Podcasts about clinical journal

“Everyone's brain is extremely heterogenic, so it's different. You can put five of us in a room; we can all have the same diagnosis of a [glioblastoma multiforme], but all of ours can be different. They're highly aggressive biologically. It's a small area in a hard shell. So trying to get through the blood–brain barrier is different. There's a lot of areas of hypoxia in the brain. There's a lot of pressure there. The microbiology is very different—it's a cold environment versus a hot environment—and then the pathways are just different,” Lori Cappello, MSN, APN-C, CCRP, research advanced practice nurse at the John Theurer Cancer Center of Hackensack Meridian Health in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about brain malignancies and caring for patients with them. 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 April 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 related to brain malignancies and their diagnosis and treatment. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 235: Self-Advocacy Skills for Patients Episode 166: Cognitive Behavioral Interventions Help Patients With a Spectrum of Cancer Symptoms ONS Voice articles: Glioblastoma Diagnosis, Treatment, Side Effect Management, and Survivorship Recommendations Blocking Fatty Acid Storage May Induce Glioblastoma Apoptosis Brain Tumor Navigator Role Bridges the Intersection of Cancer and Neuroscience Researchers Tie More Cancers, Mortality to NF1 Disorders Larotrectinib and Other Tumor-Agnostic Targeted Therapies Are Leading Cancer Care Into the Next Frontier McCain Announcement Sheds Light on Nurses' Role in Advance Care Planning ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) Clinical Journal of Oncology Nursing articles: Implementing a Standardized Educational Tool for Patients With Brain Tumors Undergoing Concurrent Temozolomide and Radiation Therapy Exercise Intervention: A Pilot Study to Assess the Feasibility and Impact on Cancer-Related Fatigue and Quality of Life Among Patients With High-Grade Glioma Society for Neuro-Oncology Musella Foundation End Brain Cancer Initiative Brain Tumor Network American Brain Tumor Association Glioblastoma Research Organization Brain Tumor Funders' Collaborative Optune Gio® website Nurse.org article: Mysterious Brain Tumor Cluster Grows: Another Nurse Diagnosed at Newton-Wellesley Lori Cappello's contact information: lori.cappello@hmhn.org 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 glioblastoma actually is the most predominant brain tumor that we do see. It is the most diagnosed of the brain tumors. And then I would say that an anaplastic astrocytoma is probably the second diagnosed. Historically a GBM, they used to say was probably an elderly patient for these. But we are definitely seeing it diagnosed at a much younger age now, definitely much more prevalent for people under 60.” TS 3:17 “Nine times out of ten, either a patient out of nowhere has a seizure, or they present with what they think are stroke-like symptoms. They noticed that they were slurring, or they were becoming more forgetful, or a family member noticed it and said, ‘Hey, what is going on with you?' But usually they present to the [emergency department], and a [computed tomography] scan is always done first. And lo and behold, something is seen.” TS 4:50 “The only other U.S. Food and Drug Administration-approved treatment that has come along in the last 20 years is a device called Optune Gio, which is an alternating electric field that stops cell division at the mitosis stage.” TS 7:45 “They lose so much of their independence, especially if they don't have a caregiver or help. That is huge. Medication management at home, to making sure that they're taking the medication properly, that they are actually taking their medication. Transportation is another huge problem. Getting to and from appointments is a challenge. Those are big issues—real, day-to-day, simple issues that people don't think about.” TS 17:11 “I think that having a brain tumor is very unique in the fact that you really need a dedicated neuro-oncologist. And depending on where you live, there are not a lot in the area. I actually had a patient that was moving out west, and the closest dedicated neuro-oncologist was four hours from them. … if you're not seeing dedicated neuro oncologists, you might not be getting the best treatment for yourself. So I think that having the resources and helping patients find the best care or the best brain tumor society—and there's a bunch of really good brain tumor groups to help patients find the best resources out there. I think that's really, really important for patients to know or for families to know.” TS 19:17 “So trying to help patients, there are always going to be challenges, and there are always going to be ups and downs. But finding that one person that they can go to, that they trust, that they have a great relationship with, whether at the doctor's office or whatever, and being available to them makes such a difference in their journey. I think that that is the most important for anybody in the journey.” TS 22:08 “With brain, there are going to be expectations. They are going to lose functionality at some point—and preparing them for that thing or preparing them for things that can help themselves. Like sometimes I say, ‘Go to the dollar store, get coloring books,' if they have weakness in one hand. Little tricks of the trade that can help them. About treatment options, going through the side effects, preparing them for whatever they can be prepared for.” TS 22:39 “It is not one of the better cancers to have, but it doesn't immediately mean it's a death sentence, and we shouldn't treat them like they're dying. We shouldn't take away their ability to live just because they were diagnosed with it. We shouldn't take away hope.” TS 25:35 “I think there's not enough discussed about [brain malignancies] and the lack of resources for this. These patients need a lot more resources and are available. There's just not enough available for it.” TS 26:59

On this episode of the AMSSM Sports Medcast, host Dr. Jeremy Schroeder, DO, is joined by Dr. Jordan Lyons, MD, who delivered one of the Best Overall Case Presentations during the 2024 AMSSM Annual Meeting in Baltimore, MD. In this conversation, Dr. Lyons discusses his award-winning case – Collapse of a Special Operator: Exertional Illness or More Than Meets the Eye? – and shares the findings and takeaways from this crucial medical diagnosis. Resources: 2024 AMSSM Case Podium Presentations, published in the Clinical Journal of Sport Medicine Exercise Collapse Associated with Sickle Cell Trait Practice Recommendation

On this episode of the AMSSM Sports Medcast, host Dr. Jeremy Schroeder, DO, is joined by Dr. Jordan Lyons, MD, who delivered one of the Best Overall Case Presentations during the 2024 AMSSM Annual Meeting in Baltimore, MD. In this conversation, Dr. Lyons discusses his award-winning case – Collapse of a Special Operator: Exertional Illness or More Than Meets the Eye? – and shares the findings and takeaways from this crucial medical diagnosis. Resources: 2024 AMSSM Case Podium Presentations, published in the Clinical Journal of Sport Medicine Exercise Collapse Associated with Sickle Cell Trait Practice Recommendation

Wie viel Muskulatur kannst Du wirklich aufbauen – ohne Deine Gesundheit zu verzocken? Und woran erkennst Du, wie weit Du Dein genetisches Fitness-Potenzial schon ausgereizt hast?Lass uns gemeinsam ein paar gängige Mythen rund ums genetische Muskelaufbaupotenzial entzaubern. Du erfährst, wie stark Du realistischerweise (und ohne Doping) werden kannst, was BMI und FFMI in dem Kontext wirklich aussagen und wie Du Deine Trainingserfolge besser einordnen kannst – basierend auf Wissenschaft, Erfahrung und einer Grafik, die es auf den Punkt bringt.In dieser Folge erfährst Du:Was das genetische Limit im Muskelaufbau tatsächlich bedeutetWie Du den FFMI nutzt, um Deinen Fortschritt greifbar zu machenWarum Social Media oft ein verzerrtes Bild liefertUnd wie eine simple Grafik Dir dabei hilft, smarter zu trainieren – statt härterViel Spaß beim Hören!____________*WERBUNG: Infos zum Werbepartner dieser Folge und allen weiteren Werbepartnern findest Du hier.____________Ressourcen zur Folge:Vollständiger Artikel mit der erwähnten Grafik zur FolgeAlles über Muskelfasertypen (Folge 265)kostenloser FFMI RechnerFitnessstudio: ScoopWeitere Quellen:Kouri, E. M., Pope, H. G., Katz, D. L., & Oliva, P. (1995). Fat-free mass index in users and nonusers of anabolic-androgenic steroids. Clinical Journal of Sport Medicine, 5(4), 223–228. https://doi.org/10.1097/00042752-199510000-00005Sagoe, D., Molde, H., Andreassen, C. S., Torsheim, T., & Pallesen, S. (2014). The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Annals of Epidemiology, 24(5), 383–398. https://doi.org/10.1016/j.annepidem.2014.01.009Hubal, M. J., Gordish-Dressman, H., Thompson, P. D., et al. (2005). Variability in muscle size and strength gain after unilateral resistance training. Medicine & Science in Sports & Exercise, 37(6), 964–972. https://doi.org/10.1249/01.mss.0000170469.90461.5fSchoenfeld, B. J., Grgic, J., Ogborn, D., & Krieger, J. W. (2017). Strength and hypertrophy adaptations between low- vs. high-load resistance training: a meta-analysis. Journal of Strength and Conditioning Research, 31(12), 3508–3523. https://doi.org/10.1519/JSC.0000000000002200Grgic, J., Schoenfeld, B. J., Orazem, J., & Sabol, F. (2018). Effects of resistance training frequency on measures of muscle hypertrophy: a systematic review and meta-analysis. Sports Medicine, 48(5), 1207–1220. https://doi.org/10.1007/s40279-018-0872-x Hosted on Acast. See acast.com/privacy for more information.

"In B cell malignancies, BTKi inhibits that BTK enzyme which is very upstream. It tells NF-κB to stop signaling into the nucleus and then inhibits proliferation and survival of B cells."  Puja Patel, PharmD, BCOP, Clinical Oncology Pharmacist at Northwestern Medicine Cancer Center at Delnor Hospital in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about BTK inhibitors.  Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0   Earn 1.0 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 17, 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 BTK inhibitor drug class.  Episode Notes   Complete this evaluation for free NCPD.  ONS Podcast™ Pharmacology 101 series  ONS Voice articles:  BTK Inhibitor Effective for Relapsed Hairy Cell Leukemia  FDA Grants Accelerated Approval to Pirtobrutinib for Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma  Ibrutinib Is the First Anticancer Agent to Be Negotiated for Medicare Drug Pricing  Oncology Drug Reference Sheet: Pirtobrutinib  Oncology Drug Reference Sheet: Zanubrutinib  ONS books:  Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)  Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)  Clinical Journal of Oncology Nursing article: B-Cell Malignancies: The Use of Small Molecule Agents for Treatment and Management  ONS courses:   ONS Cancer Biology™  ONS/ONCC Chemotherapy Immunotherapy Certificate™   Safe Handling Basics   ONS Guidelines™ and Symptom Interventions:   Chemotherapy-Induced Diarrhea  Prevention of Bleeding  Prevention of Infection: General  ONS Learning Library: Oral Anticancer Medication  ONS/NCODA/HOPA/ACCC's Oral Chemotherapy Education Sheets  Other resources:  Advanced Practice Providers Oncology Summit  Ash Publications article: Managing Toxicities of Bruton Tyrosine Kinase Inhibitors  Blood Advances article: BTK Inhibitors in CLL: Second-Generation Drugs and Beyond  CLL Society Fact Sheets  International Journal of Molecular Sciences article: Bruton's Tyrosine Kinase Inhibitors: Recent Updates  National Cancer Institute article: Two Drugs Show Efficacy against Common Form of Leukemia  National Comprehensive Cancer Network Guidelines for Patients: Chronic Lymphocytic Leukemia  National Study of Lymphoma (University of Oxford network site-specific group— Hematology)  NCODA's Positive Quality Intervention resources  Pharmacy Times BTK Inhibitor Comparison Charts  ScienceDirect article: Treating CLL with Bruton Tyrosine Kinase Inhibitors: The Role of the Outpatient Oncology Nurse  The Video Journal of Hematology and Hematological 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  “1952 we have the discovery by Colonel Ogden Bruton of that severe immunodeficiency due to lack of B-cell maturation, and next linked to e-gamma globular anemia. In 1993, we had Professor Vetrie and colleagues discover that this was actually due to mutation in a kinase, and they called that BTK. And then in 1993 was a discovery of our first BTKi inhibitor in the lab setting, and that's called LFM-A13. It wasn't until 2013, so that's 20 years after BTK kinase was discovered, where ibrutinib was our first-in-class BTK inhibitor, and the success of ibrutinib really promoted the exploration of second- and third-generation BTKis.” TS 6:24     “It's thought that BTK and other members in the pathway are constitutively phosphorylated, which just means they're spontaneously on. This leads to this uncontrolled activation of NF- κB signaling and thus uncontrolled proliferation and suppression of apoptosis. So, these B cells are rapidly dividing, but they're not functioning like they're supposed to be, meaning they won't differentiate, or, you know, they won't grow up to be either a plasma cell, like we talked about, or a memory B cell. They've been hacked.” TS 10:11     “This class is generally called—if you have to think of an umbrella term—it's just called targeted small molecule therapies. Now a subclass is BTKi or Bruton tyrosine kinase inhibitors. So, we're really shifting away from the use of cytotoxic chemotherapy, which is kind of designed to indiscriminately destroy rapidly dividing cells, to a more precise approach of targeting cells based on specific molecular changes in tumor DNA.” TS 13:47     “Cardiac toxicity can manifest as atrial fibrillation. And here I'll specifically talk about ibrutinib values because we have the most data with it, and the numbers actually get better with second- and third-generation BTKis. So frequency: Grade 1–2 atrial fibrillation was reported in 12%–15% of patients on Ibrutinib. And grade 3 AFib is 3%–5%. The onset, median onset is 8–13 months.” TS 20:23     “For nurses, they should really advise their patients that the caliber of headaches are easily managed and they will decrease over time over a period of four weeks. This is an upfront conversation reassuring the patient that this is not a long-term side effect.” TS 33:47     “One aspect that was being discussed at length was kind of identifying biases and then methods to neutralize those biases. So, I think first you have to identify what your bias could be toward BTK, maybe it's age or comorbidities or side-effect profile. And then, how can we mitigate our own biases is kind of the solution part to that.” TS 46:26 

Dr. Emily Eshleman discusses the #1 article of 2023, “Efficacy of Platelet-Rich Plasma Versus Placebo in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Trials,” which was originally published in the Clinical Journal of Sport Medicine in January 2023. Dr. Jeremy Schroeder serves as the series host. Dr. Eshleman is a member of the AMSSM Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2023, as selected for the 2024 AMSSM Annual Meeting. Efficacy of Platelet-Rich Plasma Versus Placebo in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Trials https://journals.lww.com/cjsportsmed/abstract/2023/01000/efficacy_of_platelet_rich_plasma_versus_placebo_in.10.aspx

