This action might not be possible to undo. Are you sure you want to continue?
THE OFFICIAL NEWS MAGAZINE OF THE ONCOLOGY NURSING SOCIETY
Childhood Cancer Survivors
Lifelong Surveillance Page 8
IN THIS ISSUE
All About Sperm and Egg Banking page 17
“Shift” Your Life page 22 How to Have Difficult Conversations page 26
Survivors Have High Quality of Life
8Childhood Cancer Survivorship: A Lifelong
ALSO IN THIS ISSUE
5 EDITOR’S NOTE
Today’s survivors require new resources.
Life as a cancer survivor can be challenging for young adults.
6 JUST IN
News from the oncology field
14 How Does YourSurvivors? Meet the Needs Institution of Childhood Cancer
YOU TELL US A reader describes the program at her institution.
16 WEB CONNECT
Helpful Web sites for childhood survivors
18 CAPITOL CONNECTION
Smoking banned in House Speaker’s Lobby
15A Year in the Life—Month Six
UP CLOSE & PROFESSIONAL A CLOSER LOOK
Is regimen standardization better?
Jamel and Heather talk about the values they learned growing up.
17Sperm andAfter BankingTreatment Hope Egg Give Patients for Parenthood Cancer
Today’s patients have more fertility preservation options than ever.
22 CAREGIVER CARE
Do you know how to adjust to shift work?
25 SAYING GOODBYE
A tribute to former ONS executive director
19 Drug Approved Dual-Action
NEW TREATMENTS, NEW HOPE
25 NOMINATING COMMITTEE
Apply now for 2008 open positions. You can make a difference.
for Use in Advanced Breast Cancer
26 NOTICE NURSING NOW
Learn how to have difficult conversations.
Lapatinib targets cancer-specific cells.
27 WORKING FOR YOU
Learn about the evaluation system for charities.
20Levels of Health-Related Quality of Life Childhood Cancer Survivors Tend to Have High
FIVE-MINUTE IN-SERVICE Study measures quality of life and the factors that influence it.
28 CALENDAR OF EVENTS
Find information about ONS education programs.
Visit ONS Connect online at www.ons.org/publications/journals/connect to read this issue’s Board Briefs.
ONS Connect is indexed in the Cumulative Index to Nursing and Allied Health Literature®, MEDLINE®, and the International Nursing Index. The Oncology Nursing Society and the ONS Connect Editorial Board do not assume responsibility for the opinions expressed by authors. Acceptance of advertising or corporate support does not indicate or imply endorsement by ONS Connect or the Oncology Nursing Society. Mention of specific products and opinions related to those products do not indicate or imply endorsement by ONS Connect or the Oncology Nursing Society. Web sites published in ONS Connect are provided for information only; the hosts are responsible for their own content and availability. Postage Privileges: Periodical rates paid at Pittsburgh, PA, and at additional mailing offices. Postmaster: Send address changes to ONS Connect, Oncology Nursing Society, 125 Enterprise Drive, Pittsburgh, PA 15275-1214. Published monthly by the Oncology Nursing Society, P.O. Box 3510, Pittsburgh, PA 15230-3510. Yearly subscription rates are $19.99 for individual nonmembers and $29.99 for institutions. As part of ONS membership dues, $5 are for a one-year subscription to ONS Connect. Vol. 22, No. 6. ISSN: 1935-1623. Copyright © 2007 by the Oncology Nursing Society. Blanket permission for copying any material in ONS Connect is granted to ONS members.
Contributing Editor Robin M. & Ganz.. Editor As nurses. insurers. a sister magazine of Cure. Aimee Sznewajs. & Ganz. J. PNP. Editor] M Debra M.gov/ ocs/index.000 siblings of children diagnosed with cancer each year. CNS. the siblings’ lives are deeply affected when cancer enters the family. The name refers to the growing population of more than 18. MSN. The definition holds true today with more than 10. Rowland. brings us up to date on current efforts to address the long-term needs of childhood cancer survivors. describes the Passport Program developed at the University of California. and their needs often go unmet because of the focus on the child with cancer. RN. Fall. P. Wujcik. BA. The office’s Web site (http://cancercontrol. that is devoted to living well after cancer. The shadow survivors. According to the article. J. JUNE 2007 ONS CONNECT 5 .cancer. Lally. An article in the fall issue of Cure identified another group of survivors known as the “Shadow Survivors” (Cavallo..66–69.EDITOR’SNOTE Today’s Survivors Require New Resources for Information and Support [By Debra M. ✱ Cavallo. A final resource is the National Cancer Institute’s Office of Cancer Survivorship. The focus of this issue of ONS Connect is childhood cancer survivorship. RN. advocates. AOCN ®. the definition of a cancer survivor began to change. and healthcare providers.supersibs. The summer 2007 premier issue features an article titled “The Survivor Has Arrived” that chronicles the development of the survivor movement. caregivers. RN. An organization called the Su- persibs™ has been formed to heighten awareness of the needs of siblings of children with cancer.html) also provides resources for survivors. ore than 20 years ago. (2006). PhD. Journal of Clinical Oncology. Editorials represent the opinions of the author and not necessarily those of the Oncology Nursing Society. the National Coalition for Cancer Survivorship determined that an individual becomes a survivor at the time of diagnosis. Hewitt.html. RN. and survivors. 2006). In 1986. AOCN®. Wujcik. Cancer survivorship: A new challenge in delivering quality cancer care. 14% of whom were diagnosed more than 20 years ago (Rowland. The traditional definition of a survivor was someone who remained disease free for five years.H. Hewitt. Cure. we can be the link for optimal and continued care after our patients leave the oncology clinic. MSN. As the current population of cancer survivors grows. and pass it along to nononcology healthcare providers. additional resources will be needed. whose mission is to enhance the quality and length of survival of people diagnosed with cancer and minimize or stabilize adverse effects experienced during survivorship. Another new resource is Heal. As nurses. Information and support services can be found at www . a tool to help pediatric cancer survivors communicate their history and obtain the continual care needed.org/aboutUs.5 million survivors living in the United States. M. AOCN®. 2006). (2006).A. 24. Please use this information to increase your own awareness of the needs of cancer survivors. 5101–5104. we can be the link for optimal and continued care after our patients leave the oncology clinic. MS.
145 women at high risk for breast cancer took part in one of the studies. It is used for the treatment of early and advanced breast cancer in pre. MD. a team from the Royal Marsden Hospital in London analyzed 20-year follow-up data on healthy women at high risk for breast cancer who took tamoxifen for six to seven years. CPON ®. 1239–1246. 87 women who took tamoxifen were diagnosed with hormone-sensitive breast cancer. & Partridge. They underwent a clinical review every six months and a mammogram every year. “The significance of our study is not to say that the drug industry does anything wrong. “If more and more research is funded by drug companies. 1998. According to Jeffrey Peppercorn. RN. drug companies were involved in 57% of the trials. Of the industrysponsored trials in 2003. the pharmaceutical industry spent more than $38 billion in 2004 on research and development. and 2003. The researchers looked at 140 studies from 10 medical journals and found that trials sponsored by the pharmaceutical industry were smaller. Now. In the second study. The study reviewed research published in 1993. duration. One study found that the drug reduced the risk of hormone-sensitive (estrogen receptor–positive) breast cancer by 39% over 20 years. patients get the same treatment with no control groups to compare efficacy.” said Peppercorn. (2007). in the post-treatment JUNE 2007 . In single-arm trials. A total of 7. E. but IBIS found that side effects did not continue after treatment was stopped. According to a trade group. however. less likely to include random comparison groups. compared with 129 in the placebo group. Eight years later. However. Association between pharmaceutical involvement and outcomes in breast cancer clinical trials. Tamoxifen is an oral selective estrogen receptor modulator that blocks the effects of estrogen. The study found significant differences in the design of trials and types of questions addressed by industrysponsored trials compared to non–industry-sponsored trials. Peppercorn. MSN. J. Tamoxifen Shown to Reduce Risk of ERPositive Breast Cancer T wo studies have suggested that tamoxifen reduces the long-term risk of breast cancer. according to a new study. the article’s lead author. In 2003. compared with 44% in 1993. A. Contributing Editor] Industry-Sponsored Trials More Likely to Find Positive Results C linical trials sponsored by drug companies to study the treatment of breast cancer are more likely than independently financed studies to find that the treatments are effective. Winer. pursuing important questions about optimal dosing. Women took either a daily dose of tamoxifen or a placebo for five years. compared with one of every three industry-sponsored trials.. Blood. exceeding the entire budget of the National Institutes of Health. two of every three independently financed trials were randomized. compared with 62% of those with no backing from drug manufacturers. known as the International Breast Cancer Intervention Study (IBIS). The drug reduced the overall risk of hormone-sensitive breast cancer by 39%.. They are excellent at 6 ONS CONNECT developing new therapies and there are many recent examples in breast cancer research. Tamoxifen has been linked to an increased risk of blood clots.JUSTIN [By Deborah McBride. The women were chosen randomly to take either 20 mg of tamoxifen daily or a placebo daily for eight years. Cancer. 109. according to Peppercorn. single-arm trials for patients with advanced breast cancer. E.and postmenopausal women. then the limited amount of funding coming from other sources may need to be directed to address other questions.” said Peppercorn. and more likely to have positive results. two studies suggest that it might protect healthy women at high risk for the disease. nonrandomized trials to establish safety. In 2003.. and identification of patients who may have better or worse outcomes on treatment may not be in the financial interests of the companies. 84% had positive results. new drugs require small. is that pharmaceutical companies are interested only in certain types of investigations. A second study found a 34% reduction eight years after therapy was stopped. it is a reflection of their role in the development of new drugs. The researchers wrote that although the pharmaceutical industry may be more interested in smaller. The problem.
