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    Health

    The ONS Podcast

    Where ONS Voices Talk Cancer

    Join oncology nurses on the Oncology Nursing Society’s award-winning podcast as they sit down to discuss the topics important to nursing practice and treating patients with cancer.

    ISSN 2998-2308

    Advertise

    Copyright: © Copyright 2017

    • Apple Podcasts
    • Google Play
    • Spotify

    Latest Episodes:
    Episode 317: AYAs With Cancer: A Patient's Experience Jun 21, 2024
    Show notes

    "I was in this really unique space of being 19. So I'm over the 18 cut-off of peds but diagnosed with Ewing sarcoma, but I was an adult. I was able and supposed to be making my own decisions but treated in a pediatric setting. And not everybody in that setting is expecting to talk to someone who is educated and understands what's going on," Alec Kupelian, a cancer survivor and operations and program development specialist at Teen Cancer America in Los Angeles, CA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about advocacy for adolescents and young adults (AYAs) with cancer and his own cancer journey.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to the experience of AYA patients with cancer.

    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 episodes:
      • Episode 307: AYAs With Cancer: Financial Toxicity
      • Episode 300: AYAs With Cancer: End-of-Life Care Planning
      • Episode 9: How to Support Adolescent and Young Adult Patients With Cancer
    • ONS Voice articles:
      • AYA Cancer Survivorship: Younger Survivors Face Different Challenges and Prefer More Casual Support Programs
      • Nursing Considerations for Adolescent and Young Adult Cancer Survivorship Care
      • Have Meaningful Conversations With Pediatric, Adolescent, and Young Adult Patients and Their Families
      • AYA Champions Clinic Fills Gaps in Care and Addresses Unmet Needs
    • ONS book: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
    • ONS course: Advocacy 101: Making a Difference
    • Clinical Journal of Oncology Nursing articles:
      • Adolescent and Young Adult Cancer Survivors: Development of an Interprofessional Survivorship Clinic
      • Two Case Reports on Financial Toxicity and Healthcare Transitions in Adolescent and Young Adult Cancer Survivors
      • Sexual Health: A Nursing Approach to Supporting the Needs of Young Adult Cancer Survivors
    • Oncology Nursing Forum articles:
      • Integrative Literature Review on Psychological Distress and Coping Strategies Among Survivors of Adolescent Cancer
      • Physical Activity in Young Adult Cancer Survivors: A Scoping Review
    • ONS Huddle Cards:
      • Coping
      • Fertility Preservation
      • Sexuality
    • ONS Learning Libraries:
      • Inclusive Care
      • Survivorship
    • Teen Cancer America
      • The Monthly Drip
      • AYA Oncology Healthcare Professionals Program Advisory Group
    • Stupid Cancer
    • Adolescent and Young Adult Cancer Congress
    • 988 Suicide and Crisis Lifeline
    • Supportive Care in Cancer article: An Actionable Needs Assessment for Adolescents and Young Adults With Cancer: The AYA Needs Assessment and Service Bridge (NA-SB)
    • 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 pubONSVoice@ons.org.

    Highlights From This Episode

    "I joke a lot of the times that cancer was actually one of the best years of my life, and that's not because it was good necessarily. It's because that next year, after cancer, was probably the worst year of my life, and that drop-off into that early survivorship was a really brutal experience for me, and from talking to other cancer survivors, for them as well." TS 3:25

    "I talk to a lot of clinicians and a lot of young adult cancer survivors, and the more that I hear other people's stories, the more clear it is to me that you never know who a patient is going to disclose information to. A lot of those symptoms or side effects or secondary issues that come about from cancer, which complicate every part of your life, it may not come to the [physician]. I was most comfortable with my nurses because I spent time with them." TS 9:15

    "You put your nose to the grindstone, and there's a good guy, which is you, and a bad guy, which is cancer, and you just get through it. It's very clear. And you have so much attention and dedicated support. And then when treatment's over, everybody pats your back, dusts their shoulders, and says, 'Congrats, go get out there.' And all that structure goes away, and you are left floundering, trying to reconnect to what you were before and what life looked like. And it's not always the same. … Most AYA patients would say treatment was the easy part. And those first two years after treatment were the hardest part of cancer—that reintegrating into life, that trying to contend with what just happened when you're no longer in survival mode." TS 26:14

    "An AYA patient may have another 50 years of life after that. How does survivorship work for that? What is sexual health? Fertility? What is palliative care? … What does end-of-life care look for a patient who hasn't gotten a chance to live their whole life? It's really important stuff, and that is too much to ask any one person to figure out. And so Teen Cancer America wants to provide some of that framework." TS 31:03

    "Allowing nurses to say that, 'There is going to be stuff that I don't know, and that isn't a failing on my part. Saying I don't know something helps my patient have more confidence in me.' I hear all the time clinicians are like, 'I don't bring up sexual health because I don't know what to say, and I don't want them to lose confidence in me.' They don't. They don't lose confidence in you because you don't know something. You're a human, also. They lose confidence in you when you stop caring about them." TS 43:44


    Episode 316: Pharmacology 101: Estrogen-Targeting Therapies Jun 14, 2024
    Show notes

    "Estrogen plays a key role in promoting the proliferation of normal and breast cancer epithelium. So now we have gone from focusing just on the estrogen to also look at estrogen receptors on breast cancer cells and targeting that—and now even to a point of looking at the downstream effects of when the estrogen binds to estrogen receptor of those signaling pathways," Rowena "Moe" Schwartz, PharmD, BCOP, FHOPA, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about estrogen-targeting anticancer therapies.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to estrogen-targeting therapies.