“CDK4/6 inhibition is considered to be a milestone in the realm of targeted breast cancer therapy. The combination of CDK4/6 inhibitors with the endocrine therapy has really emerged as the foremost therapeutic modality for patients diagnosed with hormone receptor–positive, HER2-negative, advanced breast cancer,” ONS member Teresa Knoop, MSN, RN, AOCN®-emeritus, independent nurse consultant in Nashville, TN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during the latest episode in our series about anticancer drug classes. 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 October 18, 2026. 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 CDK inhibitors. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Pharmacology 101 series Episode 329: Pharmacology 101: BRAF Inhibitors Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion Episode 80: Patients Need Checkpoint Inhibitor Education Episode 5: New Guidelines for Managing Immunotherapy-Related Adverse Events ONS Voice articles: Combination CDK4/6 and Fulvestrant Has Survival Benefits in Late-Stage Breast Cancer FDA Approves Inavolisib With Palbociclib and Fulvestrant for Endocrine-Resistant, PIK3CA-Variant, HR-Positive, HER2-Negative, Advanced Breast Cancer FDA Approves Ribociclib With an Aromatase Inhibitor and Ribociclib and Letrozole Co-Pack for Early High-Risk Breast Cancer FDA Expands Early Breast Cancer Indication for Abemaciclib With Endocrine Therapy FDA Warns of Rare Lung Inflammation With Certain CDK4/6 Inhibitors Manage Immunotherapy-Related Diarrhea and Colitis Oncology Drug Reference Sheet: Ribociclib The Case of the CTCAE Assessment for CDK4/6 Adverse Events ONS book: Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Clinical Journal of Oncology Nursing article: Targeted Therapies: Treatment Options for Patients With Metastatic Breast Cancer ONS Symptom Intervention: Prevention of Infection: General  ONS Breast Cancer Learning Library ONS CDK4/6 Administration Checklist ONS Oral Anticancer Medication Toolkit  Breastcancer.org Susan G. Komen: CDK4/6 Inhibitors Ibrance® (palbociclib) patient site Kisqali® (ribociclib) patient site Verzenio® (abemaciclib) patient site To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an Oncology Nursing 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 “Common toxicity among this class of agents are things like nausea/vomiting, diarrhea, fatigue. All three are associated with low white blood cell counts, which we know as neutropenia, which can cause an increased risk of infection.” TS 10:46 “All three of these CDK4/6 inhibitors are pills taken by mouth, and in most cases they're all given along with endocrine therapy treatments. So, patients will be taking more than one drug. Teach patients how they will take their medication. And the frequency among the three drugs may vary.” TS 13:33 “Patients and caregivers need to know the time of day to take the pills, whether they need to be taken with or without food, or what to do if they miss a dose. We need to help them with a system for organizing the medications. They may find it helpful to use a pill organizer or set reminders on their smartphone, their smartwatch, their computer.” TS 14:29  “Pharmacy and nursing, in my experience, collaborate greatly by determining those drug–drug and drug–food interactions. It is so crucial in determining those interactions and educating our patients because we have to remind patients at each appointment and review these drugs and foods and other things they may be taking, at each appointment. And that often can be done by either pharmacists or nurses or both in collaboration.” TS 23:29 “This class of drug is generally well-tolerated, and I do want nurses to know that that we can help patients with these side effects. And they are generally well-tolerated with appropriate management.” TS 30:55 

“One of the things that's really challenging with these BRAF inhibitors, plus MEK inhibitors, is that there's a huge scope of potential toxicity, and they're not all going to happen. So I think that there's a real need to educate patients that they need to work with us so that when a toxicity develops, we can help address it. We can help think of strategies, whether it be medication strategies or whether it be other types of strategies, to make them feel better,” 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 the BRAF inhibitor drug class. 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 13, 2026. 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 BRAF inhibitors.  Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Pharmacology 101 series Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs ONS Voice articles: First-Line Combination Immunotherapy Prolongs Survival in BRAF Advanced Melanoma Predictive and Diagnostic Biomarkers: Identifying Variants Helps Providers Tailor Cancer Surveillance Plans and Treatment Selection BRAF Mutations Guide Treatment in Metastatic Colorectal Cancer Melanoma Prevention, Screening, Treatment, and Survivorship Recommendations Nursing Considerations for Melanoma Survivorship Care 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 article: BRAF/MEK Inhibitor Therapy: Consensus Statement From the Faculty of the Melanoma Nursing Initiative on Managing Adverse Events and Potential Drug Interactions Oncology Nursing Forum articles:  Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards MAPK Pathway–Targeted Therapies: Care and Management of Unique Toxicities in Patients With Advanced Melanoma ONS Learning Library: Oral Anticancer Medication ONS Biomarker Database Oral Chemotherapy Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an Oncology Nursing 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 “BRAF is a gene found on chromosome 7 that encodes for protein that is also called BRAF. And this protein is really important in cell growth and signaling and promoting cell division, as well as some other functions. When you have a variant in BRAF, this causes that gene to turn on the protein and to keep it on. That means there's a continual signaling to the cell to keep dividing and there's no instruction to stop dividing.” TS 2:24 “[Side effects] are things like pyrexia, fatigue, muscle aches, those things. There is definitely rash. And as I mentioned, there are those secondary skin cancers, which are significantly less with the combination with MEK inhibitors. GI [gastrointestinal] toxicities are not uncommon. Different patients, different tolerance in terms of like nausea, taste changes. I think taste changes are one of the ones that are really challenging.” TS 10:17  “How to get rid of the agents when they're done—I love that our institution has a program where they can bring them back, and we can help them get rid of it, because people just don't know how to get rid of them when they're no longer taking them. And you really don't want them having them around the house.” TS 15:28 “Don't assume that you can modify formulation. So if there is someone who can't take oral pills and has to use a suspension, some drugs, there's clear indications how to do that. Other ones there's not. So collaborating on that is a really good thing. I hear too much where people will say, ‘Just crush the pill.' These are not the drugs that you want to do that with.” TS 23:07

On this episode of the AMSSM Sports Medcast, host Dr. Jeremy Schroeder, DO, is joined by Dr. Adam Cordum, who delivered one of the Best Overall Case Presentations during the 2024 AMSSM Annual Meeting in Baltimore, MD. In this conversation, Dr. Cordum discusses his award-winning case – A Cold Hand During a Wisconsin Summer – and shares the findings and key takeaways from this unique medical diagnosis. Resources: 2024 AMSSM Case Podium Presentations, published in the Clinical Journal of Sport Medicine

Episode 321: Pharmacology 101: CYP17 Inhibitors “I think we're in a scientific golden age for prostate cancer and probably cancer as a whole, but we're talking about prostate cancer today. So I'm excited to be sitting on the front lines, seeing the new ways that we can help our patients. But I do still think CYP17 inhibitors will continue to be one of our main weapons against prostate cancer for a very long time,” Andrew Ruplin, PharmD, clinical oncology pharmacist at Fred Hutchinson Cancer Center in Seattle, WA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the CYP17 inhibitor drug class. 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 myoutcomes.ons.org by July 19, 2026. 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: The learner will report an increase in knowledge related to CYP17 inhibitors. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Pharmacology 101 series Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs Episode 154: New Drug Approvals for Metastatic Castration-Sensitive Prostate Cancer ONS Voice article: The Case of the Genomics-Guided Care for Prostate Cancer ONS course: Safe Handling Basics ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Safe Handling of Hazardous Drugs (fourth edition) Clinical Journal of Oncology Nursing article: Navigating Treatment of Metastatic Castration-Resistant Prostate Cancer: Nursing Perspectives Oncology Nursing Forum articles: Interventions to Support Adherence to Oral Anticancer Medications: Systematic Review and Meta-Analysis ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications ONS Huddle Card: Hormone Therapy ONS Biomarker Database (refine by prostate cancer) ONS Learning Libraries: Cancer of the Genitourinary Tract Oral Anticancer Medication Oral Chemotherapy Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an Oncology Nursing 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 “Identification of CYP17 as a target to decrease androgen production led to the first synthesis of a dedicated inhibitor of CYP17 named abiraterone acetate in the 1990s. But it would also not be until 2011, when there was sufficient evidence through clinical trials, for the [U.S. Food and Drug Administration] to approve abiraterone as treatment for castrate-resistant prostate cancer. And since then, abiraterone has been studied in many different stages of prostate cancer and has demonstrated clear benefits to survival for patients with metastatic or nonmetastatic prostate cancer and in the castrate-sensitive setting, as well.” TS 3:07 “Patients on abiraterone, regardless of the formulation that they get, they also have to receive an oral steroid every day while undergoing treatment due to the risk of that mineralocorticoid excess. … CYP17 inhibition by abiraterone leads to the loss of negative feedback on the adrenocorticotropic hormone, or ACTH, through a relative cortisol deficiency, which then results in higher levels of ACTH, which then cause the formation of excess precursors, including those mineralocorticoids that are upstream of the CYP17 inhibition step of androgen formation.” TS 14:04 “I recommend that patients take the standard formulation of abiraterone on an empty stomach. Conversely, I do recommend patients take their steroids with food to reduce the chances of [gastrointestinal] upset from their steroids. And so, I emphasize to these patients that abiraterone and the steroid do not need to be taken together at the same time, even though they are both a component of their treatment, and that they probably should, in fact, take them a little bit separately.” TS 23:00 “Now we're really in the phase of studying combination treatments, and we've had some really good results so far. So, one of the combinations that made a splash a few years ago is what we call triplet therapy, so abiraterone plus docetaxel plus [androgen-deprivation therapy], docetaxel being a traditional cytotoxic chemotherapy that's been used in prostate cancer for several decades now. But now we're combining it with CYP17 inhibitors and other novel hormonal therapies, which has been exciting. So, this has been implemented into the standard of care for metastatic hormone-sensitive prostate cancer.” TS 27:26  

Welcome to The Peds NP Acute Care Faculty series! This collaborative series was created and peer-reviewed by national experts and leaders in acute care PNP education to meet the needs of our current and future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.    This episode applies the concepts from the prior episode on “Delivering Bad News” (S11 Ep. 71) to a few examples where HIV status was disclosed to a pediatric patient. After reflection and discussion of a few ethical principles important to consent/assent, it's time to practice delivering bad news in a case study. An unfolding case poses questions to get you thinking about what you might say. Make it interactive by pausing your podcast and answer the question yourself. The case walks you step-by-step through the process of delivering bad news to a child and their family using the SPIKES protocol. There's no perfect answer, but this example helps to prepare you for competency-based learning, so that you're ready to deliver bad news in practice.   Authors (alphabetical): Becky Carson, DNP, APRN, CPNP-PC/AC, Ann Felauer, DNP, APRN, CPNP-PC/AC, Belinda Large, DNP, APRN, CPNP-PC/AC, and Robynn Stamm, DNP, APRN, CPNP-PC/AC   References Brouwer, M. A., Maeckelberghe, E. L. M., van der Heide, A., Hein, I. M., & Verhagen, E. A. A. E. (2021). Breaking bad news: what parents would like you to know. Archives of disease in childhood, 106(3), 276–281. https://doi.org/10.1136/archdischild-2019-318398  Cassim, S., Kidd, J., Keenan, R., Middleton, K., Rolleston, A., Hokowhitu, B., Firth, M., Aitken, D., Wong, J., & Lawrenson, R. (2021). Indigenous perspectives on breaking bad news: ethical considerations for healthcare providers. Journal of medical ethics, medethics-2020-106916. Advance online publication. https://doi.org/10.1136/medethics-2020-106916 Field, M.J. & Behrman, R.E. (2003). When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. Chapter 4 communication, goal setting, and care   planning. Committee on Palliative and End-of-Life Care for Children and Their Families. Institute of Medicine (US) Holmes, S. N., & Illing, J. (2021). Breaking bad news: tackling cultural dilemmas. BMJ supportive & palliative care, 11(2), 128–132. https://doi.org/10.1136/bmjspcare-2020-002700 Kaplan, M. (2010). SPIKES: A framework for breaking bad news to patients with cancer. Clinical Journal of Oncology Nursing, 14(4), 514-516.                   https://cjon.ons.org/cjon/14/4/spikes-framework-breaking-bad-news-patients-cancer Kumar, V., & Sarkhel, S. (2023). Clinical Practice Guidelines on Breaking Bad News. Indian journal of psychiatry, 65(2), 238–244. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_498_22 Labaf, A., Jahanshir, A., Baradaran, H., & Shahvaraninasab, A. (2015). Is it appropriate to use Western guidelines for breaking bad news in non-Western emergency departments? A patients' perspective. Clinical Ethics, 10(1–2), 13–21. https://doi.org/10.1177/1477750915581797 Monden, K. R., Gentry, L., & Cox, T. R. (2016). Delivering bad news to patients. Proceedings (Baylor University. Medical Center), 29(1), 101–102. https://doi.org/10.1080/08998280.2016.11929380 Mostafavian, Z., Shaye, Z. A., & Farajpour, A. (2018). Mothers' preferences toward breaking bad news about their children cancer. Journal of family medicine and primary care, 7(3), 596–600. https://doi.org/10.4103/jfmpc.jfmpc_342_17

“In my role as an associate editor, I truly felt like I was bringing the voices of nurses who were new to oncology or new to writing forward. I was able to provide a venue for those oncology nurses who also wanted to bring forward some of the cool quality improvement projects that they were working on. I was really happy to share that knowledge through this role, so that all the other institutions can learn and maybe implement some of those solutions,” Megha Shah, DNP, FNP, OCN®, charge nurse at Northwestern Medicine Cancer Center Delnor in Geneva, IL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during about her experience volunteering as a peer reviewer and associate editor for the Clinical Journal of Oncology Nursing (CJON). 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 myoutcomes.ons.org by July 12, 2026. 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 role of a peer reviewer and associate editor for an ONS journal. Episode Notes  Complete this evaluation for free NCPD.  Volunteer Opportunities on ONS Communities Open Call for CJON Peer Reviewers Open Call for Oncology Nursing Forum Peer Reviewers Oncology Nursing Podcast episodes: Episode 73: Overcoming Challenges as a New Nurse Author Episode 25: How Publishing Can Advance Your Nursing Career – Part 2 Episode 24: How Publishing Can Advance Your Nursing Career – Part 1 ONS Voice articles: Publish Your First Article With ONS Voice The Power of Peer Review: With a Little Professional Polish, Your Work Will Shine Clinical Journal of Oncology Nursing resources: For Authors Peer Review CJON Writing Mentorship Program Oncology Nursing Forum resources: For Authors Peer Review Upon Further Review: Peer Process Vital to Publishing ONS Career Development Learning Library ONS Resources for Book Authors and Editors ONS Books Peer Review To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an Oncology Nursing 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 review an article for relevancy and accuracy, score the article, provide detailed comments and feedback on sections that need improvement or the sections that look wonderful and can go straight to publishing. After that, I submit the article to the editor. You have to meet the deadlines that are given. So, I could say an article on an average takes me about one to two hours to review, which is not bad. And you're given about three or four days to review an article, so it's very attainable.” TS 7:23 “Honestly, I wasn't expecting to be picked for the associate editor position because I did not have any prior experience when I applied. But then soon after I applied, I got a call from the editor of CJON that she had reviewed my resume, she had reviewed my application, and she would love for me to join the team. She couldn't see me on the call, but I was jumping up and down.” TS 9:24 “It's fun, it's rewarding, and I promise it will help you at some point in your career or your personal life. Whether you're helping to lead a project at work or helping your child to write a paper for school, it's going to come in handy; I promise you.” TS 17:00 “I feel like one of the biggest common misconceptions is [that volunteering as a peer reviewer] is a lot of work and it's boring. That's what I hear some of the nurses say. I disagree with that. I feel like it's a lot of fun, and it's rewarding, and it's a great opportunity. I feel like everybody should try it.” TS 18:47