from http://dx. the most accurate sensor to detect the presence of lung cancer from a patient’s breath is a dog. R. J. which is slightly bigger than a quarter. Tidy. including very early tumors. 81. but the colorimetric sensor array is. S. 39% for leukemia. said. 99. indicating that tamoxifen can prevent breast cancer.072892 Prenatal Multivitamins May Reduce the Risk of Childhood Cancers childhood cancers: leukemia. “We feel these results are very important because it is the first clear evidence that blocking estrogen can. and neuroblastoma. who worked on IBIS. 283–290. Experts have known for years that the chemical composition of the breath changes when people develop lung cancer.E.org/10. P. Ashley. (2007). The canines’ accuracy rate is 99%. W.” Tony Howell. J. According to Trevor Powles.. but this is the first time that clear evidence is available on the benefits and side effects of tamoxifen after treatment with the drug has stopped. Journal of the National Cancer Institute. Einarson. where it can be treated most effectively. & Koren.. concluded that a large proportion of several early cancers can be prevented by taking a prenatal multivitamin. in the long term.. M.. The sensor was able to accurately identify the presence of cancer in three out of four of those with lung cancer. E. The sensor. Clinical Pharmacology and Therapeutics. lead researcher in the study. doubleblinded tamoxifen breast cancer prevention trial. In the past. 685–691.. The test. J. Women who are considering pregnancy are often advised to take folic acid supplements. Mazzone. Researchers tested the breath of 122 people with different lung diseases.” Cuzick. Mazzone said that those results show promise for the development of clinical tools that are as accurate as the dogs.doi.R. Additional research is required to determine which components of the multivitamin can be attributed to the protective effects and which are associated with the folic acid component. Ultimately... the finding could lead to an inexpensive. (2007). (2007). Forbes. 99. Smith.J. T. Prenatal multivitamin supplementation and rates of pediatric cancers: A metaanalysis.. Twenty-year follow-up of the Royal Marsden randomized. Powles.2006. & Dweik. 272–282... Although previous studies have investigated the effect of prenatal vitamins on pediatric tumors. Peter Mazzone. Hammel. According to the study authors.. according to researchers at the Hospital for Sick Children at the University of Toronto. principal author of the Marsden study. The study examined findings of seven studies and found that taking prenatal multivitamins containing folic acid is associated with a 47% protective effect for neuroblastoma. The principle of a chemical test for patients with lung cancer is not new. I. G..F. explained that it is important that the sensor pick up cancer in its early stages. Retrieved May 14. the study’s principal investigator. Spots on the sensor change color according to the chemicals they come in contact with. Journal of the National Cancer Institute. Sestak. according to preliminary research. This is because lung cancer cells give off volatile organic compounds that are then breathed out. Long-term results of tamoxifen prophylaxis for breast cancer 96-month follow-up of the randomized IBIS-I trial. I. ”Previous studies have already shown that tamoxifen lowered the risk of developing breast cancer during active preventive treatment. is inexpensive and easy to use. Bollano. Lung cancer diagnosis by the analysis of exhaled breath with a colorimetric sensor array. Color Breath Test May Detect Lung Cancer R esearchers have developed an inexpensive breath test that can accurately detect lung cancer in three out of four people with the disease.period.1136/ thx. noninvasive screening or diagnostic test for lung cancer. prevent breast cancer in healthy women. brain tumors. The new color sensor is inexpensive and easy to use. & Cawthorn. including 49 with cancer and 21 healthy people. the reduction in risk was 51%. 2007. Thorax [E-pub ahead of print]. & Dowsett. (2007). but this study suggests that a multivitamin with folic acid may be preferred. ✱ Goh. T aking a prenatal multivitamin fortified with folic acid before and during pregnancy reduces the risk of three JUNE 2007 ONS CONNECT 7 . this is the first meta-analysis of prenatal multivitamin use before and during early pregnancy and its protective effect for several pediatric cancers. requires more development before it can become available clinically. T.I. because lung cancer is often “silent” and difficult to detect in the early stages. Y.J. A. Gideon Koren. however. gas chromatography and mass spec- troscopy were used to read the chemicals with a high degree of accuracy. and 27% for brain tumors. But the machines were costly and required expertly trained individuals to interpret the results.
at age 14. 1998). PhD.UPFRONT Childhood Cancer Survivorship: A Lifelong Surveillance [By Robin M. Lally. 8 ONS CONNECT Brennan appeared on stage during his mother’s 1998 Mara Mogensen Flaherty Memorial Lecture. Now. RN. CNS. Contributing Editor] I n her 1998 Mara Mogensen Flaherty Memorial Lecture. FAAN. JUNE 2007 . RN. PhD. shared her family’s cancer journey following her son Brennan’s diagnosis of acute lymphoblastic leukemia (PostWhite. more than 10 years after being diagnosed.” ONS member Janice Post-White. BA. “Wind Behind the Sails: Empowering Our Patients and Ourselves. Brennan is transitioning to life as an adolescent and a survivor of childhood cancer. AOCN®.
To fulfill that need. “but they also need boundaries of what’s required. during a recent acute illness. “He really connects with them. With so many people on the journey from childhood cancer to adult survivorship. Long-Term Follow-Up Because of an increased risk of future health problems (see sidebar on p. however. and that number is expected to rise by another 100. & Simone.Brennan and his mother. “Brennan is very empathetic to others who are disadvantaged. childhood cancer survivors are recommended to receive regular monitoring from diagnosis through young adulthood and beyond (Freyer & Kibrick-Lazear.” Post-White says.” For example. 2006).” such as attending a late-effects clinic. “Teenagers need to have some say. FAAN. “I just did what I had to do.000 adult survivors of pediatric cancers currently are living in the United States. Post-White has a different point of view. She says that Brennan is a typical “invincible teenager” even though he has lived through cancer. have learned positive life lessons during Brennan’s cancer experience. 2003). 10). Brennan de- cided that all of the appointments were a waste of time and the pills were making things worse. oncology nurses need to better understand the myriad challenges that those survivors face.” she says.” Although positive life lessons have come from Brennan’s cancer experience. Approximately 270. Janice Post-White.000 in the next decade (Hewitt. Brennan is in good company. Brennan says.” adding that he feels cancer has not affected his life. When thinking back to his cancer treatment. Post-White also acknowledges that teens can be “notoriously challenging in terms of compliance.” As his mother and an oncology nurse. but the experience has affected and been integrated into her son’s life. “I am who I am. Weiner. cancer cenJUNE 2007 ONS CONNECT 9 . PhD. RN.
including • Type of treatment received • The child’s age at the time of treatment (younger children are at higher risk) • Predisposing genetic factors • Health problems before. RN. ONS member Debbie Crom. CPNP. Jude Children’s Research Hospital’s After Completion Therapy (ACT) Clinic in Memphis. RN.cancer. Sweeney. whichever is later. PhD. Jude’s ACT Clinic is that patients are not charged for services. Jude’s ACT Clinic.UPFRONT Adopting healthpromoting behaviors is one of the struggles for teenaged survivors of childhood cancer.” she says. Sweeney. Risk of developing late effects may depend on many factors.gov/cancertopics/pdq/treatment/late effects/HealthProfessional 10 ONS CONNECT JUNE 2007 . Established in 1984. PhD. “Poverty makes effective health promotion interventions very difficult. ters began developing long-term followup programs in the 1980s. described specific challenges of providing long-term follow-up care for childhood cancer survivors. CPNP. Coupled with adolescence. says that a unique aspect of St. the program follows more than 5. RN. Childhood Survivors May Experience Late Effects of Treatment Late effects are health problems that may not appear for years or months after cancer therapy is completed. Cognitive impairments after treatment to the central nervous system Eyesight or hearing changes Growth and development impairment Thyroid dysfunction Cardiac or respiratory problems Second malignancies Impaired fertility National Cancer Institute. 2007. often face challenges when providing long-term care for childhood cancer survivors. MSN. Survivors enter the program when they have been cancer-free for five years and are followed until they are 18 years old or 10 years postdiagnosis. Late effects of childhood cancer [PDQ®]. during. from http://www. MSN. Crom and Teresa A. Retrieved February 28. or after treatment.000 childhood cancer survivors annually and is the largest long-term follow-up clinic for survivors of pediatric cancers in the United States. TN. this can offer additional challenges to the survivorship experience. • • • • • • • Examples of late effects follow. and Debbie Crom. St. • Encouraging adolescents to practice effective health promotion behaviors is difficult because some engage in Teresa A. RN. is one such program. a fellow nurse practitioner at St. (2007).
