying to be independent, to suddenly have to be at home and rely on my mom to take me to my chemo appointment. … So I think one really important bias is to remember where they are in the developmental stages of life. They're not 40-something. They haven't lived X amount of life, and we need to take a step back and try to remember when we were their age, what was important to us? Where were our priorities at that point? And then hear them when they're telling us what's important to them." TS 29:22 "From a female standpoint … we frequently throw these patients into menopause or have early menopausal symptoms, and I think we forget how devastating that can be. … They now are at higher risk for osteopenia or osteoporosis. … And then we tell people, 'Be as normal as possible, get back and do those normal things.' Well, they're in a relationship, and they want to be intimate [but] suddenly having sexual intercourse is incredibly painful. Or if it's not painful, sometimes they've just lost pure interest in that. They don't feel confident about their body. All of those things need to be addressed because patients are trying to live each day as normally as possible." TS 31:55 | |||
| Episode 288: Pharmacology 101: Antimetabolites | 01 Dec 2023 | 00:27:22 | |
"I think that there are certain agents that are so foundational in some diseases that they will remain. Whether they remain first-line, maybe not; maybe they'll go to second line as we see things evolve with new agents. Some of these drugs have been very effective in the diseases in which they are used to treat patients. There's a long term place in therapy for these, and I think that will still be using these," Rowena Schwartz, PharmD, BCOP, FHOPA, known to many as "Moe," professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about what oncology nurses need to know about antimetabolites. This episode is part of a series about drug classes, which we'll include a link to in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to antimetabolites. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Antimetabolites are relatively old agents. They are some of the oldest anti-cancer drugs that we have. They were developed to be similar to naturally occurring compounds that are important in cellular production. They are similar but not the same. So, they sometimes will bind to an enzyme important for cell proliferation. And because it binds to an enzyme, does it mean that it helps the enzyme? It may block it and that may cause cell death. And so, they've been used for a long time in oncology." TS 1:44 "There's different classes of antimetabolites in oncology. If you think of the structure of DNA, there is purines, that's adenine and guanine, there are pyrimidines, which are things like cytosine and limonene, and then in RNA there's uracil. So, some of the antimetabolites are either purine analogues or pyrimidine analogues, meaning they look very much like the natural parts of DNA, and by being incorporated into the DNA they cause cell death. There's also a class of antimetabolites that interfere with how we use folate in the body, such as methotrexate is an obvious one, and these are called folate antagonists." TS 2:43 "The purine analogs—and those are things like fludarabine or clofarabine—those drugs are very toxic to lymphocytes. And because they're very toxic to lymphocytes, these are drugs that we use in lymphocytic diseases. But that also means that these are drugs that we get immunosuppression because of the toxicity to lymphocytes. So, these patients have risk of infections because of their decreased lymphocyte activity after receiving these drugs." TS 6:37 "Methotrexate works by blocking an enzyme that decreases the ability to make the folate that we need in our body to make cells. So, one of the things that we do when we use really high doses of methotrexate is we let it work for 24 hours and then we come in and we give leucovorin, which is the thing that we blocked. So, you're coming into rescue cells. And you're rescuing cells because the cancers we use high-dose methotrexate, we know that 24-hour exposure is going to be a really good effect on those cancer cells. So that's why we use leucovorin after methotrexate. We use it to minimize the toxicities that you would see with methotrexate. You decrease GI mucositis; you decrease the bone marrow suppression when you come in and adequately rescue with leucovorin." TS 12:22 "I think [that's] one of the biggest challenges. I just had a situation that was an antimetabolites drug I'd never used before. I couldn't find in the literature and through resources I normally use, how to manage, so I actually reached out to colleagues to find out, who have used the medications to say, 'What's your experience? What's worked for you?' It's one of the reasons I really love ONS, because I think it gives a forum for people to ask those questions together." TS 15:23 "I think developing good patient education tools that people can take home that highlight the most important things about the regimen, including the antimetabolite aspects, making sure patients know what to monitor for so that they can contact their team if they need them. Diarrhea is something I always talk about with patients getting 5-fluorouracil. I do it because otherwise people self-manage and don't actually know what to do, and we really want to make sure that they contact us if they're having problems with diarrhea." TS 17:14 "I think one of the best things that people can do is work together in the development of the order sets, whether they be electronic or not. And, so, that within the order sets there is clear indications of those things that highlight to patients the strategies to take, to manage. I think that's really helpful, and I think it's best done by a team. And to modify those order sets as things are learned that are helpful so that, you know, the strategy is dose reduction that's clear that that's going to be the strategy. So, I think that in this day and age it's really important that there is collaboration in developing whatever resources that we have." TS 18:55 "Because gemcitabine is such a good radio sensitizer, when we use it with radiation, we use a very small dose. Very small. We're not talking anything near what we use when we use it in combination chemotherapy. So, when you have a patient getting gemcitabine, if somebody decides that they're going to do radiation, you have to make sure everybody knows they're on gemcitabine because you may hold the drug while they're getting radiation because you don't want to increase in toxicity." TS 22:31 "I think that there are so many new, exciting agents and there are so many older agents that are still used in practice, that it's becoming very difficult for people to understand the mechanisms of the drugs that we're using and the agent-specific toxicities. So, I think that the education that's needed is the foundation and fundamentals of chemotherapy, because they still are used so much in practice. And I would hate to lose the knowledge that practitioners have because we're excited about the new, exciting therapies that are new and exciting." TS 25:09 | |||
| Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care | 24 Nov 2023 | 00:34:24 | |
"I think the key in effective communication is building trust, because without trust, patients are not likely to engage in their care as effectively, which can influence patient well-being and their overall health outcomes. Building trust is, I think, crucial," Deb Christensen, MSN, APRN, AGCNS-BC, AOCNS®, founder and chief patient officer at the Cancer Help Desk, a nonprofit that provides personalized cancer treatment resources, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about strategies oncology nurses can use when approaching difficult conversations with patients across all populations. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to difficult conversations in cancer care. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Patients tend to be less anxious when they have a trusting relationship with their providers, with their oncology team on a whole, and they tend to follow through better on their treatment plan because they trust what you're saying. It's not easy to establish a trusting relationship when you first meet someone. But what I found in my practice is that anticipating their needs and really listening to their story has made a world of difference in establishing that trusting relationship—and admitting if I don't know the answer to something or if perhaps I've gotten something wrong." TS 2:32 "Intellectual empathy asks you to imagine yourself in that person's place. And we've all had challenging experiences; we just don't get through life without them. And as a result, we can generally think of a time when we might have been in a similar situation, maybe not exactly the same, but a similar situation, and garner that empathy for the patient and, importantly, for the caregiver, too. Because we genuinely, genuinely want to understand somebody. Intellectual empathy really comes from listening carefully to what's being said and what's not being said, analyzing different people's perspective, knowing your own bias, and asking open-ended questions." TS 4:41 "I think that the first thing that an oncology nurse needs to do is recognize that patients have their own autonomy to make their own decisions and not go into a conversation expecting a specific outcome. So going in with the intention to do your best, but also be open to what the patient wants to do." TS 8:30 "Our biggest foe in all of this communication, these communication strategies, really is time. We just do not have the amount of time. I mean, we love the luxury of time to be able to sit and really get into these kind of deeper conversations with people, but we may only have 30 minutes. We may only have 15. So, how do we do that? That is still a question that's out there that there's a lot of investigating. Are there techniques that can help? And there are." TS 13:47 "All of these points in the continuum have one thing in common, and that's uncertainty. That's really a whirlpool—uncertainty—for people. One of the communication strategies that I've used with people is letting them know that this is a very common emotion to experience—a sense of loss of control, uncertainty—and that in my experience, that people generally, once they have a plan, the anxiety settles. So, giving them kind of a guidepost, hope in the future, that the anxiety will settle. Because I would say 98% of the time it does, once people gain a sense of control, because they have a plan of action to move forward." TS 16:10 "The setting is really, really important, especially when you're having these challenging conversations. Always checking for understanding: What is that perception? What is the patient perceiving? What is the caregiver family perceiving? Are they understanding you correctly? And being respectful of what people want to know, because sometimes they don't want to know specific things." TS 21:57 "Oncology nurses need to be aware of their own biases and their own emotional state when they're going into these emotional conversations, these difficult conversations they really need to be in. You might not always be the right one for the conversation. I think that's an important thing to note too, and be able to admit that you may have had a personal life experience that just is not going to allow you to get around a bias or an emotional reaction to the conversation, and so you might not be the right one." TS 23:11 "I've always felt like if you can help someone find joy and peace in the moment, then that moment was made better. Life is a series of moments. That's kind of how I get through that piece of it." TS 26:20 | |||
| Episode 286: Pharmacology 101: Alkylating Agents | 17 Nov 2023 | 00:34:52 | |
"When I meet with patients, I try and remind them, 'Yes, you do have these side effects that can happen' and make sure that they're informed, but also try and reassure them that not everyone gets it as severe as maybe the movies and TV shows portray," Dane Fritzsche, PharmD, BCOP, informatics pharmacist from the Fred Hutchinson Cancer Center at the University of Washington Medicine in Seattle, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses need to know about alkylating agents for patients with cancer. This episode is the first in a series about drug classes, which we'll include a link to in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to alkylating agents. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Alkylating agents are a very interesting class of chemotherapy agents, both mechanistically as well as historically. I remember back in pharmacy school learning this was actually the first class of medicines used to treat cancer, and it actually starts way back in World War I with the use of sulfur mustard gas, in kind of a military fashion, and then noticing some of the responses that soldiers as well as civilians who were actually exposed to that. They would develop things like bone marrow suppression, as well as other antitumor effects. Sadly, it's rough to see mustard gas as being the first agent to lead to something so remarkable, because it was a weapon of devastation, but it did lead to some breakthroughs." TS 1:43 "The first thing that jumps to my mind when thinking about alkylating agents is their toxicities and then their supportive care agents that we use to make sure that we're treating our patients well and making their care optimum. So, when I, as an oncology pharmacist, would look at these orders, I immediately am jumping to, are we giving them appropriate antiemetics? Because a lot of these agents are highly emetogenic or moderately emetogenic by NCCN. A lot of them have other organ toxicities, like are really harsh on the kidneys. Are they getting their pre- and post-hydration? And then also many of these agents are very bone marrow suppressing, meaning they're targeting the red blood cells, they're hitting platelets, they're reducing our ANCs and making patients at higher risk for infection, you know, so do we need growth factor support here? Are the patients—their current labs—are they able to take another dose at this time or do we need to dose reduce or delay therapy because their platelets are just too low now?" TS 09:54 "Honestly, it's probably one of the most important things is collaborating together to help provide optimal patient care. And to me, kind of the biggest thing that jumps out is just good communication between the various team members. I can't tell you how many times I would learn crucial information either from an infusion nurse chatting with the patient or walking down the hall or giving a call to one of our lovely clinical nurse coordinators here at Fred Hutch. You know, I always wanted to make sure that I go in and have the full picture of where the patient's at, what, if any, challenges there have been with this patient's particular case, just to make sure that I'm up to date about them and able to provide as good of care as I can." TS 14:55 "Unfortunately, this class of drugs does come with kind of those generic chemotherapy side effects that we think of: hair loss, nausea and vomiting, and bone marrow suppression. That just comes as a function of how these work. These agents are not selective for just cancer. They're more selective for rapidly dividing cells. So, that leaves our normal cells that rapidly divide like our hair, our GI tract, our bone marrow, you know, to get hit by these." TS 17:50 "The next thing I always drill my residents on, when I'm teaching them how to provide actionable and helpful information about their regimens that they're getting, is kind of like you're saying, outlining those expectations. How do you prevent these side effects? When do these side effects even start to show up? Like, am I going to immediately be nauseous right when the cisplatin gets turned on? Well, maybe, not super common, but it's more common that we'll see it in, you know, at the end, in the next couple of days and within the next 72 hours or going into the nuances between acute versus chronic nausea and things like that. So, it's really trying to empower the patients with information. How do they prevent this? What are we doing to help prevent it? And then when should they call us? When is the stuff that we're preventing didn't help? When should they call us to get more help?" TS 24:04 "I think that's a misconception that we as healthcare professionals can really help alleviate with our patients, reminding them that, yes, they do carry risks, but we also have a lot of supportive care agents to kind of help minimize that toxicity. And then we have this whole team of professionals behind you to help carry you through the treatment." TS 29:34 | |||
| Episode 285: Transarterial Chemoembolization: The Oncology Nurse's Role | 10 Nov 2023 | 00:36:41 | |
"I think oftentimes people think this is just a radiology procedure that is rather benign. That's really the role of the oncology nurse, just to be [an educator], support, emotional support, and a coach," Lisa Parks, MS, APRN-CNP, ANP-BC, nurse practitioner in hepatobiliary surgery at The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center in Columbus, Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses should know about transarterial chemoembolization administration and their role surrounding that procedure. This episode is part of a series about non-IV chemotherapy administration; the others are linked below. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to transarterial chemoembolization. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "So, TACE was commonly used to treat liver metastatic cancers, primarily metastatic colon cancer, until research showed that some of these cancers were not responding to TACE. Therefore, it is no longer really used in metastatic colon cancer. TACE is used in hepatocellular cancer. It also was used more than 10 years ago to treat metastatic neuroendocrine cancers. But recent research has showed that neuroendocrine cancers respond to this embolization without the use of chemotherapy. By eliminating chemotherapy, we also eliminate the potential for side effects." TS 3:29 "TACE, or TAE, is usually completed more than once in the course of a patient's treatment. Depending on the tumor burden of the liver, the procedure can be segmentally completed on a liver lobe, or you can do the procedure on the right lobe and then follow-up treatment in about six weeks in the left lobe." TS 5:45 "This is something that isn't even really taught in medical school. So it's really important to understand that even though this is a postprocedural side effect, there are certain things that you have to be aware of. So, the most common side effect that you will see is right upper-quadrant pain, and this is very common. And if the left side of the liver has received the therapy, this pain can radiate to the epigastric area and the patient will describe it as chest pain. And when you have the patient point to that area where he's having pain, it's often epigastric and it's just a referred pain, it's not cardiac pain, typically. You can get a EKG and troponin, but those are almost always negative and it's just really part of this embolization syndrome." TS 14:30 "As far as what the oncology nurse needs to really be aware of pre-TACE or pre-TAE, I just want to emphasize the importance of patient education. The patient and their family need to understand again, it's not a surgery, it's a radiology procedure, and that the patient is going to have abdominal pain and nausea and vomiting that will last for several weeks and that is why they are not kept in the hospital for three weeks until these symptoms dissipate. Oftentimes these symptoms will be present until they get reimaged at the medical oncologist and then it's time for them to come back and maybe get another phase of their procedure that they are supposed to have as part of their treatment plan." TS 17:44 "I do want to let you know, though, that patients that have a significant spike of their transaminases over 1,000, those patients are of great concern of going into liver failure. So, the nurses need to let the patient know that they will be monitored and kept in the hospital until we start to see a downtrend in those transaminases before they will be discharged." TS 19:48 "As an oncology nurse and medical oncology, [it's] education, education, education. Also being able to triage these patients on the phone, talking them through how to keep themselves hydrated. . . . So I just think it's really a coaching job of the oncology nurse. A lot of reassurance, a lot of suggestions on how to get through this very uncomfortable difficult procedure." TS 21:16 "I want it to be clear that if you're doing local regional therapy, TACE or TAE, this is considered a palliative procedure. You are not going to get a cure with this treatment. In this situation, neuroendocrine carcinoma, it's already metastatic if you're treating the liver. And with hepatocellular, again, it's still palliative because you're not doing a surgical resection on this patient. And every TACE experience for every patient, I've had patients that've and I've had six of these procedures, every experience they get is different." TS 28:11 "When the patient comes back to our floor after having the treatment, it's just very important for those nurses to know the 'abnormal normal,' to know that some of the things that they're seeing, the hypertension, the severe pain, the severe nausea, is actually normal and the provider will work with them to try to come up with a regimen that will make the patient as comfortable as possible." TS 33:22 | |||