Episode 319: Difficult Conversations About Pregnancy Testing in Cancer Care “For people diagnosed with cancer that are of childbearing potential, we have to consider how [pregnancy] testing could impact them. So we never know what someone has been through, and it's important to lead with empathy while providing education of the importance of this testing. So someone may find now that pregnancy testing is a dreaded experience instead of what they thought would be a joyous one,” Marissa Fors, LCSW, OSW-C, CCM, director of specialized programs at CancerCare in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the psychosocial aspects of pregnancy testing in cancer care. 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 myoutcomes.ons.org by July 5, 2026. 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 patient experience of pregnancy testing during cancer treatment. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Episode 311: Standardized Pregnancy Testing Processes in Cancer Care Episode 293: Access to Care: How to Manage Moral Dilemmas and Advocate for Your Patients  Episode 262: LGBTQ+ Inclusive Nursing Care Begins With Using Supportive Language Episode 217: Support Pregnant and Postpartum Patients During Cancer Diagnosis and Treatment Episode 211: Apply the LGBTQIA+ Lived Experience to Your Patient Interactions Episode 208: How to Have Fertility Preservation Conversations With Your Patients ONS Voice articles: Cultural Humility Is a Nursing Clinical Competency The Case of the Pregnancy Predicament Transgender Patient Populations: Inclusive Care Involves Listening and Communicating Trauma-Informed Care Provides Person-Centered Support for Patients During Deep Distress Use Active Listening to Engage More Deeply in Patient Discussions 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 Congress® abstract: System Approach to Fertility Preservation and Pregnancy Status During Active Cancer Treatment ONS Huddle Cards: Fertility Preservation Sexuality ECHO Training Program (Enriching Communication Skills for Health Professionals in Oncofertility) Journal of the National Comprehensive Cancer Network article: Pregnancy Screening in Patients With Cancer 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 “In everyday life, pregnancy testing is actually still really complex. It's more than just the positive pregnancy test and the happy parent we may see on commercials. For those that are hopeful for a positive test, there's still a lot of anxiety, worry, fear, maybe before, during, or after the results. And I think about how long this person has been trying to conceive and the financial impacts involved, change in family dynamics. What if that test comes back negative? Then I think about the potential disappointment or the heartbreak. I also consider the flipside—those that are scared of a positive result for fears of becoming pregnant for a range of different reasons.” TS 3:40 “I think it's important to always lead with empathy and kindness and an open mind. So you don't want to assume you know or understand how a person feels or may respond. Allow your patients to share with you how they're feeling in a nonjudgmental manner. This could be an incredibly vulnerable moment, and nurses can be a valuable source of support. Take a moment to just listen, normalize their feelings or let them ask questions. And I recognize it can be difficult to know what to say or do, but sometimes just being there for someone in those ways is incredibly meaningful and opens up more effective communication and trust.” TS 8:48 “For the patient that has been trying to conceive, taking another pregnancy test could be so daunting or triggering and bring back so many moments of grief. Seeing the results being negative could be heartbreaking all over again. Some people may find some relief knowing their fetus will be harmed and they won't have to make tough decisions. And then there may be guilt for feeling that way. There's no one way to feel or right or wrong way to feel. … Let them know their feelings are valid and anything they feel is okay and normal.” TS 13:40 “I think that a common misconception is that if a pregnancy test comes back positive, there are no options for treatment. Education and communication with your healthcare team can help clear up those options you may have and bring back the element of shared decision-making to make these decisions together with your healthcare team.” TS 31:03

“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  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by June 14, 2026. 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  Complete this evaluation for free NCPD.  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  

“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  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by May 31, 2026. 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  Complete this evaluation for free NCPD.  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  

“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  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by May 24, 2026. 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  Complete this evaluation for free NCPD.  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

“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  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by May 17, 2026. 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  Complete this evaluation for free NCPD.  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

“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  Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by May 10, 2026. 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  Complete this evaluation for free NCPD.  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

Dr. Scott Paradise concludes the countdown and reviews the No. 1 article of 2022 on this episode of the Top Sports Medicine Articles podcast, which is hosted by Dr. Jeremy Schroeder. The top-rated article examines, “Comparative Efficacy of Nonoperative Treatments for Greater Trochanteric Pain Syndrome: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials,” which was originally published in the Clinical Journal of Sport Medicine in July 2022. Dr. Paradise is a member of the AMSSM Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2022, as selected for the 2023 AMSSM Annual Meeting in Phoenix, AZ. Thanks to everyone who helped determine the top sports medicine articles of 2022, and find out what the top articles of 2023 will be during the AMSSM Annual Meeting in Baltimore, MD. Comparative Efficacy of Nonoperative Treatments for Greater Trochanteric Pain Syndrome: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials DOI: doi.org/10.1097/JSM.0000000000000924

“When we're talking about the role of nurses in addressing these challenges, they play a critical role because of when they actually get to see patients. And so, if we can help with early identification and assessment, really finding out, using financial screening tools to identify any patients that might be at risk, early on, of financial toxicity, that can really allow for timely interventions,” Sarah Paul, LCSW, OSW-C, senior director of social work at CancerCare in New York, NY, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about financial toxicity in adolescent and young adult (AYA) cancer survivors. 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 myoutcomes.ons.org by April 12, 2026. 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 financial toxicity in the adolescent and young adult population. Episode Notes  Complete this evaluation for free NCPD. Oncology Nursing Podcast episodes: Episode 300: AYAs With Cancer: End-of-Life Care Planning Episode 294: AYAs With Cancer: Clinical Trial Enrollment Barriers and Facilitators Episode 287: Tools, Techniques, and Real-World Examples for Difficult Conversations in Cancer Care Episode 276: Support Young Families During a Parent's Cancer Journey Episode 62: Financial Toxicity Legislation 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 How to Support Adolescents and Young Adults With Cancer at the End of Life LGB AYA Patients With Cancer Have High Burden of Chronic Conditions in Survivorship 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) Clinical Journal of Oncology Nursing articles: Two Case Reports on Financial Toxicity and Healthcare Transitions in Adolescent and Young Adult Cancer Survivors Crucial Conversations: Addressing Informational Needs of Adolescents and Young Adults Diagnosed With Cancer A Nurse-Pharmacist Collaborative Approach to Reducing Financial Toxicity in Cancer Care Oncology Nursing Forum article: A Brief Screening Tool for Assessment of Financial Toxicity ONS Financial Toxicity Huddle Card ONS Nurse Navigation Learning Library Adolescent and Young Adult Cancer Awareness Week American Society of Clinical Oncology CancerCare Got Transition National Comprehensive Cancer Network Patient Advocate Foundation Triage Cancer 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 “For nurses that are caring for AYA patients, it's really important to not only be aware of financial toxicity but know how to assess for financial toxicity because of the pivotal stage that these patients are at in their life. They often don't have the financial stability or insurance coverage that adults who are maybe middle age or even in the older adult population might have.” TS 2:11 “The idea of [AYAs] not really understanding insurance coverage—I think it's really important that as a team, we simplify some of this complex information, breaking it down into more manageable steps and providing that guidance on the documents and all the information that's needed to apply [for financial assistance].” TS 8:59 “We see significant impacts in the AYA community, especially those that are in school or at the early stages of their career, because putting a job or school on hold to focus on treatment can have long-term effects. So, we see a couple of things. In education, we see academic delays; interrupting education can delay graduation or achievement of certain educational milestones, which would affect their ability to pursue higher education or even specialized training for their career. We also see, which is very difficult, loss of scholarships or financial aid. Some AYAs are starting school. It's based on a scholarship or a grant or financial aid, and they can't meet those full-time enrollment requirements or be able to maintain the GPA that they need to stay in the program. We see people losing their scholarships, and this is not their fault.” TS 10:11 “Down the road, you have this stress leading to chronic stress. We know that constant worry about finances can create a chronic stress environment. That is going to impact mental health across the board, which can lead to increased irritability, feelings of sadness, or even conflict among family members. So when we talk about managing these dynamics, we really want to focus on the importance of open communication because a lot of times we see families avoid discussing financial issues to shield each other from that additional stress.” TS 18:06 “One of the challenges that we face with this population is that we might assume that if they're not talking about it, if an AYA is not bringing up finances, that it's not an issue. And so sometimes even our own assumptions or assumptions of healthcare professionals that they don't even need to ask, ‘How are finances going? Are you working currently? Do you feel financially stable? Are you insured?' Often, maybe there's not room for those questions. Maybe the appointments are too rushed. … Healthcare professionals could maybe take a pause to evaluate their own hidden or implicit bias, reflecting on their own experience, really trying to become aware of the assumptions they might have about this population.” TS 32:46

“At the beginning, like when you first meet someone before they've even started anything, kind of get a baseline of ‘What's your ability to complete your daily activities? How is your coordination? How's your speech now? How is your writing ability?' up front before we start anything that could be toxic. And then prior to every treatment, I tend to look at their gait, watch them walk in or walk out of the office, to see if they're changing at all,” Colleen Erb, MSN, CRNP, ACNP-BC, AOCNP®, hematology and oncology nurse practitioner at Jefferson Health Asplundh Cancer Pavilion in Willow Grove, PA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about central nervous system toxicity. 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 myoutcomes.ons.org by April 5, 2026. 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 CNS toxicities. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Episode 303: Cancer Symptom Management Basics: Ocular Toxicities Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy Episode 278: Cancer Symptom Management Basics: Hepatic Complications Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 250: Cancer Symptom Management Basics: Dermatologic Complications Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications ONS Voice articles: Cognitive Impairment Is Much More Than “Chemo Brain” When Delirium Is Recognized and Addressed Early, Patient Outcomes Improve An Oncology Nurse's Guide to Bispecific Antibodies CNS Survivorship Needs More Research, Funding, and Training, Expert Panel Says ONS courses: Essentials in Advanced Practice Symptom Management Treatment and Symptom Management—Oncology RN Nursing Considerations for CAR T-Cell Therapy for Patients With Hematologic Malignancies: Patient Education and Symptom Management ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition) Core Curriculum for Oncology Nursing (seventh edition) Clinical Journal of Oncology Nursing articles: Associated Toxicities: Assessment and Management Related to CAR T-Cell Therapy Dronabinol Therapy: Central Nervous System Adverse Events in Adults With Primary Brain Tumors Primary Central Nervous System Lymphoma: Treatment and Nursing Management of Immunocompetent Patients ONS Huddle Card: Immune Effector Cell–Associated Neurotoxicity Syndrome (ICANS) American Society of Clinical Oncology (ASCO) Nervous System Side Effects Management of Immune-Related Adverse Events in Patients Treated With Chimeric Antigen Receptor T-Cell Therapy: ASCO Guideline 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 “Biotherapy, immunotherapy, and cellular therapy can cause changes in cognitive function and personality, even without other signs of obvious neurotoxicity. Things like cytokines, whether it's infused or as a result of side effects, can bypass the blood-brain barrier and can also alter that vascular permeability to allow other substances to kind of cross the barrier and can also alter your hypothalamic activity.” TS 2:26 “There's definitely an effect on patients who are older. You know, there's less pliability, less ability of their nervous system to sort of rebound from an insult in some cases. And I think there's more exposure. There's more risk of coexisting conditions, things like diabetes or thyroid issues. There's also higher risk of impaired liver and renal function or dehydration or polypharmacy-type things. So I think there's just a lot of sort of inherent risks as people get older and have more coexisting conditions.” TS 5:33 “[Their caregiver says] they used to read all the time—and if you ask the patients, they're like, “Oh, well, I can't focus on the words because they all seem too blurry.” … But when you, if you ask them specifically, “Is your vision blurry?” they'll say no. Then when you really get down to it, that caregiver piece I think is really crucial in this kind of toxicity, because it's the little things that if you catch them when they're little things, then won't lead to big things.” TS 11:00  

“A couple of things I think are really important when you look at this class of drug: It developed by a concerted effort in cancer drug development to look at new agents that would be effective based on the mechanism. And then once they found a drug in this class that was beneficial, they further modified it to try to get better efficacy and less toxicity,” 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 the nitrosoureas drug class. 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 myoutcomes.ons.org by March 29, 2026. 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 nitrosourea administration. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Episode 286: Pharmacology 101: Alkylating Agents Episode 288: Pharmacology 101: Antimetabolites Episode 296: Pharmacology 101: Anthracyclines and Other Antitumor Antibiotics Episode 299: Pharmacology 101: Plant Alkaloids ONS Voice article: The Oncology Nurse's Role in Oral Anticancer Therapies ONS courses: ONS/ONCC Chemotherapy Immunotherapy Administration Certificate™ ONS Fundamentals of Chemotherapy and Immunotherapy Administration™ ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Safe Handling of Hazardous Drugs (fourth edition) Clinical Journal of Oncology Nursing article: Primary Central Nervous System Lymphoma: Treatment and Nursing Management of Immunocompetent Patients Oncology Nursing Forum article: ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications ONS Oral Anticancer Medication Learning Library ONS Oral Adherence Video National Institute for Occupational Safety and Health: Hazardous Drugs in Healthcare Settings 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 “With the nitrosoureas, there's something really interesting because there's another mechanism that has been identified. And that is that when you put these nitrosoureas in the body, they break down into intermediates, and one of them is an isocyanate. … These isocyanates, what they do is they inhibit DNA repair, therefore have an impact on cells that are damaged. You can think of it as the second mechanism, and people that work in the neuro-oncology space think of this when they think of drugs like lomustine in brain cancer, how that drug decreases the DNA repair protein O6-methylguanine-DNA methyltransferase.” TS 4:11 “These drugs are very lipophilic, meaning they cross the blood-brain barrier. That's why we use them in brain tumors, so that's one of the key things. That's also one of the toxicities we see when drugs cross blood-brain barrier; we see neurotoxicity. So that's one to at least always consider but also the benefit of it crossing over and being able to treat cancers within the CNS.” TS 8:19 “As a group, these drugs are alkylating agents, so definitely the safe handling is essential. And with DNA-damaging agents, that means anybody who is going to come in contact with these drugs. So, carmustine is given intravenously. Lomustine or CCNU, those are capsules. So handling is different depending on the agents.” TS 12:45 “The thing with the lomustine or the CCNU capsules, the thing that's really important here is that the dosing is really different than how we normally give oral medications. And so, it's really important that patients are aware of exactly how much they take and not that they don't repeat the dose every day. So I think just like with other oral regimens that are not daily, we really have to make sure patients are aware of the specifics of how they take the drug.” TS 14:25

“First, you want to refer patients to an eye care provider prior to initiating therapy, and I think communication at this point is really important. You need to tell the eye care provider why they're being referred, what treatment they're getting, the most common ocular toxicities, and also what needs to be done at every visit. They need to do a visual acuity; they need to do a slit-lamp eye exam. And these eye care providers need to know that ahead of time, so they're doing everything at that visit,” Courtney Arn, APRN-CNP, nurse practitioner at the Ohio State University James Cancer Hospital in Columbus, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about ocular toxicities and their management in cancer care. The advertising messages in this episode are paid for by Dartmouth Hitchcock Cancer Center. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Episode Notes NCPD contact hours are not available for this episode. Oncology Nursing Podcast Cancer Symptom Management Basics series: Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications Episode 250: Cancer Symptom Management Basics: Dermatologic Complications Episode 256: Cancer Symptom Management Basics: Hematologic Complications Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications Episode 278: Cancer Symptom Management Basics: Hepatic Complications Episode 290: Cancer Symptom Management Basics: Peripheral Neuropathy ONS Voice articles: Oncology Drug Reference Sheet: Mirvetuximab Soravtansine-Gynx Oncology Drug Reference Sheet: Tisotumab Vedotin-Tftv Oncology Drug Reference Sheet: Belantamab Mafodotin-Blmf ONS courses: ONS Cancer Basics™ Essentials in Advanced Practice Symptom Management Treatment and Symptom Management—Oncology RN Symptom Management—Oncology APN ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition) Clinical Journal of Oncology Nursing articles: Transfusion Reactions: A Case Study of an Ocular Adverse Event During Autologous Transplantation Ocular Graft-Versus-Host Disease After Allogeneic Transplantation Enfortumab Vedotin: Nursing Perspectives on the Management of Adverse Events in Patients With Locally Advanced or Metastatic Urothelial Carcinoma Oncology Nursing Forum article: Ocular Toxicity of Tyrosine Kinase Inhibitors 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 most common ocular toxicities that we see with cancer treatments currently are vision impairment, which can include decreased visual acuity or blurred vision. We also see keratopathy or keratitis, very common to have dry eyes, photophobia, eye pain. Sometimes patients can develop cataracts, conjunctivitis, or even blepharitis, which is inflammation of the eyelid.” TS 2:27 “Fortunately, most of the ocular toxicities that develop when being treated with these treatments are short term, and so most of them are reversible. And they actually resolve relatively quickly after stopping treatment that's causing the ocular toxicity. So usually within one to two months, the ocular toxicities have significantly improved or resolved.” TS 4:55 “Sometimes patients come in and you're asking them, ‘Are you having any symptoms, or do you have any blurred vision?' And they'll say, you know, ‘I haven't been able to see my computer as well,' or ‘I've noticed when driving, I can't read the road sign.' And what I really hear often is watching TV, they can't see the scores of sports games at the bottom of the screen.” TS 7:43 “The nurses are very important in this process from the beginning of doing the patient education prior to them starting therapy, helping with the referral process to getting them in, making sure the patients have their eye drops, making sure they know how to use their eye drops, making sure they're aware of the signs and symptoms to be calling and reporting, and then also identifying at their visits, too, if they're having any new symptoms. So they definitely play a heavy, heavy role in this process.” TS 14:22