risk-taking behaviors such as smoking.” Recommended Examinations Recommended Screening Tests for Long-Term Follow-Up of Childhood Cancer Survivors System Cardiac Treatment-Related Causes Anthracyclines. and Sweeney agree that adopting healthpromoting behaviors is one of the struggles for teen-aged survivors of childhood cancer. Retrieved April 20.org). Based on information from “Long-Term Follow-Up Guidelines for Survivors of Childhood. • Research illuminating the life experience of childhood cancer survivors to better inform intervention is lacking. radiation to the chest Echocardiogram or multiple gaited acquisition scan at baseline. • Few community-based clinicians are trained in the specific needs of adult survivors of childhood cancer and are familiar with the Children’s Oncology Group risk-based.” PostWhite says. “Integrating the reality of risk into who they are and how they care for themselves without letting cancer define them is one of the most important lessons on this journey. she says.survivorshipguidelines.0].” Post-White. carmustine Busulfan Heavy metals Note. Brennan wouldn’t want to leave the clinic because of the fun he had there.” He remembers one of the first times he attended a survivorship clinic at age 12: “I had to sit through an hourlong lecture on the effects of treatment. which I just tuned out. 2006. and unprotected sexual activity. and dual x-ray absorptiometry if hypogonadal Pulmonary function testing and chest x-ray as indicated Examine for visual acuity and cataracts yearly. JUNE 2007 ONS CONNECT 11 . Post-White adds that promoting “fun—even in survivorship clinics— should be a goal of healthcare providers.” by Children’s Oncology Group. Brennan says that the late-effects clinic is “just something that I have to do. Crom. Otoscopic examination yearly and audiogram at baseline and as indicated Reproductive Alkylators.” She recalls that during treatment. despite having a usually fabulous memory.org. Getting Teen Survivors on Board With Health Promotion Today. electrocardiogram yearly Follicle-stimulating hormone. and eating smart was just something he didn’t want to hear. “Information about controlling weight. Adolescent. from http://www. Dealing with illness is also a challenge because “general pediatric clinics do not always consider survivors’ inability to fight illness and long-term follow-up clinics typically do not address acute illness.sur vivorshipguidelines. “We are left to our own advocacy and persistence. luteinizing hormone. estradiol yearly after age 13. exposure-related clinical practice guidelines (www. alcohol abuse. then per guidelines for cumulative dose and chest radiation therapy. radiation to the ovaries Respiratory Ocular Auditory Busulfan.” Post-White Post-White says that survivorship clinics should emphasize fun to help motivate teenagers like Brennan to attend.” Post-White confirms that Brennan did not remember or believe the information provided. and Young Adult Cancers [Version 2. exercising. 2007. More likely.
treating childhood cancer survivors. and educational as well as vocational achievement as part of the program’s mission.• Motivate and inspire teenagers to take comes more meaningful. schoolwork when “normal” viruses and • Begin career counseling early to idenchildhood illness cause extended absenctify goals and abilities. AOCN®. J. J. the harder it is for him to keep up with and self-advocate. she says. DC: National Academies Press. All ONS members may join one SIG for free with their ONS membership. 1702–1709. Oncology Nursing Forum.” Crom and Sweeney believe that transitioning between long-term follow-up and community care is challenging.UPFRONT “general pediatric clinics do not always consider survivors’ inability to fight illness. social functioning. “Brennan already laments the fact agers determine their strengths on an that appointments will be ongoing.” ✱ Freyer. and long-term follow-up clinics typically do not address acute illness. Wind behind the sails: Empowering our patients and ourselves. RN. Crom says that St. Facilitating that transition is one of several missions of St. Jude’s ACT Clinic attempts to address those needs by “including physical and emotional health. manage stress.. The time missed with friends also be. BA. Cancer. Dealresponsibility for their health. 12 ONS CONNECT JUNE 2007 . & Simone. We soon will initiate a program called St. Hewitt. Adolescent. and don’t let cancer lead your life and define who you are.” she says. & Kibrick-Lazear. When asked how oncology nurses and survivorship clinics can support the future of childhood cancer Crom says that nurses need to survivors. D. M.” • Teach skills to negotiate adjustment. For more information on these SIGs or to join a SIG.org. balance workload. es.. and ability to access insurance coverage and health care.. Post-White offers the following advice: “Keep perspective. 7). Post-White ofaddress specific challenges when fered the following tips. Use the wisdom of others as you integrate your own experiences and launch into survivorship. Childhood cancer survivorship: Improving care and quality of life. especially for survivors who lack resources. Two ONS SIGs Address Survivorship and Cancer in Children ONS’s Survivorship.ons. identifies is that the older Brennan gets. Quality of Life. Contributing Editor Robin M. (2003). which will follow childhood cancer survivors for life to study physical morbidity as well as the attainment of adult life goals. Jude Life. “We are left to our own advocacy and persistence. 25. (2006). Jude’s ACT Clinic. To parents and survivors. Washington. Check ing with illness is a challenge because back with them periodically to assess their understanding and reteach the importance of healthy lifestyle behaviors. R.” Post-White says. S.vc. (Eds. CNS. and ongoing basis to balance limitations I can see the plans forming in his mind created by cancer treatment and deto ignore the expectation once he moves creased energy. Lally. (1998). In sickness and in health. whereas the Pediatric. additional SIG memberships are only $15. such as marriage. and Young Adult SIG promotes the highest professional standard of pediatric oncology nursing.L. and Rehabilitation Special Interest Group (SIG) increases awareness and promotes understanding of cancer survivorship issues. PhD. away from home.).V. 1011–1017. is a research assistant professor in the School of Nursing at the State University of New York at Buffalo.R. Post-White. develop the self. 107(Suppl. • Help children and teensays. Another struggle that Post-White Create life balance. visit the SIGs Virtual Community at http://sig. Weiner. employment. one step at a time.
RN. The Passport has been in use for two years. laminated card was designed by Robert Goldsby. RN. MSN. Janet Veatch. uses the survivor’s Passport Program to assist childhood survivors long into adulthood. MS. and others to summarize the survivor’s treatment history and customized follow-up needs in lay language. PNP. Although mortality has decreased. patients.ONENURSE’SPERSPECTIVE Aimee Sznewajs. JUNE 2007 ONS CONNECT 13 . Passport Program. and we are working toward collaboration with other centers to increase its use and evaluate its effectiveness in improving healthcare follow-up behaviors over time in childhood cancer survivors. The Survivors of Childhood Cancer Program at the University of California. The President’s Cancer Panel report and the Institute of Medicine’s 2005 From Cancer Patient to Cancer Survivor: Lost in Transition have Sznewajs and a patient review a passport. portable. describes the University of California. a tool for survivors of childhood cancers that summarizes their treatment and long-term care plan. RN. San Francisco. What Programs Do You Have in Place to Support Childhood Cancer Survivors? UCSF Passport Program Helps Increase Compliance Aimee Sznewajs. PNP. Patients want education so they feel empowered about what to expect and how to stay well. CNS. possibly moving far from home or entering into new primary care practices. MD. stressed that survivors need a concise but detailed summary of treatment received and monitoring needed as part of lifelong healthcare planning and maintenance. clinicians. ✱ W e are so fortunate that innovations in pediatric oncology have resulted in more survivors—about 1 in every 500 adults in the United States today is a childhood cancer survivor. This small. developed the survivors’ Passport Program to assist survivors as they grow into adulthood. MS. San Francisco. and health policy makers have a great deal of awareness regarding late effects of treatments.
NJ You Tell Us. and blood work or tests are ordered specifically based on therapy. and child-life specialists. acts of service. a neuropsychologist. RN. Referrals to specialists are made when late effects are identified. Information. submit a bylaw amendment by September 1 or a resolution proposal by January 1. We hold an annual Survivors’ Education Night for patients and families. a social worker. MSN. A complete physical examination is done at each patient’s annual visit. Dawn Carey. ONS offers a free Resolutions Kit to help members prepare resolutions.org). nurses. and exemplary practices. Consider Submitting a Resolution or Bylaw Proposal Is there a hot topic that you think influences the course of oncology nursing practice? If so. Oncology Nursing Society awards annually celebrate and honor best practices and excellence in the oncology nursing ﬁeld. Treatment effects. We review each child’s medical files and prepare a binder for the potential late effects. review tests and laboratory results. please tell us! We’d love to hear from you.org/Publications/journals/ Connect). a nutritionist. outstanding recipients were recognized for their dedication to oncology nursing through their special and unique endeavors. Readers! “You Tell Us” is a forum for ONS Connect readers to share comments with their professional colleagues. or psychological issues. This year. The goal is to provide childhood cancer survivors with the best quality of life while addressing their individual late effects. Patients receive a book on being a childhood cancer survivor. Pittsburgh. 2008. and Evaluation) program. If you have knowledge to share on the following topic.org).org. September: How do you prepare patients with cancer for a disaster? (Submit by July 3) Submissions should be approximately 125 words and may be edited for clarity and space. infertility. The survivors are our future. The program is a collaborative team comprised of a physician. and initiate appropriate referrals. pulmonary complications.org. or online (www. APN Pediatric Nurse Practitioner LITE Program Coordinator The Cancer Institute of New Jersey New Brunswick. 125 Enterprise Drive. customer. We use the Children’s Oncology Group long-term follow-up Web site’s instruction sheets for each patient. which brings community resources to CINJ that provide survivors with tools and education to meet their needs. Survivors also meet with a nutritionist and a social worker at each visit.YOUTELLUS How Does Your Institution Meet the Needs of Childhood Cancer Survivors? Program Addresses Individual Late Effects he Cancer Institute of New Jersey (CINJ) created the LITE (Longterm. The LITE team has a postmeeting to summarize each patient. T such as cardiac changes. endocrinology complications. Send responses by the deadline listed in parentheses to Editorial Manager Sharon Padezanin via e-mail (pubONSConnect @ons. PA 15275-1214 or e-mail executive@ons. 14 ONS CONNECT JUNE 2007 . The meeting helps us review and discuss the followup plan. Send proposals to the ONS Board of Directors. so we empower them with the knowledge they need to live life to the fullest. fax (412-859-6163).service@ons. View all 2007 award recipients at www. an advanced practice nurse.ons.ons. contact ONS Customer Service toll free at 866-257-4ONS (412-859-6100. To order the kit.
