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Articles by Debi Fischer
Using AI as an Oncology Nurse
As an RN working in a 30-bed oncology step-down unit, I am aware that 96% of hospitals in this country use an electronic health care record (EHR). Artificial intelligence (AI) can look at and synthesize data to create algorithms that can alert nurses and social workers to take action in the oncology unit and other arenas. These clinicians can familiarize themselves with AI.
Revisiting My Interview With Suzanne Somers
Back in 2009, I interviewed Suzanne Somers who died on Sunday October 15, 2023, from an aggressive form of breast cancer. After I finished my master’s in social work (MSW) at Florida International University, I wanted to see if I could try to get some experience at a college radio station. My goal was to try to get on public radio as an RN/MSW and discuss health care and mental health.
What I Learned During Oral Chemotherapy Orientation
I recently received orientation/training in administering oral, known as “PO chemotherapy,” at the hospital where I work. This was a formalized training where my only responsibility that day was to administer chemotherapy while I was supervised by an experienced nurse. Like many other nurses, I have an oral chemotherapy card from the Oncology Nursing Society which is renewable every 2 years.
Opinion: We Need to Advocate for Patients During the Chemotherapy Shortage
Carboplatin and cisplatin are in shorter supply than normal. It has been reported that this chemotherapy shortage began when 1 manufacturing facility began to experience a quality issue. Because only 5 manufacturers produce these drugs, the quality issue started a ripple effect. Carboplatin contains platinum that prevents the progress of cancer cells by harming their DNA. Cisplatin is an alkylating agent which halts cancer cells from dividing and renders them dead.
Opinion: The Chemotherapy Shortage Is Hard to Wrap Your Head Around
As an RN in a surgical oncology unit, I have cared for many patients receiving chemotherapy. What happens when there is a shortage of chemotherapy drugs? How will this affect patients? Let us consider some patient stories: Kathy, a 40-year-old writer, was diagnosed with triple-negative breast cancer. She is receiving care at a well-known hospital in Florida. They are out of carboplatin that she needs to survive. But it isn’t available. Denise, a 65-year-old IT consultant, has stage III breast cancer.
Opinion: The Epic Rover App Is An Easy Way to Elevate Oncology Nursing Practice
Epic Rover uses a “mobile application interface” that enables RNs and other clinicians to give medications, look at patient records, and chart in real time.1 The Epic website lists 4 main innovative features. These features are “touchscreen functionality,” “mobility for core workflows,” “in-app camera access,” and “task management.”1 As far as camera access is concerned, I have already used Epic Rover for wound care documentation.
Opinion: New Technology Can Help Improve Patient Communication in the Oncology Setting
Being able to communicate with patients is a key component of delivering care, especially in surgical oncology. No matter how skilled the surgeon is, if the patient does not understand their plan for the shift or the entire length of their stay, they will be lost in a sea of misunderstanding. As a nurse, have you ever considered what this experience is like for a patient that has trouble communicating?
Opinion: The Iris App Could Be a “Game-Changer” for Patients With Cancer
An e-poster presentation that caught my attention during the 48th Annual Oncology Nursing Society Conference in April highlighted the potential benefit of a new app called Iris. The app was developed by Oncohealth, and the presentation was authored by Amy Pilotte, ANP-BC, ACHPN, OCN, along with 5 other RNs—all of whom are associated with OncoHealth. The idea behind the Iris app was to use technology to deliver supportive care to all patients with cancer.
Opinion: Professional Development Plans Can Help Build Nursing Resilience
During the 48th Annual Oncology Nursing Society Congress, Kate B. Hubbard, MSN, RN, OCN, NPD-BC; and Elaine S. DeMeyer, MSN, RN, AOCN, presented an e-poster that spoke to my career paths as an RN and LCSW. The name of the e-poster was Building Resilience by Creating a Professional Development Plan. The authors argue that creating a specific career development plan is a useful strategy to mitigate burnout.
