Oncology Nursing and Cancer Care

Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
Editor-in-Chief, JONS; Co-Founder, AONN+; University Distinguished Service Professor of Breast Cancer, Administrative Director, The Johns Hopkins Breast Center; Director, Johns Hopkins Cancer Survivorship Programs; Professor of Surgery and Oncology, JHU School of Medicine; Co-Creator, Work Stride-Managing Cancer at Work
Brenda Nevidjon, MSN, RN, FAAN
CEO, Oncology Nursing Society (ONS)

Oncology nurses and nurse navigators are positioned on the front lines of cancer care, playing an integral role in patients’ battles against cancer. Ms Shockney and Ms Nevidjon discussed the rapidly changing world that oncology nurses are facing because of COVID-19.

“We’ve got this time crunch now for being able to provide the patient education and the psychosocial support, and the majority of that is being done through telehealth, not with the patient face to face,” Ms Shockney said.

She explained that oncology nurse navigators have a unique position in supporting patients with cancer, including identifying and addressing barriers to care. Such barriers have only increased during the COVID-19 pandemic, especially in relation to financial barriers and delays in care.

“We’re relying more on our nonclinical patient navigators,” Ms Shockney noted, for connecting patients with financial resources and for supportive services.

COVID-19 has delayed at least 2 important aspects of cancer care, she said. Approximately 80% of cancer screenings have been halted amid the crisis, as has community outreach. The crisis has also called on navigators to adapt their roles.

According to Ms Shockney, oncology nurse navigators are performing many of their former duties as an oncology nurse to fill the increasing need for nurses. “But the navigation doesn’t go away, so they’re wearing both hats at this particular point in time,” she said.

According to Ms Nevidjon, this is true for all oncology nursing, with oncology nurses now deployed based on nursing needs within health systems, which are not limited to oncology.

“I think the strength of what has happened among the oncology nursing community is that we know that first we’re a nurse, and then we’re an oncology nurse,” Ms Nevidjon said. “One of the things we’re concerned about as an association is the potential of a nurse being floated one day to a COVID-19 treatment unit and the next back to the oncology inpatient unit.”

According to Ms Shockney, there is a “crisis method of management” in cancer care, which applies specifically to patients with advanced cancers. “Time won’t stand still for them,” she said. With many patients too immunocompromised to receive their next treatment, referrals to hospice and palliative care are happening sooner, which, ironically, is something AONN+ advocates for.

“The patients will live longer, we know that from research, and they will have better quality of life as one of the outcomes of this ironic change,” Ms Shockney added.

Another concern is continuing cancer treatments for patients with COVID-19, Ms Nevidjon said. The current recommendation is to try to move their appointments to the end of the day and to conduct a deep cleaning overnight. The full recommendations are updated regularly on the ONS website.

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Last modified: May 7, 2020

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