 “What you teach patients about that the side effects may be somewhat different, because it's more of a regional treatment with less systemic toxicities, so it's teaching patients about the drugs, the side effects, and the actual procedure itself,” Lisa Hartkopf-Smith, MS, RN, AOCN®, CHPN, advanced practice nurse at OhioHealth Center in Columbus and ProMedica Cancer Institute in Toledo, OH, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about the oncology nurse's role in intra-arterial chemotherapy administration. This episode is part of a series about chemotherapy administration, which we'll include a link to in the episode notes. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. 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), which may be applied to the nursing practice, oncology nursing practice, or treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by February 2, 2026. 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: The learner will report an increase in knowledge about the nurse's role in intra-arterial chemotherapy administration. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast: Episode 252: Intraperitoneal Administration: The Oncology Nurse's Role Episode 285: Transarterial Chemoembolization: The Oncology Nurse's Role Additional episodes about chemotherapy administration Clinical Journal of Oncology Nursing article: Evaluation of a Chemotherapy and Medication Education Process for Patients Starting Cancer Treatment ONS Huddle Card: Chemotherapy ONS Courses: ONS Fundamentals of Chemotherapy and Immunotherapy Administration ONS/ONCC Chemotherapy Immunotherapy Administration Certificate™ ONS books:  Access Device Guidelines: Recommendations for Nursing Practice and Education (fourth edition) Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) 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 Today's Episode  “Intra-arterial chemotherapy has actually been in existence over 70-plus years. It's been around for a long time. There are case reports in the literature as early as 1950 of intra-arterial chemotherapy, one specifically being giving nitrogen mustard, of all things, interactively through a catheter for the treatment of Hodgkin lymphoma.” TS 1:43  “Retinoblastoma is a common indication at this point in time for intra-arterial chemotherapy and has very good success rates. Intra-arterial chemotherapy is also used in liver cancers, whether it's an unresectable liver metastasis from adenocarcinoma of the colon or it's unresectable intrahepatic cholangiocarcinoma, as an another example where it's used. And it can also be used in hepatocellular or HCC carcinoma.” TS 6:36  “Some of the things, like pretreatment, things that the nurse has to look for in any of those are labs and particularly clotting times. You know, to make sure that a PT and an INR and a platelet count was drawn because this patient is going to have a catheter in their artery and frequently will have heparin, so we need to make sure you know what that is.” TS 8:22  “When you're pulling your drug information, your patient drug information sheets, it may not be appropriate to give the Adriamycin® teaching sheet from OncoLink or ChemoCare or ONS because that's generally the side effects of systemic treatment. Whereas if it's going to be given intra-arterially, they are probably not going to have hair loss and mouth sores, and their blood counts may not be affected.” TS 10:36  “In some cases, the nurse may be actually administering the medication, and in other cases they're not going to be actually administering it. So, if you have the situation where that intra-arterial procedure is done, like within the operating room or interventional radiology, then typically the radiologist or another physician will be administering it, but the RN may be in the room. It's often not a chemotherapy-qualified RN, it's often interventional radiology RN, so this is really a group effort between oncology nurses and those interventional radiology nurses and operating room nurses.” TS 12:03  “But in that case, as far as administration, again, it will probably be the physician, but where the nurse can play the role is with all those steps of verification. So, the dual verification process for chemotherapy needs to not just apply when you're giving it ID and an infusion center or inpatient. But it needs to happen in those off sites like interventional radiology in the operating room. So, the nurse in this suite can work and be part of that dual verification process, you know, comparing the orders with the drug and the patient identifiers. The nurse in that type of situation, in interventional radiology or operating room, can help ensure that safe handling occurs because those employees and physicians may not be as familiar with it. So, making sure that you have the PPE gowns the gloves goggles in the correct ways to dispose of it in those suites.” TS 12:43  “With time, just as it would with a venous port, that catheter can move out of place. So, even with the implanted pumps I was mentioning before, those catheters can move, and so we don't routinely check placement of the tip. What can happen is if the tip moves into another place, the patient will have those high doses of chemotherapy going systemic and will experience more side effects.” TS 19:22  “Some part of the adverse reactions could be related to the catheter or the pump itself, and then some of the adverse reactions are related to the drug itself.” TS 20:06  “So, other things that can happen with catheters and pumps, whether they're temporary or permanent, is always the risk for hemorrhage because it's in an artery. So, if something breaks or some tubing becomes disconnected, then the patient could hemorrhage. So, it's important that everything is always lured locked, connections taped, and that is being checked frequently to make sure that everything is tight and secure so that there's not that risk for hemorrhage from a catheter, an IV tubing, or needle becoming disconnected.” TS 21:11  “I honestly think this entire topic is something that's not discussed much, and I wish people knew more about it. I also wish people knew more about one of the areas of this topic—hepatic chemoembolizations, also called TACE [trans-arterial chemoembolization]. There are a lot of patients out there that are getting this in different locations, different hospitals, parts of the country, but because we typically are working in infusion centers are impatient areas, we are often not that knowledgeable about it because it happens somewhere else in interventional radiology or the OR. But our patients are affected by it, and we need to know more about it.” TS 26:55 

“I think educating patients of what can happen and those are the symptoms you're really looking for to decrease this from getting to the severe level is like the sensory stuff. It's kind of your starting point and it progresses from there,” Colleen Erb, MSN, CRNP, ACNP-BC, AOCNP®, hematology and oncology nurse practitioner at Jefferson Health Asplundh Cancer Pavilion in Willow Grove, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what nurses need to know about cancer- and treatment-related peripheral neuropathy. This episode is part of a series on cancer symptom management basics; the rest are linked below.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   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), which may be applied to the symptom management, palliative care, and supportive care ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by December 15, 2025. 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: The learner will report an increase in knowledge related to peripheral neuropathy.  Episode Notes  Complete this evaluation for free NCPD.   Oncology Nursing Podcast Cancer Symptom Management Basics series  Clinical Journal of Oncology Nursing articles: Balance and Gait Impairment: Sensor-Based Assessment for Patients With Peripheral Neuropathy  Chemotherapy-Induced Peripheral Neuropathy: Use of an Electronic Care Planning System to Improve Adherence to Recommended Assessment and Management Practices Instruments for Assessing Chemotherapy-Induced Peripheral Neuropathy: A Review of the Literature Extremity Cooling: A Synthesis of Cryotherapy Interventions to Reduce Peripheral Neuropathy and Nail Changes From Taxane-Based Chemotherapy  Oncology Nursing Forum article: Chemotherapy-Induced Peripheral Neuropathy Assessment Tools: A Systematic Review  ONS Symptom Interventions and Guidelines™: Peripheral Neuropathy  American Cancer Society's patient information for peripheral neuropathy  American Society of Clinical Oncology (ASCO) Guideline: Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers  Multinational Association of Supportive Care in Cancer (MASCC): Neurological Complications  Overview of nursing skills for routine neurologic assessments   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 Today's Episode  “Our nervous system is sort of divided into three parts. The autonomic nervous system, which is kind of controlled homeostasis, blood pressure, your intestinal motility, things like that. The motor system, which is the efferent system, which is reflexes, muscle strength, sort of your big muscle movements, if you want to think of it that way. And then the sensory system, which is the afferent system, which is really what defines motion.” TS 1:51  “I think patients tend to blow off the mild numbness and tingling because they're just like, ‘Oh, it's just the side effect of my chemo' and they don't realize that that can get progressively worse. So, they tend to not tell you, you know, ‘Oh do you have numbness and tingling? Yeah, I get it every visit.' But they're like, ‘No, no, it's fine. It's just once in a while,' and all of a sudden, two months down the line, they come in and they can't walk as well.” TS 6:53  “Some other disease-related comorbidities, things like diabetes, thyroid disease, there's nutritional deficiencies—like vitamin B is a big one. We tend to check B12, but B1, which is thiamin, can also cause this. Other things like inherited neurologic disease, toxin exposures like alcohol and people with alcohol dependance, infections like HIV and herpes or shingles as we all know it. Cardiac disease, which, you know, peripheral vascular particularly, but other cardiac diseases can do it too. And then medications that people have been on forever, you know, there's a list of like the highly likely ones, things like amiodarone, aminoglycosides, colchicine, hydralazine, metronidazole, linezolid, and statins can actually cause a preexisting peripheral neuropathy or make you more likely to develop it in the duration of your cancer treatment.” TS 9:38  “I think the most important thing for any patient, but specifically when you're looking for peripheral neuropathy is a really good history and review of systems like other medications, any supplements, any comorbidities, any underlying diseases that they may not be treated for yet, or things like that. But a good history can really go a long way in finding out sort of your risk factors.” TS 11:55  “I think nurses knowing how to do a basic neuro exam, you know, we all learn this. But do we actually do it all the time? Probably not. But I think really knowing how to like, you know, can they feel a light touch or a pinprick, test their muscle strength, watch them walk down the hallway and see if it changes over time? Like are they starting to sway a little bit when they walk? Can they get out of the chair without pushing on the handle and using their arms to get up? Things like that really can tell you a lot.” TS 13:36  “Sadly, there's really nothing proven to prevent the development of neuropathy. You know, we know that you can't really catch it before people start having symptoms. Unfortunately, it's really when you start to detect symptoms that you can prevent it from getting to the severe point where it's really impacting their quality of life. And I think the biggest thing is proactive assessment and diagnosing it when it's early and being able to kind of intervene before it gets to the point of debilitating.” TS 16:52  “It can really happen to anyone at any time. And generally, with any drug, not just those ones that it's the tough side effect; it really can affect any drugs. So, assessment is kind of key for everyone.” TS 27:06 

Jubala CoffeeNational Advisory Committee on Microbiological Criteria for Foods (NACMCF) | Food Safety and Inspection ServiceWhat is a Plenary Session?Parameters for determining inoculated pack/challenge study protocols - PubMed13th Microbial Challenge Testing for Foods Workshop - International Association for Food ProtectionPast Presidents - International Association for Food ProtectionBuffalo Trace Bourbon - HomeAdam Johnson (ice hockey) - WikipediaSkate Blade Neck Lacerations: A Survey and Case Follow-up : Clinical Journal of Sport MedicineInfluence of Neck Laceration Protectors on Cervical Range of Moti…: Ingenta ConnectUSA Hockey Board of Directors unanimously voted…Which FoodCORE/FoodNet Pathogen Are You?Tyson Recalling Dinosaur Chicken Nuggets After Complaints of Metal Pieces - The New York TimesTyson recalls nearly 30,000 pounds of dino chicken nuggets - CBS NewsFood Safety & Quality Assurance Manager - TikTokNicole Potenza | LinkedInHow to Plan Thanksgiving Dinner - The New York TimesThe Biggest Thanksgiving Turkey Mistakes, According To Food Safety Experts | HuffPost Life86. Thawing Poultry at Room Temperature — Risky or Not?Don Schaffner

“When I meet with patients, I try and remind them, ‘Yes, you do have these side effects that can happen' and make sure that they're informed, but also try and reassure them that not everyone gets it as severe as maybe the movies and TV shows portray,” Dane Fritzsche, PharmD, BCOP, informatics pharmacist from the Fred Hutchinson Cancer Center at the University of Washington Medicine in Seattle, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses need to know about alkylating agents for patients with cancer. This episode is the first in a series about drug classes, which we'll include a link to in the episode notes.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   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), which may be applied to the oncology nursing practice and treatment ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by November 17, 2025. 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: The learner will report an increase in knowledge related to alkylating agents.   Episode Notes  Complete this evaluation for free NCPD.   Oncology Nursing Podcast Episode 242: Oncology Pharmacology 2023: Today's Treatments and Tomorrow's Breakthroughs  ONS Voice oncology drug reference sheets  Clinical Journal of Oncology Nursing article: Chemoprevention: An Overview of Pharmacologic Agents and Nursing Considerations  ONS book: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)  ONS Huddle Card: Alkylating Agents  The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee  ChemoCare drug information  Hematology/Oncology Pharmacy Association (HOPA)  National Cancer Institute's A to Z List of Cancer Drugs  Patient education guides created as a collaboration between ONS, HOPA, NCODA, and the Association of Community Cancer Centers:  Oral Chemotherapy Education Sheets  IV Cancer Treatment 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 pubONSVoice@ons.org.  Highlights From Today's Episode  “Alkylating agents are a very interesting class of chemotherapy agents, both mechanistically as well as historically. I remember back in pharmacy school learning this was actually the first class of medicines used to treat cancer, and it actually starts way back in World War I with the use of sulfur mustard gas, in kind of a military fashion, and then noticing some of the responses that soldiers as well as civilians who were actually exposed to that. They would develop things like bone marrow suppression, as well as other antitumor effects. Sadly, it's rough to see mustard gas as being the first agent to lead to something so remarkable, because it was a weapon of devastation, but it did lead to some breakthroughs.” TS 1:43  “The first thing that jumps to my mind when thinking about alkylating agents is their toxicities and then their supportive care agents that we use to make sure that we're treating our patients well and making their care optimum. So, when I, as an oncology pharmacist, would look at these orders, I immediately am jumping to, are we giving them appropriate antiemetics? Because a lot of these agents are highly emetogenic or moderately emetogenic by NCCN. A lot of them have other organ toxicities, like are really harsh on the kidneys. Are they getting their pre- and post-hydration? And then also many of these agents are very bone marrow suppressing, meaning they're targeting the red blood cells, they're hitting platelets, they're reducing our ANCs and making patients at higher risk for infection, you know, so do we need growth factor support here? Are the patients—their current labs—are they able to take another dose at this time or do we need to dose reduce or delay therapy because their platelets are just too low now?” TS 09:54  “Honestly, it's probably one of the most important things is collaborating together to help provide optimal patient care. And to me, kind of the biggest thing that jumps out is just good communication between the various team members. I can't tell you how many times I would learn crucial information either from an infusion nurse chatting with the patient or walking down the hall or giving a call to one of our lovely clinical nurse coordinators here at Fred Hutch. You know, I always wanted to make sure that I go in and have the full picture of where the patient's at, what, if any, challenges there have been with this patient's particular case, just to make sure that I'm up to date about them and able to provide as good of care as I can.” TS 14:55  “Unfortunately, this class of drugs does come with kind of those generic chemotherapy side effects that we think of: hair loss, nausea and vomiting, and bone marrow suppression. That just comes as a function of how these work. These agents are not selective for just cancer. They're more selective for rapidly dividing cells. So, that leaves our normal cells that rapidly divide like our hair, our GI tract, our bone marrow, you know, to get hit by these.” TS 17:50  “The next thing I always drill my residents on, when I'm teaching them how to provide actionable and helpful information about their regimens that they're getting, is kind of like you're saying, outlining those expectations. How do you prevent these side effects? When do these side effects even start to show up? Like, am I going to immediately be nauseous right when the cisplatin gets turned on? Well, maybe, not super common, but it's more common that we'll see it in, you know, at the end, in the next couple of days and within the next 72 hours or going into the nuances between acute versus chronic nausea and things like that. So, it's really trying to empower the patients with information. How do they prevent this? What are we doing to help prevent it? And then when should they call us? When is the stuff that we're preventing didn't help? When should they call us to get more help?” TS 24:04  “I think that's a misconception that we as healthcare professionals can really help alleviate with our patients, reminding them that, yes, they do carry risks, but we also have a lot of supportive care agents to kind of help minimize that toxicity. And then we have this whole team of professionals behind you to help carry you through the treatment.” TS 29:34   

