"Nurses are the front line. Oncology nurses see their patients almost all day. If you're noticing that anxiety is causing significant distress or anxiety is disrupting a patient's ability to concentrate during medical conversations or decision-making—anytime you're seeing significant distress or disruption to functioning, that's a pretty good indicator that referral to a psychiatric nurse and psychiatric care could be very helpful for that patient," Amber Altidor, DNP, APRN-FPA, PMHNP-BC, assistant professor at Rush University College of Nursing and psychiatric nurse practitioner at Optimal Mental Health PLLC and Rush MD Anderson Cancer Center in Chicago, IL, told Katie Hubbard, MSN, RN, OCN®, NPD-BC, oncology clinical specialist at ONS, during a conversation about oncology and psychiatric nurse collaboration to support psychosocial health.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD), by listening to the full recording and completing an evaluation at courses.ons.org by September 25, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge of how oncology nurses can collaborate with psychiatric nurses to support the psychosocial health of people with cancer.

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 426: Tools to Support Patients and Nurses Through Medical Trauma in Oncology
  • Episode 421: Medical Trauma in Oncology
  • Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care
  • Episode 240: Spirituality in Cancer Care
  • Episode 219: Use Acupuncture and Acupressure to Manage Cancer Symptoms and Side Effects
• ONS Voice articles:
  • Anxiety and Depression Are Biggest Concerns for Patients With Cancer, Survivors, Caregivers
  • AYA Cancer Survivors Experience Five Times Higher Depression Rates Than Individuals Diagnosed at Older Ages
  • Guidelines Define the Role of Integrative Oncology Care for Managing Anxiety and Depression in Adults With Cancer
  • Natural Language Processing Can Tell You Which Patients May Benefit From Psychosocial Referrals
  • Physical Activity, Psychological Care Reduce Cancer-Related Fatigue
  • What Assessment Tools Are Used for Patients With Cancer and Psychiatric Diagnoses?
• ONS course: Psychosocial Dimensions of Cancer Care™
• Clinical Journal of Oncology Nursing articles:
  • Psychosocial Barriers to Care: Recognizing and Responding Through a Trauma-Informed Care Approach
  • Psychosocial Distress Screening: An Educational Program's Impact on Participants' Goals for Screening Implementation in Routine Cancer Care
• Oncology Nursing Forum articles:
  • Effects of Expressive Writing on Psychosocial Symptoms and Quality of Life in Patients With Breast Cancer: A Systematic Review and Meta-Analysis
  • Relations of Mindfulness and Illness Acceptance With Psychosocial Functioning in Patients With Metastatic Breast Cancer and Caregivers
  • The Distress Thermometer: Cutoff Points and Clinical Use
• ONS Symptom Management Resources:
  • Anxiety
  • Depression
  • Fatigue
• ONS Coping Huddle Card
• American Cancer Society: Therapy, Counseling, and Support Resources for People With Cancer
• American Psychological Association: Patient Health Questionnaire-9 (PHQ-9)
• American Psychosocial Oncology Society:
  • Distress Screening
  • Resources for Psychosocial Oncology Professionals
• Columbia-Suicide Severity Rating Scale (C-SSRS)
• Generalized Anxiety Disorder 7-Item (GAD-7) Scale
• National Comprehensive Cancer Network

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].

"Cancer is traumatic. It's sudden. And many patients have not previously had a serious health condition, so in the beginning, they're just kind of focused on survival. Get the biopsy done. Have the conversations with teams. Have the imaging that's recommended. Many, many appointments. The medical appointment burden is very high. Sometimes patients are not processing what's happening in the moment. Sometimes we also see some lingering symptoms of trauma as care goes on as well. Sometimes patients are having intrusive thoughts and flashbacks to their cancer experience too." TS 4:55

"The National Comprehensive Cancer Network, or NCCN as we commonly refer to it, created a distress thermometer that can be provided to patients each during each encounter at a cancer center. It has an actual written thermometer on it where patients can rate their distress from 0–10: 0 being none, 10 being the most extreme that they could imagine. A score of 4 or higher for most cancer centers would indicate that the patient needs further evaluation and referral to psychosocial or supportive care services. There's also a section on the distress thermometer handout where patients can identify specific areas for concern. And that's really helpful for the healthcare team because we can take a look at exactly what that patient is noting as contributing to their distress." TS 9:33

"When we start to notice that there are significant sleep issues that are not responding to just psychotherapy on its own, or if there is significant depression, anxiety symptoms that are moderate to severe, or other underlying psychiatric concerns that are more chronic in nature ... at that point, it's important for the multidisciplinary team to start thinking about a referral to psychiatry and medication management. Medications can be very effective for treating those symptoms, so it's important for nurses to assess using the skills that we discussed to identify those categories for severity and think about medication management at that point." TS 16:01

"I think that it's important to remember that there's a stigma about cancer, but there's also a stigma about accessing mental health care as well. As nurses, we definitely want to be aware of that and address that with patients. Do you have any specific concerns about what it means to be someone who is seeking therapy services or someone who's seeking medication for symptom management? What does that mean to you, to your community, to others in your religion? Talk with me about this stigma that you're experiencing. Patients need a chance to process that. Oncology nurses certainly can identify if a patient has some ambivalence towards seeking psychosocial care and explore that with them or refer them to a therapist or a psychologist." TS 23:09

"Grief is not linear, so it's important to educate patients after you tell them about the stages that we talked about earlier. Remind them that grief is not linear. It's very common to at one time feel like you're angry, and then also feel sad, then also go back to a sense of, 'This is not real. This is not happening.' So remind your patients that it's not linear. This is something that we can continue to talk about, continue to process, so that they can feel a sense of acceptance. We don't want grief to become complicated and just kind of persist long term. We talked about how there's that survival mode that patients are in, so they don't always have a chance to process in the moment." TS 30:14