    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 episodes:
      • Pharmacology 101 series
      • Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs
      • Episode 194: Sex Is a Component of Patient-Centered Care
      • Episode 113: Manage Cancer-Related Hot Flashes With ONS Guidelines™
    • ONS Voice articles:
      • Oncology Drug Reference Sheet: Elacestrant
      • Sexual Considerations for Patients With Cancer: Evidence-Based Approaches to Confront Challenges and Offer Support
      • Oncology Drug Reference Sheet: Alpelisib
      • ONS Guidelines™ Offer Framework for Managing Treatment-Related Hot Flashes
    • ONS courses:
      • Breast Cancer: Survivorship and Quality of Life
      • Breast Cancer: Treatment and Symptom Management
      • ONS/ONCC Chemotherapy Immunotherapy Certificate
    • ONS books:
      • 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 articles:
      • Hot Flashes: Clinical Summary of the ONS Guidelines™ for Cancer Treatment-Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cancer
      • Hot Flashes: Common Side Effect
      • Treatment-Induced Ovarian Insufficiency and Early Menopause in Breast Cancer Survivors
      • Targeted Therapies: Treatment Options for Patients With Metastatic Breast Cancer
    • Oncology Nursing Forum articles:
      • Associations Between Cholecalciferol Supplementation and Self-Reported Symptoms Among Women With Metastatic Breast Cancer and Vitamin D Deficiency: A Pilot Study
      • Comparing Interventions for Management of Hot Flashes in Patients With Breast and Prostate Cancer: A Systematic Review With Meta-Analyses
    • ONS Learning Libraries:
      • Breast Cancer
      • Oral Anticancer Medication
    • ONS Guidelines™ and Symptom Interventions:
      • Hot Flashes
      • Oral Anticancer Medication
    • ONS Huddle Cards:
      • Hormone Therapy
      • Sexuality
    • Oral Chemotherapy Patient Education Sheets: Managing Hormonal Side Effects/Menopausal Symptoms

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "One of the kind of interesting things about [selective estrogen receptor degraders] is that these novel compounds also reduce the estrogen receptor alpha protein level. That becomes really important when we talk about elacestrant, because when there are mutations in the estrogen receptor protein, this is where this drug is actually indicated." TS 7:48

    "Every time I talk about tamoxifen side effects, I just think about when I was early in my career and we used to talk at some support groups, and I would talk about tamoxifen having no side effects, because we really thought it had no side effects at that time. But we have learned since then that there are side effects because of its effect on other tissues. So one of the things that we have learned is that increased risk of endometrial cancer, and that is something really important for women to be aware of." TS 10:10

    "It's important to monitor bone mineral density, prior to the initiation of therapy and then usually yearly afterward. And then again, stress some of those lifestyle management strategies: avoiding smoking, to avoid chronic alcohol use, vitamin D and calcium, regular weight-bearing exercises, as well as looking at things such as bisphosphonate therapy or denosumab for prevention of treatment-induced bone loss." TS 14:13

    "I think there is this concept that hormone receptor–positive breast cancer is one disease. It is not. … Not only are there disease-specific aspects that we need to look at, there are patient-specific aspects that we need to look at: whether a patient is premenopausal or postmenopausal or male. Those are things that we need to consider. So I think the big misconception is that all of these drugs work the same way because all breast cancer is the same." TS 26:39


    Episode 315: Processing Grief as an Oncology Nurse Jun 07, 2024
    Show notes

    "I think the reality is that we as humans are having a human experience, some of which is incredible and some of which is terrible. And to deny ourselves the opportunity to feel any of those emotions would be to deny our own human experience. And so processing feelings, and I think the bigger ones in particular, like grief, especially in the work that we do, it's not only good to do, but it's part of just what it means to, I think, be a human," Ann Konkoly, MBA, MSN, APRN-CNM, chief executive officer of Authentic Koaching LLC and Kultivate Women's Health LLC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about processing grief in a healthcare context.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to processing grief.

    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 episodes:
      • Episode 264: Stop the Stressors and Improve Your Mental Health as a Nurse
      • Episode 236: Coping With Grief
      • Episode 187: The Critical Need for Well-Being and Resiliency and How to Practice
    • ONS Voice articles:
      • Writing Condolence Cards Supports Nurses as Well as Deceased Patients' Families
      • When Grief Goes Beyond Burnout, Organizations Must Intervene
      • Peer Groups Offer a Safe Space for Oncology Nurses to Share Lived Experiences
      • Critical Event Debriefings Can Reduce Oncology Nurses' Risk of Compassion Fatigue and Burnout
      • Moral Injury and Trauma in Nursing: What You're Feeling Is More Than Compassion Fatigue, but You're Not Alone
      • Achieve a Healthy Work-Life Balance With These ONS Member-Tested Techniques
      • Involve All Populations in the Nurse Well-Being Conversation
    • Clinical Journal of Oncology Nursing articles:
      • Complicated Grief: Risk Factors, Interventions, and Resources for Oncology Nurses
      • Songs for the Soul: A Program to Address a Nurse's Grief
      • A Concept Analysis of Nurses' Grief
      • Helping Nurses Cope With Grief and Compassion Fatigue: An Educational Intervention
    • ONS Nurse Well-Being Learning Library
    • ONS Huddle Card: Moral Resilience
    • American Association of Colleges of Nursing: End-of-Life Nursing Education Consortium
    • Nurses Living the Good Life podcast
    • Tara Brach: RAIN (Recognize, Allow, Investigate, Nurture) Technique
    • Books mentioned in this episode:
      • Permission to Feel by Mark Brackett
      • Atlas of the Heart by Brené Brown
      • Take Back Your Brain by Kara Loewentheil
    • Feelings Wheel