Cancer Support Groups of Interest to RNs and Social Workers
As RNs and social workers who are in the day-to-day reality of the minefield that is cancer, we see the toll that this disease has on the patient population. Support groups give the tools to the patient to cope with this unforgiving illness. These groups can meet in-person, at the hospital in patient unit, or virtually. A look at these programs yielded valuable information that RNs and social workers can pass on to their patients and their family members.
Opinion: Innovative Strategies Improve Travel Nurse Orientation at Major Cancer Center
In this column, I looked at outcomes from a travel nurse orientation program that were recently presented in a poster at the 48th annual Oncology Nursing Society (ONS) Congress.1 This poster was presented by Clare Acquilano, BSN, RN, who is a staff nurse at the Wilmot Cancer Institute, in Rochester, New York. The poster highlights how changes in health care after the pandemic have increased the need for travel nurses. As a result, better orientation for travel nurses has become important.
Integrative Health Resources for the Oncology RN or Social Worker
The National Cancer Institute, (NCI) defines integrative medicine as a view of treatment that acknowledges the importance of aligning accepted medical practice with alternative approaches such as acupuncture and yoga.1 Most practices are geared toward the patient and can include evidence-based treatments that seek to help treat the entire person. Patients who receive integrative oncology treatments should also receive their standard medications, such as chemotherapy, surgery or radiation.
Opinion: Novel Data Collection Method May Provide New Insight on Cancer Recurrence
There is currently no population-level data system monitoring cancer recurrence standard in the United States. However, oncology nurses and social workers who work in Florida now have a new tool in their fight against cancer. The Cancer Connect Collaborative, announced by Florida First Lady, breast cancer survivor and advocate, Casey DeSantis, will make Florida the first state to collect recurrence data at a state-wide level.
Opinion: Improving Hospice Care Is a Concern for Oncology RNs and Social Workers
Combined with the effects of the pandemic, there has been a growing crisis worldwide for those who need hospice and palliative care.
Opinion: Exploring Available Narrative Medicine Courses as an Oncology RN and Social Worker
I have been growing more and more interested in the concept of narrative medicine. I recently became familiar with “A Piece of My Mind,” which is published in JAMA.1 These are essays where clinicians offer their reflections on a myriad of topics regarding their patients and health care in general. In one essay that I read, an emergency department physician, Jonathan Zygowiec, DO, wrote about his experience with stage IV colorectal cancer.
Opinion: Narrative Oncology Can Help RNs and Social Workers Better Relate to Our Work
Narrative medicine was started in 2001 by Rita Charon, MD, PhD, of Columbia University.1 Charon graduated from Harvard Medical School in 1978 and completed her residency at the Montefiore Hospital and Medical Center in the Bronx, New York, before going on to teach at Columbia University College of Physicians and Surgeons. Throughout the 1990s, she completed both a masters and a doctorate in English.
Opinion: Clear Communication Is A Form Of Patient Advocacy
Advocacy is naturally embedded into the workflow of oncology nurses and clinical social workers. According to Blackburn et al, advocacy is defined as “identifying a cause or issue, building support for this cause, and influencing decision-making bodies, such as state or national legislatures, to take action toward a desired outcome.”1 The most famous nurse advocate was Florence Nightingale, who is credited as being in the background as a “shadow author”1 for early health care policy.
Donation Awareness For The Month of February
Debi Fischer, MSW, BSN, BA, LCSW, RN February is a month to celebrate love. It is also a great time to review vital information for RNs and social workers about donations in the form of eye, organs, tissues, hair, and blood. National Donor Day always occurs during the month of February, and for RNs and clinical social workers in oncology, information regarding donations can be part of our wheelhouse.1 For RNs and clinical social workers some of this review about donation might be new information.
Opinion: As RNs We Must Strive to Help Improve Cancer Prevention
Debi Fischer, MSW, BSN, BA, LCSW, RN In 2023, the theme for National Cancer Prevention Month, which takes place in February, is “Close the Care Gap.” As RNs and social workers, it is vital that we familiarize ourselves with information to address care gaps, such as screening and preventive measures, in order to inform and educate our patients.