"Unlike our cancer indications where we use these medications often to activate the immune system to target cancerous cells, in noncancer indications, the goal is really to either suppress an overactive immune or inflammatory cells or modulate the immune system. Immune modulation by use of chemotherapy and immunotherapy can help reduce abnormal inflammation, decrease autoantibody production, and also can alter T-cell and B-cell activity," ONS member Kelsey Miller, MSN, RN, AGCNS-BC, OCN®, clinical nurse specialist in oncology and infusion therapy at Reading Hospital in West Reading, PA, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about chemotherapy and immunotherapy for noncancer indications.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 18, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the use of anticancer therapies for noncancer indications.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Pharmacology 101 series
• Episode 152: Administer Rituximab Immunotherapy With Confidence
• ONS Voice articles:
• JAK1 Inhibitor Quickly Relieves ICI-Related Dermatitis
• Oncology Drug Reference Sheet: Cyclophosphamide
• Oncology Drug Reference Sheet: Methotrexate
• What Oncology Nurses Need to Know About Arboviral Disease in Patients Receiving B-Cell–Depleting or –Modulating Therapies
• ONS books:
• Access Device Guidelines: Recommendations for Nursing Practice and Education (fourth edition)
• Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
• Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
• Clinical Journal of Oncology Nursing article: Early Recognition and Response of Chemotherapy-Induced Hypersensitivity Reactions: A Nursing Discussion
• ONS courses:
• ONS Fundamentals of Chemotherapy and Immunotherapy Administration™
• Safe Handling Basics
• Vascular Access Devices
• ONS Huddle Cards:
• Anaphylaxis
• Monoclonal Antibodies
• ONS position statement: Education of the Nurse Who Administers and Cares for the Individual Receiving Antineoplastic Therapies
• American Academy of Neurology: Practice Guideline Recommendations: Disease-Modifying Therapies for Adults With Multiple Sclerosis
• American College of Rheumatology: Treatments
• National Multiple Sclerosis Society:
• Infused therapies
• Injectable therapies
• Medications Used Off-Label
• NCODA Patient Education Sheets

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

"The most common immunotherapy agent that's well known to both oncology and other autoimmune disorders is rituximab. And that is used for rheumatoid arthritis, granulomatous, and antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. And then it also has many off-label indications for other autoimmune disorders, such as lupus and multiple sclerosis. It's also used in immune thrombocytopenia and Sjogren's condition." TS 3:28

"Two common chemotherapy agents that come to mind that are used in lower doses for noncancer conditions are methotrexate, which helps modify the underlying disease process to reduce inflammation and preserve organ and joint function. And that's most commonly used rheumatology-wise first-line for rheumatoid arthritis and psoriatic arthritis. A second chemotherapy agent that's well known to oncology is cyclophosphamide, and that really serves as a powerful immunosuppressant for conditions such as ANCA-associated vasculitis and severe lupus nephritis." TS 3:57

"When talking about the monoclonal antibody frequency, it's often shorter in our oncology indications. We may see it weekly, every 21 days, every 28 days—compared to our autoimmune disorders that are months in between. This is really due to cancer cells continuously proliferating, so we need to stop the growth and not allow residual cancer cells to remain. And for the monoclonal antibodies, for example, rituximab again, it's depleting B cells that contribute to autoantibody production and inflammation. So targeting that after one to two infusions, the peripheral B cells are often depleted within days to weeks because of how well the drug works, how targeted it is. Those effects may persist for 6–12 months or even longer." TS 8:39

"Infection prevention education—it's so important to get to know the patient to individualize your teaching. For example, you need to know what matters most of the patients when they go home. Are they taking care of their grandchildren? Do they love to go outside and garden and do mulching? Are they cleaning up their chicken coop? So those kind of things, as a nurse, you can then help tailor your education so you can help prevent infection in these patients because I don't think just standard run-of-the-mill infection prevention teaching is as beneficial as when you can individualize it for that patient." TS 17:33

"If organizations are going to allow non-oncology nurses to administer, we just want to make sure that there is an established process or a protocol to administer rescue medications. That may include what you're already doing if you have a change in patient condition—calling for activating that emergency response system if you're in an inpatient setting. When we look at our ambulatory infusion centers that may have non-oncology nurses administering, you still have to have that training and competency verification and also emergency medical equipment readily available. That would include oxygen and your rescue medications. For the non-oncology nurse, some key points are to make sure that you check on your patient throughout these infusions and have that conversation up front to report any symptoms, both big and small." TS 23:06

"For safe handling, there are many misconceptions that it differs between cancer and non-cancer. When I first started at our organization, even some providers may minimize the risk for low-dose oral chemotherapy. However, it's still metabolized and excreted through our bodily fluids. And we know that traditional chemotherapy, like methotrexate and cyclophosphamide, is cytotoxic. So if a patient's prescribed them for noncancer indications, you still need to cover the basics, like shared bathrooms, what to do if there's contaminated linen, and also bring up the topic of contraception to ensure that our patients and their partners remain safe and do not get exposed." TS 27:13

"It's a chronic disease. It never goes away for some people, and so therefore it has these periods of remission where it's really quiet and well controlled. Then there can be periods of flares where you're actively engaged in treatment or it's impacting other pieces. There's this feeling patients have of, 'When am I going to have that flare?' You know, this anticipatory anxiety of, 'When are things going to be done differently?' or 'When do I need to change?'" ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer Institute in Boston, MA, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about long-term chronic lymphocytic leukemia (CLL) considerations for oncology nurses.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD), including 15 minutes of pharmacotherapeutic content, by listening to the full recording and completing an evaluation at courses.ons.org by September 11, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the nursing considerations of caring for people with long-term CLL.

