Cancer nurses face ‘perfect storm' after COVID pandemic

Cancer nurses are weathering a 'perfect storm' of challenges as they face severe workforce shortages and struggle to recover from the pandemic.

Guidelines for teleconsultations

Introduction: The COVID-19 pandemic forced oncology nurses to deliver more consultations by telephone (teleconsultations). Nurses in Switzerland are in general not trained to provide teleconsultations, making this change of practice a considerable challenge. The Academic Society Oncology Nursing invited health care professionals to webinars in French and German to discuss their experiences related to COVID-19 policies. Method(s): Members of the Academic Society searched for international guidelines and already implemented digital tools to facilitate teleconsulta-tions in oncological settings. Overall, ten national and international health care experts including nurses, an oncologist, and an expert for telephone consultations participated at two webinars. The same outline was used in French and German and both webinars were video recorded. Result(s): COVID-19 pandemic policies drove an increase in teleconsulta-tions. Guidelines for telephone triage from the Oncology Nursing Society (ONS) in the USA and in the UK (UKONS) incorporated procedures to assess COVID-19 symptoms and to defne patient referrals based on local health system capacities. In France, the Gustave Roussy Institute created the CAPRI-COVID program to facilitate the remote monitoring of cancer patients during the COVID-19 pandemic. In Switzerland, nurses used local guidelines implemented for follow-up consultations by telephone to support cancer patient adherence to treatment and to assess symptom trajectories, to structure their teleconsultations. The assessment of COVID-19 symptoms was not always included. The sudden change to support patients remotely was challenging when no guidelines or standards for this kind of support were already in place. Documenting tele-consultations was difcult when no electronic documentation system was implemented. The reimbursement of nursing teleconsultations was a major, important barrier nurses faced, leading to unpaid provided services. Conclusion(s): The federal health system in Switzerland has provided no national recommendations for nursing teleconsultations. However, ONS and UKONS guidelines could inform the development of evidence based recommendations for oncology nursing teleconsultations in Switzerland. The Academic Society Oncology Nursing will take an initiative to discuss reimbursement of nursing teleconsultations with Swiss stakeholders including health care professionals and policy makers.

Guidelines for teleconsultations

Introduction: The COVID-19 pandemic forced oncology nurses to deliver more consultations by telephone (teleconsultations). Nurses in Switzerland are in general not trained to provide teleconsultations, making this change of practice a considerable challenge. The Academic Society Oncology Nursing invited health care professionals to webinars in French and German to discuss their experiences related to COVID-19 policies. Method(s): Members of the Academic Society searched for international guidelines and already implemented digital tools to facilitate teleconsulta-tions in oncological settings. Overall, ten national and international health care experts including nurses, an oncologist, and an expert for telephone consultations participated at two webinars. The same outline was used in French and German and both webinars were video recorded. Result(s): COVID-19 pandemic policies drove an increase in teleconsulta-tions. Guidelines for telephone triage from the Oncology Nursing Society (ONS) in the USA and in the UK (UKONS) incorporated procedures to assess COVID-19 symptoms and to defne patient referrals based on local health system capacities. In France, the Gustave Roussy Institute created the CAPRI-COVID program to facilitate the remote monitoring of cancer patients during the COVID-19 pandemic. In Switzerland, nurses used local guidelines implemented for follow-up consultations by telephone to support cancer patient adherence to treatment and to assess symptom trajectories, to structure their teleconsultations. The assessment of COVID-19 symptoms was not always included. The sudden change to support patients remotely was challenging when no guidelines or standards for this kind of support were already in place. Documenting tele-consultations was difcult when no electronic documentation system was implemented. The reimbursement of nursing teleconsultations was a major, important barrier nurses faced, leading to unpaid provided services. Conclusion(s): The federal health system in Switzerland has provided no national recommendations for nursing teleconsultations. However, ONS and UKONS guidelines could inform the development of evidence based recommendations for oncology nursing teleconsultations in Switzerland. The Academic Society Oncology Nursing will take an initiative to discuss reimbursement of nursing teleconsultations with Swiss stakeholders including health care professionals and policy makers.