| Episode 284: How AI Is Influencing Cancer Care and Oncology Nursing | 03 Nov 2023 | 00:40:31 | |
"We incorporate nurses and clinicians and users for any tool from the very beginning. They say, 'You know, we need help with this.' And then we start ideation: We start understanding the problem, we meet with them, we try to see what is it that they're trying to do, is it feasible given the data we have? We go back, we do some research, feasibility study. We say we think this is something we can predict with decent performance. Now let's do it," Nasim Eftekhari, MS, executive director of applied artificial intelligence (AI) and data science at the City of Hope National Medical Center in Duarte, CA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about how the use of AI in cancer care affects an oncology nurse's daily work. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The advertising messages in this episode are brought to you by LUNGevity. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "So, there is a lot of applications of AI in cancer care, so I can't possibly give you an exhaustive list. But the ones that come to my mind, at least the ones that we are actively working on are early detection and diagnosis, treatment planning, predictive modeling for predicting unwanted outcomes, remote monitoring, radiology applications, pathology applications, improving operations and helping the resource allocation, precision medicine, and research. And we also started a year or so incorporating AI and helping with drug discovery." TS 2:13 "We've been using AI for a very, very long time. Recently, we just hear more about AI, but AI is in our lives, in health care or not, all day, every day. Google Maps, Google search, all of this is enabled by AI, but we may not realize even that we're using it." TS 8:27 "So, for technical challenges, you have to always consider: Is this model performing in a decent manner for this application? And depending on the use case, that's different. If you're providing a decision support to someone that is impacting patient care, then you have to be very careful about model performance. So, model performance is one technical consideration, then how do you really technically integrate with the EMR system? It's not easy, EMR systems are not usually very open, and that's a whole challenge in itself to be able to read from any EMR system in real time and feed data back into it in real time." TS 10:16 "For nurses to successfully approach and adopt this work, I think the most important thing is to keep an open mind to really realize that these technologies can, at best, take the mundane part of their work away so they can operate at the top of their license, but what AI does best is to do things that are repetitive and doesn't require a ton of human intelligence. I think that would be very helpful. Just that mindset could make things more collaborative and cooperative, and that's the only way that we can make these successful." TS 12:37 "What could help is for nurses to learn the basic concepts that are involved in the development and deployment and testing of these models, so that they can really understand the limitations and capabilities and they can take an active part in the development as well. So, it's not like we build something for you and then we're trying to convince you this is good for you. We try to build together. As an AI and computer scientist, I'm always learning the medical language. I try to educate myself about the clinicians' workflows and language, and I think the same needs to happen on the clinician side for us to be able to build tools that really work in their workflows for their everyday life." TS 13:58 "We incorporate nurses and clinicians and users for any tool that will be developed from the very beginning. So, usually, the need for something, like a predictive model, comes from nurses and doctors. They say, 'You know, we need help with this.' And then we start ideation: We start understanding the problem, we meet with them, we try to see what is it that they're trying to do, and is it feasible given the data we have? We go back, we do some research, feasibility study. We come back and say we think this is something we can predict, you know, with decent performance. Now let's do it." TS 14:30 "All of our models, even the ones that have been in production for the longest, we're still getting feedback, we're still improving, and we're still retraining models, not only with new data that becomes available but also with the feedback that we get from our users." TS 17:43 "For example, after going live, we've had less ICU admissions because of sepsis or septic shock, or after going live had less sepsis mortality, which is very reassuring. So that seems like we're doing the right thing, and our model is working, but if you want to put your scientist hat on, you cannot say 100% this is the impact of the model because there is a lot of different workstreams that are trying to improve those same metrics. And unless you do a clinical trial or what we call in industry A/B testing, where you control for everything else and it's only the model intervention that is the variable, you cannot say for 100% that this is the impact of the model. That's why we combine our qualitative metrics that seem to be right in the right direction with the quantitative metrics." TS 22:17 "I think for the first time, something has come up that can really make a big change in health care. I could not say this before generative AI. AI has always been helpful, but now I think it's the time to see real change. We're still experimenting. It's really new technology. We are experimenting with in-house development as well as third-party tools that we are testing and evaluating. Again, there's a huge potential in reducing manual labor and documentation, note taking, there are implications in billing and finance, data abstraction for research or whatever other purposes that we need them, tumor boards, predictive modeling, clinical trial matching is one big use case in oncology, and finding similar patients—something that we've been aspiring to for a really long time—seems to be very possible now with these technologies." TS 25:30 "The users also weigh in. So, if you're considering it to improve clinical operations, the people who will be using the tool will have a say in, 'Yes, we think this tool will be helpful.' So, it's not just looking at the technical and cybersecurity and ethical and legal aspects, but also is this something that our users will use because that's the ultimate goal. If they don't use it, it doesn't matter how good the tool is. It won't work." TS 31:13 "Making it successful is not about the technology, but mostly about people and processes and operational support." TS 33:33 "Helping people, helping clinicians, nurses to be more free of mundane tasks and be able to interact with patients, do patient care, which is what they should be doing, rather than the things that I know a lot of nurses hate. I think we have a very exciting time ahead of us." TS 38:47 | |||
| Episode 283: Desensitization Strategies to Reintroduce Treatment After an Infusion-Related Reaction | 27 Oct 2023 | 00:38:48 | |
"Having a nurse-driven protocol, at my facility we call them clinical practice guidelines, allows for that immediate action and swift intervention for the patient," Maura Price, MSN, RN, AOCNS®, oncology clinical nurse specialist at the Lehigh Valley Topper Cancer Institute in Bethlehem, PA, told Jaime Weimer, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses should know about desensitization strategies. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to desensitization strategies after an infusion-related reaction. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "An allergic reaction is kind of a more general term that's used when someone has an allergy, whether that be to a medication, an environmental allergy. But an allergic reaction can really range in symptoms, anywhere from mild to severe. So, if a patient tells me 'I'm allergic to amoxicillin' or 'I had an allergic reaction, when I take this drug,' definitely ask them to elaborate." TS 4:40 "Your assessment in grading is really going to be based on the symptoms that the patient is experiencing during the reaction. So, just personally knowing the CTCAE grading so well, this really helps us to identify those next steps for the patient. So, if the reaction was mild and more of a grade one or two, then we can consider rechallenging the patient after additional meds we're always giving and intervening at that point. So, the patient may already have taken premeds prior to starting the infusion. And then we're giving rescue meds to help them through this reaction. So we could potentially rechallenge at that point and either continue them but at the same rate that we were using it at or, per the prescribing information, maybe slow the rate down." TS 13:58 "I always like to use the example of a GYN-onc patient that's receiving either typically taxol carbo for either their diagnosis of ovarian cancer or endometrial cancer. So that taxane-platinum doublet is really the gold standard for these patients. We know that that is standard of care for them to receive that doublet chemotherapy. So, if the patient has a reaction to the carboplatin but is willing to continue receiving the drug if they pursue that desensitization, they're still getting that gold-standard treatment. So alternatively, completely fine for the patient if they would not like to pursue that and they tell you 'I'm scared' or for whatever reason they don't, that's why it's just very important to have these conversations up front and educate the patients on the risk versus benefits of all of their treatment options." TS 16:13 "A great example that I typically use is that patient again with ovarian cancer that had six cycles of taxol carbo. Maybe they then went on to maintenance PARP inhibitor and then several months or years later, they unfortunately have recurrence. That, like you said, it kind of looking back at their treatment history to say, 'Oh my goodness, this patient already had six doses of the taxol carbo.' So even though it looks like it's fresh taxol carbo—maybe in the treatment plan—they've already been sensitized to that, so as you said, making sure that you're looking back and you know their treatment history." TS 24:54 "Just remembering that with a desens, this is never a permanent tolerance; it's only temporary. So, making sure that we are closely observing the patient, getting their vital signs, educating them, making sure that they know, 'Hey, you've reacted to this drug previously. We of course want to keep you on this drug. That's why we're going this route with desensitization. So, if you are feeling anything out of the ordinary, you want to let us know right away." Making sure that we have our emergency equipment and medications available and right at the bedside or chair side, making sure that there's no contraindications for the desensitization." TS 27:35 "I think explaining the rationale behind the desensitization and why we're doing it is really key, explaining to them we want to keep you on this drug that you're currently getting, explaining that whole process. None of us like to go into anything without knowing a plan, so it's even just as simple as giving the patient the plan and explaining the process." TS 30:59 "I'd say the most common misconception that I hear, or get the question about, is this is once and done. So, definitely not the case, it's not once and done. When we do desensitize, just keeping in mind that is a temporary tolerance to the drug. So every time that the patient is going to receive this drug in the future, that is going to require the desensitization. So definitely get that question from nurses that are unfamiliar with it and then also patients thinking like, 'Oh, I'll be good after I get this one time over a long day, then I'll be okay,' but just reiterating, this is for every single subsequent administration with this medication." TS 33:55 "It's very scary for patients, and as we said earlier, if they have a friend or a family member with them, it's really a scary time for them. So, reassuring all of them, everyone that's there that day, definitely encouraging them. Another thing that I think gets forgotten is just the financial implications of it. So, if we have a younger patient or even a middle-aged patient that's still working full-time, this is not a short infusion that they were used to prior before they had the reaction. This is a long day. So if they are working full-time, making sure that they understand, 'You are going to need to miss a day of work each time that you get this going forward.' So, I would say some of those psychosocial things are things that are not often discussed, but definitely important to have that conversation with your patient." TS 34:40 | |||
| Episode 282: Telehealth-Based Oncology Palliative Care | 20 Oct 2023 | 00:33:37 | |
"We really need to do our best to reach people who don't have access to palliative care in their communities, and this is an innovative way for us to do that," Carey Ramirez, ANP-C, ACHPN, nurse practitioner and manager of advanced practice and supportive care medicine at the City of Hope National Medical Center in Duarte, CA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about how telehealth is overcoming barriers and disparities that previously limited patients' access to timely oncology palliative care. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to telehealth-based oncology palliative care. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "If a person is uncertain of their prognosis or if a provider is uncertain of the goals that the patient has for themselves, that might be an appropriate time to consider palliative consultation. These are all important considerations for triggers that might make palliative a possibility for patients in those scenarios. The take-home message, though, is that the sooner that palliative care is involved, the more likely the patient and family are to benefit." TS 2:51 "From a patient and family perspective, we frequently find that there are misperceptions regarding palliative care. Oftentimes, they'll conflate the word palliative with either hospice or end-of-life care. They unfortunately sometimes believe that they're one and the same. They demonstrate a lack of knowledge regarding the benefits, including the fact that palliative care can and should be provided alongside life-prolonging care." TS 3:53 "Palliative providers do their best to help patients maintain hope throughout their disease trajectory, regardless of how well or how poorly things are going. I tend to view things in terms of climbing a sand dune: Living with cancer can sometimes feel like you're walking up a sand dune, either at the beach or at the desert, and there will be days where you take two steps forward and you might slide only one step back. There may also be days where you take two steps forward and slide three steps back. And you find, for example, that if you keep trudging toward the top, that because the winds are constantly blowing those dunes, the top you eventually reach might be different than the one you initially set out to reach. And I think that speaks to the changing nature of hope." TS 6:08 "It's important to ensure that providers are aware of the local services available to them in their respective communities. [And] we often find that from an organizational or a structural barrier perspective, there are lack of access to palliative care in the community. We often find that outpatient programs may not be as robust, or you may find that there is great variation between outpatient programs with regard to quality." TS 10:10 "We have multiple patient populations who unfortunately do not have equal access to palliative care. They include rural populations, those who come from low socioeconomic backgrounds. We find that male patients and/or patients who are older adults have lower access to palliative care. We find that those who might be either single or live alone, those who might have an immigrant status, those who don't speak English, those who might have certain cancer diagnoses. It may surprise some of you to know that those with hematologic malignancies actually have much lower rates of palliative referral than those with solid tumors." TS 11:23 "There's a maldistribution of palliative care resources nationwide. We tend to see that many of the resources are in urban areas, and as a result, we find that a great many rural areas are left untouched. I think it's important for us to recognize that these social determinants of health exist. It's important for us to look intentionally at them and whether they affect some of our patient populations and to work together to overcome them." TS 14:03 "Anecdotally, I've been doing telehealth for about five years and it's been quite well received. It decreases my no-show rates. It improves my ability to monitor patients over time, and it can be carried out safely." TS 16:12 "It's important to recognize that telehealth can be utilized not only for a planned appointment that might be scheduled to surveil someone every two weeks or every month from a pain and symptom management perspective, it can also be utilized as a same-day possibility. So if, for example, we have a patient who's due to have an MRI tomorrow and their last MRI was stopped in part because they couldn't tolerate it due to pain or symptoms, we might have a primary team reach out to us and ask whether we can see that patient the day prior to their MRI and devise a plan with that patient so that they can tolerate the MRI more easily the next day." TS 22:26 "Many of our patients no longer have the ability to get to and from their place of worship, and we can sometimes bring their clergy people to them via telehealth video. We also offer psychology services, psychiatry services, child life services, all via telehealth. And I think it's important to recognize that palliative care is actually made up of an interdisciplinary team, including all of the aforementioned specialists who can basically work together to improve the experience of the patient who is living with cancer and being treated for it." TS 26:41 "Accept the inevitability of ups and downs. Learn from the downs and persevere. The outcomes are definitely worth it." TS 28:11 | |||
| Episode 281: Nursing's Role in AI in Health Care | 13 Oct 2023 | 00:44:57 | |
"I think the horizon, the trends that we are seeing today, are indicating that this technology is just going to explode and be integrated into everything we do in nursing or beyond. Many of the things with nursing are going to change significantly for us, which has already started," Maxim Topaz, PhD, MA, RN, FAAN, Elizabeth Standish Gill Associate Professor of Nursing at the School of Nursing and The Data Science Institute at Columbia University in New York, NY, and senior scientist at VNS Health, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about nursing's contributions and opportunities to shape in AI in health care. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to the nurse's role with AI in health care. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.
