Legislative: Justice for All: The Next Big Breakthrough in Cancer Care

Along with a broken and neglected public health system that lacks required federal funding to make real progress toward health equity, it is no surprise that the health status of the U.S. remains suboptimal while the costs of cancer care and survivorship continue to grow (Berwick. 2020). Cutting edge innovations with lifesaving potential unquestionably deserve investment;but if our goal is to save lives, the emphasis placed on these advances is outsized relative to the lifesaving reality of existing prevention, screening, and treatment modalities that many Americans still struggle to access due to social inequities in wealth, power and resource allocation. Tamryn F. Gray, PhD, RN, MPH Email: tamrvn qrav@dfci.harvard.edu Tamryn F. Gray is an Instructor in Medicine at Harvard Medical School within the Department of Psychosocial Oncology and Palliative Care at Dana-Farber Cancer Institute and the Department of Medicine at Brigham Women's Hospital. The result is an unregulated system between drug manufacturers who set their own list price for each drug, and pharmacy benefit managers (PBMs) and insurers that negotiate a net price for people with insurance or Medicare while reaping the reward of their negotiation.

Optimizing the Global Nursing Workforce to Ensure Universal Palliative Care Access and Alleviate Serious Health-Related Suffering Worldwide.

CONTEXT: Palliative care access is fundamental to the highest attainable standard of health and a core component of universal health coverage. Forging universal palliative care access is insurmountable without strategically optimizing the nursing workforce and integrating palliative nursing into health systems at all levels. The COVID-19 pandemic has underscored both the critical need for accessible palliative care to alleviate serious health-related suffering and the key role of nurses to achieve this goal. OBJECTIVES: 1) Summarize palliative nursing contributions to the expansion of palliative care access; 2) identify emerging nursing roles in alignment with global palliative care recommendations and policy agendas; 3) promote nursing leadership development to enhance universal access to palliative care services. METHODS: Empirical and policy literature review; best practice models; recommendations to optimize the palliative nursing workforce. RESULTS: Nurses working across settings provide a considerable untapped resource that can be leveraged to advance palliative care access and palliative care program development. Best practice models demonstrate promising approaches and outcomes related to education and training, policy and advocacy, and academic-practice partnerships. CONCLUSION: An estimated 28 million nurses account for 59% of the international healthcare workforce and deliver up to 90% of primary health services. It has been well-documented that nurses are often the first or only healthcare provider available in many parts of the world. Strategic investments in international and interdisciplinary collaboration, as well as policy changes and the safe expansion of high-quality nursing care, can optimize the efforts of the global nursing workforce to mitigate serious health-related suffering.

The Oncology Nursing Society Rapid Review and Research Priorities for Cancer Care in the Context of COVID-19.

OBJECTIVES: To identify research priorities addressing COVID-19 that build on the 2019-2022 Oncology Nursing Society (ONS) Research Agenda, in alignment with ONS's mission to promote excellence in oncology nursing and quality cancer care. METHODS & VARIABLES: Priority areas were identified using a multistep approach combining rapid review of the literature; consultation with experts/stakeholders; and review of priorities from other funding agencies, public health, and cancer-focused organizations. RESULTS: The rapid research response team identified five priority areas for research related to COVID-19. IMPLICATIONS FOR NURSING: Oncology nurses are well positioned to address the research priorities and cross-cutting themes identified through this review. The use of innovative methodologic approaches and attention to disparities are necessary to advance cancer care related to COVID-19.

Recommendations to Leverage the Palliative Nursing Role During COVID-19 and Future Public Health Crises.

With the daily number of confirmed COVID-19 cases and associated deaths rising exponentially, social fabrics on a global scale are being worn by panic, uncertainty, fear, and other consequences of the health care crisis. Comprising more than half of the global health care workforce and the highest proportion of direct patient care time than any other health professional, nurses are at the forefront of this crisis. Throughout the evolving COVID-19 pandemic, palliative nurses will increasingly exercise their expertise in symptom management, ethics, communication, and end-of-life care, among other crucial skills. The literature addressing the palliative care response to COVID-19 has surged, and yet, there is a critical gap regarding the unique contributions of palliative nurses and their essential role in mitigating the sequelae of this crisis. Thus, the primary aim herein is to provide recommendations for palliative nurses and other health care stakeholders to ensure their optimal value is realized and to promote their well-being and resilience during COVID-19 and, by extension, in anticipation of future public health crises.