“Luckily. CCRP. and particularly oncology nursing. Servodidio. It was very difficult for me as a new graduate to question a physician. but my work environment encouraged this. rely on the values they learned growing up when making personal as well as professional nursing decisions and attempt to pass that philosophy on to the next generation.” Heather remarks. OCN®. RN. and Heather Martorella. “I learned so many valuable lessons as a child.” Jamel relies on open communication with the physicians in her facility. OCN® J amel Robinson. it is important to do it because you want to and not because you are looking for something in return.” “The ability to be able to discuss clinical issues on many levels (nursing to attending) benefited patients and helped me build my communication skills. appealed to me. I always try to teach my twin girls that it is important to treat others as you want them to treat you. BSN. The ability to be able to discuss clinical issues on many levels (from nursing to attending) benefited patients and helped me build my communication skills. or the outcome was negative. RN. Contributing Editor] Jamel Robinson.” Recalling her own childhood. “I learned the importance of being a giver instead of a receiver. Our nurse manager advocates for us when it is hard for our physicians to understand our point of view. Heather says. OCN®. RN. OCN® Heather Martorella.” ✱ JUNE 2007 ONS CONNECT 15 . BSN. RN. I also learned that when you do things for other people. CRNO.” Jamel remarks. RN. “We continue to talk to the physicians about our patients and make decisions together to ensure the best outcomes. my first nursing position was in a teaching hospital. and I had support from my peers and manager. OCN ®. BSN. but I was always able to take something away from it. That may be why nursing. “My parents were very instrumental in helping me learn my life lessons by allowing me to make my own decisions. and this will result in fairness and honesty.UPCLOSE&PROFESSIONAL Values Learned in Childhood Help Nurses in Their Practice Today [By Camille A. I failed a lot of the time. We can always ask questions. because the physicians want to make sure we understand why we do what we do and how it affects our patients. I hope I can do the same with my daughter. BSN. MPH.
pbs. OCN ® The ONS Web site’s gateway to survivorship information. from diagnosis to treatment to relapse.org Ulman Cancer Fund for Young Adults www.org/docroot/CRI/content/CRI_2_6x_Late_Effects_of_ Childhood_Cancer. Quality of Life and Rehabilitation Special Interest Group Virtual Community A program of the National Children’s Cancer Society for survivors of childhood cancer. The following sites provide resources for childhood cancer survivors. provides comprehensive information on survivorship issues.childrenscause. including the ONS Survivorship List Serve and ONS Survivorship.htm. OCN ®.org Children’s Cause Cancer Advocacy www.org/clinical/supportive/ Survivorship/index.WEBCONNECT Web Sites Offer Information and Support for Childhood Cancer Survivors [By Deborah Braccia. MPA. an educational and leadership development program for childhood cancer survivors aged 18–25 Provides support programs. education. 16 ONS CONNECT JUNE 2007 .org Young Survival Coalition www.cancer. breast cancer. research.ulmanfund. ONS Web Site Editor] I nnovations in pediatric cancer care have resulted in a 77% five-year survival. Childhood cancer survivors often face unique issues related to their diagnoses and possible late effects of treatment throughout the rest of their lives.beyondthecure.ons.youngsurvival. It follows the children for six years throughout the cancer experience. including late effects of cancer treatment Contains information on Children’s Cause Cancer Advocacy’s Rise to Action program. For more information. RN. and resources free of charge to young adults affected by cancer Educates the medical.shtml Description Deborah Braccia. and legislative communities and persuades them to address breast cancer in young women. RN. an increase of 45% since the 1960s (www.org/inde pendentlens/lioninthehouse/index. ✱ Title ONS Survivorship Clinical Resource Area URL www.asp).org DVD Helps Support Children With Cancer and Their Families A Lion in the House tells the stories of ﬁve children with cancer and their families. also serves as a point of contact for young women living with breast cancer Beyond the Cure www. visit www. MPA.
2007a). during. Retrieved May 1. 2007b). Pregnancy rates are 10%–25% per embryo stored. S. Men can use sperm cryopreservation before chemotherapy so that they can later father a child through assisted reproduction.ACLOSERLOOK Sperm and Egg Banking Give Patients Hope for Parenthood After Cancer Treatment [By Susan D. The option is viable only if enough time is available before treatment to undergo a cycle of stimulation to obtain eggs and if a safe method of ovarian stimulation exists. The only established method of female fertility preservation is embryo cryopreservation. A spouse or partner. ✱ Fertile Hope. Fertile Hope (2007b) reports that only 10% do so in their practice. Once frozen. The understanding of the relationship between cancer and fertility remains an unmet need for patients in the reproductive ages. and storage can cost $600 per year. even as young as 12 or 13. Successful parenthood options exist for men and women before. from http://www. Routine tests are performed. The storage fee for each specimen is $85 per year. The advances in cryopreservation have increased post-thaw survival rates to as high as 90% and fertilization rates as high as 80% and have led to a pregnancy rate of 35% per embryo (Later Baby. Bruce. Women must undergo a cycle of in vitro fertilization and create embryos for later use.d.org/ egg-freezing. Retrieved May 1. Eggs have been difficult to freeze because they can develop ice crystals during the process. n.). Although 91% of oncology physicians agree that sperm banking should be offered to all men at risk for infertility because of cancer treatment. Bruce. and after cancer treatment (Fertile Hope. Women undergoing chemotherapy or radiation to the pelvic area during their reproductive years have a 40%–80% chance of losing their fertility. from http://www.laterbaby.htm Mills. Semen samples are collected over two weeks. Retrieved May 1. 2007. Nurses can help to ensure that patients are not left unknowingly infertile. 2007.). (2003). The cost of cryopreserving three specimens is typically about $800.fertilehope. Cancer and fertility professional education program. As long as sperm contains live sperm cells. samples can be kept for 25 years or longer. more viable options now are available for patients. Contributing Editor] A pproximately 140. OCN ®. which compromises their integrity and hardens the outer membrane (Later Baby. (n. or the woman’s willingness to use donor sperm. is an oncology staff nurse at Duke Raleigh Hospital in North Carolina. The average cost of standard embryo freezing is $8. Egg freezing services. 2007.000 Americans of reproductive age or younger are diagnosed with cancer each year (Fertile Hope. a new culture media system now protects eggs from damage during the freezing and thawing process. whereby an embryologist injects the egg with a single sperm to fertilize it.d. JUNE 2007 ONS CONNECT 17 . it can be stored for future use. However. 2007. Statistics. The procedure can be done after puberty and takes about 12– 14 days per cycle. With advances in fertility treatment.fertilehope. patients should not be left infertile because of a lack of knowledge. intracytoplasmic sperm injection.). 2003). has been developed. from http://www. is also necessary. MSN. such as hepatitis B and HIV. n. from http://www. (2007b).cfm Fertile Hope. RN. Men who have reached puberty.000 per cycle. RN.org/about/ statistics. MSN. OCN®.d. thereby minimizing the formation of ice crystals. Retrieved May 1. especially before cancer treatment. Discussion regarding fertility should occur before patients undergo cancer treatment. About six sperm deposits are needed for each child (Mills. Patients are at risk for permanent infertility from their treatments.cancersupportivecare. In addition. can bank sperm as long as the sperm contains enough live and healthy cells. The system dehydrates eggs during freezing and rehydrates them during thawing.html Contributing Editor Susan D. Private insurance carriers may cover part or all of the cost. (2007a).com/sperm bank. Sperm banking: Keeping fatherhood as an option. A new technique. only 24% of men choose to bank their sperm prior to potentially sterilizing cancer treatments.org/resources/ pe-program. As cancer survival rates continue to increase.cfm Later Baby.
MA. taking one diagnosis at a time. ✱ ONCONOMIC$ Regimen Standardization— Is It Practical. I am a firm believer that Congress should lead by example. growth factors.S. ✱ Shirley Shuster. It has been a process—one meant to help ensure best patient care and best practices for safety. and nursing staff to provide quality care in the office setting. many questions were asked. less ambiguity exists regarding treatment regimens across the practice. Standardization has reduced expenses both in drug costs and nursing time. OCN®. ONS Health Policy Associate] E arlier this year.” ONS expressed its appreciation to Pelosi by sending her a letter commending her decisive action and urging her and her colleagues to take additional steps to reduce the scourge of tobacco on the nation. Increased concern with patient insurance coverage for the regimens that can be given in the office environment has resulted in discussion about drug or regimen standardization. nothing has been more complex nor practice changing than dealing with the Medicare Modernization Act. such as granting the U. and Congressional staff—all whom have been exposed to environmental tobacco smoke for years. Inventory is better controlled. BC. It has not restricted the use of any protocols but rather has allowed us to work together as a team with physicians. which is a narrow room extending the length of the House of Representatives chamber and just outside it. OCN ®] F or nurses working in the oncology office practice or hospital outpatient departments. MPP. As our practice started the process. • Would the changes result in time savings—for nurses as well as doctors? • Would this be a restriction of practice. too. Food and Drug Administration the authority to regulate tobacco and expanding access to tobacco cessation therapies.S. Medical science has unquestionably established the dangerous effects of secondhand smoke. In it. Antiemetics. APRN. “The days of smoke-filled rooms in the U. visit www. or Restrictive? [By Shirley Shuster. We looked at what was currently used and agreed that if efficacy was the same. The room is often hazy with smoke from members who are smoking cigarettes. and hydration also were standardized. saving much nursing time waiting to clarify orders. BC. it is frequented by members of Congress.org. Many of the government printing offices have regimen tools that are helpful. Although the room is closed to the public. resulting in “cookbook medicine”? • Could we have better cost and inventory management of drugs? 18 ONS CONNECT • Would fewer errors occur? • How can we accomplish this without an electronic medical record? • Could we track outcome data better? Our practice started by reviewing the National Comprehensive Cancer Network and American Society of Clinical Oncology guidelines. members of Con- gress meet with one another and journalists and read briefing materials. Upon making her announcement. As a result. or cigars between votes. pipes. To view the letter. Capitol are over.onslac. Pelosi said. is the director of Clinical Services for Commonwealth Hematology Oncology in Quincy. including an increased risk of cancer and respiratory diseases. APRN. JUNE 2007 . specific regimens would become “preferred” regimens.CAPITOLCONNECTION Speaker of the House Bans Smoking in Speaker’s Lobby [By Ilisa Halpern Paul. nurse practitioners. Documented “unclear orders” have decreased. journalists. in one of her first official actions as speaker of the House. Necessary. Congressional Representative Nancy Pelosi (D-CA) banned smoking in the Speaker’s Lobby.