Understanding the experiences of cancer patients referred for a clinical trial during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic affected cancer patients regardless of the stage of their diagnosis or treatment. AIMS: To understand the experiences of cancer patients who were referred for a clinical trial at that time. METHOD: Cancer patients who attended their initial research outpatient appointment to discuss the possibility of taking part in a clinical trial were asked to complete the Generalised Anxiety Disorder Assessment questionnaire, and take part in semi-structured interviews. FINDINGS: Data indicated that, on average, patients had moderate levels of anxiety. Three major themes emerged from patients' interviews, which gave an insight into what they experienced during this challenging period. CONCLUSION: This study gives an insight into the experiences of cancer patients who were referred for a clinical trial at the height of the COVID-19 pandemic. It illustrated the impact of social distancing and the effect of virus-related fear on cancer patients' mental health.

Pandemic-Related Innovations in Oncology Nursing Research: Seeking the Positive: lthough COVID-19 was a major setback for completing and initiating projects, it ushered in a new era for investigators

The article focuses on the scientists across industry, academic and healthcare settings that were forced to halt their ongoing research studies because of isolation mandates associated with the management of contagion in the COVID-19 pandemic. Topics include examines for many scientists, this unprecedented stoppage continued for many months and not only disrupted preexisting studies but delayed the development of new work.

What Are the Unmet Supportive Care Needs of People Affected by Cancer: An Umbrella Systematic Review.

OBJECTIVE: The aim of this umbrella systematic review was to critically synthesize unmet supportive care needs of people affected by cancer. DATA SOURCES: The Joanna Briggs Institute (JBI) umbrella review method provided an overall examination of the body of evidence that was available in relation to the unmet supportive care needs among people living with cancer. All qualitative, quantitative, and mixed methods reviews were included irrespective of review design. Electronic databases were searched using a wide range of search terms. All records were managed using the software package Endnote X21 and uploaded to Covidence systematic review software. Duplication of records were removed. A preselection eligibility criterion was applied to all records. Data extraction and methodological quality assessment was conducted independently by two reviewers, and a meta-level narrative synthesis conducted. CONCLUSION: A total 30 systematic reviews were included representing a total of 666 publications globally. Irrespective of the type of cancer there were many commonalities in relation to the reported experiences of unmet supportive care needs, which therefore enables the development of targeted future clinical trials, clinical guidelines, and policy contribution. In descending order of frequency, the highest unmet supportive care needs were related to psychological/emotional (30 out of 30), health system/information (29 out of 30), interpersonal/intimacy (21 out of 30), social (20 out of 30), physical (19 out of 30), family (18 out of 30), practical (16 out of 30), daily living (10 out of 30), spiritual needs (8 out of 30), patient-clinician communication (8 out of 30), and cognitive needs (5 out of 30). IMPLICATIONS FOR NURSING PRACTICE: This umbrella review has underscored fundamental shortcomings in care delivery irrespective of the patient population and the type of cancer. People with cancer are continually reporting that their needs are not being met across many supportive care domains. It is time for change within the health care system and to full leverage multidisciplinary person-centered models of care to optimize recovery and survivorship experiences. In the meantime, policy makers and cancer care clinicians are encouraged to reflect on these findings to address individualized care needs.

Scientific Publications on Nursing for COVID-19 in Patients With Cancer: Scoping Review.

BACKGROUND: The needs of patients with cancer must be met, especially in times of crisis. The advent of the pandemic triggered a series of strategic actions by the nursing team to preserve the health of patients and professionals-hence the importance of studies on nursing care actions provided to patients with cancer during the COVID-19 pandemic. It is known that these patients are susceptible to severe COVID-19. However, no previous review has summarized the findings of scientific studies on nursing for COVID-19 in patients with cancer. OBJECTIVE: This study aims to map the topics addressed in scientific studies on nursing for COVID-19 in patients with cancer. METHODS: A scoping review was conducted using the methodology described in the Joanna Briggs Institute Reviewers' Manual 2015. The research question was elaborated using the population, concept, and context framework: What topics have been studied in nursing publications about COVID-19 in adult patients with cancer? The searches were carried out in 8 databases between April and November 2021 without time restrictions. RESULTS: In total, 973 publications were identified using the search strategies in the databases, and 12 papers were retrieved by consulting the references. A total of 31 (3.2%) publications were included in the final analysis, generating 4 thematic categories on the subject: "restructuring the services: how oncology nursing was adapted during the pandemic," "experiences of patients and performance of the nursing team during the COVID-19 pandemic," "protocols and recommendations for dealing with the COVID-19 pandemic," and "challenges and the role of oncology nurses facing the COVID-19 pandemic." CONCLUSIONS: Several strategies used by oncology nurses to face the COVID-19 pandemic in the international scenario were identified. Reports about the restructuring of services and the team's reactions to the pandemic predominated. However, there is a lack of reports regarding emotional support strategies for health care professionals. Another gap identified was the scarcity of clinical studies on the activities developed by oncology nurses. Therefore, there is a need for clinical research in the oncology area and emotional coping strategies to support oncology nurses.