“We really need to do our best to reach people who don't have access to palliative care in their communities, and this is an innovative way for us to do that,” Carey Ramirez, ANP-C, ACHPN, nurse practitioner and manager of advanced practice and supportive care medicine at the City of Hope National Medical Center in Duarte, CA, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about how telehealth is overcoming barriers and disparities that previously limited patients' access to timely oncology palliative care.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.5 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the care continuum, coordination of care, nursing practice, oncology nursing practice, psychosocial dimensions of care, quality of life, symptom management, palliative care, supportive care, treatment https://www.oncc.org/ilnaILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by October 20, 2025. 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. 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: The learner will report an increase in knowledge related to telehealth-based oncology palliative care.  Episode Notes  Complete this evaluation for free NCPD. Oncology Nursing Podcast:  Episode 251: Palliative Care Programs for Patients With Cancer  Episode 135: ELNEC Has Trained More Than One Million Nurses in End-of-Life Care  Episode 41: Advocating for Palliative Care and Hospice Education  ONS Voice articles:  Bipartisan PCHETA Legislation Reintroduced in U.S. Senate  U.S. Senators Introduce Legislation for Earlier Palliative Care  Help Your Patients Prepare for the End From the Beginning  APRNs Can Lead by Example When Integrating Palliative Care in Practice  Clinical Journal of Oncology Nursing articles:  Palliative Care: Oncology Nurses' Confidence in Provision to Patients With Cancer  Telehealth in Palliative Care: Communication Strategies From the COVID-19 Pandemic  Clinical Oncology Nurse Best Practices: Palliative Care and End-of-Life Conversations   Integrating Palliative Care in Hematopoietic Stem Cell Transplantation: A Qualitative Study Exploring Patient, Caregiver, and Clinician Perspectives   ONS Palliative Care Huddle Card  ONS clinical practice resource: Palliative Care Communication Strategies  ONS book: Integration of Palliative Care in Chronic Conditions: An Interdisciplinary Approach  Center to Advance Palliative Care (CAPC)  Hospice and Palliative Nurses Association (HPNA)  National Hospice and Palliative Care Organization (NHPCO)    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 Today's Episode  “If a person is uncertain of their prognosis or if a provider is uncertain of the goals that the patient has for themselves, that might be an appropriate time to consider palliative consultation. These are all important considerations for triggers that might make palliative a possibility for patients in those scenarios. The take-home message, though, is that the sooner that palliative care is involved, the more likely the patient and family are to benefit.” TS 2:51  “From a patient and family perspective, we frequently find that there are misperceptions regarding palliative care. Oftentimes, they'll conflate the word palliative with either hospice or end-of-life care. They unfortunately sometimes believe that they're one and the same. They demonstrate a lack of knowledge regarding the benefits, including the fact that palliative care can and should be provided alongside life-prolonging care.” TS 3:53  “Palliative providers do their best to help patients maintain hope throughout their disease trajectory, regardless of how well or how poorly things are going. I tend to view things in terms of climbing a sand dune: Living with cancer can sometimes feel like you're walking up a sand dune, either at the beach or at the desert, and there will be days where you take two steps forward and you might slide only one step back. There may also be days where you take two steps forward and slide three steps back. And you find, for example, that if you keep trudging toward the top, that because the winds are constantly blowing those dunes, the top you eventually reach might be different than the one you initially set out to reach. And I think that speaks to the changing nature of hope.” TS 6:08  “It's important to ensure that providers are aware of the local services available to them in their respective communities. [And] we often find that from an organizational or a structural barrier perspective, there are lack of access to palliative care in the community. We often find that outpatient programs may not be as robust, or you may find that there is great variation between outpatient programs with regard to quality.” TS 10:10  “We have multiple patient populations who unfortunately do not have equal access to palliative care. They include rural populations, those who come from low socioeconomic backgrounds. We find that male patients and/or patients who are older adults have lower access to palliative care. We find that those who might be either single or live alone, those who might have an immigrant status, those who don't speak English, those who might have certain cancer diagnoses. It may surprise some of you to know that those with hematologic malignancies actually have much lower rates of palliative referral than those with solid tumors.” TS 11:23  “There's a maldistribution of palliative care resources nationwide. We tend to see that many of the resources are in urban areas, and as a result, we find that a great many rural areas are left untouched. I think it's important for us to recognize that these social determinants of health exist. It's important for us to look intentionally at them and whether they affect some of our patient populations and to work together to overcome them.” TS 14:03  “Anecdotally, I've been doing telehealth for about five years and it's been quite well received. It decreases my no-show rates. It improves my ability to monitor patients over time, and it can be carried out safely.” TS 16:12  “It's important to recognize that telehealth can be utilized not only for a planned appointment that might be scheduled to surveil someone every two weeks or every month from a pain and symptom management perspective, it can also be utilized as a same-day possibility. So if, for example, we have a patient who's due to have an MRI tomorrow and their last MRI was stopped in part because they couldn't tolerate it due to pain or symptoms, we might have a primary team reach out to us and ask whether we can see that patient the day prior to their MRI and devise a plan with that patient so that they can tolerate the MRI more easily the next day.” TS 22:26  “Many of our patients no longer have the ability to get to and from their place of worship, and we can sometimes bring their clergy people to them via telehealth video. We also offer psychology services, psychiatry services, child life services, all via telehealth. And I think it's important to recognize that palliative care is actually made up of an interdisciplinary team, including all of the aforementioned specialists who can basically work together to improve the experience of the patient who is living with cancer and being treated for it.” TS 26:41  “Accept the inevitability of ups and downs. Learn from the downs and persevere. The outcomes are definitely worth it.” TS 28:11 

“As nurses and healthcare providers, we need to be up to date with the most current evidence-based practices. To achieve and maintain this, we must institute a learning culture. It is critical to promote a learning culture and healthcare institution to keep both patients and nurses safe,” Klara Culmone, MSN, RN, OCN®, assistant nurse manager at the Laura and Isaac Perlmutter Cancer Center at NYU Langone Health in New York, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what oncology nurses should know about creating a learning culture in the workplace for nurses at all levels, from staff to managers and administrators. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the professional practice/performance ILNA category, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by October 6, 2025. 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: The learner will report an increase in knowledge related to creating a culture of learning and safety. Episode Notes ·       Complete this evaluation for free NCPD. Oncology Nursing Podcast: Episode 246: Create a Culture of Safety: Fair and Just Culture Episode 266: Create a Culture of Safety: Reporting Culture  Episode 231: Nurses Thrive in a Healthy Work Culture ONS Voice culture of safety topic tag Clinical Journal of Oncology Nursing article: Vaught's Single Story and Health Care's Culture of Safety ONS professional development resources ONS On-Demand™ The Joint Commission's 11 Tenets of a Safety Culture 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 Today's Episode “There are a few ways to demonstrate to nurses that a healthcare organization values and promotes a learning culture. So, for example, allowing the time off to attend relevant conferences including covering costs such as transportation, registration, et cetera, as we know that these costs can really go up quickly.” TS 2:20 “Allowing time off the unit with the adequate coverage is really critical, and I think that's a challenge that many of us face right now. So, staffing may not always allow for it, but trying to have a plan set in advance can really help ease this challenge. So, some things that we have implemented to minimize staffing impact on the unit would include, perhaps, paying the nurse to attend the class on a day outside of their scheduled shift, so this is especially helpful for remote learning.” TS 5:48 “Nurse leaders are really critical in the development of a positive learning environment. Nurse leaders should conduct the learning needs assessment within their team and then tailor the educational plan based off of the results. And this really, ideally, should be done in collaboration with their nursing professional development specialists. It's important for nurses to share new knowledge with one another.” TS 7:59 “One of the best ways for nursing schools and facilities to collaborate is by hosting student clinical groups. Having nursing students work with nurses allows the nurse to share their knowledge with the future of the nursing workforce. They are teaching a new generation of nurses. I mean, many of us remember the best clinical experiences during our training. And it is always the preceptor nurse who spent the most time teaching and answering our questions that gave us the motivation and drive to continue learning.” TS 10:39 “I would just really encourage all of our fellow nurses to just be open to new learning, open to new ideas, and willing to teach one another, because I think we really do the best when we build one another up, we listen to each other, and we learn from one another.” TS 19:20

“I think the most amazing thing we see is the softening of the skin, which can occur during the first two weeks of the conditioning regimen. The nurses on the floor see it, and I think it's just a tremendous gratification for them to see the results of something right before your eyes,” Tanya Helms, PA-C, from the division of hematological malignancies and cellular therapy at Duke University Medical Center in Durham, NC, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a discussion about what oncology nurses should know about transplantation for patients with non-oncologic conditions such as autoimmune disease, how the transplant process differs for non-oncology indications, and the clinical pearls oncology nurses should consider when caring for patients with autoimmune diseases during the transplantation process.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.5 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the early post-transplant management and education, treatment modalities, diagnosis, staging and treatment planning, or coordination of care ILNA category, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by September 29, 2025. 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: The learner will report an increase in knowledge related to hematopoietic stem cell transplantation for scleroderma and other autoimmune diseases.   Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast:  Episode 173: Oncology Nurses' Role in Stem Cell Transplants for Pediatric Sickle Cell Disease  Episode 148: Stem Cell Transplant Nursing in the Home Setting  ONS Voice article: What Oncology Nurses Need to Know About Vaccination and Cancer (and other immunocompromised diseases)  Clinical Journal of Oncology Nursing article: Early Intervention With Transplantation Recipients to Improve Access to and Knowledge of Palliative Care  ONS course: Hematopoietic Stem Cell Transplantation  ONS Huddle Card™: Hematopoietic Stem Cell Transplantation  National Scleroderma Foundation  New England Journal of Medicine article about the SCOT trial: Myeloablative Autologous Stem-Cell Transplantation for Severe Scleroderma  Systemic Sclerosis as an Indication for Autologous Hematopoietic Cell Transplantation: Position Statement from the American Society for Blood and Marrow Transplantation  Autologous Hematopoietic Stem Cell Transplantation for Systemic Sclerosis: A Systematic Review and Meta-Analysis    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 Today's Episode  “The goal of treatment for patients with scleroderma is to reset the immune system, and there are three main components of the regimen used at Duke—that's total body radiation, cyclophosphamide, and ATG. This targets all the areas where the immune effector cells live. We also use CD34 selection, which is a process that separates CD34-positive cells from the stem cell product that's collected prior to transplant, to eliminate the possibility of reinfusing activated immune cells back into the patients.” TS 3:18  “For patients with diffuse scleroderma, you want to offer transplant when they have evidence of significant disease, but they're not so compromised that they can't tolerate or have increased risk of complications from the conditioning regimen. Understanding the patient's rate of disease progression is key when determining to transplant.” TS 6:45  “When a patient is referred, we call the patient, and we talk about how the transplant conditioning regimen works to reset the immune system and stop disease progression. We explain the workup visit and go over an example of the timeline needed to collect the cells, admit to the hospital for conditioning, and the recovery process as an outpatient. We want patients to understand the big picture before they ever come to Duke.” TS 7:57  “Some patients come to us significantly disabled by their scleroderma. They may be in a wheelchair, so they require special vehicles for travel. Patients whose hands are severely involved need assistance with their ADLs [activities of daily living].” TS 11:43  “There have been three clinical trials that show autologous transplant improves event-free survival and overall survival and has been shown to decrease all-cause mortality. But it does not repair damaged gastrointestinal, pulmonary, or cardiac tissue. Any fibrosis that has happened is permanent.” TS 12:22  “The most amazing thing we see is the softening of the skin, which can occur during the first two weeks of the conditioning regimen. The nurses on the floor see it, and I think it's just a tremendous gratification for them to see the results of something right before your eyes.” TS 13:01  “Social media has been a huge contributor towards patient self-referrals. Patients are telling their stories on Facebook; patients are asking other questions about how to get referred to a transplant center; and patients whose rheumatologists have not referred them will seek out transplant centers to learn more about transplant for scleroderma.” TS 13:48  “For people with hematologic malignancies, it's all about getting that patient to remission and then transplanting them. . . . These patients have experienced chemotherapy and the adverse effects. They know about low blood counts and fatigue and recovery. They know about central lines and transfusions. The scleroderma patients come to transplantation with progressive disease. They've typically not had blood transfusions, but they are now going to receive total body radiation, chemotherapy, and a stem cell transplant over the next six weeks. And it can be overwhelming. . . . Every day is something new for them to process and learn.” TS 14:56  “Patients become pancytopenic, and they are heavily immunosuppressed. They are on steroids during the conditioning regimen to prevent scleroderma flares during conditioning. These patients have a central line so monitoring for infections, such as assessing vital signs for signs and symptoms of infection, and being aware that steroids can mask a fever.” TS 16:49   

“I think that as oncology nurses, we need to keep ourselves really educated and up to date with these new therapies, because I honestly feel like we still haven't really seen the long-term effects of this treatment,” ONS member Lisa Parks, MS, APRN-CNP, ANP-BC, nurse practitioner in hepatobiliary surgery at The James Cancer Hospital and Solove Research Institute at The Ohio State University Comprehensive Cancer Center in Columbus, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about recognizing hepatic complications and understanding the basics of its symptom management strategies. This episode is part of a series on cancer symptom management basics; the others are linked below.   You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.5 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the disease-related biology, treatment, or symptom management, palliative care, supportive care ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by September 22, 2025. 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.22, 2025. 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: The learner will report an increase in knowledge in cancer symptom management basics and hepatic complications.   Episode Notes  Complete this evaluation for free NCPD.   Oncology Nursing Podcast:  Episode 269: Cancer Symptom Management Basics: Gastrointestinal Complications  Episode 256: Cancer Symptom Management Basics: Hematologic Complications  Episode 250: Cancer Symptom Management Basics: Dermatologic Complications   Episode 244: Cancer Symptom Management Basics: Cardiovascular Complications  ONS Voice article: To Prevent Hepatotoxicity, Monitor Liver Function During Cancer Treatment  Clinical Journal of Oncology Nursing articles:   Checkpoint Inhibitors: Common Immune-Related Adverse Events and Their Management  Identification and Management: Sinusoidal Obstruction Syndrome/Veno-Occlusive Disease Related to Hematopoietic Stem Cell Transplantation  Use of Hepatic Artery Infusion Pumps in the Treatment of Hepatic Metastases  ONS courses:  ONS/ONCC Chemotherapy Immunotherapy Certificate Course  ONS/ONCC Radiation Therapy Certificate Course  ONS books:  Cancer Basics (third edition)https://www.ons.org/books/cancer-basics-third-edition  Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)  Manual for Radiation Oncology Nursing Practice and Education (fifth edition)  Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)   American Gastroenterological Association  American Gastroenterological Association Institute guideline on the prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy    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 Today's Episode  “There is something called chemotherapy-induced liver injury. What the chemotherapy does is it has a direct hepatotoxic effect on the hepatocytes themselves. If you have preexisting liver disease such as cirrhosis, it can lead to very severe hepatotoxicity because the function of the liver is already compromised by the damage previously done to it.” TS 3:47  “The American Gastroenterological Association published guidelines on the management of HBV reactivation for patients during immunosuppressive treatment, and they basically do recommend any patients with a hep B virus that they receive antiviral prophylaxis to prevent this reactivation from occurring. Also in 2008, the CDC recommended universal HBV screening for all patients before administering chemotherapy. This one you see most commonly in patients who receive chemotherapy for a hematological cancer following hemopoietic stem cell transplantation.” TS 14:19  “One of the most common things that I've encountered in my practice is that there seems to be a thought that once hepatic complications are identified, there is treatment for this, and in these patients, we can't reverse liver injury. Really, what we offer these patients is supportive care. These patients often can decompensate really quickly, and often these patients may require being transferred to the intensive care unit and it's not because there's any intervention that we're going to do. But I think it's very frustrating for nurses to see these severe liver injuries, that are life threatening, and not to be able to do anything about it.” TS 19:06 