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 428: Chronic Lymphocytic Leukemia Treatment Considerations for Oncology Nurses
  • Episode 422: An Overview of Chronic Lymphocytic Leukemia for Oncology Nurses
  • Episode 256: Cancer Symptom Management Basics: Hematologic Complications
  • Episode 201: Which Survivorship Care Model Is Right for Your Patient?
• ONS Voice articles:
  • Cardio-Oncology Program Monitors Heart Toxicities Throughout Survivorship
  • Fixed-Duration Therapy for CLL May Lower Cardiovascular Risks and Costs Less Than Continuous Treatment
  • Individuals With CLL Face Increased Risk for Skin Cancer
  • Patients With CLL Report Worse QoL and Other Factors
• Clinical Journal of Oncology Nursing articles:
  • In Remission: A Patient's Experience of Continued Care After Chronic Lymphocytic Leukemia
  • Venetoclax: Management and Care for Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia
• ONS book: Site-Specific Cancer Series: Leukemia (first edition)
• ONS Learning Libraries:
  • Hematology, Cellular Therapy, and Stem Cell Transplantation Learning Library
  • Survivorship Learning Library
• ONS Symptom Management Resources:
  • Prevention of Bleeding
  • Prevention of Infection: General
• CLL Society: Living With CLL
• Lymphoma Research Foundation: Remission and Long-Term Survivorship
• National Comprehensive Cancer Network

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].

"I think about the immunocompromised state that often comes from the CD20 monoclonal antibodies such as obinutuzumab, rituximab, and ofatumumab. All of those are agents that have been used in CLL, and they can lead to hypogammaglobulinemia. That is something that can be short-lived right after therapy, but can be prolonged or even a lifelong status after receiving these types of therapies. And then some of the other pieces that we think about are increased risk of basal cell carcinoma, routine skin exams, and maintaining some of those components of evaluation, monitoring, and preventative types of health care." TS 1:57

"We think about how we comanage some of these comorbidities, especially cardiovascular. … The evolution of cardio-oncology programs has been incredibly valuable, specifically for a lot of agents that have such a significant impact on the risk of developing hypertension but also on the potential for atrial fibrillation. When we think about our aging population and common cardiovascular risks, cardio-oncology has been an incredible partner to be able to collaborate and effectively manage their cardiovascular health in a way that keeps that risk reduction strategy in place, but also allows us to maintain these really effective oncologic agents." TS 4:50

"When we think about indefinite therapy, the consideration is that patients are on a therapeutic agent for as long as that agent is working, so there's no set time that is indicated. We oftentimes talk about cycle length or a year of therapy or things like that. But when we think about indefinite treatment, it's really a shift in the perspective of looking at CLL like a chronic disease that is continually being managed. I think this is when we partner and think about other comorbidities that we manage, such as hypertension. You have to take something every day to effectively manage this disease. And so this is what we think about with indefinite treatment—that the patient is going to be receiving treatment or engaged in taking these agents for as long as they're working and it's giving the patient the intended benefit." TS 12:30

"CLL might not be something that requires an action plan. There's a lot of active surveillance and routine monitoring, and there's not really something the patient can do to say, 'I'm kind of in the driver's seat.' I think this is one of those components that really ties together what we can advocate for our patients to be doing to reduce the risk of complications. I often talk about immunizations and vaccines and really staying up to date because that's going to be the most effective way for them to reduce the risk of infections." TS 15:01

"Everyone's going to need different support, but there's so much opportunity to really provide a meaningful quality of life. Whether patients are on active surveillance or have never needed therapy, if they need periods of treatment or are off therapy, or if they're continuously on therapy, I think that there are a lot of things that we can do to advocate for them to have a really good quality of life and be able to live fully with this diagnosis." TS 27:44

"Think about all the important things our kidneys do for the body. Those things are compromised. If we have excess buildup of toxins and waste in the body, you're having problems with fluid reabsorption. Then you have also problems with electrolytes not being balanced. Then in turn, you have ongoing shutdown of systems. So the cardiopulmonary system gets compromise. Your circulatory system then gets compromised. And then all the things in the body that depend upon ongoing circulatory flow are then causing major resets in the system that need to be addressed," ONS member Brenda S. Nettles, DNP, MS, ACNP-BC, AOCNP, CNE, assistant professor at the Johns Hopkins School of Nursing and nurse practitioner at Johns Hopkins Hospital in Baltimore, MD, told Madeline Johnston, MSN, RN, OCN®, oncology clinical specialist at ONS, during a conversation about urinary obstructions.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 4, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge relating to urinary obstruction as an oncologic emergency.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Oncologic Emergencies 101 series
• Episode 424: Radiation Site-Specific Side Effects: Cancers of the Pelvis
• Episode 394: Prostate Cancer Survivorship Considerations for Nurses
• Episode 390: Prostate Cancer Treatment Considerations for Nurses
• Episode 387: Prostate Cancer Screening, Early Detection, and Disparities
• ONS Voice articles:
• A Primer on Urothelial Cancer
• Oncology Urgent Care Provides the Right Place, Right Time, and Right Treatment for Patients Experiencing Cancer-Related Emergencies
• In the Event of an Oncologic Emergency, Make Sure You're Prepared to Deliver Compassionate, Life-Saving Care
• ONS book: Understanding and Managing Oncologic Emergencies: Traditional and Emerging
• ONS course: ONS Oncologic Emergencies™
• ONS Oncologic Emergencies Learning Library
• American Cancer Society anatomy galleries:
• Female Genitourinary System
• Male Genitourinary System

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

"As far as diagnoses go, I think that the ones that we see most common are impacted by the actual genitourinary system itself being impacted, so your patients with prostate cancer and patients with bladder cancer are definitely the ones that we see most often. But you'll see that it's also in individuals that have a diagnosis of either mucinous neoplasms or invasive peritoneal disease that invades all the cavities of the body—and also your sarcomas, because they also will actually the involve different parts of the renal system as part of their spread pattern." TS 3:55

"The first thing you want to do is try to eliminate the causative factor. So what's causing the obstruction? If there's something that's limiting flow because of the compression from the outside of the ureter or compressing around the kidney itself that they can't drain adequately, then you can look at ways to manage that by inserting a nephrostomy tube into the kidney. You can also put in ureteral stents to help alleviate the pressure from drainage from the kidney to the ureter and into the bladder." TS 7:20

"It's very common when people have a partial obstruction to have still some degree of urinary output. But the key thing is looking at, over time, how that may change. So if they do develop some progressive symptoms of the flank pain, and then also renal function begins to get a little bit lower and lower over time. Hematuria or signs of infection—those are again that next-level discussion that needs to be had about what gets evaluated next to confirm a possible obstruction." TS 10:00