Influence of the COVID-19 Pandemic on Clinical Oncology Nursing Care.

Exactly where are we in the practice of clinical oncology nursing, now indelibly altered by the COVID-19 pandemic? Depending on the day or hour, experts in clinical oncology care claim that clinical oncology practice has stab.

Have Hope for the Next Generation of Oncology Nurses

The article offers information that how oncology nurses embrace hope in daily practice and can often impart it to patients and families. It mentions that challenges faced by the oncology nursing amid the Covid-19 pandemic. It discusses that nurses confronted burnout and compassion fatigue prior to the Covid-19 pandemic.

Cancer survivors' perceptions of priorities for geriatric oncology research: A qualitative study

Background: People living with and after cancer may experience complex physical and psychosocial issues requiring multidisciplinary support. While adults over the age of 65 are the group most commonly diagnosed with cancer, they also represent the group most under-represented in research. Therefore, this study aims to explore older adults' perceptions of priorities for research in cancer and haematological malignancies. Methods: A descriptive qualitative study was undertaken with sixteen older adults over the age of 65 who were living with or after a diagnosis of cancer. Participants were purposively recruited via a regional cancer centre and cancer advocacy organisations. Participants engaged in a one-to-one semi-structured telephone interview, which discussed their experiences of cancer, and their perceptions of cancer-related issues which they believed were priorities for research in the future. Qualitative data were thematically analysed. Results: Participants were overwhelmingly satisfied with the cancer-related care they received, but discussed a variety of issues related to their experiences of information, symptoms, and support beyond the hospital setting which warranted further research. Forty-two priorities for future research were categorised within six themes, containing a total of eleven sub-themes. Priorities for future research included the recognition of the signs and symptoms of cancer in older adulthood;research about cancer treatments for older adults;supporting the assessment and management of co-morbidities;the unmet needs of older adults living with and after cancer;the impact of COVID-19 on people living with or after cancer and on cancer services;and the impact of cancer on caregivers and family members. Conclusions: The results of this study represent a basis for future priority setting for research in the field of geriatric oncology. The results of this study have the potential to underpin priorities for research which are driven by the population who are most affected by, and most in need of research to address the complex issues associated with diagnosis, treatment, survivorship, and end of life care for people living with or after cancer in older adulthood. Legal entity responsible for the study: University College Dublin. Funding: Irish Research Council. Disclosure: A. Drury: Financial Interests, Personal, Full or part-time Employment: University College Dublin;Financial Interests, Institutional, Research Grant, I am a collaborator on the Pfizer-funded project ABC4Nurses, which is coordinated and managed by EONS: Pfizer;Non-Financial Interests, Invited Speaker: European Oncology Nursing Society;Non-Financial Interests, Advisory Role, I am an advisor on several EONS projects, including ABC4Nurses and RCC & HCC PROMS: European Oncology Nursing Society. All other authors have declared no conflicts of interest.