“One of the things about futility is many people will say, ‘Oh this is futile care,' when what they really mean is, ‘Who in their right mind would want this?' or ‘I would never ever want this,' and that's different. That's not futile care. That's potentially inappropriate care. And sometimes that's the big step for folks,” Lucia D. Wocial, PhD, RN, FAAN, HEC-C, senior clinical ethicist in the John J. Lynch Center for Ethics at the MedStar Washington Hospital Center in Washington, DC, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about futile care: how to recognize it, how to approach communication during difficult situations, and how to address a nurse's associated ethical distress.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 1.0 NCPD contact hours of nursing continuing professional development (NCPD), which may be applied to the treatment care continuum, psychosocial dimensions of care, or quality of life ILNA category, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by September 15, 2025. 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: The learner will report an increase in knowledge related to futility in care and how to speak up for patients and prevent ethical distress.   Episode Notes  Complete this evaluation for free NCPD.   Wocial's Moral Distress Thermometer for Nurses   Oncology Nursing Podcast:  Episode 222: Ethical and Moral Dilemmas of Futility in Cancer Care and Treatment  Episode 78: Ethical Distress Impacts Nursing Practice  ONS Voice articles:  Moral Injury and Trauma in Nursing  Four R's and Resilience Approach Help Oncology Nurses Respond to Morally Distressing Challenges  Sort Through Ethical Dilemmas in Medically Futile Care  When Do You Stop Fighting?  Clinical Journal of Oncology Nursing articles:  The Ethical Dilemma of Medical Futility: The Case of Mr. X  Understanding the Moral Distress of Nurses Witnessing Medically Futile Care  When Does Treatment in Cancer Care Become Futile?  American Association of Critical Care Nurses moral distress resources  American Nurses Association moral distress toolkit  End-of-Life Nursing Education Consortium (ELNEC)    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 Today's Episode  “It's a term that appeared in the literature back in the 1980s when it became clear that we had medical technology that could sustain people's lives but not actually return them to a healthy state. And so, there was this attempt to try and identify and define when it was that the care we were providing, the treatments we were providing, could no longer work. And so, some people tried ‘qualitative futilities,' some people tried ‘quantitative futility.' People have been working on it for a long time, but the shortest definition is a treatment intervention that will not have its intended effect.” TS 1:52  “And first of all, it says futility is a definition that should be used sparingly. There are lots of times when a treatment may be considered what we call ‘potentially inappropriate.' And when thinking about what's the difference between futility and potentially inappropriate? Futility is, it's clearly not going to work. Potentially inappropriate is, well, it might work, but there are lots of competing reasons why maybe we ought not to do it. And some of those reasons might be significant burden. Some of them may be the patient won't be able to achieve a neurologic state where they be able to actually perceive the benefit of ongoing biological existence. That statement, it has some very clear recommendations about: be very careful about how you use the words.” TS 7:15  “In my work as a clinical ethicist, far and away the more frequent reason we get called is families want to keep going. It's not the other way around. And in fact, when a family or a patient is ready to stop, those become incredibly difficult for the healthcare team, particularly when there's a physician who feels like, ‘But I know this will work. Don't not do this. You have a 50%, 60%, 70% chance of surviving. don't you want to try?' So to know that you have the ability to give them a chance is one thing.” TS 13:33  “And here's the tragedy in this, and I hear oncologists say this, ‘Well, it's not time yet.' That's my favorite response, it's, ‘Not yet. Not yet.' So, when you ask most people, ‘If you knew that you were going to die in the next three months, are there things that you would want to do before you die?' most people are like, ‘Well yeah'. To fail to invite this conversation robs them of this choice.” TS 16:04  “Step one: Don't keep it to yourself. A lot of it is making sure that you talk with other folks, and if you work in an inpatient setting and your hospital is Joint Commission certified, then there is some mechanism in place in your institution for dealing with an ethics challenge. But the idea is what we do is hard. And one of the biggest challenges for people who are experiencing ethics distress or moral distress is very rarely do ethical challenges happen when people are having a good time. There's a tragedy somewhere, and part of the big challenge is to separate the tragedy, like the cosmic unfairness, injustice, from ‘Are we as a healthcare team contributing to the injustice?'” TS 40:51 

“It's really important to look at where your target is and what the toxicities are associated with hitting that target. Make sure you include that thinking when you're talking about bispecifics,” ONS member Rowena (Moe) Schwartz, PharmD, BCOP, professor of pharmacy practice at the 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 discussion about the use of bispecific monoclonal antibodies in hematologic cancers and solid tumors.   You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   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), which may be applied to the treatment ILNA category, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by September 1, 2025. 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: The learner will report an increase in knowledge related to bispecific monoclonal antibodies in hematologic cancers and solid tumors.  Episode Notes  Complete this evaluation for free NCPD.  ONS Voice drug reference sheets and FDA announcements about bispecific anticancer therapies  ONS resources for cytokine release syndrome  Oncology Nursing Podcast Episode 176: Oncologic Emergencies 101: Cytokine Release Syndrome  Clinical Journal of Oncology Nursing article: STAT: Cytokine Release Syndrome  Clinical Practice Resource  Clinical Practice Video  Huddle Card™  Cancer article: The BiTE (Bispecific T-Cell Engager) Platform: Development and Future Potential of a Targeted Immuno-Oncology Therapy Across Tumor Types  Pharmaceutics article: Bispecific Antibodies in Cancer Immunotherapy: A Novel Response to an Old Question  U.S. Food and Drug Administration label search for package inserts  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 Today's Episode  “When we talk about bispecifics, we need to really pay attention to both the target on the cancer and the target for T-cell engaging, because that impacts both efficacy but also toxicity.” TS 4:20  “If you really look deep into the clinical trials, often the patients that are receiving these agents in clinical trials have had more than the required three or four lines of treatment. They may have had five or more lines of treatment. So it's really important to kind of look at where it sits right now, knowing, of course, that that's an evolving target.” TS 7:13  “One of the things I think can be missed, at times, is the fact that you need to consider the toxicities associated with your target on the cancer cell.” TS 10:06  “In terms of mitigating risk, there's been two major ways that have been done. One is a step-up dose schedule, and so one of the key things I would say: If you're not familiar with an agent that you're going to be administering, it's really important to review the entire step-up scheme because it's different for each agent. In some cases, patients need to be admitted to the hospital for the entire step-up strategy. Other times it's just the first dose. So it's really important to look at that.” TS 11:58  “I think we're going to get to the point where our teaching strategy is going to have to be somewhat tailored to the agent we're giving. So, how the drug is given during the step-up, what the subsequent cycling is going to be, whether it's going to be a Q21-day cycle or a weekly dosing administration or every-two-week administration after a certain point. So, I think some understanding of what to expect going forward because these are drugs that are given continually in most situations and so it's important for people to know what to expect.” TS 14:25  “I think we're going to see bispecifics that perhaps engage other aspects of the immune system besides CD3. In fact, those are in clinical trials. And I do believe that we're going to see these more and more developed for cancers beyond the hematologic malignancies. There's a lot of work being done at looking at targets that we know are helpful targets in certain cancers. And I think we'll see more drugs approved beyond the myeloma and the lymphoma and the leukemia space.” TS 20:42 

An essential act of well-being, the practice of storytelling creates a social connection that fosters a sense of community and mutual support in both the storyteller and listener. During the Second Annual ONS Storytelling session held at the 48th Annual ONS Congress® in April 2023, ONS members Sarah Lewis, MNE, RN, OCN®, palliative care nurse navigator at Oregon Health and Science University in Portland; Crystal Johnson, RN, BSN, OCN®, patient engagement liaison at Genmab who lives in Ohio; Susie Maloney, MS, APRN, AOCN®, AOCNS®, senior director of the Medical Affairs Company and principal of Oncology Nursing Advisors, LLC, in Dayton, OH; and Brenda Sandoval Tawakelevu, BSN, RN, OCN®, nursing professional development practitioner at the Huntsman Cancer Institute in Salt Lake City, UT, engaged in the practice of storytelling around the theme of renewal in the context of oncology nursing. In this episode, the four oncology nurses share their tales with hosts Anne Ireland, DNP, RN, AOCN®, CENP, and Jaime Weimer, MSN, RN, AGCNS-BC, AOCNS®, oncology clinical specialists at ONS. 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 myoutcomes.ons.org by April 28, 2025. 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: The learner will report an increase in knowledge related to how nurses learn from one another through storytelling.  Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes:  Episode 101: Why We Love Oncology  Episode 90: The Year of the Nurse  ONS Voice articles:  Behind Our Masks, I See You, I Hear You  Mrs. Jones Gave Me the ‘Ah-Ha' Moment That Guided My Entire Nursing Career  As Oncology Nurses, We Are the Fish  Connect With Your Patients on a Human Level as Well as a Healthcare Level  Our Patients Give Us Peace in Unexpected Circumstances  Beyond the Bedside: Oncology Nurses Have Endless Opportunities in Unexpected Careers  Nursing Representation Is Critical in All Industries—Even Those Outside of Health Care  Clinical Journal of Oncology Nursing article: How Can Nurses Stay Resilient and Engaged During a Long and Ever-Changing Career Path?  ONS books:  Continuing the Legacy: More Voices of Oncology Nurses  Reflections on COVID-19 and Cancer Care: Stories by Oncology Nurses  Reflections on COVID-19 and Cancer Care: Stories by Oncology Nurses (volume 2)  ONS Career Development 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 pubONSVoice@ons.org.  Highlights From Today's Episode  Sarah Lewis  “An opportunity presented in spring 2021 to join the outpatient palliative care team as a registered nurse and after much careful consideration, I decided to take the leap. It seemed like it was a good time for a change, it seemed like a ‘dream' position, and I knew I could always go back to bone marrow transplant if it didn't work out. I was surprised when so early after I switched positions my decision was affirmed, and my oncology nursing career reinvigorated.” Timestamp (TS) 04:06  “I learned early on in my oncology nursing career the power of education but will always appreciate the real-life lesson my patient taught me that day. It not only reinforced my decision to step into this brand-new role, but it also re-energized my practice and spirit to continue to perform this awesome work we oncology nurses have the privilege to do every day.” TS 06:32  Crystal Johnson  “Being an oncology nurse, you inevitably become an extension of your patient's family. Often, we are with our patients throughout every step of their oncologic journey: initial diagnosis, first chemo, symptom management, remission, relapse, progression and, ultimately end-of-life transition.” TS 07:24  “From the moment I cared for my first oncology patient, I knew I had found my calling, but being able to be a part of something and inspire others in a way that is able to reach far greater than the patients I've cared for throughout my career is the reason I continue to show up every single day. Trusting that what we do makes a difference, and we can continue to cultivate a culture of hope within a community that is forever linked together by an unimaginable bond that no one asked to share.” TS 10:44  Susie Maloney  “One thing I've learned when teaching in countries with different cultures is that it is important to respect the people and be educated on what their beliefs happen to be. It is not our job to ‘teach them our Western ways.' This can be a challenge, however, particularly when some beliefs or practices are not evidence based.” TS 12:28  “When working in impoverished countries, it is important to consider what is within their achievable means. We would not teach about the latest therapies that are used in the United States if there is no chance of patients having access to such therapies or medications.” TS 15:28  Brenda Sandoval Tawakelevu  “Although I have many fond memories or patients and families that I have loved and cared for, I wouldn't be truthful if I didn't tell you I've also had many doubts about oncology nursing during some of the very rough seasons of life that we all experience. I've been at the crossroads, and I have seen the two roads the poet Robert Frost has so beautifully written about. This hasn't occurred just once but many times through the years as I have experienced the highs and the lows of ‘this road less traveled' of oncology nursing.” TS 18:40  “Now, eight years have passed, and I keep going day by day in the wonderful field of oncology. The flames of passion continue to grow, and that passion has been shared with hundreds of students and nurses that have been in my path over the years. I invite each one of you to choose to connect, choose to find your own balance in the field of oncology nursing, choose to heal your own wounds life has left upon you, and most of all, continue to choose oncology nursing.” TS 26:26 

“The reason that oncology nursing developed at the moment it did was from you and the other few people who were real leaders in your field. . . . It happened in that particular moment because of you and [the other founding members of ONS],” George Hill, MD, MA, DLitt, Captain, Medical Corps, U.S. Navy Reserve (retired), told Cindi Cantril, MPH, RN, OCN®, CBCN, founding board member and first vice president of ONS. Hill was a monumental supporter of ONS's founding and incorporation in 1975, and the duo reflected on their experiences and the history of oncology nursing. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. 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 myoutcomes.ons.org by May 5, 2025. 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: The learner will report an increase in knowledge related to the early formation of ONS. Episode Notes Complete this evaluation for free NCPD. Learn more about the history of ONS. ONS Voice articles: NOBC Partnerships Advance Nurses' Placements on Local and National Boards Boards and Committees Need Oncology APRN Voices. Will You Step Up to the Challenge? Clinical Journal of Oncology Nursing article: Supporting One Another for 40 Years The Early Days: Four Smiles and a Post Office Box Oncology Nursing Foundation Association of Community Cancer Centers American Association for Cancer Education European Association for Cancer Education National Cancer Act of 1971 To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “There's no doubt that the National Cancer Act elevated the whole field of oncology into something that was very different. . . . The reason that oncology nursing developed at the moment it did was from you and the other few people who were real leaders in your field. . . . It happened in that particular moment because of you and [the other founding members of ONS].” Timestamp (TS) 02:48 “In the 1950s and 60s, cancer was a word that was never mentioned. The idea of having something called cancer was so mysterious, so dangerous, so frightful, you could not mention cancer. Memorial Sloan Kettering Cancer Center in New York City was a pioneer in introducing the word cancer to be able to be used. But most everywhere else, even in oncology, we had to dodge around the term.” TS 09:43 “Throughout America, people need medical care and cancer care close to home. People can often drive many hours just to reach a community cancer center. To reach a comprehensive cancer center such as Memorial Sloan Kettering or MD Anderson would be impossible. So, the idea of developing physicians and radiation therapists and nursing oncologists who can do the job close to home is terribly important, otherwise they just don't get treated.” TS 12:44 “The opportunity and the goal of working with people of like mind in other countries is well worth doing. And we also learn from them.” TS 28:33

Dr. Rebecca King reviews the “AMSSM Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine,” which was originally published in the Clinical Journal of Sport Medicine in November 2021. Dr. Jeremy Schroeder serves as moderator. Dr. King is a member of the AMSSM Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2021, as selected for the 2022 AMSSM Annual Meeting in Austin, TX.   American Medical Society for Sports Medicine Position Statement: Principles for the Responsible Use of Regenerative Medicine in Sports Medicine DOI: 10.1097/JSM.0000000000000973

