"We are there for whatever issue, whether it's skin management or helping just cheer them on and manage small things or big things, you know, to get them through these treatments. And then as a patient completes the treatment, we continue the nurse education and [managing] the late toxicities," Michele "Michi" Gray, RN, radiation oncology care coordinator at the Cleveland Clinic in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what you should know about nursing's important role in radiation oncology.

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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: Learners will report an increase knowledge of the radiation oncology nurse role.

Episode Notes

• The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast episodes. Find a full list of opportunities.

• Oncology Nursing Podcast:

• • Episode 272: Oncologic Emergencies 101: Radiation Therapy for Emergent and Urgent Interventions

  • Episode 104: How Radiation Affects All Areas of Oncology Nursing

• ONS Voice article: The Intersection of Radiation and Medical Oncology Nursing

• ONS course: ONS/ONCC Radiation Therapy Certificate Course

• ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)

• ONS Huddle Card: Radiation

• ONS Congress® Radiation Track

• American Society for Radiation Oncology

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 [email protected].

Highlights From Today's Episode

"There's many different forms of therapeutic radiation. External beam radiation is probably the most common type of radiation therapy used in cancer treatments. Using x-rays and gamma rays are types of external beam, and that is the most common and what everybody thinks of when we talk about radiation therapy. Also, particles would be another type. Particles would be electrons and protons. Then there's brachytherapy. That's internal radiation, which is a technique that is sealed radioactive sources placed directly into or adjacent to the tumor." TS 3:13

"First step [in the treatment coordination process] is that consult—getting the patients in the door. Quite honestly, this consult can be a long day for the patients. They may just have a consult with the radiation oncologist. [But if they're coming from a distance,] they might seeing a multidisciplinary clinic, so they are seeing all the physicians all in one day: the medical oncologist, the radiation oncologist, a surgeon." TS 6:31

"We have a clinic team that oversees a lot of the clinical nursing side of things with rooming and then anesthesia recovery and things like that. And then we have the nursing working with the physicians and care coordination. We kind of have two different nursing roles within the Cleveland Clinic. So, education from both sides, you know, doing education, providing care for the patients and the patients' families." TS 16:28

"This is one of the many phone calls that we get, I should say, almost daily. We get several phone calls from patients who say, 'I've looked at my chart, I don't see my radiation treatment. Why are they no longer there? I don't see them. What's going on?' And it is because your radiation treatments ... do not interface with [the electronic health record]. You will be given a handout when you come because there is an issue with the system we use. We use a different system for the computerized radiation treatment, and then we use a different system for our computer charting. And they do not interface, they do not like each other. So, all of their radiation treatments do not show up in their [electronic health record]. They do not show up in their computer system." TS 19:09

"Within the first two weeks, at least at the Cleveland Clinic, our plan is to give those patients a call back, see how they're doing, how they're doing with their side effects. Have they got scheduled for their follow-up? Do a check-in. Some of our patients have tox visits at six weeks with their nurse care coordinators, and that's just to check and see if they're having any lingering side effects, as well. And then we continue to get calls." TS 26:31

"Listening to tumor board if you have the patience, so you know what patients that are going to be coming down the pike, because you've heard all the physicians discussing these cases. So, you know the plan because you've heard the surgeon, the radiation oncologist, the medical oncologist discuss the case. So, you know kind of what the plan is, then you can kind of get an idea, 'Hey, I this one might be coming to me soon, and maybe I should be watching out for this patient or discussing this with my physician if I haven't seen it.'" TS 34:46

"In reality, it can be those days afterward, after they finish, that actually can be the worst. Letting the patients know that and that we're still only a phone call away and, you know, we're there for them. So, you know, continuing to educate also on when to call us—when to call, when to show up in clinic. We're there. We will get them an appointment. We will get them hydrated. We will do whatever they need." TS 39:16

"Radiation therapy is not only used to treat cancers and malignant conditions. It is also used to treat quite a few benign conditions: arthritic knees, V-tach [ventricular tachycardia] in cardiac patients, Dupuytren's contractures—if you've watched the commercials that they're showing all over now—so, the Dupuytren's contractures of the hands and even plantar warts. So we use a lot of radiation therapy to treat these benign conditions, so it's not just malignant cancers." TS 42:42