Highlights From Today's Episode "So, today, I think this technology advances every week. There are updates for this technology, specifically ChatGPT technology, that are not incremental, I think, they're pretty evolutional, though, and are making me excited about this field. I was excited before, but I was very skeptical, actually, before the recent advancements in the last year or so about our ability to get to a place where we would interact with those large language models." TS 10:31 "My goal right now is to try to see how we use this technology appropriately for nurses in general, including oncology nursing. The use cases that I can see are more multiple, and one thing is generating the summary of your care. If the interaction between you and the patient can be recorded, then some summary can be generated. Now in oncology, there are a lot of things that machine learning in general, including technologies like ChatGPT, can do." TS 13:35 "When we build machine learning models using the secondary data that kind of captures those biases, then this propagates. So their ability, those machine learning models, they just learn patterns from data. So, they're going to be biased as well as the data that goes in, basically." TS 18:25 "You need to think about your population. You need to think about your specific setting. You need to think about what are the historic factors that kind of influence what's going on in practice. And, what is your kind of moral compass. And then, you make decisions about how to fix the machine learning algorithm." TS 22:04 "The field that, today, kind of the name for this field, I think, is changing to AI, right. They used to call this informatics. So, you know, that's kind of traditional name, right, that is what you would search for on those platforms, so like healthcare informatics, right. I have a course on eDEX. This platform that thousands of people from more than fifty countries have taken and learned about informatics." TS 35:33 "[In terms of nurses] thinking about ethical aspects and thinking about some of the biases that can be embedded in the technology, we're really good at this. I would definitely encourage nurses that are seeing explosion of this technology to think about those trends and not just blindly apply this knowledge in practice, but think about what implications does it have for our patients? So having the patients in mind, having the person in mind, is kind of that central thing. And that's what we're doing every day." TS 42:08 | |||
| Episode 280: Create a Culture of Safety: Learning Culture | 06 Oct 2023 | 00:20:14 | |
"As nurses and healthcare providers, we need to be up to date with the most current evidence-based practices. To achieve and maintain this, we must institute a learning culture. It is critical to promote a learning culture and healthcare institution to keep both patients and nurses safe," Klara Culmone, MSN, RN, OCN®, assistant nurse manager at the Laura and Isaac Perlmutter Cancer Center at NYU Langone Health in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses should know about creating a learning culture in the workplace for nurses at all levels, from staff to managers and administrators. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to creating a culture of learning and safety. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.
Highlights From Today's Episode "There are a few ways to demonstrate to nurses that a healthcare organization values and promotes a learning culture. So, for example, allowing the time off to attend relevant conferences including covering costs such as transportation, registration, et cetera, as we know that these costs can really go up quickly." TS 2:20 "Allowing time off the unit with the adequate coverage is really critical, and I think that's a challenge that many of us face right now. So, staffing may not always allow for it, but trying to have a plan set in advance can really help ease this challenge. So, some things that we have implemented to minimize staffing impact on the unit would include, perhaps, paying the nurse to attend the class on a day outside of their scheduled shift, so this is especially helpful for remote learning." TS 5:48 "Nurse leaders are really critical in the development of a positive learning environment. Nurse leaders should conduct the learning needs assessment within their team and then tailor the educational plan based off of the results. And this really, ideally, should be done in collaboration with their nursing professional development specialists. It's important for nurses to share new knowledge with one another." TS 7:59 "One of the best ways for nursing schools and facilities to collaborate is by hosting student clinical groups. Having nursing students work with nurses allows the nurse to share their knowledge with the future of the nursing workforce. They are teaching a new generation of nurses. I mean, many of us remember the best clinical experiences during our training. And it is always the preceptor nurse who spent the most time teaching and answering our questions that gave us the motivation and drive to continue learning." TS 10:39 "I would just really encourage all of our fellow nurses to just be open to new learning, open to new ideas, and willing to teach one another, because I think we really do the best when we build one another up, we listen to each other, and we learn from one another." TS 19:20 | |||
| Episode 279: Hematopoietic Stem Cell Transplantation for Scleroderma and Other Autoimmune Diseases | 29 Sep 2023 | 00:27:31 | |
"I think the most amazing thing we see is the softening of the skin, which can occur during the first two weeks of the conditioning regimen. The nurses on the floor see it, and I think it's just a tremendous gratification for them to see the results of something right before your eyes," Tanya Helms, PA-C, from the division of hematological malignancies and cellular therapy at Duke University Medical Center in Durham, NC, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about what oncology nurses should know about transplantation for patients with non-oncologic conditions such as autoimmune disease, how the transplant process differs for non-oncology indications, and the clinical pearls oncology nurses should consider when caring for patients with autoimmune diseases during the transplantation process. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to hematopoietic stem cell transplantation for scleroderma and other autoimmune diseases. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.
Highlights From Today's Episode "The goal of treatment for patients with scleroderma is to reset the immune system, and there are three main components of the regimen used at Duke—that's total body radiation, cyclophosphamide, and ATG. This targets all the areas where the immune effector cells live. We also use CD34 selection, which is a process that separates CD34-positive cells from the stem cell product that's collected prior to transplant, to eliminate the possibility of reinfusing activated immune cells back into the patients." TS 3:18 "For patients with diffuse scleroderma, you want to offer transplant when they have evidence of significant disease, but they're not so compromised that they can't tolerate or have increased risk of complications from the conditioning regimen. Understanding the patient's rate of disease progression is key when determining to transplant." TS 6:45 "When a patient is referred, we call the patient, and we talk about how the transplant conditioning regimen works to reset the immune system and stop disease progression. We explain the workup visit and go over an example of the timeline needed to collect the cells, admit to the hospital for conditioning, and the recovery process as an outpatient. We want patients to understand the big picture before they ever come to Duke." TS 7:57 "Some patients come to us significantly disabled by their scleroderma. They may be in a wheelchair, so they require special vehicles for travel. Patients whose hands are severely involved need assistance with their ADLs [activities of daily living]." TS 11:43 "There have been three clinical trials that show autologous transplant improves event-free survival and overall survival and has been shown to decrease all-cause mortality. But it does not repair damaged gastrointestinal, pulmonary, or cardiac tissue. Any fibrosis that has happened is permanent." TS 12:22 "The most amazing thing we see is the softening of the skin, which can occur during the first two weeks of the conditioning regimen. The nurses on the floor see it, and I think it's just a tremendous gratification for them to see the results of something right before your eyes." TS 13:01 "Social media has been a huge contributor towards patient self-referrals. Patients are telling their stories on Facebook; patients are asking other questions about how to get referred to a transplant center; and patients whose rheumatologists have not referred them will seek out transplant centers to learn more about transplant for scleroderma." TS 13:48 "For people with hematologic malignancies, it's all about getting that patient to remission and then transplanting them. . . . These patients have experienced chemotherapy and the adverse effects. They know about low blood counts and fatigue and recovery. They know about central lines and transfusions. The scleroderma patients come to transplantation with progressive disease. They've typically not had blood transfusions, but they are now going to receive total body radiation, chemotherapy, and a stem cell transplant over the next six weeks. And it can be overwhelming. . . . Every day is something new for them to process and learn." TS 14:56 "Patients become pancytopenic, and they are heavily immunosuppressed. They are on steroids during the conditioning regimen to prevent scleroderma flares during conditioning. These patients have a central line so monitoring for infections, such as assessing vital signs for signs and symptoms of infection, and being aware that steroids can mask a fever." TS 16:49 | |||
| Episode 377: Creating and Implementing Radiopharmaceutical Policies and Procedures | 22 Aug 2025 | 00:23:09 | |
"Policies help make sure that we're giving patients the right education and discharge instructions. Radiation doesn't end when the syringe is empty. Patients go home with potential radioactive exposure. They need to know how to protect their families, what precautions to take, and what healthcare providers can do if something goes wrong—like a spill, extravasation, or even a pregnant staff member who's involved in the care. This isn't just a documentation exercise. It's about making sure every part of the system speaks the same language when it comes to safety, handling, and patient care," ONS member Ella-Mae Shupe, MSN, RN, OCN®, nursing practice and professional development specialist for radiation oncology at Johns Hopkins Health System Sydney Kimmel Cancer Center based in Baltimore, MD, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about creating and implementing radiopharmaceutical policies and procedures. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 22, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to implementing policies and procedures to support administration of radiopharmaceuticals for cancer treatment. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "[Lutetium lu 177 vipivotide tetraxetan] has shown so effective in clinical studies that the FDA recently approved expanded use, and it can now be given prior to chemotherapy." TS 1:56 "There are typically three parts to a radiopharmaceutical. One is a radioisotope, which emits the radiation. The second is a targeting molecule, which directs the compound to a specific site. And the third is a linker that binds the isotope to the targeting molecules securely. The targeting molecule is usually a substance that binds specifically to receptors, antigens, or metabolic pathways that are overexpressed on cancer cells." TS 2:08 "We have an interdisciplinary team involvement. There's a physicist, nurse, and provider that confirm lab values are within normal limits. The patient meets all the clinical and safety criteria for administration. Second is an IV placement where a nurse or clin tech starts the IV and verifies a strong blood return. This is critical to avoid extravasation, which can be harmful due to the vesicant-like nature of radiopharmaceuticals. And third, our patient voids immediately before the injection, which reduces bladder radiation dose. During the administration, our provider administers the radiopharmaceutical using a shielded syringe holder to reduce radiation exposure. The physicist remains present throughout the procedure. Lead aprons are worn by any team members close to the IV site, and then the Geiger counter is used by physics to measure ionizing radiation, which is done before, during, and after the procedure." TS 3:28 "The policy we created doesn't just address general principles. It includes very specific guidance for both [radium 223 dichloride] and [lutetium lu 177 vipivotide tetraxetan]. That includes everything from determining patient eligibility to completing the treatment directive, confirming patient identity, verifying delivery parameters, documenting the treatment itself, and ensuring the treatment environment is appropriate and safe. We've also built in drug- specific practices because [radium 223 dichloride] and [lutetium lu 177 vipivotide tetraxetan] each come with their own considerations. This includes competencies for nursing, tailored patient education for each therapy, and an extravasation checklist that outlines what to do and who's responsible for tasks if infiltration occurs."TS 11:24 "We created two separate versions [of an attestation model], one for clinical staff and one for non-clinical staff. Why include non-clinical staff? Because the risks extend beyond just the clinical team. What if environmental services comes in to clean and the patient has urinated on the floor? Or what if dietary delivers a tray and moves a urinal without knowing the risk? Or what if transport comes in and handles an incontinent brief without awareness? Each of these scenarios has potential for contamination and exposure. And that's exactly why education for all roles matter." TS 15:22 "These are such an exciting treatment for our patients, that's not chemotherapy, that's not radiation, and their quality of life has been amazing. We have had patients coming in that could barely walk because of the pain from bone mets and after a few treatments, they're much better. We've had PSAs go from five, six hundreds down to 0.5, so we're seeing a lot of really good options for these patients and treatment." TS 22:09 | |||
| Episode 278: Cancer Symptom Management Basics: Hepatic Complications | 22 Sep 2023 | 00:25:37 | |
"I think that as oncology nurses, we need to keep ourselves really educated and up to date with these new therapies, because I honestly feel like we still haven't really seen the long-term effects of this treatment," ONS member Lisa Parks, MS, APRN-CNP, ANP-BC, nurse practitioner in hepatobiliary surgery at The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center in Columbus, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about recognizing hepatic complications and understanding the basics of its symptom management strategies. This episode is part of a series on cancer symptom management basics; the others are linked below. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge in cancer symptom management basics and hepatic complications. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org
Highlights From Today's Episode "There is something called chemotherapy-induced liver injury. What the chemotherapy does is it has a direct hepatotoxic effect on the hepatocytes themselves. If you have preexisting liver disease such as cirrhosis, it can lead to very severe hepatotoxicity because the function of the liver is already compromised by the damage previously done to it." TS 3:47 "The American Gastroenterological Association published guidelines on the management of HBV reactivation for patients during immunosuppressive treatment, and they basically do recommend any patients with a hep B virus that they receive antiviral prophylaxis to prevent this reactivation from occurring. Also in 2008, the CDC recommended universal HBV screening for all patients before administering chemotherapy. This one you see most commonly in patients who receive chemotherapy for a hematological cancer following hemopoietic stem cell transplantation." TS 14:19 "One of the most common things that I've encountered in my practice is that there seems to be a thought that once hepatic complications are identified, there is treatment for this, and in these patients, we can't reverse liver injury. Really, what we offer these patients is supportive care. These patients often can decompensate really quickly, and often these patients may require being transferred to the intensive care unit and it's not because there's any intervention that we're going to do. But I think it's very frustrating for nurses to see these severe liver injuries, that are life threatening, and not to be able to do anything about it." TS 19:06 | |||
| Episode 277: Futility in Care: How to Advocate for Your Patients and Prevent Ethical Distress | 15 Sep 2023 | 00:51:29 | |
"One of the things about futility is many people will say, 'Oh this is futile care,' when what they really mean is, 'Who in their right mind would want this?' or 'I would never ever want this,' and that's different. That's not futile care. That's potentially inappropriate care. And sometimes that's the big step for folks," Lucia D. Wocial, PhD, RN, FAAN, HEC-C, senior clinical ethicist in the John J. Lynch Center for Ethics at the MedStar Washington Hospital Center in Washington, DC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about futile care: how to recognize it, how to approach communication during difficult situations, and how to address a nurse's associated ethical distress. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to futility in care and how to speak up for patients and prevent ethical distress. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "It's a term that appeared in the literature back in the 1980s when it became clear that we had medical technology that could sustain people's lives but not actually return them to a healthy state. And so, there was this attempt to try and identify and define when it was that the care we were providing, the treatments we were providing, could no longer work. And so, some people tried 'qualitative futilities,' some people tried 'quantitative futility.' People have been working on it for a long time, but the shortest definition is a treatment intervention that will not have its intended effect." TS 1:52 "And first of all, it says futility is a definition that should be used sparingly. There are lots of times when a treatment may be considered what we call 'potentially inappropriate.' And when thinking about what's the difference between futility and potentially inappropriate? Futility is, it's clearly not going to work. Potentially inappropriate is, well, it might work, but there are lots of competing reasons why maybe we ought not to do it. And some of those reasons might be significant burden. Some of them may be the patient won't be able to achieve a neurologic state where they be able to actually perceive the benefit of ongoing biological existence. That statement, it has some very clear recommendations about: be very careful about how you use the words." TS 7:15 "In my work as a clinical ethicist, far and away the more frequent reason we get called is families want to keep going. It's not the other way around. And in fact, when a family or a patient is ready to stop, those become incredibly difficult for the healthcare team, particularly when there's a physician who feels like, 'But I know this will work. Don't not do this. You have a 50%, 60%, 70% chance of surviving. don't you want to try?' So to know that you have the ability to give them a chance is one thing." TS 13:33 "And here's the tragedy in this, and I hear oncologists say this, 'Well, it's not time yet.' That's my favorite response, it's, 'Not yet. Not yet.' So, when you ask most people, 'If you knew that you were going to die in the next three months, are there things that you would want to do before you die?' most people are like, 'Well yeah'. To fail to invite this conversation robs them of this choice." TS 16:04 "Step one: Don't keep it to yourself. A lot of it is making sure that you talk with other folks, and if you work in an inpatient setting and your hospital is Joint Commission certified, then there is some mechanism in place in your institution for dealing with an ethics challenge. But the idea is what we do is hard. And one of the biggest challenges for people who are experiencing ethics distress or moral distress is very rarely do ethical challenges happen when people are having a good time. There's a tragedy somewhere, and part of the big challenge is to separate the tragedy, like the cosmic unfairness, injustice, from 'Are we as a healthcare team contributing to the injustice?'" TS 40:51 | |||