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "Processing is just what we do with these big feelings or these small feelings that come up and how we work through them. And it really depends on the individual and what coping tools and mechanisms that they use. But usually for a lot of people, what we see is that when there is some sort of feeling—like grief—that comes along, one of the most important things that we can do is just to, number one, acknowledge that we are having some sort of a feeling and to then subsequently name it." TS 2:05

    "The brain, usually the limbic system, is driven by these three main things that it wants you to do at all times: It wants you to seek pleasure—number one. Number two, it wants you to avoid pain. And number three, it wants you to conserve energy. … And so from an evolutionary standpoint, it totally makes sense that when faced with a feeling like grief, the limbic system drives us to say, 'Let's avoid all that pain, because that feels really heavy and hard, and it's going to take a lot of energy.' And so many of us from a purely, you know, as a human approach to things that cause pain, we usually turn away from them." TS 17:18

    "For those of us out there who find we're somewhat ill equipped and our partners or our colleagues are saying, 'Boy, what's going on?' and we don't know, the next step is to say, 'Well, wait a minute. Who can help me kind of figure this out?' And I think whether it's therapy, whether it's a coach, whether it's a trusted mentor or colleague that you could have a very honest conversation with, whether it's your employee assistance program that provides you with some resources and support, there's no right or wrong way to go about it." TS 26:45

    "We have good data to say just the act of naming a feeling can be so helpful, can decrease our symptoms of that emotion by about 50%, which is crazy. Just from naming it, just from acknowledging that there's a vibration there in your body and then naming it as like, 'Oh, that vibration, that feeling that I have in my body that equates to grief or shame or discouragement.'" TS 32:58

    "Are you willing to train your brain to see it differently and to make it work for you, and to find a way that it can work for you, and that you can think differently and that you can change your mindset? Because if you can do that, if you can learn to allow your feelings to come up and process them like grief when they come, if you can observe what you do in certain situations and what you don't do—if you are willing to do that, you could go anywhere and do anything." TS 43:06


    Episode 314: Plasma and Cryoprecipitate Administration: The Oncology Nurse's Role May 31, 2024
    Show notes

    "Transfusion safety is really a registered nurse activity, and I just continue to reiterate the blessing of nursing assessment, getting those vitals before the transfusion, and then monitoring them closely and stopping the transfusion if they have a reaction, because that's really an assessment, and we can't delegate that to nonlicensed staff. And so that's really why we just celebrate that nurses have such a great role in transfusion safety," Renee LeBlanc, BSN, RN, manager of the infusion services office at Fred Hutchinson Cancer Center in Seattle, WA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about administration of plasma and cryoprecipitate.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to plasma and cryoprecipitate administration.

    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 episodes:
      • Episode 234: Oncologic Emergencies 101: Thrombotic Thrombocytopenia Purpura
      • Episode 228: Oncologic Emergencies 101: Disseminated Intravascular Coagulation
      • Episode 196: Oncologic Emergencies 101: Bleeding and Thrombosis
      • Episode 176: Oncologic Emergencies 101: Cytokine Release Syndrome
    • ONS Voice articles:
      • Nursing Considerations for Adverse Events From CAR T-Cell Therapy
      • Manage Thrombosis in Patients With Cancer
    • ONS courses:
      • Essentials in Oncologic Emergencies for the Advanced Practice Provider
      • Oncologic Emergencies
    • ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition)
    • Clinical Journal of Oncology Nursing article: STAT: Cytokine Release Syndrome
    • ONS Huddle Cards
      • Cytokine Release Syndrome
      • Disseminated Intravascular Coagulation
    • AABB (Association for the Advancement of Blood and Biotherapies, formerly American Association of Blood Banks)
    • American Association of Clinical Oncology
    • Blood Bank Guy (Joe Chaffin, MD)
    • Joint Commission: Patient Blood Management Certification Review Process Guide 2021

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "Plasma is indicated for massive transfusions and emergent reversal of warfarin therapy–related intracranial hemorrhage. Nurses may also see plasma ordered pre-op for multiple coagulation deficiencies or factor XI deficiency." TS 2:58

    "Surgical centers performing procedures with large-volume blood loss would be a prime location for staff to be experts in transfusing plasma and cryo. Nurses caring for patients with cytokine release syndrome may be familiar with monitoring for hypofibrinogenemia. Cryoprecipitate in this setting may be given more prophylactically than for a patient who's actively bleeding or having a procedure." TS 6:48

    "Plasma coagulation factors have a short half-life. Transfusing as close to the procedure will ensure the highest level of factor activity at the time of the procedure. Nurses can ensure best outcomes through care coordination and timing the transfusions as close to the procedure as possible. So we don't want to start transfusing plasma at midnight if the factors are going to be expiring and their procedure isn't until 9:00 in the morning." TS 10:40

    "One of the questions that I get sometimes, especially with plasma, is, 'I don't have time to be at the bedside for 15 minutes for four units.' Remember that each unit is a different donor, and what they eat, what kind of antibodies they have, whether they were pregnant—it's all part of that experience. It's not the same plasma product given four different times or three different times. And so just really drawing nurses into the value of being at the bedside for that first 15 minutes of that final determination of acceptability and tolerance." TS 14:20


    Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications May 24, 2024
    Show notes

    "Of all the eight different pulmonary toxicities you and I have talked about over these two different podcasts, they're all very different etiologies and treatments. So, we went everywhere from infection and good stewardship with antibiotics to pulmonary GVHD to diffuse alveolar hemorrhage. And I think that's what's the hardest part for us as nurses. It's not just one thing that's causing it, and there's multiple different ways to treat these things," Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about pulmonary toxicities in cancer treatment.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to pulmonary complications in people with cancer.