Opinion: Nurses on Social Media Have A Responsibility to Be Professional
Debi Fischer, MSW, BSN, BA, LCSW, RN Working the night shift in surgical oncology has given me time to observe that the patients, for the most part, are online. They are either texting or on FaceTime with friends and family to stay connected with the outside world. With the Internet at their fingertips, they also have time to be on social media, where they can learn about their diagnosis and treatment.
Oncology RNs and Social Workers Play Key Role in Cervical Cancer Awareness and Advocacy
RNs and social workers in oncology are key players in promoting cervical cancer awareness and advocating for patients. As discussed in this series, January is cervical prevention month. As patient advocates, RNs and social workers can help push the agenda of eradicating this disease entirely in a few generations.1 The ribbon associated with this disease is the color teal.
Nurses Must Stay Up-to-Date With Treatments and Clinical Trials for Patients With Cervical Cancer
Oncology nurses and social workers working with patients with cervical cancer must have the most current information regarding available cancer treatment modalities and actively enrolling clinical trials. After a patient receives a diagnosis of cervical cancer, the patient along with her gynecologist can select from a whole host of treatment options. The first step in this journey is to find a board-certified gynecologist oncologist, or GYO.
Opinion: Oncology Nurses Require an Understanding of Cervical Cancer Testing and Screening
January is cervical cancer awareness month. This second article in a series highlights current cervical screening guidelines. It is important that oncology RNs and social workers be aware of the screening and testing guidelines for cervical cancer. For this second article in a weekly series for cervical cancer awareness month, we will look at the current screening recommendations. Pap Smear Information The Papanicolaou test can detect changes involving the cervix before they evolve into cancer.
Cervical Cancer Prevention Comes Into Focus for Awareness Month
The US Congress has officially selected January as Cervical Health Awareness Month.1 This is a disease that afflicts more than 14,000 women in this country every year.1 However, according to the National Cervical Cancer Coalition, this disease is preventable through human papilloma virus (HPV) vaccination and appropriate screening, including Papanicolaou tests. This is the first part of a weekly series on cervical cancer this month.
Opinion: Self-Care Is Key to Preserve Mental and Emotional Wellness for Oncology Nurses
Although there is holiday cheer all around us, RNs in oncology still face the reality of burnout and post-traumatic stress disorder (PTSD). RNs with serious mental illness have been a focus of conversation since Nicole Linton, a travel nurse, was charged with killing 6 people in a horrific car accident.1 Nicole Linton is a 37-year-old travel nurse currently in jail in Los Angeles, California.1 She walked out of her job at a major LA hospital and was involved in a horrific car fatality.
Opinion: The Good Nurse Brings Safe Narcotic Handling to the Forefront of Nursing Minds
Pain management is essential in cancer care, especially in surgical oncology settings. Oncology RNs may administer narcotic pain killers to their patients on either a prn (“pro re nata” or as needed basis) or a scheduled basis. Unfortunately, this also opens the door to nurse abuse of high-risk medications, and other issues.
Opinion: The Return of the Hospital Visitors Merits Conversation About Workplace Violence
In addition to worrying about the staffing needs in oncology units, RNs are facing workplace violence concerns at increasing rates. Workplace violence events can mean violence between staff membors or with visitors. As COVID-19 restrictions are relaxing and more hopsitals are welcoming visitors, safety considerations have become more relevant.
Opinion: Oncology Nurses Should Know the Celebrity Stars Raising Cancer Awareness
Teddi Mellencamp, celebrity known for her appearance on the Real Housewives of Beverly Hills, is currently battling stage 2 melanoma. She discovered this at her 3-month checkup after an initial melanoma surgery.
Opinion: The Couric Effect May Be Just What the Breast Cancer Community Needs
In the middle of Breast Cancer Awareness month, First Lady Jill Biden visited Miami, Florida, where I am based, to spotlight President Biden’s Cancer Moonshot initiative, which is designed to combat and end cancer.
Opinion: Oncology Nurses Should Know the History of the Pink Breast Cancer Awareness Ribbon
October is Breast Cancer Awareness month. This disease is relentless and again back in the news. This past week, TV journalist Katie Couric, revealed she had received a diagnosis of breast cancer in June. Couric, age 65, has been treated with radiation and a lumpectomy.