| Episode 276: Support Young Families During a Parent's Cancer Journey | 08 Sep 2023 | 00:30:41 | |
"Reassuring doesn't always mean providing solutions. Sometimes, it's providing support. There are some key tips that can be helpful for supporting patients when they're ready, when they're asking, 'What about my kids?' Like, what are the things when you leave this hospital that your kids are going to see, hear, or notice? That's a great place to start," Kelsey Mora, certified child life specialist, licensed clinical professional counselor, and chief clinical officer at Pickles Group, a national nonprofit organization that provides support and resources to children and teens whose parents have cancer, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about how oncology nurses can support young families during a parent's cancer journey. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to supporting young family members during a parent's cancer journey. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "I think there's a concern that young kids won't understand or won't remember, and what we actually see is that even the youngest kids can really pick up on changes in their environment. So, when there's a cancer diagnosis, there is inevitably unavoidable change and disruption, whether it be to caregiving routines, availability, schedules, their appearance and ability status, hospitalizations, and certainly observed emotions. Kids are curious at all ages, so they pick up on things and they try to make sense of things on their own. And so, my role is really around helping nurses help parents and parents help their kids understand what's going on so that they're not left trying to figure it out on their own." TS 3:52 "Providing kids with honest and age-appropriate information is about providing them with a narrative to make sense of what's going on, and so it is honest, but it is age appropriate to kind of tailor it to the age or development of the child." TS 5:03 "Pickles Group was born out of finding families where kids were saying, you know, 'I want to meet other kids who can relate to this,' because the second there is a cancer diagnosis, they feel really different from their friends and their peers. And so being able to connect with others who can understand more of their experience is super important." TS 5:48 "I always tell parents that 'I don't know' is a real answer. That's an honest answer, right? Being able to say, 'You know, that's a great question. I don't know the answer right now, but as soon as I do, I'll definitely talk about it with you.'" TS 9:35 "I think it's so important to normalize that grief occurs the second that there is a diagnosis, because there is so much change and transition and loss and uncertainty. A lot of times for kids, that's just like the loss of the way things were before or the loss of being able to relate to peers or the loss of the things that my parent was able to do before or just them not being around as much." TS 16:32 | |||
| Episode 275: Bispecific Monoclonal Antibodies in Hematologic Cancers and Solid Tumors | 01 Sep 2023 | 00:26:12 | |
"It's really important to look at where your target is and what the toxicities are associated with hitting that target. Make sure you include that thinking when you're talking about bispecifics," ONS member Rowena (Moe) Schwartz, PharmD, BCOP, professor of pharmacy practice at the James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about the use of bispecific monoclonal antibodies in hematologic cancers and solid tumors. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to bispecific monoclonal antibodies in hematologic cancers and solid tumors. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "When we talk about bispecifics, we need to really pay attention to both the target on the cancer and the target for T-cell engaging, because that impacts both efficacy but also toxicity." TS 4:20 "If you really look deep into the clinical trials, often the patients that are receiving these agents in clinical trials have had more than the required three or four lines of treatment. They may have had five or more lines of treatment. So it's really important to kind of look at where it sits right now, knowing, of course, that that's an evolving target." TS 7:13 "One of the things I think can be missed, at times, is the fact that you need to consider the toxicities associated with your target on the cancer cell." TS 10:06 "In terms of mitigating risk, there's been two major ways that have been done. One is a step-up dose schedule, and so one of the key things I would say: If you're not familiar with an agent that you're going to be administering, it's really important to review the entire step-up scheme because it's different for each agent. In some cases, patients need to be admitted to the hospital for the entire step-up strategy. Other times it's just the first dose. So it's really important to look at that." TS 11:58 "I think we're going to get to the point where our teaching strategy is going to have to be somewhat tailored to the agent we're giving. So, how the drug is given during the step-up, what the subsequent cycling is going to be, whether it's going to be a Q21-day cycle or a weekly dosing administration or every-two-week administration after a certain point. So, I think some understanding of what to expect going forward because these are drugs that are given continually in most situations and so it's important for people to know what to expect." TS 14:25 "I think we're going to see bispecifics that perhaps engage other aspects of the immune system besides CD3. In fact, those are in clinical trials. And I do believe that we're going to see these more and more developed for cancers beyond the hematologic malignancies. There's a lot of work being done at looking at targets that we know are helpful targets in certain cancers. And I think we'll see more drugs approved beyond the myeloma and the lymphoma and the leukemia space." TS 20:42 | |||
| Episode 274: Music Therapy for Patients With Cancer | 25 Aug 2023 | 00:34:15 | |
"You don't have to have any musical background to benefit from musical therapy," ONS member Susan Yaguda, MSN, RN, manager of integrative oncology and survivorship in the Department of Supportive Oncology at the Levine Cancer Institute in Charlotte, North Carolina, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about how music therapists and oncology nurses collaborate to offer music therapy's benefits to patients with cancer. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to the use of music therapy. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "A lot of people have their workout playlist or something that kind of pumps them up before they're going to go play a tennis match or something like that. But in using music in this way, there isn't really a specific therapeutic goal and the relationship in these situations. And while any of us can provide recorded music or live music to patients, certainly our care partners, if we're not trained as music therapists, it just should not be considered or referred to as music therapy." TS 3:56 "It might be using music to help regulate breath work, to reduce stress and anxiety associated with whatever they're having done in the suite. It can also be used as a distraction." TS 6:19 "Oftentimes after that point, our patients may be starting to experience some other troubling side effects or symptoms from their treatment or their cancer. The music therapist can help them with better manage those in a supportive way. And this can be done in things like techniques to help them manage pain, techniques to help them maybe destress and get more restful, sleep even." TS 7:00 "Sometimes using music as that tool helps create the space that does feel even more safe. It's not necessarily having to talk to someone directly, but music is the vehicle for doing that processing work." TS 15:01 "There is receptive music therapy. So that is basically where the person receiving music therapy is not co-creating music, or writing lyrics, or anything like that, they're just listening. There might just be some paced breathing exercises that are incorporated into this. It tends to be a more repetitive type of cadence to the music that can help create just being in a better zone if they're trying to and bring the anxiety level down." TS 16:16 | |||
| Episode 273: Updates in Chemotherapy and Immunotherapy | 18 Aug 2023 | 00:38:01 | |
"It's really an exciting time to be in the field of oncology because we can have these specific drugs that target these specific variants rather than, back in the day, when we had to use kind of generic cancer therapies that weren't specific for an individual's cancer," ONS member Suzanne Walker, PhD, CRNP, AOCN®, senior advanced practice provider and coordinator for thoracic malignancies at the Abramson Cancer Center at Penn Presbyterian Medical Center in Philadelphia, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about the latest updates in chemotherapy and immunotherapy treatments. Walker is one of the editors of ONS's second edition of the Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice book. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to updates in chemotherapy and immunotherapy. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "We've seen significant improvement in cancer survival over the past one to two decades. And primarily we've seen this not only from reductions in smoking and earlier cancer detection, but advancements in some of our treatments, most notably in the realm of immunotherapy and targeted therapy." Timestamp (TS) 02:07 "With the discovery of the biomarkers, it has brought around the discovery of genomic-driven therapies that are specific to these biomarkers. That's really changed the landscape of oncology for people that have one of these driver variants." TS 07:55 "I've definitely seen in my practice where therapy has been completed and, especially for some of these immunotherapy drugs, a couple of months later the patient develops a toxicity that is from the prior immunotherapy. Even chemotherapy can have some long-term toxicities, but we do have to even keep it in mind for immunotherapy that once these drugs are finished, there still could be some long-term side effects. Since they are newer drugs, we still are learning about what some of these long-term toxicities look like." TS 26:56 "There haven't been a ton of new FDA approvals specific for chemotherapy; however, we have seen chemotherapy still used in practice, particularly in combination with some of these novel therapies. Particularly, we see a lot of chemotherapy and immunotherapy combinations." TS 27:47 | |||
| Episode 272: Oncologic Emergencies 101: Radiation Therapy for Emergent and Urgent Interventions | 11 Aug 2023 | 00:43:13 | |
"Like all emergencies, they're unpredictable. I have seen them at the very beginning and sometimes, unfortunately, that can be the patient's first sign or symptom that they have cancer. It can be something like they've lost the ability to walk, or their breathing gets difficult. I've also seen it during the middle of their care continuum where we finish a round of radiation and they develop metastatic disease so the next time you see then for radiation can be for a cord compression. I've also seen it toward the end of their care continuum where this is strictly a quality-of-life measure," ONS member John Hollman, BSN, RN, OCN®, senior nurse manager of radiation oncology at AdventHealth Cancer Institute in Orlando, FL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about radiation therapy for emergent and urgent interventions. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to radiation therapy when used in the emergent and urgent setting. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "It is a larger dose per day typically than you would give for six weeks. So, you want to give a lower dose per day if you're going to stretch it out for six to eight weeks. Shorter courses like these, for emergencies, are a higher dose per day but a short time frame of treatment." Timestamp (TS) 14:34 "As a nurse, I kind of like to overeducate, and you can kind of tell which patients are more receptive to knowing everything, and some of them want to know the bare minimum." TS 16:14 "The thing that's different with these patients is that sometimes those side effects will hit when they're no longer in your clinic." TS 17:19 "I say get to know your medical oncologists and your radiation oncologist. Communication can be open; it doesn't have to be a silo if you don't need it to be." TS 22:14 "The more educated the patient is, it lessens their nerves. I feel like the more educated they are, they know what to expect. They know every step of the process." TS 32:02 | |||
| Episode 271: Intraventricular and Intrathecal Administration: The Oncology Nurse's Role | 04 Aug 2023 | 00:29:05 | |
"These patients have very intense regimens of chemotherapy. They're tired a lot of the time. Between their oral chemotherapy, their IV chemotherapy, their hospitalizations, and then coming in. Everything takes longer than we would like it to for these patients. They are long days to come in for a procedure," ONS member Rebekah Rabinowitz, RN, BSN, OCN®, neuro-oncology nurse at Emory University Hospital in Atlanta, GA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, oncology clinical specialist at ONS, during a discussion about nursing considerations for intraventricular and intrathecal administration. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to antineoplastic administration via intraventricular and intrathecal routes. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "We're not actually giving the chemotherapy intrathecal or intraventricular, but we're there for the whole process. Handing the chemotherapy and the check off, the whole thing. We're monitoring them if they're sedated. We're making sure they're getting their antiemetics." Timestamp (TS) 12:31 "When we're doing teaching with the patient, we often do bring up that it's similar to when women get an epidural when they're having a baby. It's the same space that we're using. We're using a smaller needle, we're not leaving a catheter in, but pregnant people do it every day. That sort of helps ease a little anxiety when they think about it that way." TS 15:04 "You have to meet their medical literacy needs. They may not be aware that this administration route even exists." TS 21:42 "People think that it's going to be a painful procedure. It's uncomfortable, people don't like it, but it's not horribly painful. If we do see pain, that's concerning. It'll likely be an ER visit for imaging." TS 26:36 | |||
| Episode 270: Meet the ONS Board of Directors: Brown, MacIntyre, and Woods | 28 Jul 2023 | 00:43:09 | |
What is it like to guide a professional association that serves more than 100,000 oncology nurses? ONS Chief Executive Officer Brenda Nevidjon, MSN, RN, FAAN, and 2023–2026 Directors-at-Large Susan Brown, PhD, MSN, CENP, Jessica MacIntyre, DNP, MBA, APRN, AOCNP®, and Trey Woods, RN, MSN, NP-C, discuss the ONS Leadership Development Committee's appointment process for the ONS Board of Directors, reflect on their experience in ONS, and elaborate on the work they do in their leadership positions. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to the role of the ONS Board of Directors. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode Trey Woods: "An emphasis of my service really has been on lots of volunteer opportunities and lots of committee work, and I just feel like that's opened the door to me for so many great networking opportunities. I would certainly encourage anybody who's interested in leadership or volunteering to look into the multitude of opportunities that ONS makes available to the members." Timestamp (TS) 9:41 Jessica MacIntyre: "I really wanted to pay it forward, and I also want to continue to be a voice and advocate for our patients and members. And there's no better platform than ONS to take my advocacy to the next level. I couldn't be prouder to lead ONS in this role and to contribute to its mission of excellence in oncology nursing and transforming cancer care." TS 14:50 Jessica MacIntyre: "What struck me the most is the breadth and depth of issues we tackle. I think from policy to strategic initiatives, the agenda is truly dynamic, and it's been a testament to how every aspect of our profession can be a catalyst for change." TS 24:48 Susan Brown: "I'm just so impressed and inspired by the dedication and commitment of the people sitting around the ONS Board table." TS 31:27 Trey Woods: "When it comes to nursing burnout, I think the focus really needs to be on what is encouraging, because for all the things that concern me, I think that there's opportunity for encouragement. I think there's opportunities for organizations like ours to move nursing forward." TS 33:52 Susan Brown: "We keep having a lot of first-timers at ONS Congress®, and that just tells me that our job of educating oncology nurses of the future is a never-ending process." TS 37:22 | |||
| Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications | 21 Jul 2023 | 00:44:14 | |
"Since gastrointestinal complications are so broad, you will see these types of complications in really any oncology setting," ONS member Kara Freedman, MS, RN, AGCNS-BC, PCCN, OCN®, clinical nurse specialist in ambulatory GI surgery/medicine at Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, oncology clinical specialist at ONS, during a discussion about managing gastrointestinal complications. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to gastrointestinal symptom management. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Preparing our patients, not scaring the daylights out of them, but preparing them for what to expect and really when to contact us, not to wait until it gets too severe so that it's even harder to treat. We really do want to make sure we're driving this home when we're educating our patients." Timestamp (TS) 17:52 "As nurses, we know dietary suggestions that we can give them, but if we are finding a patient needs a little more help, reaching out to our local dietician could really help benefit the patient in a positive way." TS 24:12 "It takes a village. You know, we are not siloed by ourselves caring for these patients. The patient will benefit from the more support that we give them." TS 39:05 "There are many other issues and problems that occur, other than nausea and vomiting, for these patients with cancer. This can not only affect their weight and their nutritional status but their overall quality of life as well. It's really important to make sure we are looking at the whole patient." TS 39:58 | |||
