“There have been many changes since the ’70s that have shaped the nurse’s role in administering chemo, and in supporting patients. The major change early on was the transition from that of nurses mixing chemo to that of pharmacists. Regulatory agencies like NIOSH and OSHA defined chemotherapy as hazardous drugs, and professional organizations became involved, leading to the publication of the joint ASCO and ONS Standards of Safe Handling,” ONS member Scarlott Mueller, MPH, RN, FAAN, secretary of the American Cancer Society Cancer Action Network Board and member of the Oncology Nursing Foundation Capital Campaign Cabinet, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, ONS member and chair of the ONS 50th Anniversary Committee during a conversation about the evolution of chemotherapy treatment. Along with Mueller, Burbage spoke with John Hillson, DNP, NP, Mary Anderson, BSN, RN, OCN®, and Kathleen Shannon-Dorcy, PhD, RN, FAAN, about the changes in radiation, oral chemotherapy, and cellular therapy treatments they have witnessed during their careers.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Episode Notes 

• This episode is not eligible for NCPD.
• ONS Podcast™ episodes:
  • 50th anniversary series
  • Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs
  • Episode 59: Blood and Marrow Transplant Nursing
  • Episode 16: Navigating the Challenges of Oral Chemotherapy
• ONS Voice article:Safe Handling—We’ve Come a Long Way, Baby!
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Hematopoietic Stem Cell Transplantation: A Manual for Nursing Practice (third edition)
  • Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
  • Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses:
  • ONS Hematopoietic Stem Cell Transplantation™
  • ONS/ONCC® Chemotherapy Immunotherapy Certificate™
  • ONS/ONCC® Radiation Therapy Certificate™
  • Safe Handling Basics
• Oral Anticancer Medication Toolkit
• Oral Anticancer Medication Care Compass
• Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers:
  • IV Cancer Treatment Education Sheets
  • Oral Chemotherapy Education Sheets
• Connie Henke Yarbro Oncology Nursing History Center

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 This Episode

Hillson: “I remember as a new grad, from back in ’98, walking up to the oncology floor. We had patients with pink labels on the chart and that was the radiation oncology service. I hadn’t heard of such a thing before. … I’d gone through nursing school and hospital orientation and unit orientation without ever hearing of these therapies. At the time, both the management and the union had no interest in specialist nurses, and the really weren’t any books that were targeting the role. And it was very isolating and frightening. I was very glad to find ONS when I moved to the U.S. Right now, the Oncology Nursing Society Manual for Radiation Oncology, Nursing Practice, and Education, it’s in its fifth edition and a sixth is underway. There’s nothing else like it. Most books are very much geared towards other professions.” TS 5:34

Mueller: “We mixed our chemo in a very small medication room on the unit, under a horizontal laminar flow hood, which we later discovered should have been a vertical laminar flow hood. Initially, we did not use any personal protective equipment. I remember mixing drugs like bleomycin and getting a little spray that from the vial onto my face. And to this day, I still have a few facial blemishes from that.” TS 14:28

Anderson: “As the increasing number of these actionable mutations continue to grow, so will the number of oral anticancer medications that patients are going to be taking. And we are already seeing that there's multiple combination regimens and complex schedules that the patients have to take. So this role the oral oncolytic nurse and the nursing role, like you said, it cannot be owned by one individual or discipline. So it’s not a pharmacist; the pharmacies aren’t owning this. The nurses are not owning this. It takes a village.” TS 32:12

Shannon-Dorcy: Then as immunotherapy comes into the picture, we start to learn about [cytokine release syndrome]. All of a sudden, we had no concept that this was a deadly consequence. ONS was on the front lines, convening people across the country together so we could speak to the investigative work with science and find ways that we could intervene, how we can look for signs of it early on with handwriting testing.” TS 39:58