"The biggest misconception, I believe, would be that you have time to figure it out. And the individual that already has immunocompromised states and also possible decline in baseline renal function have very low thresholds for us to really wait on these things too long. It's always better to err on the side of caution and do at least the due diligence of minimal evaluation by looking at the individual's vital signs and looking at their ability to still have urine output. Then if that's now compromised, work further into the process in a more timely manner." TS 13:47

"It's always good to have a refresher about how to manage different types of urinary diversion systems, so check with your facility in regards to what they carry for nephrostomy tube devices and the maintenance plans they have for those as far as frequency of flushing. So you can be a problem solver for your individual that has these diversion devices place for urinary obstructions." TS 16:19

"If you are considering board service, I would say take the leap. Start with your local chapter. It will give you some valuable skills that will help prepare you when you are applying for your national level. And I always say, if you want to do it, just do it because what's the worst that can happen? They can say no, but that doesn't mean that you will never serve on a board. I always tell people delayed is not denied," Cassandra Green, DNP, RN, OCN®, ONS member and past president of the Oncology Nursing Certification Corporation (ONCC) Board of Directors, told Evelyn Wempe, DNP, MBA, APRN, ACNP-BC, AOCNP®, CRN, NEA-BC, chair of the ONS Leadership Succession Committee (formerly known as the Leadership Development Committee), during a conversation about service on a board of directors. Wempe spoke with Green and ONS members Kristin Ferguson, DNP, MBA, RN, OCN®, CGNC, former treasurer and director-at-large on the ONS Board of Directors, and Yanka Campbell, DNP, RN, CPHQ, AGPCNP-BC, CNE, member of the Oncology Nursing Foundation (ONF) Board of Directors, about their experiences with board service.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 28, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to serving on a board of directors for a professional organization.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Meet the ONS Board of Directors series
• Episode 342: What It's Like to Serve on the Leadership Development Committee
• ONS Voice articles:
• Could Today Be the Start of Your ONS Leadership Journey?
• Nursing Leadership Unlocked
• Leading With Purpose Creates a Vision for the Future of Oncology Nursing
• ONS courses:
• A Guide to Chapter Leadership: Chapter President Training
• Board Leadership: Nurses in Governance
• Clinical Journal of Oncology Nursing article: Rearview Mirror Leadership: Looking Backward to Move Forward
• ONS Board Self-Assessment
• ONS Leadership
• ONCC Board of Directors
• ONF Leadership
• Your Roadmap to Future Service on the ONS Board of Directors
• ONS Leadership Learning Library

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

Campbell: "Joining a board was a natural next step for me to maintain my connection to bedside nursing that I've loved for so many years, and to find a way to give back to advanced practice nurses as well in this role. The Oncology Nursing Society and Foundation were especially meaningful for me because I knew firsthand the importance of having scholarship, research, funding, and leadership development programs that can really change the trajectory of a nurse's career. I realized I wanted to help shape the opportunities that were available to me for future nurses, and I just did not want to continue to do that through one-on-one mentorships, which I have done extensively throughout my career, but find a way to help more broadly toward guiding organizational mission and strategic objectives." TS 7:20

Green: "Everyone was so welcoming on the board. Everyone was so friendly. One of the first things I remember our executive director Tony Ellis telling me is, 'Most of our new board members are really quiet and reserved at our first meeting. They just kind of keep things to themselves. They don't ask a lot of questions.' I don't know if they were prepared for me because I came in with guns a-blazing, and I had lots of questions. I was not quiet. I was very involved and very vocal. I still am, but that was one of the best experiences ever. Before that, I had never really been in a board setting other than my local chapter, and even then, I was just starting to be in that setting because I was the president of my local chapter and on the [ONCC] Board of Directors at the same time." TS 10:29

Ferguson: "A nonclinical mentor I would absolutely identify would be Alec Stone, who used to be the ONS director of public affairs. … He helped me to learn a lot about health policy and advocacy and the impact a nurse's voice can have. Learning how to speak about my experiences in health care in public by doing programs like the Nurses in Washington Internship … or ONS's Capitol Hill Days ended up giving me a lot more confidence that I didn't know I would have in expressing my point of view and being very open and collegial and expressing my opinions. … This really lent itself well to my future board experience because, as Cassandra mentioned, board members have to speak their mind and speak up at the meetings." TS 12:11

Campbell: "One of the most unexpected benefits was when I reached out to my executive leadership team at the Kimmel Cancer Center at Johns Hopkins and said, 'I'm being considered to serve on the ONF Board. This is going to require me taking time away from work to attend meetings, to attend some in-person meetings. And then it would be really wonderful at the institution if I'm able to also financially impact the nurses who need to benefit from what I've benefited from in my career.' Usually when you have those conversations, you are expecting to present a deck of PowerPoint slides to make your case, but the answer from my leadership team in participating in ONF and supporting the Board was an immediate yes. It was 'Yes, when can you start? Yes, what can we do to support you?' And really making sure that I had dedicated time to be fully present." TS 14:15

Ferguson: "There are many skills and experiences that can lend themselves to being a strong board member. … The ability to speak your mind clearly and express your thoughts, which really boils down to strong communication skills. We are lucky in our careers. We all have worked as nurses in different settings and health care, and nurses are naturally skilled and good at communication. We learn strategies like SBAR—situation, background assessment, recommendation. Nurses every day are communicating in their places of work, oftentimes with patients who are sick and need education, or perhaps with new nurses they're teaching or mentoring. And they are communicating with non-nurses, as well, and nonpatients, so clinical roles and nonclinical roles. So nurses already have a good understanding of best practices when it comes to communication, and this can lend itself well to any board position." TS 21:04

Green: "When you [come into a] leadership role, I think that's when we learn most about ourselves and what we expect. And be the leader type of leader that you want to be and the type of leader that you would like to work with so that you can make your experience valuable and pleasurable." TS 28:57