Food and Drug Administration (FDA) for use in patients with metastatic breast cancer in conjunction with the chemotherapy drug capecitabine (Xeloda ®. 355. Trastuzumab blocks the protein on the cell’s surface while lapatinib blocks it inside the cell. D. Geyer. When the new agents are combined with The potential for these agents lies in their use before metastatic disease has developed and when their addition to conventional chemotherapy may increase the chance for a cure.S. The drugs are the result of advances in molecular biology that permit the identification of qualitative and quantitative differences in gene expression between cancer cells and normal cells. (2006). Inc. New England Journal of Medicine. Like trastuzumab (Herceptin ®. Because the targets of these therapies are specific to cancer cells. Lapatinib plus capecitabine for HER2positive advanced breast cancer..4 months for the capecitabine-alone group and 8. Foster. 2783–2785. Genentech BioOncology). JUNE 2007 ONS CONNECT 19 . toxicity is increased only minimally.). The potential for these agents lies in their use before metastatic disease has developed and when their addition to conventional chemotherapy may increase the chance for a cure. Trials are now in progress to explore the use of lapatinib before metastatic disease is evident. the conventional treatment uses single agents on a sequential basis to control the growth of metastases and improve quality of life. conventional chemotherapy. However. The finding is important because breast cancer tumors frequently spread to the central nervous system. GlaxoSmithKline) has been approved by the U.. Foster. fewer patients in the combination therapy group had central nervous system metastases (4 versus 11 patients). In addition. these new agents may be able to prolong survival and convert metastatic breast cancer to a chronic. however. The median time to progression was 4. The combination therapy group had a higher tumor response rate (22% versus 14%). is changing with the development of targeted therapies that block one or more critical pathways involved in cancer cell growth and metastases.4 months for the combination therapy group. manageable disease. CPON ®. Roche Laboratories.NEWTREATMENTS. MSN. C. no difference existed in survival between the two groups: 22% of patients died by the end of the study. ✱ Geyer. which is made in large quantities in roughly one-fourth of all breast cancers. J. Contributing Editor] L apatinib (Tykerb ® .. the new drugs generally have fewer side effects than most conventional chemotherapy drugs. Lapatinib has been shown to arrest the development of breast cancer in some patients with metastatic.E. S. In the trial that led to FDA approval. The treatment. If toxicity can be minimized while improving response rates and time to tumor progression. RN. Although metastatic breast cancer is incurable. lapatinib targets HER2/ neu. where the tumors are protected from most chemotherapeutic agents. Lindquist. treatment-refractory disease. Lindquist. Lapatinib has a dual mechanism of action. blocking the tyrosine kinase receptor for epidermal growth factor receptor and HER2/neu receptors.NEWHOPE Dual-Action Drug Approved for Use in Advanced Breast Cancer [By Deborah McBride. & Chan. and Chan (2006) randomly assigned 324 patients with metastatic breast cancer that had progressed after initial chemotherapy to a group receiving capecitabine alone or in combination with lapatinib.
Incorporate nursing research on health-related quality of life into clinical trials. existing measures may not incorporate patients’ values and preferences sufficiently. & Stutzer. Making meaning and being positive are also facets of well-being described in the research.000 survivors of childhood cancer may be at risk for medical and psychosocial sequelae that can adversely affect their health status. Cantrell provided a thought-provoking literature review that summarized the empirical state of the knowledge about and theoretical understanding of the health-related quality of life (HRQOL) of survivors of childhood cancer and of adolescents with cancer. Heiney. defined from the perspective of children and adolescents undergoing cancer treatment. Questions regarding the information presented in this Five-Minute In-Service should be directed to the ONF editor at ONFEditor@ons. Despite the existence of the Childhood Cancer Survivor Study. PhD. social functioning and relationships. tracked 14. and caretakers who understand and influence the strategies will influence HRQOL and survivorship. psychological adjustment. ONS Scientific Writer] A s Mary Ann Cantrell. courage.000 long-term survivors of childhood cancer. Strategies to Inﬂuence Health-Related Quality of Life • • • • • • • Facilitate ongoing psychosocial development and functioning. AOCN ®. Successful strategies or interventions that support children and adolescents undergoing cancer treatment also were discussed (see Figure 1). Photocopying of this article for educational purposes and group discussion is permitted. Nevertheless. Promote a positive future view. For example. Promote healthy lifestyles. and Key Deﬁnitions Childhood Cancer Survivor Study: longitudinal cohort study funded by the National Cancer Institute. “Five-Minute In-Service” is a monthly feature that offers readers a concise recap of full-length articles published recently in the Clinical Journal of Oncology Nursing and Oncology Nursing Forum (ONF). However. Encourage reliance on non–avoidance-type coping. RN. survivors of childhood cancer and their QOL have been studied much less than survivors of adult cancer. The Adolescent Resilience Model (Haase. self-perceived construct that includes aspects of physical functioning and activity. Ruccione. common and significant goals of “being normal” and “getting on with life” have been noted repeatedly in the literature. and an overall sense of well-being Meaning-Based Model: a type of theoretical model used to evaluate HRQOL that emphasizes patterns and the treatment experience of cancer from a subjective and holistic perspective tension exists between function-based and meaning-based models. 1999) pro- Figure 1. Hopefulness. RN. This edition summarizes “Health-Related Quality of Life in Childhood Cancer: State of the Science” by Mary Ann Cantrell. 2007. Foster a positive sense of well-being and hopefulness. Screen and treat survivors at high risk for physical and psychosocial sequelae. Based on information from Cantrell. MS. examined physical and psychological dimensions of survivorship Function-Based Model: a type of theoretical model used to evaluate health-related quality of life (HRQOL) that emphasizes physical functioning and the impact of long-term treatment effects on health status HRQOL: a multidimensional. pointed out in the January 2007 issue of the Oncology Nursing Forum.org. Measuring Health-Related Quality of Life A number of articles address the concept and measurement of HRQOL in the general healthcare literature. RN. 20 ONS CONNECT JUNE 2007 . Note. Researchers recognize a dynamic overlap of concepts and challenges faced by children and adolescents.FIVEMINUTEINSERVICE AS SEEN IN THE ONCOLOGY NURSING FORUM Childhood Cancer Survivors Tend to Have High Levels of Health-Related Quality of Life [By Marcella Williams. some 270. PhD. and resiliency are coping strategies that assist adolescents to manage their experiences with cancer. HRQOL can be measured more effectively because several valid and reliable instruments have been developed (see Table 1). which was featured in the January 2007 issue of ONF.
J. Katz. 20. 2007. E.. Role functioning and social support Physical health status Note. D. Factors related to education level and economic status have an interactive and multifactorial effect on HRQOL for childhood cancer survivors. and cognitive functioning Pediatric Cancer QOL Inventory Child report (8–12 years) and teen report (13–18 years) Varni et al..E.R. Adolescents undergoing therapy strive to maintain normalcy. 23-item. Friedman. The Pediatric Cancer Quality of Life Inventory-32 (PCQL-32): Reliability and validity. K. Restricted social support systems and different support needs may exist for children with chronic illness.R.. Gender and age are important factors inﬂuencing self-image and coping.P. however.H. vides substantial insight into adolescent experiences with cancer treatment. M. The Minneapolis-Manchester Quality Instrument: Reliability and validity of the Adolescent Form. 6... Health-Related Quality-of-Life (QOL) Instruments Instrument MinneapolisManchester QOL Instrument Target Age Group Youth form (8–12 years). and response to current medical treatments.L. 2007. psychological function. Ruccione. Heiney. physical symptoms. Based on information from Cantrell. 1998 Note. Boggs. J.. ✱ Bhatia. Seid. Cantrell. Research involving survivors of adult forms of cancer also show direct correlation between social support and coping. (1998). International Journal of Cancer. Quiggins. Haase. J.. The author reviewed significant research related to HRQOL assessment and QOL. Research triangulation to derive meaning-based quality-of-life theory: Adolescent resilience model and instrument development. and outlook on life Pediatric Oncology QOL Measure Goodwin et al. Psychological Assessments. A. Bogue.. Children with limited support systems are at risk for long-term psychosocial maladjustment. & Stutzer.K. et al. 103–111.). T.. J. Feusner. emotional distress. adolescent form (13–20 years).Table 1. social functioning.W... & Friedman-Bender.. J. three-point (never to always) Likert scale with four subscales: physical. Table 2. psychological.E.. S. Subscores for each factor or a combined total score may be obtained. S. (1999).. (2002). The perception of psychosocial well-being inﬂuences physical functioning and treatment outcome. role restriction and physical function.S. Social support is a signiﬁcant determinant of coping ability. 1994 21-item scale measuring three factors. Health-related quality of life in childhood cancer: State of the science. C. 82. S. 321–328. JUNE 2007 ONS CONNECT 21 . D.. Based on information from Cantrell. Original article reviews additional research. Long-term effects of cancer treatment on body image and physical health are great concerns for those disﬁgured by treatment.H. Cancer. Determinants of HRQOL are further summarized in Table 2. research results with adolescents diagnosed with cancer are inconsistent. Cantrell (2007) demonstrated the need for research to further identify evidence-based interventions. M.. Protecting the future health and QOL of survivors involves teaching methods of coping with uncertainty. 4692–4698. Original article also contains reliability and validity data.A.A. Journal of Clinical Oncology. Direct and Indirect Determinants of Health-Related Quality of Life (HRQOL) for Adolescents With Cancer HRQOL Determinants Psychosocial development and adaptation Summary Most adolescents meet development tasks. M. 2002 Description 32-item scale with four subscales: physical function.. Implications for Nursing Emerging research suggests that high levels of QOL are generally reported by survivors of childhood cancer. Self esteem is a signiﬁcant predictor of later psychosocial adjustment. 34.. 1184–1196. Oncology Nursing Forum. 12(Suppl. (2007). D. Goodwin. M. & Graham-Pole. Jenney. and young adult form (21–45 years) – Author Bhatia et al. Rockwood. Varni. Development and validation of the Pediatric Oncology Quality of Life Scale. (1994). 125–131.