“Evidence-based practice is asking the right clinical question, searching the evidence and then really appraising and determining what is the quality of the evidence, and synthesizing it to move forward with a recommendation or a possible implementation plan,” Caroline Clark, MSN, APRN, OCN®, AG-CNS, director of evidence-based practice and inquiry at ONS, told Jaime Weimer, MSN, RN, AGNCS-BC, AOCNS®, oncology clinical specialist at ONS, during a discussion about the nurse's role in evidence-based oncology care. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.5 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by February 24, 2025. 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: The learner will report an increase in knowledge related to evidence-based practice. Episode Notes Complete this evaluation for free NCPD. ONS Evidence-Based Practice Learning Library ONS Voice articles: Real-World Usage Reports Show That ONS Guidelines™ Empower Nurses to Provide Best Patient Care Evidence-Based Practice Gives Oncology Nurses Knowledge and Standards for Clinical Care From Evidence to Standard: The Role of Clinical Guidelines in Oncology Care Overcome Barriers to Applying an Evidence-Based Process for Practice Change Adopt an Evidence-Based Practice Model to Facilitate Practice Change Strengthen a Commitment to Practice Change Through EBP Immersions The Difference Between Quality Improvement, Evidence-Based Practice, and Research Nursing evidence-based practice topic tag Clinical Journal of Oncology Nursing articles: Evidence-Based Practice in Oncology Nursing: Oncology Nursing Society Survey Results Success Is Not Final: Onward to the Future of Evidence-Based Practice Oncology Nursing Forum article: Measuring Clinical Decision Support Influence on Evidence-Based Nursing Practice ONS Biomarker Database The Ohio State University College of Nursing course: EBP Basics National Institutes of Health: Evidence-based practices, programs, and resources National Cancer Institute: Evidence-based cancer control programs Healthy People 2030 National Comprehensive Cancer Network American Society of Clinical Oncology To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Evidence-based practice (EBP) is asking the right clinical question, searching the evidence and then really appraising and determining what is the quality of the evidence, and synthesizing it to move forward with a recommendation or a possible implementation plan.” Timestamp (TS) 01:56 “Having a culture and environment that supports EBP is really foundational. An environment that encourages questions is going to cultivate the mentors in that environment and has leadership support. And often, that means tying EBP into your whole organizations mission and vision just to sustain evidence-based changes.” TS 06:15 “Developing your skills in critical appraisal does take time. It's not something that happens overnight, so you have to look for the opportunities to practice. Mentorship is certainly important. . . . Many organizations have adopted an EBP methodology, so while there's a lot of methodologies out there to choose from, there's so much overlap in them and the tools they use. I would really just explore if there's something already preferred in your organization.” TS 13:18 “Some key players to ask around about EBP are your nursing professional development specialists, your clinical nurse specialists, your DNP-prepared nurses, and your nurse scientists. And a great, low-risk way to practice critical appraisal is through journal clubs.” TS 13:57 “I think there's a lot of great work going on with the overarching theme of closing that gap from research to translation into practice. Some general things that I think are happening are really incorporating evidence into daily practice. That could be clinical decision support tools that are embedded in our electronic health record and then physicians, nurses, and clinicians have that at their fingertips at the point of care. And then standardized policies and templates to guide care for specific populations. And I think the use of religiously developed practice guidelines that are current at the point of care, as well.” TS 22:20 “If you're embarking on EBP change early on—I cannot stress this enough—you really need to determine what your outcome measures will be. How are things measured and recorded in the literature? How would you apply them in your practice? . . . From the start, consider specifically what the patient outcomes will be that you're monitoring that you're hoping to make a positive change in.” TS 31:12

“It's the oncology nurse who might be the only cheerleader this person has to keep them motivated moving forward. We need to make sure our patients' motivation and competence stay high so that they can stay on this journey of quitting,” ONS member Maureen O'Brien, MS, RN, PMHCNS, NCTTP, a certified tobacco treatment specialist at the Memorial Sloan Kettering Cancer Center in New York, NY, told Jaime Weimer, MSN, RN, AGNCS-BC, AOCNS®, oncology clinical specialist at ONS, during a discussion about the benefits of smoking cessation for patients with cancer and how oncology nurses can encourage reduction or quit attempts and support their patients through the process. You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1.0 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by February 17, 2025. 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: The learner will report an increase in knowledge related to smoking treatment of people with cancer. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast Episode 110: FDA Takes on Tobacco Use and Its Impact on Cancer Care  ONS Voice articles:  Nurses Must Take the Lead in Tobacco Cessation  Oncology APRNs Are Change Agents for Tobacco Cessation  When Healthcare Professionals Join Organizations to Advocate, Patients' Voices Are Heard  Other articles about tobacco and cancer  Clinical Journal of Oncology Nursing articles:  Tobacco Dependence Treatment: Examining Cessation Effectiveness in Oncology Settings  Smoking Cessation: An Oncology Clinical Nurse Specialist–Led Program  Selection of Optimal Tobacco Cessation Medication Treatment in Patients With Cancer  Oncology Nursing Forum article: Smoking Prevalence and Management Among Cancer Survivors  ONS E-Cigarettes and Vaping Learning Library  ONS position statements:  Use of E-Cigarettes and Vaping  International Society of Nurses in Cancer Care Tobacco Position Statement  Cancer article: Training Oncology Care Providers in the Assessment and Treatment of Tobacco Use and Dependence  Memorial Sloan Kettering Cancer Center tobacco programs:  Assessment and Treatment of Tobacco Dependence in Cancer Care  Four-Day Tobacco Treatment Specialist Training Workshop  Agency for Healthcare Research and Quality: Treating Tobacco Use and Dependence: Public Health Service Clinical Practice Guideline  Centers for Disease Control and Prevention:  Smoking and Tobacco Use  The Brief Tobacco Intervention  American Cancer Society: Health Benefits of Quitting Smoking Over Time  American Lung Association  QuitAssist  U.S. Food and Drug Administration: Health Effects of Tobacco Use  To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “For every person who dies from smoking, at least 30 people will live with a serious smoking-related illness. Smoking causes cancer; heart disease; strokes; lung diseases, including chronic obstructive pulmonary disease, which include emphysema and chronic bronchitis; and diabetes. 87% of all lung cancers are directly linked to smoking. . . . One out of every three cancer deaths are directly related to smoking.” Timestamp (TS) 11:50 “When and if a patient continues to smoke with a cancer diagnosis, it's because there's a high nicotine dependence. They're smoking to manage their withdrawal symptoms. The biggest withdrawal symptoms are anxiety and depression. And one might say that just being diagnosed with a cancer diagnosis is very anxiety-provoking. . . . They get very, very anxious, and the nicotine receptors in the brain will actually tell them to have a cigarette.” TS 15:58 “One of the byproducts of tobacco is carbon monoxide, and that is retained in the lungs. . . . And in eight hours, we can start to reverse that. In 24 hours, the risk of a heart attack decreases if you stop smoking. In about two weeks to three months after stopping smoking, your circulation starts to improve and your lung function increases.” TS 27:43 “As an oncology nurse, I think we need to start really focusing on some of the positive reasons why patients need to stop smoking in any prognosis that they have across the board. I think people respond to positive feedback better than negative feedback. That's why the benefits of smoking cessation for patients with cancer are so important to talk about.” TS 29:35 “It's the oncology nurse who might be the only cheerleader this person has to keep them motivated moving forward, and that's what we need to do. We need to make sure our patients' motivation and competence stay high so that they can continue on this journey of quitting.” TS 31:50

We're joined by global pain expert and pain psychologist Dr. Rachel Zoffness to discuss how pain works and how we can alleviate the root causes of pain instead of seeking short-term relief from addictive painkillers.Dr. Rachel Zoffness / WebsiteDr. Rachel Zoffness (@therealdoczoff) / InstagramDr. Rachel Zoffness (@DrZoffness) / TwitterRachel Zoffness PhD - Pain psychologist / LinkedIn The Pain Management Workbook: Powerful CBT and Mindfulness Skills to Take Control of Pain and Reclaim Your LifeIf you are in a crisis or think you have an emergency, call your doctor or 911. If you're considering suicide, call 1-800-273-TALK to speak with a skilled trained counselor.RADICALLY GENUINE PODCASTRadically Genuine Podcast Website Twitter: Roger K. McFillin, Psy.D., ABPPInstagram @radgenpodTikTok @radgenpodRadGenPodcast@gmail.comADDITIONAL RESOURCES4:30 Gate Control Theory of Pain - Physiopedia7:00 What Is a Pain Psychologist? | Psychology Today9:00 The Science of Pain10:20 Think Pain Is Purely Medical? Think Again. | Psychology Today11:00 Congenital insensitivity to pain: MedlinePlus Genetics11:50 Phantom Limb Pain - Physiopedia12:30 The Emotional Brain as a Predictor and Amplifier of Chronic Pain - PMC14:00 Tackling the Grand Challenge of chronic pain needs widespread reform: Prof John Loeser16:30 Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It's So Hard to Stop17:15 Radically Genuine Podcast | 57. Beliefs, mindsets and the placebo effect22:30 How to explain central sensitization to patients with ‘unexplained' chronic musculoskeletal pain: Practice guidelines - ScienceDirect25:00 Pain Tolerance and Sensitivity in Men, Women, Redheads, and More29:00 Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine - The Lancet Rheumatology31:00 A ‘Volume Control' for Pain | Harvard Medical School38:00 How to Calm an Anxious Stomach: The Brain-Gut Connection | Anxiety and Depression Association of America, ADAA39:30 The Brain-Gut Connection | Johns Hopkins Medicine40:30 Microbes Help Produce Serotonin in Gut44:00 Pain Recipe - @therealdoczoff49:30 Increased Pain Sensitivity in Accident-related Chronic Pain... : The Clinical Journal of Pain51:00 Hypervigilance in PTSD and Other Disorders53:30 The mind's mirror

“I think that we as nurses need to advocate when a patient is uncomfortable. And it's not your classic ‘pain in my hip' kind of thing. This is a more subtle, ‘I can't breathe, I have a sense of impending doom, I'm panicked, I want someone beside me.' It may sometimes appear to be a psychosocial coping issue when it really is a physiologic one,” ONS member Brenda Shelton, DNP, RN, AOCN®, clinical nurse specialist at Johns Hopkins Medicine in Baltimore, MD, told Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS. Shelton discussed the warning signs of superior vena cava syndrome and nursing considerations for its management. This episode is part of a series about oncologic emergencies; the others are linked in the episode notes. You can earn free NCPD contact hours after listening to this episode by completing the evaluation linked below. 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 myoutcomes.ons.org by September 2, 2024. 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. Episode Notes Complete this evaluation for free NCPD. Other Oncology Nursing Podcast episodes on oncologic emergencies Clinical Journal of Oncology Nursing articles: STAT: Superior Vena Cava Syndrome Superior Vena Cava Syndrome: An Education Sheet for Patients ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) ONS courses: Oncologic Emergencies Treatment and Symptom Management—Oncology RN Essentials in Oncologic Emergencies for the Advanced Practice Provider ONS Huddle Cards™ Information from the National Cancer Institute Information from Cancer.net National Comprehensive Cancer Network Guidelines American Cancer Society To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Superior vena cava syndrome was first recognized with tuberculosis, and now it's almost exclusively going to occur in patients with cancer because it's physiologically the outcome of too much mass in between the sternum and the spine.” Timestamp (TS) 01:57 “You might see some very subtle right arm heaviness, edema; you might see a prominent right antecubital, or prominent veins on the hand of the right arm, or a prominent right jugular vein. But these are all things that can be subtle, and the patient may present with aching of the arm, numbness or tingling of that arm, just really things that don't necessarily raise your awareness because it's not the classic signs or symptoms you see in your textbooks.” TS 05:35 “When we think of superior vena cava syndrome, we associate it with upper body edema, particularly worse in the morning when somebody rises after having laid flat for all night. . . . But the thing that patients report the most is dyspnea. It is not necessarily entirely due to respiratory problems. In this case, it's due to compression of the vena cava and an alteration of the blood returned to the heart that leads to an altered cardiac output.” TS 06:45 “The three biggest life-threatening complications I think about are airway incompetence, cardiovascular collapse, and clotting. As you compress the vena cava, you are going to diminish the blood return into the heart, and this is going to compromise your ability to oxygenate that blood and put it back out the other side.” TS 08:46 “We always start with a total body assessment, and it's hard because this patient is going to present with potentially neurologic symptoms, cardiac and respiratory symptoms, as well as just generalized discomfort and constitutional symptoms. You know, we're so focused sometimes on febrile neutropenia and the very classic complications, that this one is a little more subtle. And so the nurse needs to be very comfortable with their cardiovascular assessment in general and be looking at vessels and be looking at jugular venous distention and pulsations.” TS 15:32 “I think that we as nurses need to advocate when a patient is uncomfortable. And it's not your classic ‘pain in my hip' kind of thing. This is a more subtle, ‘I can't breathe, I have a sense of impending doom, I'm panicked, I want someone beside me.' It may sometimes appear to be a psychosocial coping issue when it really is a physiologic one.” TS 17:16 “We often think of this as something that is a sign of terrible, bad, irreversible disease, when in fact, it could be the presenting symptoms.” TS 19:32

“Let's take time, invest time, in learning more about futility. Let's invest some time in learning more about how to understand our patient's goals, their family's goals, what their values are,” Kathleen Turner, BSN, RN, CHPN, CCRN-CMC, clinical nurse in the medical-surgical intensive care unit at the University of California, San Francisco, Medical Center, told Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS, during a discussion on a nurse's approach to futility in cancer care and treatment. You can earn free NCPD contact hours after listening to this episode by completing the evaluation linked below. 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 myoutcomes.ons.org by August 26, 2024. 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. Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast: Episode 78: Ethical Distress Impacts Nursing Practice Episode 135: ELNEC Has Trained More Than One Million Nurses in End-of-Life Care ONS Voice articles: It Takes a Team to Confront Moral Distress Palliative Care Resources Comfort Nurses Through COVID-19 Stress, Dilemmas, and Grief Articles about ethics and communications Clinical Journal of Oncology Nursing articles: When Does Treatment in Cancer Care Become Futile? How Does an Oncology Nurse Increase Moral Resilience During a Pandemic? Moral Distress: A Qualitative Study of Experiences Among Oncology Team Members Moral Distress: Identification Among Inpatient Oncology Nurses in an Academic Health System Oncology Nursing Forum article: Coping With Moral Distress in Oncology Practice: Nurse and Physician Strategies Journal of Nursing Education and Practice article: R.A.C.E. for Nurses: Cultivating Compassion in Nurse/Patient Interactions AACN Advanced Critical Care article: Ethical Discernment and Action: The Art of Pause JAMA article: Conflicts Regarding Decisions to Limit Treatment: A Differential Diagnosis Podcast: Decompress by Anthony Back Resources on Being Mortal: Book by Atul Gawande FRONTLINE documentary VitalTalk resources and IMPACT-ICU toolkit American Association of Colleges of Nursing: End-of-Life Nursing Education Consortium project To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “Medical futility has traditionally been framed as care that can't achieve its stated purpose. For instance, treating myocardial infarction with an antibiotic. There's no way that that medicine is going to fix somebody's heart attack. Often, though, I think it is something that we tend to invoke in our own practice when we feel like the care that we're providing may not be able to achieve our goal for the patient—and I mean our personal goal as opposed to a clinical goal. And from there, moral distress arises.” Timestamp (TS) 02:40 “I think that there's a tremendous opportunity for nurses to also actively participate in that conversation, especially oncology nurses, because we are with patients throughout their continuum of care and work with people for a long time and have more ‘in-the-room-time' with our patients. I think of the nurses who had been giving my own mom her chemotherapy, where they spend so much time in the room with her and talking about her impressions of her care, what she wants, what's important, what's a meaningful result, and we can share that with our physician colleagues.” TS 04:38 “I think it's the question of, ‘Because there is another thing that we can do, should we do it?' That feeling of futility that clenches at our heart, at our guts, that's a signal to us to stop and think, ‘What is the goal of treatment? Whose goal is that? And is what's happening right now aligned with that goal, or have we somehow gone astray?'” TS 08:51 “When futility rears its head in our nursing practice, our first duty to ourselves and our patients is to take a pause. . . . Stop and reflect with a learner mindset on, ‘What it is I'm not seeing in this situation, whose voice is not being heard, what are my assumptions and biases?' And then think about, ‘What's another narrative that I can write about this situation?,' trying to be very mindful of other patients that we've cared for in similar situations where we might be bringing or protecting these other patients onto this current patient.” TS 09:40 “Several years ago, when I was really going through some struggles in the ICU with this issue of futile or potentially inappropriate care, I went to a workshop and learned this mnemonic called GRACE to help clinicians remain compassionate and see what is the ethically appropriate thing to do in really fraught situations.” TS 16:18 “Let's take time, invest time, in learning more about what is futility. Let's invest some time in learning more about how to understand our patient's goals, their family's goals, what their values are. Taking some time to invest in communication training, ethics—if clinical ethics is something that's a particular interest to you—that's a great way to start, but also just really investing in learning how to communicate.” TS 36:18