"They're really worried that radiation is going to be painful. So they come in for that first day of treatment very anxious. With our patients with brain cancer, we're using the masks on the table, and those masks are very tight and hold their heads very, very still. So they'll be very worried about being claustrophobic. We may start out the first day or two with a little bit of [lorazepam]. And they'll come to me and they'll say, 'This really hasn't been as bad as I thought it was going to be,'" ONS member Catherine McCluskey, BSN, RN, OCN®, ROCN™, radiation oncology staff nurse at Atrium Health Wake Forest Baptist in Winston-Salem, NC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, who was the manager of oncology nursing practice at ONS at the time of the recording, during a conversation about radiation side effects in central nervous system (CNS) cancers.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 21, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the side effects of radiation to treat CNS cancer.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Radiation Site-Specific Side Effects series
• Episode 306: Cancer Symptom Management Basics: CNS Toxicities
• ONS Voice articles:
• Augmented Reality Simulations Reduce Patient Anxiety by Teaching Them About Radiation Therapy
• CNS Survivorship Needs More Research, Funding, and Training, Expert Panel Says
• Here's What the Updated CTCAE Version 6.0 Means for Oncology Nurses
• Highly Localized, Precision Radiation Therapies Require Nurses to Drive Care Coordination, Patient Education
• Hyperbaric Oxygen Therapy Shows Promise for Certain Radiation Side Effects
• ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)
• ONS courses:
• Indications of Targeted Radiotherapy to the Brain and Spine: 2025 ONS Congress® Session
• ONS ROCN™ Certification Review™
• ONS/ONCC® Radiation Therapy Certificate™
• Supporting Radiation Side Effect Management Through ONS Evidence-Based Resources: 2025 ONS Congress® Session
• Clinical Journal of Oncology Nursing articles:
• Implementing a Standardized Educational Tool for Patients With Brain Tumors Undergoing Concurrent Temozolomide and Radiation Therapy
• Radiation Necrosis: A Differential Diagnosis Dilemma
• The Neurocognitive Late Effects of Cranial Radiation Therapy: The Often-Unrecognized Outcomes
• Oncology Nursing Forum article: Symptom Clusters in Patients With Brain Tumors Undergoing Proton Beam Therapy
• ONS Huddle Cards:
• External Beam Radiation
• Proton Therapy Proton Therapy
• Radiation
• ONS Guidelines™ and Symptom Management Resources
• Cognitive impairment
• Fatigue
• Mucositis
• Radiodermatitis
• ONCC resources:
• Big List of CE
• Radiation Oncology Certified Nurse (ROCN™)
• Common Terminology Criteria for Adverse Events (CTCAE v6.0)
• Patient Health Questionnaire (PHQ-9 and PHQ-2)

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

"With primary tumors—glioblastomas, astrocytoma, all of those types of cancerous primary CNS tumors, the tumors are not very well-defined. They have little tentacles that kind of go out, so doing something like Gamma Knife, which is very precise, is not as effective as an external beam because the external beam will deliver radiation to all those little tentacles that are out there in the brain. And with Gamma Knife, you really can't effectively do that." TS 2:34

"When we're doing radiation to the brain, fortunately there aren't that many acute toxicities involved. Sometimes they'll have some mild dermatitis. Usually, it's not very significant. They, like everyone else who gets radiation, will have fatigue. Usually once we get to the end of the second week of radiation, into the third week for our patients with primary CNS tumors—the hair loss—they'll start to notice hair loss just in the treatment area. But those are typical, the things that we've seen most. Sometimes we'll have patients who will experience some nausea, maybe a few headaches, but really the acute toxicities are not severe typically with our patients with brain tumors." TS 8:30

"[For] the fatigue, I tell patients to just listen to their bodies. We don't want them to be sedentary, and we want them to go out and continue living their lives. But I do warn them that the fatigue is pretty much common to all patients receiving radiation at various degrees, depending on the patient. I just tell them to do what they feel like doing, and then when they're tired to rest, and if they find themselves having a nap in the afternoon, that's okay." TS 13:51

"What I find with these patients in particular is that a lot of times, their first symptoms related to any type of cancer are CNS symptoms from brain metastasis. Our patients with lung cancer or melanoma—they come in through the emergency room for altered mental status or seizures or something like that. They find a mass in their brain, and then they find a mass on their lung, or they find masses everywhere. Typically, they want to treat the brain masses first before they start them on any kind of systemic treatment. And so, they'll come to us, and they're in shock. Everything's happened very quickly. They haven't had a chance to really catch their breath. They're overwhelmed. And so I try to make sure they understand that everyone that they see here is part of their team and is with them through this journey and they're not alone." TS 25:36

"A couple of years ago, ONS put out an email asking for people to volunteer to do a delineation study about the feasibility of doing a radiation oncology certified nursing exam. And I, just on a whim, responded to that email. It's not something I've ever done before, and thinking that I would not be put on the team. … And I thought, 'I don't have enough experience, I don't know what I'm doing, and they won't choose me.' And lo and behold, they put me on this role delineation study. … I have met so many incredible nurses with all kinds of experience. I've learned so much. It has opened up a lot of things for me and it's been really exciting, so all I can do is say take advantage of those opportunities when they come. Don't think that you don't know enough, because you know more than you think you do." TS 32:38

"Measurable residual disease is where I think the terminology fits best in that, it is intended to measure the amount of cancer cells that are present in the blood or bone marrow at the time the sample was collected. We can identify one cancer cell in a million. Where that can be really valuable is when we start to think about the duration of treatments and the response to some of our treatments," ONS member Caitlin Murphy, DNP, APRN, FNP-BC, AOCNP®, chief nurse practitioner at Dana-Farber Cancer Institute in Boston, MA, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about chronic lymphocytic leukemia (CLL) treatment considerations for oncology nurses.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.75 contact hours of nursing continuing professional development (NCPD), including 45 minutes of pharmacotherapeutic content, by listening to the full recording and completing an evaluation at courses.ons.org by August 14, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to treatment of chronic lymphocytic leukemia.