develop hobbies. turn off the phone. substance abuse. and internal body clocks.gov/niosh/topics/work schedules. and a love for what you do. Shift work also means shifting activities. a healthful approach to life. More research and information are available at the National Institute for Occupational Safety and Health Web site at www. work-time sleepi- ness. Fatigue and stress are part of every shift. and interpersonal relationships can be strained. and short-term memory problems associated with disrupted circadian rhythms. dark room. Varicose veins. responsibilities. reduce fatigue. I: Increase water intake to 10 eightounce glasses per day. ✱ 22 ONS CONNECT JUNE 2007 . and simple aching back and leg muscles are common for nurses. use white noise or ear plugs to reduce distractions. additional income. or hold a second job. and even reproductive difficulties may be exacerbated by shift work. avoid caffeine and alcohol. Furthermore. chronic illness. ONS Scientific Writer] S hift work provides flexibility. Researchers confirm increased error rates. and improve leg health. “Shift” into some of these habits. S: Support stockings and good shoes optimize circulation. RN. a positive balance to work and home. H: Have enough sleep—feeing rested is critical to providing safe care and maintaining emotional stability. F: Fall asleep in a cool. Nurses know that stress and fatigue increase with variable schedules.cdc. circulatory problems. All shifts are usually spent on your feet.CAREGIVERCARE “Shift” Your Life With Variable Schedules [By Marcella Williams. or opportunities to return to school. T: Try to maintain a consistent routine. AOCN ®. MS.
One state in particular was an issue.” We w i l l m i s s h e a ring about her Bridget Culhane. We will miss the sparkle in her eyes. this is no small feat for a lifelong “Pittsburgher. contact any member of the ONS Nominating Committee (see www. APN. Maybe a new Cherry Ames book is in the making: Cherry Ames (a. Information on qualifications and job descriptions can be found in the 2008 Candidate Guide. Bridget’s influence can be seen on so many key ONS initiatives like ONStat. the Legislative Action Center. July 16. and sense of humor will be missed. Benson. ONS Board of Directors] A s I end my three-year term as the ONS secretary. MS.shtml for contact information). . MS. MN. You have a leader in you! ✱ JUNE 2007 ONS CONNECT 25 . . the laughter in her voice. former ONS executive director. Recognize your leadership qualities and consider running for office today. not only to the ONS Board but also to the Steering Council and all of the ONS staff and members. their families. This “nurse’s nurse” was lovingly called “Cherry” by some after Cherry Ames.org/membership/election or by calling ONS Customer Service toll free at 866-257-4ONS (412-859-6100). perspective. We are thankful for all that Bridget has done for ONS and nursing.a. we expect to hear all about it. MN. RN. Former Secretary. and Bridget said. As Bridget sets off on her new adventure. leader. Bridget has given so much to the Society and oncology nursing that whatever is written here will barely scratch the surface of her accomplishments. RN. Bridget decided to relocate from Pennsylvania to Oklahoma. beginning a new and exciting chapter in her life. For more information. The person who is often called on to bring that perspective to our Board of Directors’ meetings is Bridget Culhane. Her insight. and grateful that technology makes it so easy to keep in touch. and the wisdom of her words. One example of her humor that comes to mind was when we were discussing states that were attempting to limit nurses’ scope of practice. among others. she credits the books with helping her become a nurse in the first place). CAE cat’s latest hijinx. We will miss inspecting her latest jewelry find.” I once made the blunder of making a negative comment about Pittsburgh winter weather—and quickly found myself making it up to Bridget the next day by wearing a Pittsburgh T-shirt that I bought that night at an airport gift shop. and your colleagues at your institution. Cherry .ons. RN. Putting Evidence Into Practice cards. the ONS Health Policy Agenda. oncology nurses can serve and influence a broader audience as well as gain new experiences and perspectives on multiple issues. including your patients. ONS leadership changes yearly. which is available at www. “We should have let them secede from the nation when they wanted to. of book fame (Bridget owns the series. “Cherry”—You Will Be Missed [By Laura M. and the Environmental Scans. But have you thought about extending your contribution by serving in an ONS office? By doing so. quietly and wryly. happy as she writes a new chapter in her book of life. we may need you! ✱ NOMINATINGCOMMITTEE Apply for the 2008 Candidate Slate by July 16 C ontributing to oncology nursing daily in your practice is rewarding and recognized by many.SAYINGGOODBYE Say It Ain’t So. bringing fresh perspectives and new points of view.org/membership/election/nom . which kept us all laughing. originally published by Grossett and Dunlap from 1943–1968. Bridget Culhane)—Prairie Nurse. ONS staff provides a balance and brings a sense of history and a wealth of past experiences to the table. After 17 years of working at ONS. MS. Make no mistake. Four ONS leadership positions are open for election in 2008: director-at-large (2) and Nominating Committee member (2).k. Don’t forget to leave a forwarding e-mail address. AOCN ®. Bridget has been a resource. wisdom. Candidates must meet the qualifications for the office and submit an application packet to the ONS National Office by 5 pm EDT on Monday. I am cognizant of the ebb and flow of the Society’s activities. CAE. and historian.ons.
walking in the woods with my husband. who’s 10. What I like best about oncology nursing: Making a difference for patients. The authors encourage individuals to first understand the desired outcome they wish to achieve as a result of the conversation. • Employees who respectfully and rapidly communicate issues get problems solved quickly and have better results. MSN. you can increase your leadership effectiveness. MI Hometown: Michigan Family: I’ve been married 29 years to the best guy in the world. deal with them badly. and increase your individual influence personally and professionally. ONS Board of Directors Nurse Practitioner. and that each day and each patient are unique What I like least about oncology nursing: That we don’t have curative treatment for more cancers For fun. fishing. • The difference between good organizations and great organizations is how employees communicate to solve problems. By engaging in crucial conversations. • When faced with crucial conversations. hiking. it would be: Cleaning bathrooms ✱ 26 ONS CONNECT JUNE 2007 .NOTICENURSINGNOW Having Difficult Conversations Is Crucial [By Karen Hochberg.000 employees on how to plan and conduct difficult conversations. MSA. build greater teams. and doing home remodeling together If there is one task that I could avoid. ONS Director of Marketing and Public Relations] W e all have faced times when we need to deliver bad news. The research revealed the following about workplace conversations. and Tim. RN. • People’s ability to confront emotionally and politically risky topics (crucial conversations) with each other is the number-one predictor of rapid problem solving. We have two great children: Melissa. I enjoy: Music. AOCN® Director-at-Large. or deal with them well. Medical Oncology University of Michigan Comprehensive Cancer Center Ann Arbor. who’s 22. we have only three options— avoid them. What is the best way to end a relationship? Or ask a friend to repay a loan? Or talk to a team member who isn’t keeping commitments? Crucial Conversations: Tools for Talking When Stakes Are High offers insight from research repeated in two dozen industries involving more than 20. APRN-BC. ✱ MEETTHEBOARD Peg Esper. Clearly STATE the path by S: Sharing your facts T: Telling your story A: Asking for others’ paths and outcomes T: Talking tentatively E: Encouraging testing of various outcomes and language.