| Episode 376: ONS 50th Anniversary: The Science Behind the History of Nursing Burnout and Compassion Fatigue | 15 Aug 2025 | 00:28:15 | |
"At least some of the answer to these issues of compassion fatigue and burnout have to do making our practice environments the very, very best they can be so that nurses and other clinicians can really connect and care for patients in the ways that they want to be able to do that—and the patients need them to be able to do. I think there's a lot that is here already and will be coming, and I feel pretty optimistic about it," ONS member Anne Gross, PhD, RN, NEA-BC, FAAN, senior vice president for patient care services and chief nursing officer at Dana-Farber Cancer Institute in Boston, MA, told ONS member Christine Ladd, MSN, RN, OCN®, NE-BC, member of the ONS 50th anniversary committee, during a conversation about burnout and compassion fatigue in oncology nursing. Ladd spoke with Gross and ONS member Tracy Gosselin, PhD, RN, NEA-BC, AOCN®, FAAN, senior vice president and chief nursing executive at Memorial Sloan Kettering Cancer Center in New York, NY, about the history of nurse well-being and how nurses and health systems are approaching it today. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode Gross: "I was on an oncology unit early in practice. And just like today, we were dealing with very sick patients. We were dealing with death and dying. We were administering very toxic treatments and really pushing a field forward in oncology. So there were similar challenges, but I think different from today. There weren't the kind of resources; there wasn't the body of work that's been done today around compassion fatigue and burnout, work-life balance, and things like that. There was not that body of literature and science like there is today. And so there was more of a grassroots kind of support building in the clinical environment that I think I experienced." TS 2:35 Gosselin: "I think there's also a piece when we think about nurses in the work we do—we also have families. We have aging parents and children. And sometimes that burnout is multifactorial in that we have family obligations and other obligations that make it really hard. And for some people, they say work is their escape from some of that. Yet it's all hard to balance sometimes." TS 8:09 Gosselin: "It's this question that people like Anne, myself, other chief nurses are saying. If we add this new technology, what are we going to take away? Do we need another alarm to ring to the phone or to their badge? How much can you ask people to do and not be distracted when they're at point of care delivering patient care? Technology should never be a distractor, nor should it tell us how to practice. The technologies we have today—I'm like, 'Wow, I wish I had that when I started my career.' And yet there's also a double-edged sword to that. I think we have to balance when we think about care and care delivery." TS 16:36 Gross: "There are so many resources, first of all, that ONS provides to all of us at all levels and in all points in our career and our path from novice to experts. And the needs, though, are the same. Whether you're a novice nurse or whether you're a very experienced nurse, you need to continue to learn and to get new information, and ONS is an incredible resource for that. … As I think both of us keep alluding to and emphasizing here, you also need that connection to other people. And that's what ONS provides—that opportunity to get connected to other people that might be working in some other part of the country or other part of the world but is dealing with similar things that you're dealing with. So it provides that opportunity, and then it also provides an opportunity to get involved. I think when you can get involved and be part of solving a problem, it doesn't then control you and you won't feel defeated by it." TS 22:24 | |||
| Episode 268: Race in Research: From Subjects to Scientists, ONS Scholar-in-Residence Has a Career Commitment to Racial Equity | 14 Jul 2023 | 00:41:22 | |
"If we're not driving our own research agenda and we're not asking the questions we see as important, we are not realizing the full potential of nursing. We know, because we are with patients, what the issues are for patients, for families, and for communities. We have to be able to say, 'Nope, this is the question.'" Margaret (Peg) Rosenzweig, PhD, FNP-BC, AOCNP®, ONS's scholar-in-residence and professor at the University of Pittsburgh in Pennsylvania, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, oncology clinical specialist at ONS, during a discussion about her oncology nursing clinical and research career, commitment to equity, and role as ONS's scholar-in-residence. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to race in research. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "A commitment that we all have to have is toward more diversity in oncology nursing and in oncology research and thinking about what can I do in my world." Timestamp (TS) 7:52 "Unless we listen to and really fully honor what the nurse can ask about their experience with patients, we're missing so much in the way that we can help patients' families and communities." TS 17:08 "I think we haven't thought fully enough about the patient in the context of their life. I think we've thought about symptoms, but we have to think about the patient baring those symptoms, where they come from, and what they've experienced. So, I think incorporating the social determinants of health is very important." TS 18:00 "White researchers will say, 'It doesn't matter. You can hire White recruiters and as long as people are properly trained, that should not matter.' I feel like that is a bit of implicit bias that we as White researchers just don't recognize. We think it doesn't matter because it doesn't matter to us. But it does matter to Black women." TS 30:13 | |||
| Episode 267: Side-Effect Management for CAR T-Cell Therapy for Hematologic Malignancies | 07 Jul 2023 | 00:31:14 | |
"I think the take-home message here, though, is to have very specific guidelines at your institution to manage both CRS and ICANS. The protocols should be readily available to all practitioners who may participate in the care of these patients," ONS member Phyllis McKiernan, MSN, APN, OCN®, advanced practice provider at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS. McKiernan's and Taylor's conversation centered around the nurse's role in recognizing and managing toxicities related to CAR T-cell therapy for hematologic malignancies, specifically ICANS and CRS, which was an educational priority that ONS members identified during two ONS focus groups on the topic in March 2023. McKiernan was one of the content experts for those focus groups. This podcast episode is produced by ONS and supported by funding from Janssen Oncology/Legend Biotech. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "All symptoms need to be investigated fully to determine their cause and thus the best management strategy and not just simply assume that they're related to CAR T." Timestamp (TS) 9:21 "Accurate grading is really crucial to ensure that the toxicities are identified and managed consistently across the institution." TS 10:52 "Once the patient shows signs and symptoms of neurotoxicity, they should have a comprehensive neurologic examine, and that should include, a neurology consult, maybe imaging, such as an MRI or CT, and perhaps even a lumbar puncture." TS 14:12 "Letting patients and their families know what next steps are can alleviate anxiety and give the patients the confidence that the medical team is familiar with these toxicities. And let them know that these toxicities are expected and that there are protocols in place to manage these symptoms." TS 22:56 "I think that some patients, and even healthcare professionals, who aren't familiar with CAR T believe that the toxicities are always severe and always irreversible. When, in reality, most of the toxicities are mild and managed with minimal intervention or even just supportive care." TS 23:55 "Early detection, consistent grading, vigilant monitoring, and standardized care plans are crucial to the success of any CAR T program and can also help reduce the risk of the severe adverse effects and hopefully improve outcomes for our patients." TS 30:26 | |||
| Episode 266: Create a Culture of Safety: Reporting Culture | 30 Jun 2023 | 00:20:15 | |
"We need to continue to remind everyone that reporting culture improves safety, that events are usually because of a system or process gap, and there is a clear difference between a system gap and neglectful or at-risk behavior," ONS member Klara Culmone, MSN, RN, OCN®, assistant nurse manager at NYU Langone Medical Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, oncology clinical specialist at ONS, during a discussion about oncology nurses' and leaders' responsibilities in a safety-focused reporting culture. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. This episode is part of a series on creating a culture of safety; the others are linked in the episode notes below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to creating a culture of reporting errors and safety issues. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "A reporting culture is where people report their errors and near misses. Adverse events and near misses are common in health care; however, unfortunately, they are underreported." Timestamp (TS) 01:36 "I think that nurses may hesitate because of fear of retaliation or getting in trouble. Even if that error was because of a system problem or it was an honest mistake, there's still that fear. So, leaders in healthcare settings really need to create and promote a psychologically safe environment." TS 03:23 "Oncology nurses are really positioned in a great place to participate in debriefs and root-cause analysis and share their expertise as appropriate to, perhaps, update current policies and procedures to prevent this from happening again." TS 08:36 "We all have a role to play in identifying and reporting potential hazards. So, that could be a piece of equipment that needs maintenance or a slippery floor that needs attention. We can all prevent harm and keep our patients safe." TS 17:16 "It is so important for all of us to foster a culture where all employees feel empowered to report and address concerns without fear of repercussions." TS 19:14 | |||
| Episode 265: Intravesical Administration: The Oncology Nurse's Role | 23 Jun 2023 | 00:43:46 | |
"Sometimes you think, 'Oh, these are just bladder patients; it's different.' But it might not be different. They still have a cancer diagnosis; this is still going to be a very fearful and unsettling time for that patient and their caregivers," Tiffany Kurtz, MSN, RN, OCN®, manager of outpatient oncology at Summa Health Cancer Institute in Akron, OH, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, oncology clinical specialist at ONS. Kurtz discussed intravesical administration and oncology nurses' role in the treatment. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to the nurse's role in intravesical medication administration. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Intravesical administration is a localized or regional treatment. It's only going to affect the area of the body that the medication comes in contact with. So because it is administered in the bladder, the common side effects that we're going to see are going to be localized to the bladder." Timestamp (TS) 02:09 "Oncology nurses that are trained in administering chemotherapy and, in particular, intravesical chemotherapy, should administer these treatments. At my institution, all outpatient oncology RNs must obtain their ONS chemotherapy and immunotherapy provider card. In addition, any new outpatient oncology nurses that get hired in review education specifically on bladder installation, the different anticancer agents that are used, and how to perform the procedure. And then they work with their preceptor and have to be checked off on a competency checklist as being competent before they can administer it independently." TS 10:39 "It's always best to practice with a questioning attitude and put safety first. If something doesn't seem right, always check with the provider first." TS 16:40 "It needs to be clear that it's not IV treatment, and it's sad to say, but we've had patients come into our infusion centers before and have no idea that they were getting a catheter placed. Like, no idea. And it's like, okay, there was definitely a communication breakdown or a lack of something." TS 27:04 "Make sure you're assessing the patients and where they're at in their learning needs, and their education level, and what they can comprehend. Make sure that they understand; they need to know they're getting a urinary catheter into the bladder and not an IV. But of course, there's many other things they're going to need educating on." TS 27:33 | |||
| Episode 264: Stop the Stressors and Improve Your Mental Health as a Nurse | 16 Jun 2023 | 00:41:42 | |
"The mental and physical health of the healthcare team, especially the nurses, has to come first because if you are not physically and mentally and spiritually in a good place, you cannot help other people. We're going to have less good health care, we are going to have more errors, we're going to have less safety, and we are going to have another 100,000 nurses leaving the field," Matthew Loscalzo, LCSW, executive director of People and Enterprise Transformation, emeritus professor of supportive care medicine, and professor of population sciences at City of Hope in Duarte, CA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about the stressors that are affecting nurses. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Music Credit: "Birth of a Hero" by Benjamin Tissot License code: 7B2F6ZBTINETT4WQ The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to supporting the mental health of nurses. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "There is overwork, but there is something even bigger, even more sinister, and that is this evolving lack of respect throughout our society. But when it manifests in the healthcare system, where people come in vulnerable states to be protected and they have this adversity to those who care most about them, this is a profound change, this is a unique change. Although it is happening in society for all authority, when it's in the healthcare system, it manifests in a profoundly different way, and the impact on nurses cannot be overstated." Timestamp (TS) 05:44 "There is that space between your brain and your heart that I think we should inhabit. We need to have wisdom, we need to have training, but we also need to go to back to our core values. The core value that other people matter. And mostly, I cannot help those other people until I am centered." TS 19:35 "Structural change is essential, and structural change only comes with some conflict. And I mean healthy, democratic, respectful conversations with each other, with our teams, to advocate for healthier institutions." TS 27:18 "I think with all people, but especially in the complex environment of health care, focus on what you can influence. Look at your life as a circle and see yourself in that life and say, 'What can I actually influence rather than allowing myself to be frustrated by things that I cannot have any control over?'" TS 31:00 "One of the biggest problems is that nurses feel that they should just work harder, cope harder. I get very upset when I hear people say and I see it written that nurses should just practice more meditation. Or they should work harder. That is a misconception. It is toxic, and it is dangerous. We have to look at nurses within in the system, physicians within the system, all the healthcare professionals within the system, and say, 'How do we get them healthy?' If we don't get them healthy, we don't have a healthy healthcare system. We don't have a healthy society." TS 36:26 | |||
| Episode 263: Oncology Nursing Storytelling: Renewal | 09 Jun 2023 | 00:28:31 | |
An essential act of well-being, the practice of storytelling creates a social connection that fosters a sense of community and mutual support in both the storyteller and listener. During the Second Annual ONS Storytelling session held at the 48th Annual ONS Congress® in April 2023, ONS members Sarah Lewis, MNE, RN, OCN®, palliative care nurse navigator at Oregon Health and Science University in Portland; Crystal Johnson, RN, BSN, OCN®, patient engagement liaison at Genmab who lives in Ohio; Susie Maloney, MS, APRN, AOCN®, AOCNS®, senior director of the Medical Affairs Company and principal of Oncology Nursing Advisors, LLC, in Dayton, OH; and Brenda Sandoval Tawakelevu, BSN, RN, OCN®, nursing professional development practitioner at the Huntsman Cancer Institute in Salt Lake City, UT, engaged in the practice of storytelling around the theme of renewal in the context of oncology nursing. In this episode, the four oncology nurses share their tales with hosts Anne Ireland, DNP, RN, AOCN®, CENP, and Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialists at ONS. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Learning outcome: The learner will report an increase in knowledge related to how nurses learn from one another through storytelling. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode Sarah Lewis "An opportunity presented in spring 2021 to join the outpatient palliative care team as a registered nurse and after much careful consideration, I decided to take the leap. It seemed like it was a good time for a change, it seemed like a 'dream' position, and I knew I could always go back to bone marrow transplant if it didn't work out. I was surprised when so early after I switched positions my decision was affirmed, and my oncology nursing career reinvigorated." Timestamp (TS) 04:06 "I learned early on in my oncology nursing career the power of education but will always appreciate the real-life lesson my patient taught me that day. It not only reinforced my decision to step into this brand-new role, but it also re-energized my practice and spirit to continue to perform this awesome work we oncology nurses have the privilege to do every day." TS 06:32 Crystal Johnson "Being an oncology nurse, you inevitably become an extension of your patient's family. Often, we are with our patients throughout every step of their oncologic journey: initial diagnosis, first chemo, symptom management, remission, relapse, progression and, ultimately end-of-life transition." TS 07:24 "From the moment I cared for my first oncology patient, I knew I had found my calling, but being able to be a part of something and inspire others in a way that is able to reach far greater than the patients I've cared for throughout my career is the reason I continue to show up every single day. Trusting that what we do makes a difference, and we can continue to cultivate a culture of hope within a community that is forever linked together by an unimaginable bond that no one asked to share." TS 10:44 Susie Maloney "One thing I've learned when teaching in countries with different cultures is that it is important to respect the people and be educated on what their beliefs happen to be. It is not our job to 'teach them our Western ways.' This can be a challenge, however, particularly when some beliefs or practices are not evidence based." TS 12:28 "When working in impoverished countries, it is important to consider what is within their achievable means. We would not teach about the latest therapies that are used in the United States if there is no chance of patients having access to such therapies or medications." TS 15:28 Brenda Sandoval Tawakelevu "Although I have many fond memories or patients and families that I have loved and cared for, I wouldn't be truthful if I didn't tell you I've also had many doubts about oncology nursing during some of the very rough seasons of life that we all experience. I've been at the crossroads, and I have seen the two roads the poet Robert Frost has so beautifully written about. This hasn't occurred just once but many times through the years as I have experienced the highs and the lows of 'this road less traveled' of oncology nursing." TS 18:40 "Now, eight years have passed, and I keep going day by day in the wonderful field of oncology. The flames of passion continue to grow, and that passion has been shared with hundreds of students and nurses that have been in my path over the years. I invite each one of you to choose to connect, choose to find your own balance in the field of oncology nursing, choose to heal your own wounds life has left upon you, and most of all, continue to choose oncology nursing." TS 26:26 | |||