“It's actually the nurse who most often first identifies the subtle signs of sepsis in patients. Trust your clinical judgement,” ONS member Laura Zitella, MS, RN, ACNP-BC, AOCN®, nurse practitioner at the University of California, San Francisco, told listeners during a conversation with Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS. Zitella explained the nursing and management considerations for febrile neutropenia and what to do if it transitions into sepsis. This episode is part of a series about oncologic emergencies; the previous episodes are also linked below. You can also earn free NCPD contact hours after listening to this episode by completing the evaluation linked below. 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 myoutcomes.ons.org by August 12, 2024. 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. Episode Notes Complete this evaluation for free NCPD. Previous Oncology Nursing Podcast episodes on oncologic emergencies Clinical Journal of Oncology Nursing articles: Sepsis: Symptoms, Assessment, Diagnosis, and the Hour-1 Bundle in Patients With Cancer NEWS Scoring System: Use in Hematologic Malignancies and Cellular Therapeutics Patient Populations Febrile Neutropenia: Decreasing Time to Antibiotic Administration in a Community Hospital Emergency Department ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) ONS courses: Oncologic Emergencies Treatment and Symptom Management—Oncology RN Essentials in Oncologic Emergencies for the Advanced Practice Provider ONS Huddle Cards™ International Guidelines for Management of Sepsis and Septic Shock National Comprehensive Cancer Network guidelines on prevention and treatment of cancer-related infections Sepsis Alliance Surviving Sepsis Campaign To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From Today's Episode “We know that fever and neutropenia in combination needs to be treated immediately. This is a high-risk oncologic emergency. Our patients who have febrile neutropenia are at very high risk of having a severe infection or sepsis.” Timestamp (TS) 03:44 “Patients with cancer are at an increased risk for infection because of the inherent immunosuppression of the cancer itself and also the treatment.” TS 08:28 “There are some very, very basic things that patients can do [to decrease risk for infection]. The most important is good handwashing. I explain to patients that your skin is the best barrier against getting an infection. If there's no break in the skin, then infection cannot get in. So, if your hands get contaminated and you wash them before you touch your eyes or your mouth or your nose, then that is a good way to prevent infection.” TS 11:42 “Even if a patient does everything perfect, most of the time when you're neutropenic, the infections that develop come from endogenous organisms. So, our body is colonized with probably 10 times as many microbes as human cells, and when the immune system is suppressed, it allows these organisms sometimes to cause infection. So, it's very important for patients to know that if they have signs of infection that they should let us know so that we can start immediate treatment to treat the infection.” TS 14:01 “If patients are higher risk or they have any organ dysfunctions, or other symptoms—like they're unwell, nausea, vomiting, diarrhea, any symptoms like that—they should be admitted to the hospital, and we would initiate IV antibiotics.” TS 17:37 “It's actually the nurse who's most often the person that first identifies sepsis in patients, so I think it's really important to trust your clinical judgement. When you look at a patient, it's really easy to tell when something is wrong. When they're starting to breathe too heavy or they're a little bit off and they're starting to get some altered mental status, or suddenly their heart rate is elevated for no reason even though they're just lying in bed. So, nurses are really positioned and are most often the ones who first pick up on these subtle signs.” TS 27:17

“The nurse is kind of the hub of a spoked wheel. You have your pharmacy and your provider all on the outside edge, but it's the nurse that's connecting all of these different support services together and being the main connection for the patient,” ONS member Elizabeth Bettencourt, RN, MSN, OCN®, oral oncolytic nurse navigator at Palo Alto Medical Foundation in Sunnyvale, CA, and member of the Silicon Valley ONS Chapter, said. Bettencourt joined Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS, for a discussion on how oncology nurses can support their patients in adherence to oral anticancer medications. The advertising messages in this episode are paid for by Breast Cancer Index. Music Credit: "Fireflies and Stardust" by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Episode Notes ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications ONS Oral Anticancer Medication Toolkit ONS Huddle Card™ on Financial Toxicity Oral Anticancer Medication Learning Library Oral Adherence Video Oncology Nursing Podcast Episode 16: Navigating the Challenges of Oral Chemotherapy ONS Voice articles Maintain Oral Adherence With ONS Guidelines™ Oral adherence topic tag Clinical Journal of Oncology Nursing articles Oral Chemotherapy Adherence: A Novel Nursing Intervention Using an Electronic Health Record Workflow Assessment and Measurement of Medication Adherence: Oral Agents for Cancer Factors Influencing Oral Adherence: Qualitative Metasummary and Triangulation With Quantitative Evidence Overview of the Challenges Related to Oral Agents for Cancer and Their Impact on Adherence Oral Chemotherapy Education Sheets To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. 

“Sometimes in our daily routine of taking care of patients, it's more about looking at the treatment side effects. But look at those wide array of symptoms that can present with an oncologic emergency. They will kind of sneak up on you, and as an oncology nurse, we all need to be educated about them,” ONS member Diane Cope, PhD, APRN, BC, AOCNP®, director of nursing and oncology nurse practitioner at Florida Cancer Specialists and Research Institute in Fort Myers told Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS. During this episode, Cope explained the clinical manifestations associated with syndrome of inappropriate antidiuretic hormone (SIADH) and its medical and nursing interventions. The episode is part of a series about oncologic emergencies; the previous episodes are linked below. You can also earn free NCPD contact hours by completing the evaluation linked below. 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 myoutcomes.ons.org by July 1, 2024. 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. Episode Notes Check out these resources from today's episode: Complete this evaluation for free NCPD. Previous Oncology Nursing Podcast episodes on oncologic emergencies ONS Huddle Card™: Hormone Therapy 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 articles: STAT: Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Syndrome of Inappropriate Antidiuretic Hormone Secretion in Malignancy: Review and Implications for Nursing Management Hyponatremia and SIADH: A Case Study for Nursing Consideration To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

When it comes to oncologic emergencies, early identification and intervention achieves the best outcomes, but some emergencies are harder to recognize. “Oncology nurses are often the first to pick up on important symptoms of serious complications,” Laura Zitella, MS, RN, ACNP-BC, AOCN®, nurse practitioner at the University of California, San Francisco, said. Zitella joined Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS, to talk about recognizing less common complications seen in patients with cancer, such as adrenal crisis, pulmonary embolism, and malignant small bowel obstructions. She also presented on the topic at the 47th Annual ONS Congress® in Anaheim, CA, on April 27, 2022. The advertising messages in this episode are paid for by Breast Cancer Index. Music Credit: "Fireflies and Stardust" by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes Check out these resources from today's episode: NCPD contact hours are not available for this episode. Learn more about Laura's session at ONS Congress, and watch it on demand from May 23–June 30, 2022, to earn 2.00 NCPD contact hours. Clinical Journal of Oncology Nursing articles: Chronic Obstructive Pulmonary Disease: Clinical Implications for Patients With Lung Cancer Adrenal Insufficiency: Immune Checkpoint Inhibitors and Immune-Related Adverse Event Management ONS Voice article: The Case of the Post-Transplant Pulmonary Problem ONS Immunotherapy Wallet Cards ONS Guidelines™ for Opioid-Induced and Non–Opioid-Related Cancer Constipation Society for Immunotherapy of Cancer Clinical Practice Guideline on Immune Checkpoint Inhibitor–Related Adverse Events Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update NCCN Guidelines for Patients: Immune Checkpoint Inhibitors To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. 

“We call it an oncologic emergency for a reason. Even though it's usually not life threatening, the longer we wait, the more debilitating and devastating the side effects will be,” ONS member Jennifer Webster, MN, RN, AOCNS®, MPH, clinical nurse specialist at Northside Hospital in Atlanta, GA, and member of the Metro Atlanta ONS Chapter, said during her conversation with Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS. The nurses talked about the importance of early identification and intervention for malignant spinal cord compression and other nursing considerations for the oncologic emergency. This episode is a part of a series about oncologic emergencies; the previous episodes are linked below. You can also earn free NCPD contact hours by completing the evaluation linked below. 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 myoutcomes.ons.org by June 3, 2024. 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. Episode Notes Check out these resources from today's episode: Complete this evaluation for free NCPD. Previous Oncology Nursing Podcast episodes on oncologic emergencies ONS Huddle Card™: Spinal Cord Compression 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 articles: STAT: Spinal Cord Compression Back Pain: Is It Spinal Cord Compression? Nurse, My Back Hurts: Understanding Malignant Spinal Cord Compression Oncology Nursing Forum article: Oncology Emergency Modules: Spinal Cord Compression American Cancer Society information on bone metastasis and spinal cord compression Leukemia and Lymphoma Society information on multiple myeloma and spinal cord compression Bone Health & Osteoporosis Foundation To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

Talking to patients about how their cancer and treatment affects their fertility can be challenging and complicated for oncology nurses, but we owe it to our patients to have those conversations. Megan Solinger, MHS, MA, OPN-CG, director of service and care delivery at the Ulman Foundation in Baltimore, MD, joins Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS, to offer guidance, ideas, and advice that will prepare you to confidently approach those essential and ethical discussions. Megan presented the topic at the 47th Annual ONS Congress® in Anaheim, CA, on April 28, 2022.   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 myoutcomes.ons.org by May 20, 2024. 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.  Episode Notes  Check out these resources from today's episode:  Complete this evaluation for free NCPD.  Learn more about Megan's session at ONS Congress, and watch it on-demand from May 23–June 30, 2022, to earn an additional 1.25 NCPD contact hours.  Fertility Preservation ONS Huddle Card™ Previous Oncology Nursing Podcast episodes about patient education Clinical Journal of Oncology Nursing and Oncology Nursing Forum articles about fertility and preservation Alliance for Fertility Preservation's Fertility Scout database American Society of Clinical Oncology guidelines on fertility preservation ECHO Training Program Oncofertility Consortium at Northwestern University Take CHARGE  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. 

ONS member Roberta Kaplow, RN, PhD, CCRN, AOCNS®, clinical nurse specialist at Emory University Hospital in Atlanta, GA, and member of the Metro Atlanta ONS Chapter, talks with Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS, about the latest nursing management and prevention strategies for malignant pleural effusion. This episode is a part of a series about oncologic emergencies; the previous episodes are linked in the episode notes. You can also earn free NCPD contact hours by completing the evaluation linked in the episode notes.    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 myoutcomes.ons.org by May 13, 2024. 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.  Episode Notes  Check out these resources from today's episode:  Complete this evaluation for free NCPD.  Previous Oncology Nursing Podcast episodes on oncologic emergencies ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) Clinical Journal of Oncology Nursing articles about malignant pleural effusion American Thoracic Society's malignant pleural effusion patient education sheet Pleural catheter patient education video (from manufacturer) Pleural catheter provider information (from manufacturer)  The podcast conversations represent the guest's ideas and opinions and not necessarily those of ONS. Mention of specific products and opinions related to those products does not indicate endorsement by ONS.   To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. 

The inflating price tag of cancer care means that more patients are facing the difficult choice of paying for everyday needs or their cancer treatment. Matthew Banegas, PhD, MPH, MS, associate professor of radiation medicine and applied sciences at the University of California San Diego and a member of Moores Cancer Center's Cancer Control Program, talks with Stephanie Jardine, BSN, RN, oncology clinical specialist at ONS, about COVID-driven financial hardship and its implications for cancer care. Banegas presented about the topic at the 47th Annual ONS Congress in Anaheim, CA, on April 30, 2022; his session is linked in the episode notes. You can also earn free NCPD contact hours by completing the evaluation linked in the episode notes.    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 myoutcomes.ons.org by April 29, 2024. 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.  Episode Notes  Check out these resources from today's episode:  Complete this evaluation for free NCPD.  Learn more about Banegas's ONS Congress session and watch it on demand from May 23–June 30, 2022.   Oncology Nursing Podcast episodes about financial hardship and cost of care  ONS Voice articles about financial hardship and advocacy  Clinical Journal of Oncology Nursing article about financial navigation  HealthCare.gov's glossary of health insurance terminology  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. 

When you're treating patients that feel like their scapulae are asymmetrical, a rib is “out of place”, or they feel neck or thoracic stiffness without any restriction in movement, they may expect you to perform treatment that is unlikely to help, like joint mobilisation, manipulation or massage. How can you use the latest pain science in your treatment to help patients overcome the experience of asymmetry, stiffness or something being out of place? Find out in this podcast with Jo Gibson (Upper Limb Rehabilitation Specialist Physio). The handout for this podcast is an article referenced in the podcast. There is no additional transcript or handout available. Free video series “Frozen shoulder assessment & treatment” with Jo Gibson Improve your frozen shoulder assessment and treatment now with Jo Gibson's free video series at clinicaledge.co/shoulder Shoulder: Steps to Success online course with Jo Gibson Improve your assessment and treatment of shoulder pain with the Shoulder: Steps to Success online course with Jo Gibson, now available for enrolment at clinicaledge.co/shouldersuccess Free trial Clinical Edge membership Use a fresh approach to your musculoskeletal and sports injury treatment with a free trial Clinical Edge membership at clinicaledge.co/freetrial Links associated with this episode: Get your access to the free video series “Frozen shoulder assessment & treatment” with Jo Gibson Improve your shoulder assessment & treatment with the Shoulder: Steps to Success online course with Jo Gibson Improve your confidence and clinical reasoning with a free trial Clinical Edge membership Join Jo Gibson live on Facebook & ask your shoulder related questions every Monday Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Jo Gibson on Twitter Let David know what you liked about this podcast on Twitter Review the podcast on iTunes Infographics by Clinical Edge Articles associated with this episode: CLICK HERE to download the articles associated with this podcast Tabor A, Keogh E, Eccleston C. Embodied pain—negotiating the boundaries of possible action. Pain. 2017 Jun 1;158(6):1007-11. Tabor A, Vollaard N, Keogh E, Eccleston C. Predicting the consequences of physical activity: An investigation into the relationship between anxiety sensitivity, interoceptive accuracy and action. Plos one. 2019 Mar 28;14(3):e0210853. Tabor A, Van Ryckeghem DM, Hasenbring MI. Pain unstuck: the role of action and motivation. The Clinical Journal of Pain. 2020 Mar 10;36(3):143-9. Venter E. Toward an embodied, embedded predictive processing account. Frontiers in Psychology. 2021:137.