thus The ONS Foundation is here to serve not accurately reflecting revenue in sub. The entire amount of revenue that Paula T. important to a charity’s future sustain. Information and Research (CLIR). NV. FAAN was raised initially is recognized in the first year of the campaign. scholarships. That funding effort generated substantial support over many years for specific programs to advance oncology nursing. and educational programs. and fund-raising expenses. and to build the principal over time. grants. When a charity is successful in a one-. The mission of the ONS Foundation is to improve cancer care and the lives of people with cancer by funding oncology nursing research. it can more efficient in providing funding for only become what we make it. Charities such as the ONS Foundation have come under increased scrutiny since the events of September 11. administrative expenses. 2001. as well as the foundation for awards. Several systems of rating charities now exist and are accessible to the public online or through government agencies. Some issues that are often considered include organizational efficiency. although the expenses for the originally intended programming continue to exist. Simply put. Again. research. RN. awards. Those important programs empower oncology nurses to bring positive change to the care their patients receive. MSN. or three-year special campaign—like CLIR—the systems that rate charities do not always reflect the true status of the charity. Many of the programs are still in existence today or have been completed recently. program expenses. AOCN ®. MSN. ✱ JUNE 2007 ONS CONNECT 27 . two-. the ONS Foundation conducted another major funding effort in the late 1990s. capacity. The campaign will significantly shape the future of cancer nursing and is one that I hope you will generously support.The ONS Foundation strives to keep adability. The rating systems are helpful for prospective donors who can evaluate charities and make informed decisions as to whether to support a charity financially. sequent years of the campaign. a major endowment campaign to build additional resources for our profession in the areas of education. leading to the creation of the Center for Leadership. The income or return from an ONS Foundation to serve oncology nurses endowment allows a charity to become for many years to come. Sometimes charities experience unique circumstances related to their annual fund-raising support—and the programs that are underwritten by that support— that may impact how the charity is rated.ment in ONS Foundation’s Silver Anniverdress other operational needs through sary Campaign is truly an investment in its annual fund-raising. An investprograms while also being able to ad. RN. to name a few. awards. This scholarships. the ONS Foundation kicked off its Silver Anniversary Campaign. our profession and in our future.WORKINGFORYOU Understand the System for Evaluating the Efficiency of Charities [By Paula T. and leadership. This endowment its programmatic needs well into the can greatly increase the capacity of the future. and educational Raising funds for an endowment is programs that further our profession. its members. I encourage you to unique feature of endowments is an consider generously supporting the Silver important tool for a charity to address Anniversary Campaign. For example. by funding research. scholarships. We are fortunate to have the ONS Foundation as the charitable entity of our organization. Revenue raised through fund-raising is available but not necessarily raised in each year of the campaign. AOCN ®. An endowment is like a savings ministrative costs as low as possible so account in that the interest earned on that the maximum funds are available to the principal of the endowment is used support oncology nurses who apply to for programs and expenses. ONS Chief Executive Officer] D uring the 2007 ONS Congress in Las Vegas.you. FAAN. Rieger. Rieger.
For more information: Visit http://onsopcontent. e-mail customer. Pittsburgh. creative ways to respond to these challenges. and strengthen their ability to transform changes in cancer care.service@ons. For more information: Visit the CE Central area of www. treatment.org. For more information: Visit the CE Central area of www. Safe Handling of Hazardous Drugs Online Course Dates: August 7–28 and November 13–December 4 Location: Web-based event Description: A self-paced. or call ONS. Application deadline: July 9 ONS Advanced Practice Nursing (APN) Conference Date: November 8–10 Location: Chicago. expand their knowledge base.org JUNE 2007 . e-mail customer. e-mail email@example.com. and other ONS events? Visit the ONS Web site’s easy-to-use online Oncology Calendar located at https://onsopcontent. ONS Eighth Annual Institutes of Learning (IOL) Date: November 9–11 Location: Chicago.firstname.lastname@example.org. and San Francisco. WA.shtml. or call ONS.ons. and ever-changing advances in treatment incur more and more demands on your time. The nursing shortage. awards. ONS Site-Specific Cancer Series: Lung Cancer Online Course Date: September 20–October 11 Location: Web-based event Description: Provides the cutting-edge information you need to truly understand the many complexities of lung cancer di28 ONS CONNECT agnosis. You’ll enhance your leadership skills so that you can help ensure that oncology nurses remain a driving force in cancer care.org. A re you looking for more continuing nursing education programming dates and deadlines related to certification. You’ll learn how you can step up and bring about crucial changes that will improve not only cancer care but also the specialty of oncology nursing. 2007 ONS Leadership Development Institute Date: October 18–21 Location: Peachtree City. GA Description: As a nurse today. The ONS Leadership Development Institute (LDI) will teach you innovative. IOL will provide you with detailed comprehensive information on the topics affecting your patients and nursing practice. faculty-led course providing quality instruction on the latest safe-handling practices For more information: Visit http://email@example.com. IL Description: Regardless of your practice setting or area of expertise. lack of access to care. IL Description: APNs will have the opportunity to network with colleagues as they identify the issues and trends faced in practice. PA 15275-1214 Phone: 888-257-4ONS (toll free) or 412-859-6100 Fax: 877-369-5497 (toll free) or 412-859-6165 E-mail: customer.org.ons.org/Edu cation/DistanceEducation/Lung Cancer/index.ons.ons. scholarships. You need to know how to face these challenges head on and overcome them. or call ONS. LDI will teach you how to take an active role as a leader in your job Contact ONS 125 Enterprise Drive. and symptom management. CA Description: Explores improved patient outcomes through standardized risk assessment and standing orders for managing chemotherapy-induced neutropenia For more information: Visit the CE Central area of www.org/ Meetings/safehandling/index .org.org//Interactive/EventCalendar. you face many challenges.CALENDAROFEVENTS Mark Your Calendar for These Upcoming Oncology Nursing Events and Deadlines and in your field. this is a faculty-led course. grants.org.org • Web site: www. Best Practices for the Assessment and Management of Neutropenia (FREE) Dates: July 11 and July 19 Location: Lacey. Supported by the ONS Foundation through a grant from GlaxoSmithKline.
JUNE 2007 ONS CONNECT 29 . To see more conference photos.000 oncology nurses gathered to expand their knowledge and connect with colleagues from across the United States and around the world.CONGRESSSCRAPBOOK Attendees Hit the Jackpot at 2007 ONS Congress Everyone was a winner at the ONS 32nd Annual Congress.org. visit the Congress Scrapbook at http://congress.ons.vc. where more than 6.
The nurse practitioner (NP) will work collaboratively with hematology and medical oncology physicians and house and hospital staff. MA. MA 01805 or fax to 781-744-8920. 016876) At Lahey Clinic Medical Center. an oncology certified nurse or advanced oncology certified nurse is highly preferred. EOE Associate Director. Working at FCS provides the rewards of working with patients one on one. You will identify and develop strategies to meet the educational needs of patients and staff. we are seeking oncology nurse clinicians. visit www. It has recently been named one of the Top 100 Integrated Healthcare Networks in the country for the sixth consecutive year. Join our team of CRNPs who provide high-quality care to our patients in the inpatient and outpatient oncology-hematology setting. and relocation assistance. Myrtle Beach. EOE Clinical Nurse Specialist—Oncology Overlake Hospital Medical Center. or depending on position. has the following opportunity at its physician practices 30 ONS CONNECT JUNE 2007 . OCN ® certification is preferred. however. Depending on the position. The D’Amour Center for Cancer Care represents a personalized. Qualified applicants also may contact Jennifer Garrepy at 425688-5982 or jennifer. and excellent medical oncology physicians in private practice. Oncology Nurse Practitioners A state-of-the-art community-based oncology practice is seeking multiple oncology nurse practitioners. providing comprehensive care throughout the country.karmanos.lahey . please apply online at www. our exciting recent expansions—including the Bernard and Sophia Gordon Cancer Center and our rapidly expanding service team—have created wonderful opportunities for you to join our oncology/hematology department and discover how your career can grow along with us. Overlake is committed to providing a nurturing patient experience. and postanesthesia care unit (PACU) positions.garrepy@overlakehospital .org. Along with excellent clinical care. a great compensation and benefits package. infusion suite. assisting in the allocation of workload and protocol responsibilities. paid time off and holidays. preferably in an acute care setting. You also may e-mail your resume to mleslie@wpaon. will be required within 18 months of employment.000 new cancer cases per year. Participate in the evaluation and management of hematology/oncology inpatients. an affiliate of US Oncology. the nation’s largest network of oncology physicians. Clinical Trials Office As one of the nation’s top cancer centers. patients. We have multiple locations and have been in existence since 1982. Referencing a job requisition number. Interested professionals should contact Mike Neuendorf at 800-767-6612 or e-mail mike . Lahey Clinic Medical Center is a 317-bed hospital and outpatient academic medical center offering a truly collaborative multidisciplinary approach to care.overlakehospital. Candidates must have Massachusetts NP license and three years of experience as an NP in oncology. We also offer benefits such as employee paid health and life insurances. the Barbara Ann Karmanos Cancer Institute is known for innovative cancer therapies and groundbreaking clinical research. Duties and responsibilities include overseeing clinical research projects.CAREERCENTER Make a Move to Southwest Florida’s Gulf Coast Join Florida Cancer Specialists (FCS) as an oncology RN or ARNP in one of its clinics from Bradenton to Naples (www. including in practice RN. It includes a designated inpatient unit. please contact Marjie Leslie. Burlington. and Massachusetts RN licensure required. For further information or to apply for this opportunity. 401(k) plan. guiding faculty and staff toward an optimal knowledge base of requirements specific to clinical research projects. radiation oncology department. and patients’ families.org.500 employees.org. Or mail resume to Lahey Clinic. PA. Overlake Hospital continues to grow and serve its community. SC. managing a clinical research staff of about 50 full-time employees. Lahey Clinic will consider developing a competent adult NP who is not specialized in oncology. Coastal Cancer Center. as well as a menu of voluntary insurance plans. Advanced Practice Nurse Practitioner— Hematology/Oncology 32 hours per week (job requisition #016877) and 40 hours per week (job requisition #016864. a generous sick/vacation time accrual bank. we provide a competitive salary and benefit structure.com). • $5. including health insurance. and dictation of discharge summaries and transfer orders. cancer resource center. clinicians. three breast screening centers. case conferences. You also will assist in care management and program development for patients with lung cancer. 8121 Rourk Street. This position is eligible for all benefits. including daily rounds. Located in the Boston suburb of Burlington.and part-time positions are available. one of only a few in the country. and evaluate products and patient care delivery to determine quality and cost effectiveness. writing of progress notes. To learn more about Overlake and to complete an online application. developing and maintaining quality assurance measures. The center is equipped with state-ofthe-art computed tomography simulation.org. thoracic surgeons. medication. The Cancer Center has been accredited by the American College of Surgeons since 1971. We are located on the beautiful eastern coast in Myrtle Beach. three-part retirement program. Human Resources. in conjunction with the multidisciplinary lung cancer team. and experience in quality assurance and quality control aspects in cancer clinical research. We are looking for an oncology clinical nurse specialist to work 24 hours per week. Please apply by visiting our Web site at www . We are currently seeking a dedicated associate director for the Clinical Trials Office to assume the responsibility for coordinating and overseeing the day-to-day operations of the Clinical Trials Office. a minimum of two to three years of medical/surgical experience is required. develop and participate in community programs. Requirements: BSN or RN who is actively enrolled in BSN program and scheduled for completion within two years of hire. dedicated breast surgeons and radiologists.000 sign-on or retention bonus for RNs • Relocation assistance possible Resumes or CVs may be faxed to 239-278-3273 or e-mailed to resumes@flcancer. and integrated approach to cancer treatment. admission history. acting as a valuable resource and consultant to nursing and medical staff.flcancer. Prior experience in oncology and/ or hematology is preferred but not required. coordinated. Only applications with a job requisition number will be considered. As we continue to grow. and care orders. not-for-profit regional medical center with a cutting-edge oncology program.org. 31 Mall Road. Nurse Supervisor and Nurse Manager Arizona Oncology.com. Intensive care unit or PACU experience is preferred for some positions.com. fax current CV or resume to 843-429-5053. linear accelerators. We offer pleasant working conditions and a great benefit package. The Cancer Center sees almost 1. at 412204-8115. and exceptional opportunities for personal recognition and professional growth. and participating in the development of general goals of the Clinical Trials Office in support of the mission and vision of the Karmanos Cancer Institute. No weekends or holidays are required. Full. We are a 337-licensedbed.neuendorf@bhs. CRNP. and a Primatom™. SC 29572. and/or call 843-692-5000 for information. and oncology experience is strongly preferred. Qualifications include bachelor’s degree with certification in clinical trials. EEO/M/F Oncology Nurse Clinicians Baystate Health is one of New England’s largest healthcare systems with more than 9. nurses. As part of the West Penn Allegheny Health System. E-mail current CV or resume to hrccc@coastal cancercenter. Through a partnership with Siemens. Certified Registered Nurse Practitioner Full-time certified registered nurse practitioner (CRNP) opportunities are currently available with West Penn Allegheny Oncology Network in Pittsburgh. We provide payment for you to receive OCN® RN certification and pay your ONS local and national dues. chemotherapy. Bellevue (Seattle suburb). five years of progressively responsible work experience in the conduct and management of a clinical trials office. the cancer center is a national show site.org/careers. and administrators. WA With a new $125 million medical tower opening in early 2008. and physical examinations.