    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 episodes:
      • Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion
      • Episode 212: When Cancer Care Gets Complex: Those Other Oncologic Emergencies
      • Episode 206: Graft-Versus-Host Disease: Biomarkers and Beyond
      • Oncologic Emergencies 101 series
    • ONS Voice articles:
      • Pneumonitis With Immunotherapy Treatment
      • The Case of the Post-Transplant Pulmonary Problem
      • How Inhaled Cannabis May Contribute to Pulmonary Toxicity in Patients With Cancer
    • ONS courses:
      • Essentials in Oncologic Emergencies for the Advanced Practice Provider
      • Oncologic Emergencies
      • Treatment and Symptom Management—Oncology RN
    • ONS books:
      • Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition)
      • Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition)
    • Clinical Journal of Oncology Nursing article: Influenza Adherence Tool Kit: Implementation and Evaluation Among Allogeneic Hematopoietic Transplantation Recipients
    • Oncology Nursing Forum articles:
      • Community Respiratory Virus Infection in Hematopoietic Stem Cell Transplantation Recipients and Household Member Characteristics
      • Emergence of Stereotactic Body Radiation Therapy
      • Multifactorial Model of Dyspnea in Patients With Cancer
    • ONS Huddle Cards:
      • Hematopoietic Stem Cell Transplantation
      • Proton therapy
      • Radiation
      • Sepsis
    • ONS Guidelines™ and Symptom Interventions: Dyspnea
    • American Cancer Society patient resources:
      • Shortness of Breath
      • Infections in People With Cancer
    • American Lung Association

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "[Intensity-modulated radiation therapy] is a type of radiation that can really take into account certain movements. And this is particularly important with the lungs, because we can't necessarily have patients hold their breath for a long period of time, so the chest rises and falls and the heart beats while you're trying to do radiation to the lungs. So with IMRT, they can simulate that, so that the beam is going to follow that specific movement in that patient. That's really helpful because then, hopefully, we're going to keep that radiation dose mostly on cancer tissue and not on healthy tissue. And thus, that should reduce the amount of radiation that's to the healthy tissue and hopefully reduce pneumonitis." TS 3:44

    "Proton beam radiation is something that we've described in the past as radiation that will typically have an entrance dose but not an exit dose, so minimizing toxicity by hopefully around 50%. … If you're doing proton beam therapy, that radiation is designed to only have an entrance dose from either the back or the front or the side, whichever way they're going, but then hopefully stop on a dime at that tumor so that they're only really getting the entrance dose of that radiation. … So in turn, especially if you're doing that to the lungs, that should minimize dose of radiation to healthy lung tissue." TS 5:03

    "If they're having a fever, low blood count, thick ugly mucus, this often, typically can be infection as well. And then get a chest x-ray because, a lot of times I've been saying for a lot of these things, we need a CT scan to see this. Actually, infection is probably best noted on a chest x-ray because this is something that will consolidate." TS 18:58

    "[Tumors] may be directly invading a vessel. They may directly be invading the bronchus where there's a lot of capillaries or there's a lot of blood vessels that can break and then cause them to cough up blood. You can have tumors or prior treatment that then cause a bronchial fistula that then can cause bleeding. Patients with squamous cell carcinoma of the lung are much more likely to have hemoptysis and pulmonary hemorrhage than patients with adenocarcinoma, though it definitely can happen with adenocarcinoma as well." TS 22:00

    "One of the best treatments for tumor-direct hemorrhage is radiation. This is where radiation can be very helpful for these patients. It's one of the first things that we do. We're going to go in with radiation, shrink that tumor really fast to get it away from those vessels, so patients stop bleeding." TS 27:17


    Episode 312: Virtual Nursing in Health Care May 17, 2024
    Show notes

    "I think a virtual nurse can have the same sort of presence that a bedside nurse does. I like to think of a virtual nurse as pulling up a virtual chair next to that patient and spending time to ask questions and engage with them," Laura Gartner, DNP, MS, RN, NEA-BC, associate chief nursing informatics officer for inpatient shared services and north region at Jefferson Health in the Philadelphia, PA, area told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about virtual nursing care.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to virtual nursing.