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 422: An Overview of Chronic Lymphocytic Leukemia for Oncology Nurses
  • Episode 256: Cancer Symptom Management Basics: Hematologic Complications
  • Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis
  • Episode 184: Oncologic Emergencies 101: Tumor Lysis Syndrome
• ONS Voice articles:
  • Fixed-Duration Therapy for CLL May Lower Cardiovascular Risks and Costs Less Than Continuous Treatment
  • Individuals With CLL Face Increased Risk for Skin Cancer
  • Master Hypersensitivity Reactions With These Strategies for Prevention and Management
  • Patients With CLL Report Worse QoL and Other Factors
• Clinical Journal of Oncology Nursing articles:
  • Acalabrutinib: Nursing Considerations for Use in Patients With Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma
  • Pseudohyperkalemia in Chronic Lymphocytic Leukemia: An Often Overlooked Clinical Entity
  • Richter Transformation Arising From Chronic Lymphocytic Leukemia
  • Venetoclax: Management and Care for Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia
• ONS book: Site-Specific Cancer Series: Leukemia (first edition)
• ONS symptom management resources:
  • Fatigue
  • Prevention of Bleeding
  • Prevention of Infection: General
• Blood Cancer United: Chronic Lymphocytic Leukemia Treatment
• CLL Society: Patient Education Toolkit
• Lymphoma Research Foundation: Lymphoma Treatments
• Patient education sheets
  • Acalabrutinib
  • Ibrutinib
  • Pirtobrutinib

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].

"Blood work is a really nice way to evaluate if there is progression of the disease. And we evaluate their blood counts, specifically that complete blood count with a differential. We anticipate an elevated white count, and we anticipate that the absolute lymphocyte count is going to be elevated. That's characteristic of the disease. But what evolves and happens is that those numbers can rapidly change and what we get concerned about is if that white count—and the percentage of the absolute lymphocyte count specifically—starts to increase and double quickly." TS 5:52

"There are some components that help clinicians decide if we expect these things, this cadence of change to happen more readily, or if we feel really comfortable that the biology of the variants contributing to the type of CLL that each patient may have, they may not have that progression as quickly or at all. And so that kind of helps us in that follow-up and cadence. Oftentimes, we're checking blood work every three or six months. Some patients are on an annual interval of visits depending on that active surveillance. I think the other piece is that we have a relatively low threshold when there is a change in symptoms to just recheck those blood tests. It's nice that we can have a pretty readily available blood test to be able to give us a lot of information for these patients." TS 9:45

"When we think about CLL therapy, the old tried and true [treatments] still work: so, rituximab and obinutuzumab. And then we kind of start to think about pathways and the way, the mechanisms of which these treatments are integrated. We think about different pathways of how we can induce cell death, but also what are the potential side effects? What are the potential interactions?" TS 19:35

"I think a lot of this is about really having a clear understanding of the patient's goals and really being able to understand and align. I think we have a lot more data to provide guidance for those patients that really are wanting to know: What is my chance of overall survival? If I do this, does this mean that I don't need to ever be on treatment again? If I do it this way, does it mean that I have to come into clinic every week, or does it mean that I have to come in every week but I'm done? I do one year of treatment, and I don't have to think about treatment for a really long time based on some of these components that we can take into consideration." TS 24:36

"When we think about the B-cell lymphoma 2 (BCL-2) inhibitors, with venetoclax, I think the biggest component we think about is tumor lysis syndrome. It's so effective that these cancer cells release all of those electrolytes, potassium, phosphorus; you can see a rise in the lactate dehydrogenase and uric acid because those cells are breaking down. And so subsequently, that leads us to the consideration of, is the patient's kidney function able to clear it? And so a lot of frequent lab monitoring, a lot of hydration, supportive care with medications like ursodiol or allopurinol to really improve the ability to clear that cellular waste product so that it doesn't cause an oncologic emergency." TS 34:11

"A good way of thinking about this is this is the survival of the fittest clone. There could be a portion of a cancer that naturally has some resistance or ability to survive a particular drug. And over time, as the other cells around it are dying off, that particular clone is able to replicate and continue to survive in the face of that drug therapy and eventually take over as being the fittest clone. At that point, we're often seeing disease progression," Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about resistance pathways.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD), including 30 minutes of pharmacotherapeutic content, by listening to the full recording and completing an evaluation at courses.ons.org by August 7, 2027. Roman has served on advisory boards for Genetech, Pfizer, Regeneron, and Daiichi Sankyo and received honoraria payments from Pharmacy Times and Decera for faculty lectures. These financial relationships have been mitigated. 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 increased knowledge related to resistance pathways in oncology care.

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Pharmacology 101 series
  • Episode 423: Pharmacology 101: Interaction Pathways
  • Episode 406: Drug Resistance Biomarkers and Their Impact on Cancer Treatment Choices
• ONS Voice articles:
  • Predictive and Diagnostic Biomarkers
  • Scientists Identify Protein Implicated in Tumor Growth, Treatment Resistance
• ONS book: Guide to Cancer Immunotherapy (second edition)
• Genomics and Precision Oncology Learning Library
• ONS Biomarker Database
• Pharmacogenomics Huddle Card
• CancerQuest: Cancer Drug Resistance
• National Comprehensive Cancer Network
• OncoKB.org
• Research To Practice

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].