Opinion: New Cancer Treatment Options in Florida Represent Larger Shift Toward Centralized Care
Florida’s First Lady, Casey DeSantis has used her role as a breast cancer survivor to advocate for new funding for the state. This started in December 2021, when the First Lady spearheaded a $100 million proposal for cancer treatment as well as research.1 DeSantis is now cancer free since March 2022 after undergoing lifesaving surgery and radiation therapy.
Opinion: Understanding Spoon Theory Is Essential for Oncology Nurses
Cancer has become a chronic illness for many individuals. Thanks to advances in oncology, the number of long-term survivors is growing. However, this disease often saps patients and, by extension, nurses of their strength. The spoon theory has been widely used in chronic illnesses such as lupus, but it can also be applied to cancer.
Opinion: Agency Nurses May Not Be The Answer To Surgical Oncology Staffing Issues
“It’s so depressing on this floor. All my patients are dying, I need help changing a colostomy bag. It just exploded.”These are common remarks that staff surgical oncology nurses are used to hearing from agency nurses. Years ago, hospitals were reluctant or cautious in hiring agency nurses. The era of COVID-19 changed this playing field. Now it is the norm.
Opinion: New Visitor Act in Florida Will Improve Quality of Life for Patients in Oncology Units
Patients with cancer have been affected by changes to visitor policies instituted during the COVID-19 pandemic. Prior to this time, hospital visitation policies were relaxed and rarely enforced. As a staff RN in a surgical oncology unit I routinely encountered multiple family members and friends gathered together in a patient’s room prior to the pandemic. Then, seemingly overnight, visitors started to decrease and vanish. The only exception was if an individual was actively dying in a hospice unit.
FDA Approves FoundationOne Liquid CDx Liquid Biopsy for Solid Tumors
The FDA has approved the FoundationOne Liquid CDx, a liquid biopsy for all solid tumors with multiple companion diagnostic indications.1,2 The regulatory decision was based on analytical and clinical validation studies that collected over 7500 samples and 30,000 unique variants across more than 30 tumor types.
Nursing School vs. COVID-19: Tell Us Your Experiences
Schools across the United States have switched to virtual learning in recent months, affecting the next generation of nurses who are still training in the profession. Oncology Nursing News wants to hear from people who are in nursing school or furthering their education. Take our survey on nursing school and tell us how your educational and clinical experience has been impacted by the coronavirus disease 2019 (COVID-19) pandemic.
Patients and Fellow Providers Offer Advice for Oncology Nurses
A job in oncology nursing is both stressful and rewarding—whether you have been working in the profession for 10 days or 10 years. We recently asked our readers and cancer survivors what advice they would give to new oncology nurses. What follows is just some of the advice shared. "Always remember that you are caring for the whole family. They, too, are suffering." – Janet "Take the time to explain each medication, what it is for, how it might affect [patients].
Oncology Nursing News Top Stories: June 2020
Each month, we take a look back at the most popular Oncology Nursing News® stories. Here are the top 5 stories from June 2020. 5. Better Palliative Care Integration Needed for Clinical Trial Participants Take a closer look at a recent study presented at the 2020 ASCO Virtual Scientific Meeting, which showed that patients on phase I clinical trials tended to have improved quality of life outcomes when they received palliative care. 4.
Global COVID-19 Observatory and Resource Center for Childhood Cancer Helps Providers During the Pandemic
Following the arrival of the coronavirus disease 2019 (COVID-19) pandemic, St. Jude Children's Research Hospital launched the first Global COVID-19 Observatory and Resource Center for Childhood Cancer, a dynamic platform to deliver resources for oncologists treating pediatric patients who have been diagnosed with or are at risk for the virus.
FDA Approves Phesgo, an In-Home Breast Cancer Treatment
The FDA approved subcutaneous Phesgo – a combination of pertuzumab (Perjeta), trastuzumab (Herceptin), and hyaluronidase–zzxf – for the treatment of patients with metastatic HER2-positive breast cancer, as well as early-stage HER2-positive breast cancer, as selected by an FDA-approved companion diagnostic test. Of note, the drug can be delivered at home by a healthcare professional. “Currently, most patients with HER2-positive breast cancer receive trastuzumab and pertuzumab at infusion centers.