    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 episodes:
      • Episode 282: Telehealth-Based Oncology Palliative Care
      • Episode 136: Nurse Innovators Use Telehealth to Improve Adult and Pediatric Symptom Reporting
      • Episode 109: Is Telehealth the Future of Cancer Care?
    • ONS Voice articles:
      • How's Your Video Telehealth 'Webside Manner'?
      • Innovative Solutions to Maximize Oncology Nurse Staffing During a Nursing Shortage
      • Personalized Patient Education: Ensure Effective, Inclusive, and Equitable Patient Education With These Five Strategies
      • Telehealth: The Future Is Now for Patient-Centered Care
    • ONS book: Telephone Triage for Oncology Nurses (third edition)
    • Clinical Journal of Oncology Nursing articles:
      • Nursing Telemedicine Educational Encounters: Improved Patient Satisfaction in Radiation Therapy Clinics
      • Oncology Nurse Navigation: Expansion of the Navigator Role Through Telehealth
      • Telehealth Use in Rural North Carolina Counties: Perceptions Among Patients With Acute Myeloid Leukemia
      • Telemedicine Versus Clinic Visit: A Pilot Study of Patient Satisfaction and Recall of Diet and Exercise Recommendations From Survivorship Care Plans
    • Oncology Nursing Forum articles:
      • A Telemedicine-Delivered Nursing Intervention for Cancer-Related Distress in Rural Survivors
      • Breast Cancer Survivors' Satisfaction and Information Recall of Telehealth Survivorship Care Plan Appointments During the COVID-19 Pandemic
      • Rural Cancer Survivors' Perceptions of a Nurse-Led Telehealth Intervention to Manage Cancer-Related Distress
      • Telenursing Interventions for Patients With Cancer Receiving Chemotherapy: A Scoping Review
    • ONS Clinical Practice Resource: Racial Disparities in Cancer Care: Telehealth and Clinical Trial Options
    • Jefferson Health press release: Jefferson Health Launches Virtual Nurse Program

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "I think that the virtual nurse plays a really important role in nurse staffing shortages. With this shortage, we need to get creative and think outside the box so that we can facilitate nurse wellness, work-life balance, and satisfaction and make our hospitals the place that nurses want to work. I firmly believe that nothing can replace the physical touch, but there are so many things a nurse does every day that can be done by somebody remotely that can reduce the workload of that bedside nurse." TS 3:28

    "About eight nurses between these two floors have volunteered to take on this role as a virtual nurse, and so they will come right from that floor. But there's a lot of conversation about whether you should use staff from the floor, if you should use other people, things along those lines. But right now, we really hope and think that the nurses we've identified for this phase have a relationship with these units. They know how the units work, and that might help get everybody working together." TS 6:37

    "We found that it was really important to have a virtual knock for the patient so that you're not just popping into a room and taking a patient off guard. Privacy features for the patient—so if there's a camera pointing at the patient all the time, that gives a patient a little unease. 'Is somebody watching me?' And when we weren't really watching them all the time; it was intermittent care, so having a camera turn away from the patient when it's off or have a clear indicator that it's not on." TS 11:57

    "In terms of lessons learned with the virtual staff…I don't think that you can just take any nurse off the floor and put them behind a camera. There is a bit of a 'webside manner,' if you will. People need to be comfortable doing things remotely where they can't touch the patient, or having a conversation with somebody through a camera might not be a skill that everybody has or is comfortable doing." TS 13:39

    "I don't think a virtual nurse can replace that physical touch. What I see a virtual nurse is, is another member of the care team whose care complements the care the bedside nurse is providing. I don't think that we should be looking to remove resources from the bedside with this nursing shortage but rather evaluate what our nurses are doing, identify if there's tasks that someone else can do for them so that they can focus on the patient. And there are plenty of things that a virtual nurse could do so that the bedside nurse can spend more time doing quality work with that patient." TS 21:40


    Episode 311: Standardized Pregnancy Testing Processes in Cancer Care May 10, 2024
    Show notes

    "Chemotherapy exposure during the first trimester is contraindicated and increases the risk of spontaneous abortion, fetal death, and major congenital malformations. Second- and third-trimester exposure may affect some body systems still developing and can still result in fetal growth restriction, low birth weight, and preterm labor. Yet, I do want to stress that pregnancy can remain a possibility," Kelsey Miller, MSN, RN, AGCNS-BC, OCN®, clinical nurse specialist in oncology and infusion therapy at Reading Hospital in West Reading, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about policies and procedures for pregnancy testing during cancer treatment.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to pregnancy screening procedures during cancer treatment.

    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 episodes:
      • Episode 217: Support Pregnant and Postpartum Patients During Cancer Diagnosis and Treatment
      • Episode 208: How to Have Fertility Preservation Conversations With Your Patients
    • ONS Voice article: The Case of the Pregnancy Predicament
    • ONS book: Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum (second edition)
    • Clinical Journal of Oncology Nursing articles:
      • Pregnancy and Cancer Treatment: Developing a Standardized Testing Policy and Procedure
      • Unintended Pregnancy: A Systematic Review of Contraception Use and Counseling in Women With Cancer
    • ONS Huddle Cards
      • Fertility Preservation
      • Sexuality
    • ONS Congress® abstract: System Approach to Fertility Preservation and Pregnancy Status During Active Cancer Treatment (by Kelsey Miller and Ainsley Hartman)
    • ECHO program (Enriching Communication Skills for Health Professionals in Oncofertility)
    • Journal of the National Comprehensive Cancer Network article: Pregnancy Screening in Patients With Cancer
    • National Comprehensive Cancer Network Guidelines: Adolescent and Young Adult (AYA) 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 pubONSVoice@ons.org.