"As we look at drug resistance, this is the concept that cancer cells are no longer able to respond to a cancer treatment. The downstream of this is that we could end up with progression of the disease and need to look at alternative therapies that may be beneficial for the patient. This is unfortunately a very common phenomenon. Drug resistance is a major cause of treatment failure and poor patient outcomes with treatments. Unfortunately, this is an issue we see that increases over time on treatment." TS 2:29

"Genetics play a really big role in drug resistance. We know that drug resistance can be due to different things. It could be epigenetics. It could be the tumor microenvironment factors. But genetics often play a very big role in resistance pathways. It's generally considered to be a critical contributor to resistance, particularly in the way of acquired variants to drug targets or amplifications of certain oncogenes that can lead cancers to have progression. A well-known genetic alteration is the BRCA1/BRCA2 variant that helps to make the cancer more efficient at fixing DNA damage. So we're trying to get DNA damage with chemotherapy, and this particular variant helps at fixing that damage to allow the cancer to progress. So that is one genetic variant we see that plays a big role in a number of different cancers." TS 4:51

"These pathways are not mutually exclusive. Oftentimes we have multiple resistance pathways involved. I think it's important to understand some of those individually, but kind of thinking about this as we might be facing multiple resistance pathways. ... We can see resistance mechanisms that vary based on the type of treatment we use, for example, traditional cytotoxic chemotherapy. We may be more likely to see some resistance mechanisms that are working at DNA: repairing broken DNA or working on those efflux pumps that are being used to push chemotherapy out of cells. If we're talking more about the targeted therapies such as tyrosine kinase inhibitors or monoclonal antibodies, we may be more likely to see resistance mechanisms that are what we discussed with that drug target alteration: changing the way that the target agents are able to bind to the tumor cells to activate or inactivate pathways so we may see some changes there." TS 12:39

"One way to overcome this and to help to decrease the resistance from developing is using combination therapy: drugs that are targeting different pathways at once or potentially using combinations with things like chemotherapy in addition to immunotherapy. In this way, as we're getting these different targets, we can hopefully decrease the mechanism of resistance that may be developing." TS 14:48

"Biomarker testing is an incredibly important part of our practice. In many situations now, we are getting upfront, comprehensive biomarker testing to identify whether the patient may have any of those intrinsic or primary resistance mechanisms that might make it so a patient is never going to respond to a particular type of treatment. And in that case, we can spare the patient from the potential toxicities of that treatment if we don't think that there's going to be benefit there. So I think that that has become a really important way that we can tailor patients for understanding what treatments are going to be more effective. And then after that, there's usually additional biomarker testing that may be warranted at the time of progression in certain types of cancer. And that really helps us to understand that acquired resistance that might be developing." TS 17:32

"Nurses are really helpful with filling in the gaps and bringing back patient concerns that might be shared with them. And these might be early signs of progression. Better understanding how our patients are feeling and what's going on with them may help us to identify a patient that we need to do some additional testing for to understand whether there is drug resistance ongoing and potential progression of disease." TS 21:52

"When people with PTSD [post-traumatic stress disorder] get quite avoidant—and that can be expressed in so many different ways—the implications can be really profound. I think an important invitation to oncologists and oncology nurses and primary care providers who care for people battling cancer is let's explore what's underneath these avoidant behaviors. Is it a very practical thing? Or is it that underneath this avoidant behavior is really profound fear?" James C. Jackson, PsyD, research professor at Vanderbilt University Medical Center in Nashville, TN, told Lenise Taylor, MN, RN, AOCNS®, TCTCN™, oncology clinical specialist at ONS, during a conversation about addressing medical trauma in oncology.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by July 31, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to medical trauma in oncology care.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
• Episode 421: Medical Trauma in Oncology
• Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care
• Episode 264: Stop the Stressors and Improve Your Mental Health as a Nurse
• ONS Voice articles:
• Help Caregivers Control the Chronic Stress of Cancer Care and Manage PTSD [post-traumatic stress disorder]
• Past Trauma Lowers Hope, QOL, and Coping Ability During Cancer
• Managing Cancer-Related PTSD Starts With Acknowledgement
• Moral Injury and Trauma in Nursing
• Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress
• Clinical Journal of Oncology Nursing articles:
• How Can a Trauma-Informed Care Approach Be Applied to Patients With Gynecologic Cancer?
• Psychosocial Barriers to Care: Recognizing and Responding Through a Trauma-Informed Care Approach
• Oncology Nursing Forum articles:
• Post-Traumatic Distress and Symptom Experience in Patients With Head and Neck Cancer–Related Tracheostomy and Family Caregivers
• The Effect of Neuroticism, Fear of Progression, and Self-Efficacy on Post-Traumatic Growth in Patients With Lung Cancer Undergoing Chemotherapy
• The Relationship Between Colorectal Cancer Survivors' Positive Psychology, Symptom Characteristics, and Prior Trauma During Acute Cancer Survivorship
• ONS course: Psychosocial Dimensions of Cancer Care™
• ONS Huddle Card: Coping
• Screening tools
• Clinician-Administered PTSD Scale for DSM-5 [Diagnostic and Statistical Manual of Mental Disorders, 5th edition] (CAPS-5)
• Hospital Anxiety and Depression Scale
• Primary Care PTSD Screen for DSM-5
• PTSD Checklist for DSM-5
• Trauma Screening Questionnaire
• International Society for Traumatic Stress Studies: Free Resources
• PESI
• Reclaiming Your Life From Medical Trauma by James C. Jackson

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

"For many people who have been traumatized, if they can avoid it, they will. They may not avoid the annual evaluation that is so hugely consequential—they might not avoid that. But they may well avoid a routine visit for a checkup to their oncologist. They very well may avoid a visit with a psychologist who is wanting them to talk about hard things. They may avoid visiting a friend in the hospital because it reminds them of really upsetting things. So, this issue of adherence and compliance is a really big problem." TS 3:19

"Screening tools for things like PTSD can be very useful. They're quite practical, and they're appropriate to use. I really like something called the Post-Traumatic Stress Disorder Checklist. ... Using it is going to be very straightforward. You're going to want to map it onto a 30-day window, and you're going to employ it with patients. It's a 20-item self-report. It assesses 20 DSM-5 symptoms of PTSD. It's not diagnostic, but if people score in this range of 30, 31, 33, we typically are going to believe that that is very suggestive of significant PTSD." TS 9:17

"One of the things we should be doing all the time is modeling and attempting to normalize this idea of being open about mental health difficulties. When I say modeling, this is a complicated issue. ... I'm very open talking about my own battles with mental health. And in some ways, that invites my patients to do the same. I don't recommend necessarily that a nurse says, 'Oh, by the way, I have PTSD. I'm going to tell you about mine. I want you to tell me about yours.' That's a boundary issue. But I think it does behoove us as clinicians to create a culture as much as we're able, where we can talk about mental health difficulties in a matter-of-fact way, acknowledging that mental health is health. These tools, to me, go a long way in that direction." TS 13:41