| Episode 262: LGBTQ+ Inclusive Nursing Care Begins With Using Supportive Language | 02 Jun 2023 | 00:39:35 | |
"Being an ally means you're coming from a place where you know what issues are going on, you stay up to date about what's happening in the world, and just because you don't identify as part of the LGBTQIA+ community, doesn't mean that you can't teach about what's going on," Beau Amaya, MSN, RN, OCN®, associate director of patient and caregiver education at Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, oncology clinical specialist at ONS. Amaya discussed the nursing considerations when caring for LGBTQ+ patients with cancer. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Learning outcome: The learner will report an increase in knowledge related to caring for patients with cancer in the LGBTQIA+ community. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Sexual orientation and gender identify data is important because it really tells you the history and what's going on with the patient. Some patients may identify as a woman, but their sex assigned at birth may be male. The patient may be presenting as a trans woman or as a woman. You're not seeing their full health history because you may not know all of the different information about them. So, sex assigned at birth is really important to know really the full medical history and what the patient is really needing to be cared for." Timestamp (TS) 05:10 "It is not the community's duty to gain the trust from the providers. It is our duty as providers to make a safe space so patients can come to us to get care. When you have mistrust and fear of going to healthcare providers, it's not going to do well for the community. They're not going to get screened; they're not going to get diagnosed early. They're just going to have poor outcomes." TS 14:16 "We're the most trusted profession, and patients really get in tune with us. If they feel safe with the nurse, they really start to feel safe within the healthcare system, and you can really tackle a lot of the feelings and worry the patient has by just being there for the patient and by really acknowledging who they are, who their families are, who their caregivers are. And it's something that is so powerful. As nurses, we sometimes forget that we have that power." TS 16:00 "I have talked to many people, and they feel, 'I can't do a Safe Zone training. I can't talk about LGBTQ issues because I'm not part of the community.' And I always combat that and say, 'Well, I don't have cancer. I have never experienced that, but I teach about cancer. I take care of people with cancer.' Being an ally means you're coming from a place where you know what issues are going on, you stay up to date about what's happening in the world, and just because you don't identify as part of the LGBTQIA+ community, doesn't mean that you can't teach about what's going on." TS 26:32 "I wouldn't make assumptions about people. And I think this goes for all people. This isn't just an LGBTQ issue, this is a patient issue. . . . Don't assume things about patients. Ask about our patients, learn about our patients. Ask open-ended questions to really learn about people." TS 30:10 | |||
| Episode 261: CAR T-Cell Therapy for Hematologic Malignancies Requires Education and Navigation | 26 May 2023 | 00:39:28 | |
"Just like with anything we do in oncology, a lot of education is required. Nurses and coordinators are critical to start the education and provide effective resources that are reinforced throughout the treatment," ONS member Beth Faiman, PhD, MSN, APN-BC, AOCN®, BMTCN®, FAAN, FAPO, advanced practice provider at Cleveland Clinic in Ohio, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about how to address knowledge gaps and barriers to practice regarding patients who are preparing for or who have received CAR T-cell therapy for hematologic malignancies. Faiman was one of the content experts for two ONS focus groups on the topic in March 2023. This podcast episode is produced by ONS and supported by funding from Janssen Oncology/Legend Biotech. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Just like with anything we do in oncology, there is a lot of education that is required. The same navigators that take care of our patients through the transplant and cellular therapy process, we have similar cellular coordinators that were part of the focus group. These navigators were critical to start the education and provide effective resources that were reinforced throughout the treatment." Timestamp (TS) 09:00 "The nurses and coordinators play a huge role during the transition of care. Not only do they help with coordinating appointments, but also the scheduling of tests and coordinating with the referring team. I heard a lot in the focus groups about the nurses communicating from inpatient to outpatient, and also coordinating from center to center." TS 10:22 "Patients can get really nervous when they're feeling sick. I explain it to them like, "You know how you get a flu shot, and you might get a little reaction as we're training your immune system to provide immunity? Well, it's like that, but way worse.' So, you can get really sick feeling and achy from this, and so that psychosocial support is super important." TS 18:16 "It takes a lot of burden on the patient, caregiver, and the nurse to really be astute to those symptoms and intervene. We do provide wallet cards to patients. We educate the emergency department staff. We also heard about the infection monitoring and caregiver support is absolutely critical. Fortunately, the symptom management has become quite standardized, which really affords the nurses more autonomy to intervene more efficiently." TS 20:46 "The nurses found for education a teach-back tool to be quite useful. One of the nurses mentioned asking the patient questions such as, 'What will you do when you have a fever? Tell me what you do,' and "What do you understand from what the doctor just told you?' And so that was just kind of a way that they could go back and forth with the educational process and really understand what the patients understood." TS 25:46 | |||
| Episode 260: Diversity in Cancer Clinical Trials | 19 May 2023 | 00:26:21 | |
"I think it's important to ensure that you consider each person uniquely. Because no matter how much I know or the nurse knows about the population, everybody is a little bit different. It's really important to personalize every approach and ask them what they know and meet them where they are," ONS member Reneé Kurz, DNP, RN, FNP-BC, AOCNP®, director of clinical research operations at Rutgers Cancer Institute of New Jersey in New Brunswick, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about increasing diversity in clinical trials. You can earn free NCPD contact hours by completing the evaluation we've linked in the episode notes. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to increasing diversity in clinical trials. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "By ensuring access for diverse populations, we also promote trustworthiness within the diverse communities that we serve." Timestamp (TS) 02:04 "We have a centralized education team for clinical trials, and all of the new investigators get a toolkit that they can use and get training on different informed consent processes and different resources that we have. We also have a really good relationship between research and our community outreach and engagement area. . . . And if either the research nurses or the investigators come up with any barriers to enrolling a specific population, there's an online form to request community outreach services for their patients or location." TS 09:50 "A major step is the scientific review board going through each protocol and making sure that the catchment area is really represented and that protocols are inclusive. We also have disease-specific group meetings where the investigators and all the research staff discuss new protocols and the barriers to opening it in specific locations." TS 12:59 "I think nurses have to step back and figure out what they know about the communities that they serve. They're used to being on the front lines and seeing patients every day. What kind of experiences have they had with the community, or what do they know about the community? And really what do the communities know about clinical trials, because a lot of it is going to be the nurse educating them." TS 18:18 "I think it's important to ensure that you consider each person uniquely. Because no matter how much I know or the nurse knows about the population, everybody is a little bit different. It's important to personalize every approach and ask them what they know and meet them where they are." TS 18:59 | |||
| Episode 259: Patient Education for Health Literacy and Limited English Proficiency | 12 May 2023 | 00:36:42 | |
"I think there's a big misconception that health literacy means someone's ability to read or write, and really it's much more than that," ONS member Regina Carlisle, MS, BSN, RN, OCN®, senior cancer information nurse at University Hospitals Seidman Cancer Center in Cleveland, OH, and member of the Cleveland ONS Chapter, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS. Carlisle discussed developing and providing patient education across various formats for patients with limited English proficiency. You can earn free NCPD contact hours by completing the evaluation we've linked in the episode notes. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to providing education for patients with limited English proficiency. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "I think there's a big misconception that health literacy means someone's ability to read or write, and really it's much more than that. There are two basic definitions of health literacy—we have personal health literacy and organizational health literacy." Timestamp (TS) 01:48 "The best practice is to apply this approach called health literacy universal precautions to all your encounters with any patients or family members. So just as you would use proper personal protective equipment if you were encountering body fluids, you're going to use those universal precautions as you don't know what you're dealing with—the same is true for encounters with health literacy." TS 08:16 "There are international best practices that really advise against using family or staff for translations because they might not know the medical terminology, or you might be putting them in an uncomfortable situation. Plus, there might be cultural norms or family dynamics that affect that conversation, and they affect how the information is delivered between you, the family member, and the patient. It can really muddy the waters." TS 18:50 | |||
| Episode 375: Pharmacology 101: VEGF Inhibitors | 08 Aug 2025 | 00:29:07 | |
"We're really using these in many, many types of malignancies. But you can see this class of drug, these monoclonal antibodies, the small molecule inhibitors, being used in colorectal cancer, ovarian cancer, renal cell carcinoma, brain cancers, hepatocellular, non-small cell lung cancer, gynecologic malignancies, so lots of different types of cancers where we're seeing these drugs used," Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the vascular endothelial growth factor (VEGF) inhibitor drug class. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 8, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to the use of VEGF inhibitors in the treatment of cancer. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Cancer cells are known to secrete factors that cause the formation of new blood vessels, and tumors need blood vessels to supply themselves with nutrients so that they can grow and metastasize. A lot of tumors overexpress these factors, so they had more of this ability to create new blood vessels. You may hear that term somewhere neo vascularization. … And also these factors can increase the permeability of blood vessels, so making them kind of leaky blood vessels. … So the thought behind it is being able to block the ability for this new blood vessel formation and to decrease that leakiness or permeability of those blood vessels." TS 2:07 "These are drugs that are tyrosine kinase inhibitors. These are oral, small molecule drugs that are acting intracellular, so they are working within the cell to bind and prevent that downstream signaling of producing more blood vessels. So we have a number of small molecule drugs that fall into this class. Many of them target multiple types of receptors, VEGF being included, but also a lot of these drugs have other targets." TS 7:58 "I would really say, number one, something that we very commonly see with this drug class is hypertension. Giving you an example of bevacizumab—If we look at any grade hypertension, this can be up to 67% of patients, so very common toxicity really spanning all of these agents. So something that we need to be monitoring closely for." TS 13:24 "With that impaired wound healing, keeping that in mind, as we are planning for this agent, for patients and even sometimes with the minor surgical procedures, maybe a need for a short hold, and even for something like a catheter placement. I know and some of the providers I work with have a preference for holding for a short period of time around that as well." TS 20:15 "I think one big area, and we've seen some of this just recently, and particularly in the hepatocellular setting, we're seeing combinations of using the VEGF inhibitor class with immunotherapy. And so I think we're going to continue to see that evolve. Even hearing about some bispecific antibodies that are in development, where they are targeting VEGF as well as PD-L1, so getting the immunotherapy and VEGF effects." TS 24:44 | |||
| Episode 258: ONS Through the Ages: Stories From the Early Days With Cindi Cantril and George Hill | 05 May 2023 | 00:30:49 | |
"The reason that oncology nursing developed at the moment it did was from you and the other few people who were real leaders in your field. . . . It happened in that particular moment because of you and [the other founding members of ONS]," George Hill, MD, MA, DLitt, Captain, Medical Corps, U.S. Navy Reserve (retired), told Cindi Cantril, MPH, RN, OCN®, CBCN, founding board member and first vice president of ONS. Hill was a monumental supporter of ONS's founding and incorporation in 1975, and the duo reflected on their experiences and the history of oncology nursing. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to the early formation of ONS. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "There's no doubt that the National Cancer Act elevated the whole field of oncology into something that was very different. . . . The reason that oncology nursing developed at the moment it did was from you and the other few people who were real leaders in your field. . . . It happened in that particular moment because of you and [the other founding members of ONS]." Timestamp (TS) 02:48 "In the 1950s and 60s, cancer was a word that was never mentioned. The idea of having something called cancer was so mysterious, so dangerous, so frightful, you could not mention cancer. Memorial Sloan Kettering Cancer Center in New York City was a pioneer in introducing the word cancer to be able to be used. But most everywhere else, even in oncology, we had to dodge around the term." TS 09:43 "Throughout America, people need medical care and cancer care close to home. People can often drive many hours just to reach a community cancer center. To reach a comprehensive cancer center such as Memorial Sloan Kettering or MD Anderson would be impossible. So, the idea of developing physicians and radiation therapists and nursing oncologists who can do the job close to home is terribly important, otherwise they just don't get treated." TS 12:44 "The opportunity and the goal of working with people of like mind in other countries is well worth doing. And we also learn from them." TS 28:33 | |||
| Episode 257: Redefining the Bell: The Ethics of Hope for Oncology Nurses and Patients | 28 Apr 2023 | 00:24:27 | |
"The bell can have so much more meaning and significance than just the end of treatment. So, work with your patients to define what the significance of that bell can mean," ONS member Monica Cfarku, RN, MSN, BMTCN®, CCM, NE-BC, associate vice president and chief of oncology nursing at Duke Cancer Institute in Durham, NC, and member of the North Carolina Triangle ONS Chapter, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS. Cfarku discussed the ethics of the bell that patients with cancer ring following the completion of their treatment and how her institution has redefined the bell's ritual. You can earn free NCPD contact hours by completing the evaluation we've linked in the episode notes. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to treatment bell meaning and options. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "The bell has typically been associated with completion of treatment, and the patient is now considered free of cancer. The challenge with that is when patients that will never get to experience that—because there are certain cancers now that are essentially chronic conditions—they hear that bell and that is not a good sound for them. That can bring a lot of emotions around how they're never going to get to that point." Timestamp (TS) 02:19 "As nurses, it is our duty to recognize an ethical situation and help to determine what that next action or decision is in those situations. We really need to be applying our ethical sensitivity." TS 04:06 "The bell doesn't just have to be for the end of treatment. It can be the end of a particular journey, or ringing the bell for courage before you walk in. It can be used for anything." TS 13:14 "I've seen patients ring the bell before walking into the building. . . . I've been asked to meet patients at the bell on their last day of treatment so they can ring it in celebration. . . . I've seen non-oncology patients that are going into a different part of the campus and their family ring it, and I love to see that, as our bell is being used to inspire hope and courage to so many other patients across Duke University. . . . I've seen staff ring it. . . . This little project has really had a reverberating effect that we did not even anticipate." TS 16:23 "The bell can have so much more meaning and significance than just the end of treatment. So, work with your patients to define what the significance of that bell can mean." TS 20:45 | |||
| Episode 256: Cancer Symptom Management Basics: Hematologic Complications | 21 Apr 2023 | 00:34:54 | |