    Highlights From This Episode

    "It's really crucial to identify [pregnancy] prior to treatment, as this should be considered a patient safety 'never' event. We know that exposure to chemotherapy or radiation can cause mutagenic changes in reproductive cells and teratogenic effects in a developing fetus. Women of childbearing potential should have a documented pregnancy test prior to beginning cancer treatment due to the adverse effects of chemotherapy and radiation on a developing fetus." TS 1:42

    "We had a fertility risk checklist that was based off American Society of Clinical Oncology standards, that was not fully operationalized nor built into physician workflows. The checklist was a way of documenting that risks of infertility, fertility preservation, and contraception was discussed, as well as an attestation that referral to a reproductive endocrinologist was made if needed. I had a physician partner at the time who said the only way to get the providers to fill out this checklist is to make it a hard stop, so that's what we did. The fertility risk checklist is now a hard stop by means of an order validation that will pop up when the provider goes to sign the oncology treatment plan, and it will say, 'Orders cannot be signed unless the fertility risk checklist is complete.'" TS 9:27

    "Whenever I develop teams, I like to share a common vision. We're all here for patient safety, and we want to prevent harm by pregnancy screening these patients that could potentially become pregnant during cancer treatment." TS 13:20

    "There's a misconception that all cancer therapy will render patients infertile, and this is not the case. Even though chemotherapy and radiation reduce fertility and may cause premature ovarian failure, many patients still remain fertile. And we know from research that physical intimacy remains important during cancer treatment, and unintended pregnancies may occur." TS 18:13


    Episode 310: Pharmacology 101: Androgen Receptor Inhibitors and Antiandrogens May 03, 2024
    Show notes

    Episode 310: Pharmacology 101: Androgen Receptor Inhibitors and Antiandrogens

    "The things that I think creep up are things that unfortunately are quite common, and that's hot flashes. I've had patients say that those are just overwhelming, and they want to go off therapy because of it. So I think talking about pharmacologic management, as well as lifestyle management, of hot flashes, are equally as important," Rowena "Moe" Schwartz, PharmD, BCOP, FHOPA, professor of pharmacy practice at James L. Winkle College of Pharmacy at the University of Cincinnati in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about androgen receptor inhibitor and antiandrogen drug classes.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to androgen receptor inhibitors and antiandrogens.

    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 episodes:
      • Pharmacology 101 series
      • Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs
      • Episode 194: Sex Is a Component of Patient-Centered Care
      • Episode 113: Manage Cancer-Related Hot Flashes With ONS Guidelines™
    • ONS Voice articles:
      • Oncology Drug Reference Sheet: Darolutamide
      • Oncology Drug Reference Sheet: Relugolix
      • Genetic Disorder Reference Sheet: HOXB13
      • Sexual Considerations for Patients With Cancer
      • Nursing Considerations for Prostate Cancer Survivorship Care
      • Exercise Before ADT Treatment Reduces Rate of Side Effects
    • ONS books:
      • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
      • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
    • Oncology Nursing Forum articles:
      • An Exploratory Study of Cognitive Function and Central Adiposity in Men Receiving Androgen Deprivation Therapy for Prostate Cancer
      • Management of Androgen Deprivation Therapy–Associated Hot Flashes in Men With Prostate Cancer
    • Clinical Journal of Oncology Nursing articles:
      • Hot Flashes: Clinical Summary of the ONS Guidelines™ for Cancer Treatment-Related Hot Flashes in Women With Breast Cancer and Men With Prostate Cancer
      • Hot Flashes: Common Side Effect
      • Genitourinary Distress: Common Side Effect
    • ONS Guidelines™ and Symptom Interventions
      • Fatigue
      • Hot Flashes
      • Oral Anticancer Medication
    • ONS Huddle Cards:
      • Altered Body Image
      • Hormone Therapy
      • Sexuality
    • ONS Cancer of the Genitourinary Tract Learning Library
    • Cancer Research article: Studies on Prostatic Cancer. I. The Effect of Castration, of Estrogen and of Androgen Injection on Serum Phosphatases in Metastatic Carcinoma of the Prostate

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "The androgen deprivation therapy is either orchiectomy, which we tend not to use as much anymore; LHRH agonists, meaning that they act like LHRH…and then now LHRH antagonists are taking an increased role because we now have an oral drug that is an LHRH antagonist." TS 3:44

    "When you give an LHRH agonist, you initially have an increase in testosterone, but over time you cause a decrease in the ability of the pituitary to produce luteinizing hormone. Therefore, you get decreased stimulation in the testes to produce androgens. So when you think of an LHRH agonist, by continual use, what you do—you get an initial surge and then a decrease overall if patients stay on the drug. And so LHRH agonists—leuprolide, goserelin, triptorelin—those are agents that are agonist. LHRH antagonists have a direct effect to block the receptor and decrease release of luteinizing hormone and follicle-stimulating hormone, ultimately decreasing testosterone. LHRH antagonists don't have that surge of testosterone. They have an immediate effect of decreasing testosterone." TS 4:41

    "In terms of the LHRH antagonists, we've only had one drug for a while that's an antagonist. That's degarelix. Recently there was the approval of relugolix, which is an oral LHRH antagonist. And that has shown to have great effect in a noninferiority trial in terms to the LHRH agonists. And also there's some benefit with decreased cardiovascular risk with that drug. So I think this is the drug we're starting to see more and more." TS 7:01

    "The other thing with abiraterone acetate, it is recommended by labeling to take on an empty stomach at least an hour before two hours after a meal. But there is data that you can use a lower dose with a low-fat meal, and so you will see many providers providing a lower dose, often to get around the cost issue sometime around the pill burden. And that needs to be taken with a low-fat meal. So I have patients who are on the lower dose. We've talked about taking it with a low-fat meal. Now specialty pharmacy has talked about it. And then they read stuff that's online or in the literature and they're like, 'Oh, I shouldn't be taking this with any food at all.' So it's really important to make sure that you educate patients how to take the medication and warn them if there's different instruction out there than what you're giving." TS 16:47

    "Adherence to the schedule—a lot of times people are getting LHRH agonists every three months. … Maybe you're going to miss it this month. You miss one dose—that's six months. So it's really important that if people are going to not be able to get their injection, that they call, and it's rescheduled, and they have a mechanism to make sure that you don't lose people to follow up. So adherence to all therapy—essential." TS 21:27