401(k) plan. the potential exists for additional Cancer Center department and staff responsibilities. the 2007 program highlights advanced cancer pain management techniques. Suite 112. Reporting to our clinical director. medical. assessment. proven skills in working collaboratively with physicians and all levels of staff. RNs with oncology certification are preferred.mskcc. RNs and Advanced Practice RNs Enhanced Care Initiatives is growing again and introducing another comprehensive program to the market. Attend this 21st annual conference and benefit from the experience and advice of nationally recognized experts addressing the latest discoveries in oncology and cancer care.contemporaryforums. EOE.desimini@HCAhealthcare. Manager/Director of Oncology Nursing A manager/director of oncology nursing is sought to join the Cancer Center at Henrico Doctors’ Hospital in Richmond. telephone triage.. Opportunity exists for full-time. Responsibilities include inpatient leadership. The position requires an Arizona license and prior medical oncology experience in a supervisory role. Join us today. contact Sharon Hampton at Anthony J.com. MSN. and symptom management for selected malignancies. but we will train the right individuals. NJ 08071 Phone: 856-256-2300. part-time. For consideration. office practice nurses provide comprehensive professional nursing care to a defined patient population. We will treat you as the true professional that you are and provide training and education that will enhance your skills and offer opportunities for unlimited advancement. BSN. and life insurance • 401(k) and profit-sharing plan • Flexible spending account • Paid lunch break • Very generous paid time off program • Work schedule Monday–Friday with no weekends or holidays. If interested. Both areas require a New York or New Jersey RN license and a minimum of one to two years of current related clinical experience. Candidates must have recent relevant clinical experience and be willing to work as part of a multifunctional team. please send your resume to Human Resources. Nurse Supervisor—Community-Based Medical Oncology North Shore Oncology. including a comprehensive benefit package. APRN. Memorial Sloan-Kettering Cancer Center Ambulatory Care Nurses Practice nursing in an environment that supports your professional growth and development. Chemotherapy certification is preferred for chemotherapy positions—or we will educate. AZ 85712 or fax to 520-324-2777. 2007. VA. The right candidate will supervise multiple offices in the practice as part of an integrated management team. palliative care and hospice nurses. Targeted for oncology nurses. including comprehensive health insurance. and demonstrated interpersonal and leadership ability. Qualifications include Illinois RN license. with multiple offices in northern Lake County. and the CNS will be supported in his or her efforts to implement those components as well as his or her own identified areas of interest. If you are an RN or APRN who works with patients with cancer today or wishes to be part of an innovative team of oncology professionals. FL. Long Island. North Shore Oncology. For details. VA. and make your career all that you dreamed it would be when you first became a nurse! Requirements: Current New York State–licensed RNs or APRNs with three to five years of experience in oncology are preferred. New and expanded programs have created additional positions in New York City. Treatment suite nurses: Work collaboratively with designated physicians and in partnership with office practice nurses to provide patient education. Oncology Care will join Easy Care and NP Care in New York City. Westchester.com). but additional oncology subspecialties expertise is a plus because the position will continue to grow in accordance with the CNS’s interests and talents and the needs of the Cancer Center. Oncology Clinical Nurse Specialist An oncology clinical nurse specialist (CNS) is needed to join an enthusiastic and passionate group of advanced practice nurses at Henrico Doctors’ Hospital Cancer Center in Richmond. They can also visit our Web site at www. Pitman. care coordination. or job sharing. If you are interested in the position and would like some more information. Qualified candidates should mail their resumes and salary requirements to K. We offer modified work schedules and an excellent compensation package. and MSN is preferred but not required. EOE/AA Oncology Conference Oncology: Clinical Issues and Trends will be held September 26–29. profit sharing. East Holly Ave. Suite 221. The current need is for someone with a thoracic oncology interest. investigational and newly approved oncology drugs. dental. Craycroft. three to five years of progressive clinical oncology nursing experience with OCN ® certification preferred. Candidates can send their resumes to bfolb@ enhancecare. 1800 Hollister Dr. and New Jersey in the following practice areas. and educators. Libertyville. We are looking for several RNs and advanced practice RNs (APRNs) to join our distinguished team of professionals as part of our Oncology Care program. IL 60048 (email to hr@nsonc. new and emerging treatment modalities. Jannetti. 2625 N. please apply online at www. The position has a routine schedule Monday–Friday with occasional evening or weekend meetings and no holidays. Box 56. The ideal candidate must possess a passion and enthusiasm for oncology nursing.desi mini@HCAhealthcare. contact Contemporary Forums at 800-377-7707 or visit us online at www . and professional development of staff in order to achieve OCN® certification and high employee satisfaction. Bilingual English and Spanish is a plus. Fax: 856-589-7463 JUNE 2007 ONS CONNECT 31 .. please contact Esther Muscari Desimini at 804-285-5174 or email esther. in Orlando. At least three years of oncology experience are required. including • Excellent compensation • Signing bonus • Relocation assistance • Tuition reimbursement • Health.com. management and administrative skills are a plus. please contact Cancer Center Administrator Esther Muscari Desimini. as well as assisting with patient care.com. you will have an opportunity to practice nursing that truly touches peoples’ lives and allows you to spend quality time with your patients. We offer an outstanding benefit package. navigation. Mayer. IL.in Tucson: nurse supervisor and nurse manager.org. For consideration. We offer a competitive salary and excellent benefit package. Each role competency of the CNS is highly valued. previous supervisory experience. BC. We will reward you with a generous compensation program. collaboration with oncology managers and clinical leaders. Depending on experiences and qualifications. Treatment unit nurses administer standard chemotherapy regimens as well as cutting-edge treatment to patients on clinical trials. Program development. at esther. Office practice nurses: In collaboration with designated attending physicians specializing in a specific disease. clinical and case managers. Inc. and multidisciplinary collaborative care across the continuum characterize the position. office practice. and symptom management to a defined patient population. and electronic communication.com or 804-285-5174. To place a classiﬁed ad. In this role. including tuition reimbursement. RN. IL. and tuition reimbursement. you owe it to yourself to learn more about what Enhanced Care Initiatives has to offer. supervision and development of all nursing staff in conjunction with the program-based clinical nurse specialist. Become a valued member of a multifunctional team. Memorial Sloan-Kettering Cancer Center ambulatory care nurses are an integral part of a unique practice model that contributes to our reputation for excellence in patient care. This leader will supervise two oncology inpatient units—surgical (18 private beds) and medical (10 private beds). A significant component of the role is care coordination across the continuum through office visits.com. incorporation of national practice standards. is looking for an experienced nurse supervisor for our Libertyville. BSN degree and OCN® certification are preferred. Tucson. this supervisory position will be responsible for the daily leadership and management of the clinical operations of a busy medical oncology practice site.enhancecare.
This action might not be possible to undo. Are you sure you want to continue?
We've moved you to where you read on your other device.
Get the full title to continue reading from where you left off, or restart the preview.