"When someone is faced with a cancer diagnosis, you want to really try to work to make that patient an active part of their care team. Understand that there are things out of their control, but there are also things that are within their control. You can teach them how to manage fatigue associated with anemia, or how to prevent falls. These are the things you can do to prevent infection; these are the nutrition things you should focus on to help you feel your best," ONS member Kimberly Miller, BSN, RN, BMTCN®, transplant case manager at Nebraska Medicine in Omaha, and member of the Metro Omaha ONS Chapter, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about nursing management of cancer-related hematologic complications. This episode is part of a series about cancer symptom management basics. The others are linked in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to hematologic complications. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "The biggest complication is infection. You do not have the ability to present with the normal signs and symptoms of infection. You're not going to have redness and swelling and drainage. You're going to have more fever, hypertension, dysuria, shortness of breath, or cough." Timestamp (TS) 07:22 "Some patients get really nervous if their blood counts get to a certain point. I find that we just try to explain to them, 'We're watching your labs very frequently, we see you several times a week, these are the complications that can happen,' and talk them through the rationale for not giving a lot of maybe not necessary transfusions." TS 15:15 "In general, the guidelines are if you expect a patient to have severe prolonged neutropenia, lasting greater than seven days, then you would want to consider giving them an antibiotic to help prevent neutropenic fever. . . . A high-risk patient would benefit from that." TS 17:23 "Myelosuppression can delay chemotherapy, so patients who are getting treatment for their cancer may experience delays in their next cycle, they may have dose reduction, they may have to discontinue that chemotherapy if they have severe myelosuppression. That could affect their outcomes as far as their cancer treatment goes. Patients who are anemic—if you are fatigued and your legs feel heavy and you feel dizzy when you get up and you fall and your platelets are low as well, that leads to an increased risk of bleeding, and really a decrease in quality of life." TS 23:30 "Myelosuppresion and cancer treatment in general does carry other toxicities besides the physical: emotional, mental, financial, and social." TS 25:33 "For a patient with cancer, from diagnosis on, there's a lot that they can't control. When you're faced with that diagnosis, you want to really try to work to make that patient an active part of their care team. So, I think it's important to talk with a patient—understand that there are things out of their control, but there are things that are within their control. You can teach them how to manage fatigue associated with anemia or how to prevent falls. These are the things you can do to prevent infection; these are the nutrition things you should focus on to help you feel your best. Anything that you can let the patient have control over because their life has just changed dramatically." TS 29:03 "Oncology nurses are wonderful at looking at the patient as a whole person. Keep in mind that there are financial toxicities as well as physical, emotional, and mental. So, it might create a bigger team of people that need to step in and help the patient find the resources that they need to be successful. Also, don't forget about the caregivers." TS 33:47 | |||
| Episode 255: Public Thanks for Deserving Oncology Nurses | 14 Apr 2023 | 00:21:24 | |
Oncology nurses provide remarkable care every day, without even realizing the impact it has on their patients and families. Organizations like the DAISY Foundation provide a meaningful way for patients and nursing peers to recognize and thank the inspiring oncology nurses who've gone beyond their typical role. Erica Fischer-Cartlidge, DNP, RN, AOCNS®, EBP-CH, chief clinical officer at ONS, sat down with ONS member and DAISY Award recipient Laurie Rudolph, BSN, RN, OCN®, CBCN®, her nominator, Jamie Stern, RN, BSN, CCRN, and Magnet program manager Kathy Garrison, MSN, RN, NPD-BC, PCCN-K, all at the University of Virginia Health System in Charlottesville, to talk about the importance of gratitude through recognition like DAISY and its effect on nursing well-being and morale. ONS is one of the DAISY Foundation's Supportive Associations. You can also earn free NCPD contact hours by completing the evaluation we've linked in the episode notes. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to gratitude and recognition in nursing. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode Jamie:"It's truly inspiring what colleagues do in our field, and sometimes it's a thankless job. You don't always see patients from start to finish—you don't get to celebrate with them. In this case I felt that DAISY was an incredibly rewarding program, and it really is for the exceptional nurse that goes beyond measure." Timestamp (TS) 06:35 Laurie: "I think the wonderful thing about nursing is that we don't realize what an impact we have on people's lives when we're just doing our day-to-day jobs. We are always striving to provide the best care that we can to every patient and family, but there's an impact that we don't really truly understand." TS 12:55 Kathy: "Our nurses are very eager to recognize their colleagues when they see something, and their colleague would be like, 'No, no. I'm just doing my job.' But sometimes they're doing above and beyond of what is expected and normal. We do have a lot of celebration. We find its very helpful to keep morale and engagement up." TS 16:02 | |||
| Episode 254: Oncology Nursing Certification Affects the Entire Cancer Care System | 07 Apr 2023 | 00:33:49 | |
"Certification increases nurses' knowledge, ensures that they are up to date on cancer care, and helps them to be prepared to effectively manage symptoms associated with cancer and cancer treatments. They will acquire effective therapeutic communication skills while caring for people with cancer, their caregivers, and other members of the interprofessional team," ONS member Kerstin Scheper, DNP, RN-BC, OCN®, CHPN, interim assistant vice president at Robert Wood Johnson University Hospital in Somerville, NJ, and Oncology Nursing Certification Corporation Board of Directors member, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a discussion about oncology nursing certification. You can earn free NCPD contact hours by completing the evaluation we've linked in the episode notes. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to nursing certification. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "The primary purpose of a certification is an assessment. . . as it's related to oncology nursing, certification evaluates mastery of knowledge and skills required to competently provide specialized oncology care. A certificate program is different. . . . These types of programs are usually short, non-degree–granting programs that provide instruction and training to aid participants in acquiring knowledge, skills, and competencies." Timestamp (TS) 02:34 "I find that nurses who achieve certification often report an increased feeling of personal accomplishment and satisfaction, and I see right away that increased confidence they have after they've passed their certification. They believe that certification validates specialized knowledge, and it gives them a strong commitment to the profession." TS 06:09 "The personal confidence and knowledge that the nurse attains from that certification, I do believe, leads to that improved communication and improved patient outcomes. Certification can also promote recognition from peers, and that recognition promotes professional autonomy, which in turn enables the oncology nurse to take on more leadership roles . . . and gives nurses the confidence to speak up and advocate for their patients." TS 09:37 "Certification increases nurses' knowledge, it ensures that they are up to date on cancer care, and it helps them to be prepared to effectively manage symptoms associated with cancer and cancer treatments. I think teamwork and being able to use effective therapeutic communication skills while caring for people with cancer is something they will acquire, and not only communicating with people with cancer, but also their caregivers and other members of the interprofessional team." TS 20:22 "Certification offers both personal and professional awards to nurses. It promotes professionalism and demonstrates a commitment to oncology nursing and accountability for our own professional development. While that's obtaining the initial certification, we can't forget maintaining certification. That's an example of lifelong learning, which ensures our nurses are providing up-to-date and evidence-based cancer care." TS 24:58 | |||
| Episode 253: The Ethics of Caring for People You Know Personally | 31 Mar 2023 | 00:44:56 | |
"Nursing ethics is relationship centered because when your friend, family member, or colleague becomes a patient, that relationship can't be uninformed by how you know that person before they got sick. The first thing is to recognize you know them, and caring or them poses some fairly unique challenges in terms of, 'How do I maintain professional boundaries?'" Lucia D. Wocial, PhD, RN, FAAN, HEC-C, senior clinical ethicist at the Lynch Center for Ethics at the MedStar Washington Hospital Center in Washington, DC, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, about the ethical considerations and implications of providing cancer care when people you know become the patient—whether they're a friend, family member, or a colleague. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to the ethical issues surrounding caring for personal acquaintances. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Nursing ethics is relationship centered because when your friend, family member, or colleague becomes a patient, that relationship can't be uninformed by how you know that person before they got sick. The first thing is to recognize you know them, and caring or them poses some fairly unique challenges in terms of, 'How do I maintain professional boundaries?'" Timestamp (TS) 02:55 "Many oncology nurses will see patients over years, so they develop relationships with them, and maybe you see those patients outside of the hospital. It's hard to turn on and off the professional you from the personal you when those natural relationships form. So, how can you prepare yourself for that? One is: Think about it. If you're in an environment like a small town or at an important cancer center even in a mid to large city, if you are the cancer center, people are going to come and want to be cared for. So, chances are pretty good that you will, one day, encounter someone that you know in this professional capacity." TS 09:30 "It's challenging because there's this middle zone of helpfulness where on one end, there's clearly a boundary violation, and on the other end is maybe a boundary crossing. And there's no right line when we're taking care of a family member or friend. It's not like an alarm is going to go off when you cross a boundary and make a slip. So thinking about it in advance is really important, and talking with your colleagues about it openly." TS 10:41 "Nurses are so well positioned to have conversations with patients about values and goals. If you can learn about patients' values and goals, you can help them and physicians frame serious news they have to deliver. We're the most trusted profession. People look to us and think they can have these conversations with us. . . . Some of these patients feel like your friends because you've cared for them for years. You have a deep relationship with them that's been built over several years. Those are the times where you feel like somebody's got to have this conversation, and I know the information. What is my role here? What does the code of ethics tell me I'm supposed to do?" TS 26:07 "People ask me all the time: 'What would you do?' Do I answer the question? When people ask me that question, I learned recently a really nice way to answer that question. 'First of all, I'm not you, but I'd like to help you think about it. Can I help you think about this?'. . . And sometimes after all of that, patients will still press, 'Well, what would you do?' And as long as you're clear and say, 'I'm not you. If I tell you the decision I would make, I need to tell you why. And here's the decision I would make and here's why.'. . . What's within your scope of practice? It is within everybody's scope to ask permission to the patient and say, 'Would it be okay if I shared something with you?'" TS 28:44 | |||
| Episode 252: Intraperitoneal Administration: The Oncology Nurse's Role | 24 Mar 2023 | 00:46:41 | |
"Before you even get started, you have to do your checks. Just like you do with a regular systemic infusion. You're going to be doing your physical assessment prior to starting your patient, looking at your orders to make sure everything looks right, looking at the lab work," ONS member Emoke Karonis, MSN, RN, CRNI, clinical nurse specialist fellow at Memorial Sloan Kettering Cancer Center in New York, NY, said. "You have to be absolutely sure that day that patient is presenting to you in your suite, you're definitely giving what is expected for that day." Karonis was speaking to Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, about oncology nursing considerations for intraperitoneal chemotherapy administration. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to intraperitoneal therapy for cancer. Episode Notes:
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Intraperitoneal (IP) therapy is basically the administration of an agent into that space where the abdominal organs float around via an implanted port or one of those direct intraabdominal catheters. . . Patients with cancer that have metastasized to the peritoneum, who have either had a debulking surgery and have very little disease left inside or small tumors to begin with, they can be considered for IP therapy." Timestamp (TS) 02:02 "Hyperthermic IP chemotherapy is done in the operating room right after the surgeon has done all of their tumor removal. It is hyperthermic, meaning this stuff is hot, and it gets administered via a special circulating machine that heats up the chemotherapy and circulates it throughout the abdomen. . . . They are circulated for about 90 minutes–2 hours if they are at risk of overheating." TS 07:39 "In the infusion suite, before you even get started, you have to do your checks. Just like you do with a regular systemic infusion. You're going to be doing your physical assessment prior to starting your patient, looking at your orders to make sure everything looks right, looking at the lab work. . . If it's the first time you're seeing the patient, you want to check for catheter confirmation. It's not going to be in a vessel, it's going to be in the abdomen. You want to make sure that, especially if the person has more than one access device, you are looking for the correct confirmation." TS 14:00 "It is necessary to repeat yourself because we're giving patients so much information at the presurgical visit, while they're going into the operating room, when they come out of the operating room, on their discharge, and then they're going to go into the clinic for their post-op visit. There's so much being thrown at these folks all the time that you do need to constantly reteach the same thing and to always be very neutral and accepting of that—that people might not retain everything you tell them the first time." TS 22:00 "You can't emphasize enough that if there's one point where you need to slow down, take a breath, is during that independent double check. You have to be absolutely sure that day that patient is presenting to you in your suite, you're definitely giving what is expected for that day. If they're coming in multiple days, they could have a regimen that changes from day to day. . . . It's so easy to get confused, and it's very important to go back and see what has happened before that patient showed up at your suite, what's expected to happen that day, and what's going to happen the following day." TS 31:16 | |||
| Episode 251: Palliative Care Programs for Patients With Cancer | 17 Mar 2023 | 00:38:33 | |
"The idea of early palliative care was really a strategy for preventing people from going through unnecessary and unwanted suffering, treatments, and things that were not consistent with their values and preferences. . . . For people who have a serious illness, it's not good to wait until you're facing these very critical decisions. You need to plan upfront," ONS member Marie Bakitas, DNS, APRN, FAAN, AOCN®, professor and associate dean for research and scholarship at the University of Alabama at Birmingham, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about implementing palliative and supportive care for patients with cancer. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to palliative care for patients with cancer. Episode Notes:
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Now we think of palliative care as really the umbrella—it's a medical specialty, it's a nursing specialty field that you can get certified in. And hospice and comfort care are a subset of palliative care. Think of palliative care as the umbrella, and then toward the very end of life, hospice care—which is often guided by a very limited prognosis time frame of six months or less—and then within hospice care, comfort care is that care that is provided typically at the very end of life." Timestamp (TS) 03:13 "For us, the idea of early palliative care was really a prevention strategy for preventing people from going through unnecessary and unwanted suffering, treatments, and things that were not consistent with their values and preferences. We took a page out of the childbirth movement playbook and said, 'If you're pregnant, you don't wait until 8 months and 29 days, to say, 'Oh, I'm having a baby. Maybe I should think about how to plan for that.'' Similarly, for people who have a serious illness, it's not good to wait until you're facing these very critical decisions. You need to plan up-front. That was the genesis of our program that we call Project ENABLE." TS 07:18 "ENABLE was about at the time people were diagnosed, meeting them there and helping them to learn skills of symptom management, communication, problem solving, advance care planning. So that when they were ill and facing these issues, they had the skills and preparation to do so." TS 08:17 "I think the health equity issues are ones that we can overcome. We have to be aware of them. In particular with palliative care, we need to offer these treatments in ways that have been determined to be culturally acceptable." TS 11:20 "We need to be doing what we call primary palliative care, and that is that every clinician who interacts with an oncology patient who has advanced cancer, metastatic disease, or high symptom burden, has these skills of communication. Oncology nurses are the lead for pain and symptom management. But there are many communication skills that are really important and prioritizing these kinds of conversations and this kind of content being presented at the front end when people are newly diagnosed." TS 26:34 "I think it's really beneficial for individual nurses to understand to get their own individual information, but I know we all have the need to do quality improvement projects and other kinds of efforts in our clinics and organizations. This might be something that you prioritize for the year: What aspects of palliative care—this extra layer of support—can we provide? . . . We should continue to educate ourselves about the differences and the ways to present and talk about palliative care so that it removes some of the mystery, reduces some of the perceptions. . . and skillfully say, 'Hey, this is an extra layer of support for you and your family.'" TS 29:46 | |||
| Episode 250: Cancer Symptom Management Basics: Dermatologic Complications | 10 Mar 2023 | 00:56:32 | |