    Episode 309: What Brings You to ONS Congress®? Apr 26, 2024
    Show notes

    "It was really the ability to be able to connect with many individuals from my profession. Reflecting on what initially drew me to ONS Congress, I can't help but reminisce about my first time attending in 2002. I was going down memory lane the other day and found some pictures from my first time attending. As I reflected, I could not help but feel immensely grateful for the support and education I received as a novice nurse during that time from attending Congress," Jessica MacIntyre, DNP, MBA, APRN, AOCNP®, 2024–2026 ONS president, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about ONS Congress. Taylor spoke with several 2024 ONS Congress attendees, asking the question "What brought you to ONS Congress?" Listen to their stories and learn how the conference has affected their careers in this special episode.

    Music Credit: "Fireflies and Stardust" by Kevin MacLeod

    Licensed under Creative Commons by Attribution 3.0

    Episode Notes

    • Information on submitting an abstract to ONS Congress
    • Oncology Nursing Foundation ONS Congress Scholarships
    • Oncology Nursing Podcast episodes:
      • Episode 258: ONS Through the Ages: Stories From the Early Days With Cindi Cantril and George Hill
      • Episode 160: Build Innovative Staff Education Tools and Resources
      • Episode 191: Explore Orientation Opportunities for New-to-Practice Nurses
    • ONS Voice articles:
      • Our Unified Voices Can Improve Cancer Survivorship Care
      • Personalized Patient Education: Ensure Effective, Inclusive, and Equitable Patient Education With These Five Strategies
    • ONS Congress presentations from episode guests
      • The Nurse as an Effective Educator: Facilitating Patient-Centered Learning (Beau Amaya)
      • Powerful Outcomes From Nurse and Patient Policy Advocacy (Gilanie De Castro)
      • Back to Basics: Utilizing Huddles to Emphasize Standard Care and Maintenance of Central Venous Catheters in an Effort to Reduce CLABSI (Erin Hillmon)
      • Enhancing Triage Precision: Nurse Navigation's Impact on a Lymphedema Program (Jessica MacIntyre)
      • Implementing a Graduate Nurse Residency Program (Leah Scaramuzzo)

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "What I want to accomplish is really to contribute significantly to an organization that has contributed so greatly to me. And until you go to Congress, you don't fully realize the ripple effect that ONS has on the field of oncology nursing. They really are a cornerstone to our profession. So when I volunteer with ONS, I feel like I'm serving the oncology nursing community as a whole, and I'm so grateful to get to do that on a national level." (Stacey Clements, BSN, RN) TS 3:35

    "What is bringing me to Congress is to talk about patient education, health literacy, ways that we can improve the patient experience and help them understanding. And I think this is such an important topic because it's what we do at the core of nursing. We really teach patients and their caregivers how to take care of themselves. And sometimes we forget that it's not just a checklist to get the education done. It's really learning what the patient needs, what they need to think about—some consideration about what may be affecting the way that they're retaining information. Then hopefully I can give some tools and have some discussion with many different nurses across the U.S." (Beau Amaya, MS, RN, OCN®) TS 5:04

    "Why I am so excited to attend Congress is that it really gives us an opportunity to work together with our colleagues, learn what each other is doing, and kind of leverage our collective wisdom. So this way we work smarter instead of harder." (Leah Scaramuzzo, MSN, RN, MEDSURG-BC, AOCN®) TS 7:58

    "I was a scholarship recipient, which I was super excited to receive this year for the Congress 2024 in D.C. … Out of COVID, we all were virtual, so I wanted to able to see people in person and attend a national event. Also, I'm looking forward to reigniting my passion for oncology nursing because you kind of get burned out after a while in this field." (Brenda Marsolek, BSN, RN, OCN®) TS 9:14

    "I'm also really excited to share my role as a nurse resident. I hear a lot that new nurses shouldn't be hired in oncology or it's difficult to hire them. And I did it. I successfully did it with the help of [Leah and Brenda]. And so, I think other people can do that as well and that we can have new grad nurses have really healthy careers in oncology in the future." (Brandy Thornberry, ASN, RN, OCN®) TS 10:38

    "I chose to be a presenter this year because I always enjoyed listening to the presentations that everyone else brings to Congress. I always learned so much. I wanted the opportunity to be able to share one of the projects I did last year that had great results attached to it, so that hopefully others can listen to my presentation and maybe take something away from it back to their own centers." (Erin Hillmon, MSN, RN, BMTCN®) TS 11:28

    "Nurses can find ways to engage in shaping health policy. Many nurses don't recognize the connection between health policy and the bedside. Policies beyond one's institutions or organizations have a direct impact on how we nurses practice. And my goal is to empower nurses to understand that because of our professional experience, education, and interactions with those populations who we care for, we are really poised to influence and shape health policy." (Gilanie De Castro, MSN, RN, OCN®, NE-BC, CNML) TS 14:38

    "The big thing I want to let everybody know about Congress is that there's so much to learn, and there's so much experience that every attendee brings. No matter what level of education you have, what setting you work in, what kind of patients you take care of, everybody has something that they can bring to the table. It doesn't matter where you learn this information either. There's lots of sessions, posters, and networking roundtables. What I've learned in these few years is really just embracing what Congress can bring to everybody. So for anybody that's on the fence, I'd urge you to take that leap and register. Attending Congress is a decision you won't regret." (Holly Tenaglia, DNP, APRN, AGCNS-BC, OCN®) TS 19:47