PIK3A-Mutant Breast Cancer Shows Increased Sensitivity to PI3Kα Inhibition
“Double PIK3CA mutations are a novel and frequent genomic alteration in PIK3CA-mutant cancers,” said Neil Vasan, MD, PhD, medical oncologist at Memorial Sloan Kettering Cancer Center in New York, New York during a presentation that the AACR Virtual Annual Meeting II. “These findings confirm that [patients with] breast cancer [with] multiple mutant tumors achieve higher clinical benefit to PI3Kα inhibition compared to single mutant tumors.
Preparing Nurses for the 'Silver Tsunami'
About 10,000 Americans turn 65 each day, bringing on what some call a "silver tsunami" of geriatric patients flooding the healthcare system. However, less than 1% of nurses are geriatric certified.
Breast Cancer Simplified
My phone lit up with a message from a friend in a nearby town. “Let’s get together for lunch this week.” I responded with, “Sure, what’s up?” Her answer made me sit down. “Breast cancer.” Breast Cancer Statistics The “C” word is met with foreboding by us all, but breast cancer brings along with it a special dread to women: possible breast-altering surgery, treatment that can include chemo and radiation and the increasingly less likely risk of death.
Workplace Violence - What's the Law?
Dangers on the Job Nurses face many dangers on the job: from exposure to communicable diseases to high nurse/patient ratios to other staffing issues. However, one topic comes up consistently as a top concern - workplace violence. A group of nurses from Lakeland Healthcare System tackled this topic via a poster presentation at NTI 2019 in Orlando, Florida. Mary Watts, BSN, RN, allnurses.com’s Content and Community Director led a forum on this topic to further discuss their research.
Treatment of Depression and Fatigue in Cancer Survivors Needs Improvement
Cancer and its treatments can bring a number of adverse events (AEs), and as more patients are living longer after their treatment, these effects can become long-lasting. Often, oncology nurses are the first line of defense in communicating with patients about how they are feeling.
Oncology Nurses Must Navigate Difficult End-of-Life Discussions
One of the unique aspects of oncology nursing is our ability to be present during some of the most dark times patients face. Through this, we develop relationships that lead to meaningful connections and trust. Our patients will come to us and trust us to speak the truth, as well as seek a safe place where they can share their darkest and deepest secrets and concerns. Being present requires the ability to engage in conversations that ensure patients’ goals of care align with their priorities.
Plan Ahead to Get the Most Out of Conferences
Nurses often ask me which sessions they should attend when going to an oncology nursing conference, but there is no standard reply. It takes some homework to ensure that they get the most out of their conference experience. They should tailor their plan as much as possible. For example, nurses should consider if the topic of a session is unfamiliar to them and something they want to learn more about. Is the focus an issue that is causing struggles at work?
Earlier, More Thorough Conversations Eases Distress in Advanced-Stage Patients
Nurses and other healthcare providers can mitigate emotional distress and improve quality of life in patients with cancer by having earlier and more thorough conversations about their care, according to a recent study conducted at the Dana-Farber Cancer Institute.
ONN's Top 5 Stories: January 2019
Here are the top 5 Oncology Nursing News stories for January 2019. 5. Nursing Call to Action In her first piece as a contributor for ONN, Angee Kilmer highlights the importance of survivorship planning and the role oncology nurses can play in helping their patients beyond treatment. 4. Rising Cost of Cancer Drugs Takes a Toll While oncology nurses typically focus on the on the physical and emotional side of therapy, they may now have to help patients address financial barriers as well. 3.
FDA Expands Pemetrexed Approval for Frontline Pembrolizumab/Chemo Combo in NSCLC
The FDA has expanded the indication for pemetrexed (Alimta) injection in combination with pembrolizumab (Keytruda) and platinum-based chemotherapy for the first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) without EGFR or ALK alterations.1 The updated indication is based on data from the phase III KEYNOTE-189 trial, which was the basis for the FDA’s full approval of frontline pembrolizumab for use in combination with standard chemotherapy for...
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