"Sometimes when we talk about skin toxicities, it can get lost in translation for these patients when we start talking about nausea, vomiting, all those other things. . . . They don't take into consideration how serious these skin toxicities can be and how they can quickly get out of control if they're not reported to the medical team in a timely manner," ONS member George Ebanks, MSN, RN, OCN®, a medical oncology nurse in the Cutaneous Oncology Clinic at Moffitt Cancer Center in Tampa, FL, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a conversation about symptom management for the dermatologic complications of cancer therapies. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. This episode is part of a series about cancer symptom management basics. The others are linked in the episode notes. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to dermatologic complications. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "The number one thing that I teach my patients is that the skin is their largest organ. It helps protect them from serious events, and we want to maintain that skin integrity because that's the first line of defense. That's one starting point there, and I think that helps drive home the point to the patient when you do start to talk about skin toxicities that they do have to take this a little more seriously." Timestamp (TS) 02:16 "Sometimes when we talk about skin toxicities, it can get lost in translation for these patients when we start talking about nausea, vomiting, all those other things. . . . They don't take into consideration how serious these skin toxicities can be and how they can quickly get out of control if they're not reported to the medical team in a timely manner." TS 14:48 "I started doing this teaching of please, please, please keep a journal so that if this happens again, you know when this toxicity is coming back." TS 32:06 "One thing we need to remember as nurses is the photosensitivity aspect of these drugs. We need to teach patients that even if they think they're running outside for five minutes, they need to use SPF 30 or higher and keep as much of their skin covered as they possibly can." TS 34:28 "One tool that I would encourage you to use is the teach back method with our patients. Have them repeat back to you what you've taught them, and keep an eye out. Did they gloss over the rash that you talked about or the skin complication you talked about?" TS 50:15 | |||
| Episode 249: Developmental Disabilities and Cancer | 03 Mar 2023 | 00:37:38 | |
"We as oncology nurses have to understand who is this patient, where do they come from, and who is going to touch that patient, so that we can provide comprehensive, good care without these barriers, or at least to eliminate as many of these barriers as much as we can," ONS member Idalina Colburn, RN, OCN®, ONN-CG, nurse navigator at the Dana-Farber Cancer Institute in Boston, MA, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a discussion about nursing care considerations for patients with developmental disabilities and cancer. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to caring for patients with developmental disabilities and cancer. Episode Notes
Highlights From Today's Episode "Barriers for these patients could be significant or mild. The barriers are directly related to the severity of the limitation of the individual. If you have a patient who presents with a cancer diagnosis for treatment and they have a developmental or intellectual disability, but they are pretty high functioning, the barriers that they present with may be very different than that patient who is really low functioning and severely impaired." Timestamp (TS) 04:50 "We always have to consider how we assess and coordinate care for this patient population. It requires excellent coordination and communication with other providers who are caring for this patient. But mostly reaching out to the community, involving the family or the other caregivers. We as oncology nurses have to understand who is this patient, where do they come from, and who is going to touch that patient, so that we can provide comprehensive, good care without these barriers, or at least to eliminate as many of these barriers as much as we can." TS 12:21 "The goal would be patient-centered, safe oncology care for every patient who hits your chair with a developmental disability. The idea behind it is that it uses a multidisciplinary approach to care. So, it utilizes the team, including your social workers, nursing assistance, navigators, really anyone who is going to touch that patient within the medical team, but also involves the family and those community caregivers, and government or state programs that take care of these patients as well. So, we utilize all of those pieces in assessment and coordination of a specific care plan for these patients." TS 18:40 "We would want to identify the strengths for a patient, understand the level of comprehension and communication of that specific patient, what potential behaviors we might be needing to think about, what are the medical commodities that we need to address, and also an assessment of the level of training needed to the caregivers. So that when a patient leaves our chemo chair, those caregivers are prepared to provide the level of care that that patient needs in the community." TS 19:34 "Patient-centered care would also include things like environmental barriers. Part of that plan would be thinking about what do we need to do with our environment to make it conducive. So, things like making sure that the patient has the same nurse as much as possible, making sure that they're not waiting in a waiting room and they're going right into a chair, that there's someone with them with their appointments whenever possible, that we allow extra time during those appointments. All of those things would be part of the care plan." TS 20:21 "We as nurses are really in a prime position to advocate for this kind of level of care, to continue to educate ourselves. . . . I think that we can continue to make a difference, and I think community outreach is a great area that we need to do more of. And simply just educating ourselves and others and just talking about it." TS 27:02 | |||
| Episode 374: Colorectal Cancer Treatment Considerations for Nurses | 01 Aug 2025 | 00:53:58 | |
"Colorectal cancer treatment is not just about eliminating a disease. It's about preserving life quality and empowering patients through every phase. So I think nurses are really at the forefront that we can do that in the oncology nursing space. So from early detection to survivorship, the journey is deeply personal. Precision medicine, compassionate care, and informed decision-making are reshaping outcomes. Treatment's just not about protocols. It's about people," ONS member Kris Mathey, DNP, APRN-CNP, AOCNP®, gastrointestinal medical oncology nurse practitioner at The James Cancer Hospital of The Ohio State University Wexner Medical Center in Columbus, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about colorectal cancer treatment. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1.0 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 1, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to the treatment of colorectal cancer. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode "Colorectal cancer has several different types, but there is one that dominates the landscape, and that is adenocarcinoma. So I think most of us have heard that. It's fairly common, and it accounts for about 95% of all colorectal cancers. It begins in the glandular cells lining the colon or rectum and often develops from polyps, in particular adenomatous polyps." TS 1:41 "One of the biomarkers that we'll most commonly hear about is KRAS or NRAS mutations. This indicates tumor genetics, and these mutations suggest resistance to our EGFR inhibitors such as cetuximab. BRAF mutation or V600E is a more aggressive tumor subtype, and those may respond to our BRAF targeted therapy. … And then our MSI-high or MMR-deficient—microsatellite instability or mismatch repair deficiency—that really predicts an immunotherapy response and may indicate Lynch syndrome, which is a huge genetic component that takes a whole other level of counseling and genetic testing with our patients as well." TS 6:02 "Polypectomy or a local excision—that removes our small tumors or polyps during that colonoscopy. And that's what's used for those stage 0 or early stage I cancers. A colectomy removes part or all of the colon. This may be open or laparoscopic. It can include a hemicolectomy, a segmental resection, or a total colectomy, so where you take out the entire part of the colon. A proctectomy removes part or all of the rectum. This may include a low anterior resection, also known as an LAR … or an abdominal perineal resection, which is an APR. … Colostomy or ileostomy—that diverts the stool to an external bag via stoma. Sometimes this is temporary or permanent depending on the type of surgery." TS 14:11 "We'll have our patients say, 'Hey, I want immunotherapy therapy. I see commercials on it that it works so well.' We have to make sure that these patients are good candidates for it, also that we're treating them adequately. We need to make sure that they have those biomarkers, so as I mentioned, the MSI-high or MMR tumors. Our MSS-stable tumors—they may benefit from newer combinations or clinical trials. Metastatic disease—immunotherapy may be used alone or with other treatments. And then in the neoadjuvant setting, some trials are really showing promising results using immunotherapy prior to surgery." TS 25:38 "Antibody-drug conjugates are really an exciting frontier in all cancer treatments as well as colorectal cancer treatment. This is used mainly for patients with advanced or treatment-resistant disease, and these therapies combine the targeted power of monoclonal antibodies with the cell-killing ability of potent chemotherapy agents. They're still on the horizon for the most part in colorectal cancer. However, there is only one approved antibody-drug conjugate, or ADC, at this time, and that's trastuzumab deruxtecan, or Enhertu. That's approved for any solid tumor, such as colorectal cancer with HER2 IHC 3+. So again, looking back at that pathology in those markers, making sure that you have that HER2 mutation and that IHC." TS 35:00 "There are a few myths going around about colorectal cancer treatment that can lead to confusion or even delayed care. One myth is only older men get colorectal cancer. As you heard me talk in my previous podcast on screening, unfortunately, this isn't necessarily true. Colorectal cancer affects both men and women and our cases in the younger population are rising. So our screening guidelines have changed to age 45 because we are seeing it in the younger population." TS 45:54 | |||
| Episode 248: The Basics of Evidence-Based Practice for Every Oncology Nurse | 24 Feb 2023 | 00:35:18 | |
"Evidence-based practice is asking the right clinical question, searching the evidence and then really appraising and determining what is the quality of the evidence, and synthesizing it to move forward with a recommendation or a possible implementation plan," Caroline Clark, MSN, APRN, OCN®, AG-CNS, director of evidence-based practice and inquiry at ONS, told Jaime Weimer, MSN, RN, AGNCS-BC, AOCNS®, oncology clinical specialist at ONS, during a discussion about the nurse's role in evidence-based oncology care. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to evidence-based practice. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "Evidence-based practice (EBP) is asking the right clinical question, searching the evidence and then really appraising and determining what is the quality of the evidence, and synthesizing it to move forward with a recommendation or a possible implementation plan." Timestamp (TS) 01:56 "Having a culture and environment that supports EBP is really foundational. An environment that encourages questions is going to cultivate the mentors in that environment and has leadership support. And often, that means tying EBP into your whole organizations mission and vision just to sustain evidence-based changes." TS 06:15 "Developing your skills in critical appraisal does take time. It's not something that happens overnight, so you have to look for the opportunities to practice. Mentorship is certainly important. . . . Many organizations have adopted an EBP methodology, so while there's a lot of methodologies out there to choose from, there's so much overlap in them and the tools they use. I would really just explore if there's something already preferred in your organization." TS 13:18 "Some key players to ask around about EBP are your nursing professional development specialists, your clinical nurse specialists, your DNP-prepared nurses, and your nurse scientists. And a great, low-risk way to practice critical appraisal is through journal clubs." TS 13:57 "I think there's a lot of great work going on with the overarching theme of closing that gap from research to translation into practice. Some general things that I think are happening are really incorporating evidence into daily practice. That could be clinical decision support tools that are embedded in our electronic health record and then physicians, nurses, and clinicians have that at their fingertips at the point of care. And then standardized policies and templates to guide care for specific populations. And I think the use of religiously developed practice guidelines that are current at the point of care, as well." TS 22:20 "If you're embarking on EBP change early on—I cannot stress this enough—you really need to determine what your outcome measures will be. How are things measured and recorded in the literature? How would you apply them in your practice? . . . From the start, consider specifically what the patient outcomes will be that you're monitoring that you're hoping to make a positive change in." TS 31:12 | |||
| Episode 247: Tobacco Treatment for Patients With Cancer | 17 Feb 2023 | 00:49:19 | |
"It's the oncology nurse who might be the only cheerleader this person has to keep them motivated moving forward. We need to make sure our patients' motivation and competence stay high so that they can stay on this journey of quitting," ONS member Maureen O'Brien, MS, RN, PMHCNS, NCTTP, a certified tobacco treatment specialist at the Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGNCS-BC, AOCNS®, oncology clinical specialist at ONS, during a discussion about the benefits of smoking cessation for patients with cancer and how oncology nurses can encourage reduction or quit attempts and support their patients through the process. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to smoking treatment of people with cancer. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "For every person who dies from smoking, at least 30 people will live with a serious smoking-related illness. Smoking causes cancer; heart disease; strokes; lung diseases, including chronic obstructive pulmonary disease, which include emphysema and chronic bronchitis; and diabetes. 87% of all lung cancers are directly linked to smoking. . . . One out of every three cancer deaths are directly related to smoking." Timestamp (TS) 11:50 "When and if a patient continues to smoke with a cancer diagnosis, it's because there's a high nicotine dependence. They're smoking to manage their withdrawal symptoms. The biggest withdrawal symptoms are anxiety and depression. And one might say that just being diagnosed with a cancer diagnosis is very anxiety-provoking. . . . They get very, very anxious, and the nicotine receptors in the brain will actually tell them to have a cigarette." TS 15:58 "One of the byproducts of tobacco is carbon monoxide, and that is retained in the lungs. . . . And in eight hours, we can start to reverse that. In 24 hours, the risk of a heart attack decreases if you stop smoking. In about two weeks to three months after stopping smoking, your circulation starts to improve and your lung function increases." TS 27:43 "As an oncology nurse, I think we need to start really focusing on some of the positive reasons why patients need to stop smoking in any prognosis that they have across the board. I think people respond to positive feedback better than negative feedback. That's why the benefits of smoking cessation for patients with cancer are so important to talk about." TS 29:35 "It's the oncology nurse who might be the only cheerleader this person has to keep them motivated moving forward, and that's what we need to do. We need to make sure our patients' motivation and competence stay high so that they can continue on this journey of quitting." TS 31:50 | |||
| Episode 246: Create a Culture of Safety: Fair and Just Culture | 10 Feb 2023 | 00:26:13 | |
"I love the motto, 'If you see a problem, you can solve a problem.' So, no matter what level you fall on on the clinical ladder or within your administration, you always have the opportunity to promote and create positive change and do that with the leadership support," ONS member Klara Culmone, MSN, RN, OCN®, assistant nurse manager at the Laura and Isaac Perlmutter Cancer Center at NYU Langone Health, told Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialist at ONS, during a discussion about the factors involved in creating a fair and just culture. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. This episode is part of a series on creating a culture of safety, we'll add a link to future episodes in the episode notes after the next episode airs. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: The learner will report an increase in knowledge related to creating a just and fair culture. Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode "A fair and just culture includes encouraging and supporting people to discuss safety-related events or information with one another. This culture really includes a transparent, nonpunitive approach to reporting and learning from adverse events or close calls and even unsafe conditions. The goal is to prevent and minimize events that may cause harm." Timestamp (TS) 02:15 "Oncology nurses are critical in the establishment of this type of culture. They are leaders and often role models within their institutions. Oncology nurses understand policies, standards of care, and up-to-date evidence-based practice. Being on the front lines, oncology nurses see how these three things can come together and directly affect our patients and also the work environment. This global understanding positions the oncology nurses to be the liaison between patients, members of the healthcare team, and leadership." TS 02:43 "In health care, we really need to look at these different safety steps we have in place to prevent patient harm. It's really important to remind oncology nurses that we report safety events so that we can prevent them from happening again." TS 12:15 "Leaders need to support a questioning attitude from oncology nurses. They should stop and resolve using thoughtful, two-way questioning. We really encourage nurses to report anything that doesn't seem right so we can work together to ensure patient safety." TS 13:19 "Oncology nurses are equipped with knowledge and skills to create this culture. They can be familiar with current practices and standards of care for oncology patients and recommend changes if applicable. Oncology nurses can also participate in quality improvement projects, peer-to-peer education or re-education, and applicable competencies on their unit. Oncology nurses can also do team daily huddles at the beginning of their shifts to review their schedules for the day and perhaps any potential complications or safety issues that they may anticipate and come up with a plan." TS 19:01 "I love the motto, 'If you see a problem, you can solve a problem.' So, no matter what level you fall on on the clinical ladder or within your administration, you always have the opportunity to promote and create positive change and do that with the leadership support." TS 21:22 | |||