    Episode 308: Hazardous Drugs and Hazardous Waste: Personal, Patient, and Environmental Safety Apr 19, 2024
    Show notes

    "One of the things that I know Dr. [Tom] Connor worked on very heavily in his career is the long-term impact on the health of nurses and other exposed healthcare workers. We definitely need more longitudinal studies, which are difficult to do. And it's not something that you see every day where I talk to chemo nurses and said, 'Hey, I've been in this 20 years. It hasn't bothered me at all.' Well, until it does. Therefore, it's so important when we're training incoming nurses—how very important it is to start with these practices early in the career and throughout the career," Charlotte A. Smith, RPh, MS, senior regulatory advisor at Waste Management PharmEcology Services in Milwaukee, WI, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about hazardous drug and waste disposal.

    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 NCPD by the American Nurses Credentialing Center's Commission on Accreditation.

    Learning outcome: Learners will report an increase in knowledge related to hazardous drugs and hazardous waste.

    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 episodes:
      • Episode 209: Updates in Chemo PPE and Safe Handling
      • Episode 142: The How-To of Home Infusions
    • ONS Voice articles:
      • Two Oncology Nurses Implement Process to Allow Patients to Disconnect Pumps From the Comfort of Their Own Homes
      • The Oncology Nurse's Role in Oral Anticancer Therapies
      • Strategies to Promote Safe Medication Administration Practices
    • ONS Safe Handling of Hazardous Drugs Learning Library
    • ONS position statement: Infusion of Antineoplastic Therapies in the Home
    • ONS book: Safe Handling of Hazardous Drugs (fourth edition)
    • ONS course: Safe Handling Basics
    • Clinical Journal of Oncology Nursing articles:
      • Environmental Risk Factors: The Role of Oncology Nurses in Assessing and Reducing the Risk for Exposure
      • Oral Chemotherapy: A Home Safety Educational Framework for Healthcare Providers, Patients, and Caregivers
      • Oral Chemotherapy: An Evidence-Based Practice Change for Safe Handling of Patient Waste
      • Reconciliation and Disposal of Oral Medication: Creating a Safe Process for Clinical Research Personnel
    • Pharmacy Practice News article: Applying NIOSH Hazardous Drug Assessment of Risk Principles To Home Healthcare (by Charlotte Smith and Tom Connor)
    • Books mentioned in this episode:
      • Silent Spring by Rachel Carson
      • Our Stolen Future by Theo Colborn, Diane Dumanoski, and John Peterson Myers
      • Generations at Risk by Ted Schettler, Gina Solomon, Maria Valenti, and Annette Huddle
    • Drug Enforcement Agency: National Prescription Drug Takeback Day
    • Environmental Protection Agency: Final Rule: Management Standards for Hazardous Waste Pharmaceuticals and Amendment to the P075 Listing for Nicotine
    • MD Anderson Cancer Center: Chemotherapy at Home: 9 Things to Know (patient resource)
    • Memorial Sloan Kettering Cancer Center: Safe Handling of Chemotherapy and Biotherapy at Home (patient resource)
    • National Institute for Occupational Safety and Health:
      • Hazardous Drugs in Healthcare Settings
      • Managing Hazardous Drug Exposures: Information for Healthcare Settings
      • NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016

    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 pubONSVoice@ons.org.

    Highlights From This Episode

    "A hazardous waste is a chemical, some of which are drugs, that EPA has determined is hazardous to the environment. Hazardous waste may be listed waste, which are given actual numbers, or they may be characteristic waste, which meets certain levels of concern, such as ignitability or toxicity. Only a small percentage of drug waste meets the EPA's definition of hazardous waste, including a number of chemotherapy drugs." TS 2:09

    "The poster child for hazardous waste is warfarin, which, as you may be aware, is not only appropriate for managing clotting time but is also available commercially as rat poison. This is an example of how chemicals can serve more than one purpose and why dosage and regulation are so important." TS 4:04

    "Some of your listeners may have been around long enough to remember the book Silent Spring, by Rachel Carson, in which she eloquently exposed the risks to many species by the widespread use of DDT, an insecticide, at that time. More recently, the book Our Stolen Future by Theo Colborn, a pharmacist, Diane Dumanoski, and John Peterson Myers, raised the specter of the effects of endocrine disruption on wildlife and humans. The effects of drugs like diethylstilbestrol, or DES, once given during pregnancy, on the fetus, impacted the risk of cancer and other untoward effects in the offspring. The book remains a dramatic reminder of the risk of exposure to hazardous chemicals, including drugs." TS 9:37

    "Providing a homecare checklist for both the nurse and the patient and family is a simple way to keep track of all areas that need to be covered. For example, who in the household may be at most risk from exposure? This list includes infants, elderly family members, caregivers, pregnant family members, even pets. Is there a secure area to store the drug that cannot be reached by children?" TS 14:21

    "I think what happens—we become so into our routine that what we do on a daily basis, we just kind of go through and do it without always thinking about it. And we can forget that not everyone has the same context of understanding these risks that the medications have to both the environment and the individual exposed to them. And I know it's challenging to put on all the gowns and the gloves and whatnot. And, you know, it gets in the way of doing their job. It's important to educate each individual potentially exposed to these drugs, as if they do not have the understanding that we do. So embedding those consistent safety practices into daily routine is so imperative to ensure safe handling of hazardous drugs and then the proper disposal of hazardous waste pharmaceuticals." TS 18:55


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