"The survivorship process is ongoing. I think a nurse can assist a patient in so many ways longitudinally over time. ... One of those ways is to continue checking on mental health outcomes in patients. Continuing to check on mental health outcomes, continuing to explore them, and continuing to invite patients to talk about things that other people might not be asking about. It's easy for family members to assume, 'Hey, you know, you're cancer free now. You look fine, so you must be fine.' It's very possible that the patients we're talking about are not fine. They're far from fine. For that oncology nurse at a follow-up clinic or in an oncology setting to talk about this, continuing to affirm that it would be okay for patients to struggle, continuing to put this issue on a front burner—I think that's really important." TS 21:17

"I'm aware of nurse-led support groups where nurses can talk very freely about their own challenges, in a safe space. ... Working to build cultures in the context of the intensive care unit, let's say, where we have a lot of patients with cancer that prioritize well-being nurse driven programs. ... The bottom line is if there is a warning light that is blinking, nurses need to attend to that. And in attending to it, they're going to be more present for their patient. They're going to be better able to support their patient. They're going to be better able to support each other. And I think often, in the culture of nursing and psychology, too, people just put their head down, their shoulder down, and they just plow through in ways that are really counter to their mental health." TS 29:56

"The truth is medical trauma can be well-managed. It's not simple. It's not always intuitive. There are all sorts of caveats with regard to this, but the truth is people with medical trauma can live really rich and meaningful lives. ... So, the default setting, I think, should be not one of pessimism. It should be that people with medical trauma can and do get better. If you are a patient with medical trauma and you are in my purview, until proven differently, I'm going to assume that you can get better too." TS 36:28

"In oncology specifically, where care is complex, artificial intelligence (AI) can really synthesize large volumes of clinical information, flag risks such as treatment complications, and support adherence to evidence-based pathways. For nurses specifically, this enables them more time for direct patient care, clinical judgment, and care coordination, and really practice to the top of their license while reducing repetitive time and administrative tasks," Jenn Frith, DNP, RN, OCN®, NE-BC, associate vice president of clinical operations at Duke Cancer Institute in Durham, NC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS. Weimer spoke with Frith and Emily Norboge, director of clinical and research informatics at Duke Cancer Institute, about how AI can help healthcare organizations improve the cancer experience.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by July 24, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to the use of artificial intelligence in oncology nursing practice.

• Complete this evaluation for free NCPD.
• ONS Podcast™ episodes:
  • Episode 284: How AI Is Influencing Cancer Care and Oncology Nursing
  • Episode 281: Nursing's Role in AI in Health Care
• ONS Voice articles:
  • Human Connection Creates the Power Behind AI in Nursing
  • If You're Using AI in Health Care, Your Patients Want to Know
  • Majority of Adults Use AI, But Most Distrust Accuracy of Health Information
  • Nurses Are Key to Quality for AI Tools in Oncology Care
  • One-Third of Hospitals Have Integrated Generative AI Into EHRs, With More to Follow
• Clinical Journal of Oncology Nursing articles:
  • A Case for Caution: Patient Use of Artificial Intelligence
  • Artificial Intelligence in Oncology Nursing: Preparing the Workforce for the Future
  • Artificial Intelligence: Basics, Impact, and How Nurses Can Contribute
  • Integrating Artificial Intelligence Into Cancer Care: Enhancing Nursing Practice and Bridging Disparities
• Oncology Nursing Forum article: Artificial Intelligence for Oncology Nursing Authors: Potential Utility and Concerns About Large Language Model Chatbots

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].

Norboge: "Our AI voice agent has a series of workflows that it can execute. ... If a patient needs help with medical paperwork, the agent will walk the patient through how to do that paperwork. If a patient has a question that they need sent to their provider, it can document that and then send a message to the provider. There's a series of workflows so it can route to scheduling. It can answer information about test results that is compliant with our policy around test results. The goal of that agent is that it will handle all of those administrative-type tasks that don't necessarily require a nurse to fill." TS 5:44

Norboge: "When [patients] call the nurse triage line, the nurse will have to say, 'I understand you want your test results. I can contact your provider and have them reach out to you about your results.' But that's kind of where it ends. What we worked out with the agent is if a patient calls and says, 'I really want my test results,' they will in a very nice, standard way, say something similar. You know, 'I'm not authorized to discuss your test results with you, but I'd be happy to send a message to your provider and ask them to call you.' But then the agent goes one step further and says, 'Are you experiencing anxiety about your test results? If so, I can transfer you to the nurse to discuss support for a potential referral to family medical therapy if you would like help managing that anxiety.' In a clear, helpful way, it can define and help a patient with their needs and not just have a standard of 'this is our policy and I can't share it with you.'" TS 11:14

Frith: "Really, transparency is the key. The patient should understand that AI is used more as an enhancement, but not to replace the human connection. That's not the goal. The nurses can explain that the tools will help ensure accuracy, timeliness, and safety while allowing more time for the direct interaction of the nurse. I think framing AI as an additional layer of support rather than a decision maker helps build trust. And I think maintaining strong communication and presence at the bedside just reinforces that care remains fundamentally human." TS 15:32

Frith: "I think AI in oncology is going to continue to advance in our predictive analytics, personal care planning, and probably real-time decision support. I think we'll see a greater integration into symptom management, some early detection of complications, and longitudinal care coordination across our settings. I think nurses will continue to increasingly use AI to anticipate patient needs and prioritize care. I think the role of the nurse won't diminish. Rather, it will become more elevated in allowing them to practice to scope of practice." TS 19:58

Frith: "AI represents a meaningful opportunity to strengthen oncology nursing practice by reducing burden and enhancing the clinical insight. It needs to be a very thoughtful implementation. We talked about having strong governance and continued investment in the nursing workforce. I want to reinforce that oncology care remains deeply human, and AI should only be viewed as a tool that enables the nurses to do what they do best, which I feel is deliver safe, compassionate, and high-quality specialized care to our most vulnerable patients." TS 27:31