International Collaboration for Thoracic Oncology Education

Introduction: The International Thoracic Oncology Nursing Forum (ITONF) is an international lung cancer nursing organization with a mission to educate nurses around the world about caring for patients with thoracic cancers. The mission of ITONF is accomplished through educational workshops, online educational modules and networking opportunities. Methods: During 2020-2021 ITONF had been collaborating with the Mersal Cancer Center in Egypt to provide an educational program to educate Egyptian oncology nurses on the latest treatments in thoracic cancers as well as nursing management strategies. This was based on a regional need’s assessment. Due to the COVID pandemic, as well as practical needs, a hybrid delivery was required. ITONF developed 5 learning modules to meet identified needs. Educational modules with detailed slides were pre-recorded and presented to the Egyptian nurses during an educational conference. Results: A total of 18 Egyptian nurses and social workers attended the conference. Participants viewed the 5 educational modules, each covering a different topic about lung cancer. On the final day of the conference, 3 ITONF presenters joined the conference via Zoom for a live question and answer session. One Egyptian nurse was present to translate questions and facilitate an interactive discussion. During the question and answer session, expert international thoracic oncology nurses from the United States and Australia were able to provide valuable nursing education and answer questions. The Egyptian nurses submitted feedback after the completion of the conference with positive results and constructive feedback. Also, several nurses joined the ITONF organization and have since attended ITONF virtual webinars. Conclusions: ITONF serves as a unified source of international thoracic oncology nurses eager to provide education to any country or organization using a robust educational program. The collaboration with the Mersal Cancer Center in Egypt was the first customized educational program to fit the needs of the Egyptian nurses. During the pandemic, when in person educational opportunities were limited, ITONF collaborated internationally to meet the needs of thoracic oncology nurses. Based on the positive feedback, ITONF feels that this effort can be replicated for other countries and cancer centers. A hybrid educational model of live meetings, recordings, and live-streaming education is a practical model for international oncology nursing education. [Formula presented] Keywords: ITONF, Mersal Cancer Center, Collaboration

Social Isolation Among Individuals With Cancer.

The COVID-19 pandemic has intensified the social isolation of individuals with cancer. Studies about how to address social isolation among patients with cancer are limited, yet data from other high-risk populations can inform.

Experiences of interaction between people with cancer and their healthcare professionals: A systematic review and meta-synthesis of qualitative studies.

PURPOSE: This study investigates patients' experiences of interaction with their healthcare professionals (HCPs) during cancer treatment and identifies elements that HCPs can utilize to improve cancer care provision. METHODS: PubMed, CINAHL, PsycINFO, SCOPUS, and Embase were systematically searched for relevant studies published from January 2010 until February 2022. Qualitative studies investigating adult patients' perspectives on their interaction with HCPs during cancer treatment were included. Studies conducted during the diagnosis or end-of-life treatment phase were excluded. Duplicate removal, screening, and quality appraisal were independently performed by four reviewers using Covidence.org. We performed a thematic meta-synthesis of qualitative data extracted from studies meeting the quality criteria in three stages: excerpts coding, codes categorization, and theme identification by merging similar categories. RESULTS: Eighty-eight studies were included for quality appraisal, of which 50 papers met the quality inclusion criteria. Three themes were identified as essential to positively perceived patient-HCP interaction: "Support, respect and agency", "Quantity, timing, and clarity of information", and "Confidence, honesty, and expertise". Overall, patients experienced positive interaction with HCPs when the approach was person-centered and when HCPs possessed strong interpersonal skills. However, patients expressed negative experiences when their preferences regarding communication and the type of personal support needed were ignored. CONCLUSIONS: This meta-synthesis emphasizes the importance for HCPs to recognize all patients' needs, including communication and personal support preferences, to provide high-quality care. Consequently, healthcare professionals should continuously train their verbal and non-verbal communication, empathy, active listening, and collaboration skills during their undergraduate and continuing education.

P23-9 Construction of a model for palliative care education for visiting nurses involved with patients with intractable cancer

Background: Cancer patients have been living with some inconvenience and anxiety about recurrence for a longer period while continuing cancer treatment after the initial cancer treatment is completed. In the future, the recuperation period for cancer patients will become longer and more complex. Intractable cancers such as recurrent, metastatic, drug-resistant, and rare cancers are defined as those that do not respond to or are resistant to cancer treatment. In addition, More than 50% of patients with cancer answered “home” as their preferred place to die, and there is a growing need for home treatment that emphasizes their own way of life. Therefore, it is important to encourage the improvement of the quality of home health care nursing related to home treatment cancer patients. Methods: This study has been approved by the Ethical Review Committee of institution. Study 1: A questionnaire was developed from a review of national and international literature, and a pilot web-based questionnaire was administered to visiting nurses. Study 2: An educational program is being planned based on the results obtained in Study 1.Study sessions corresponding to those themes were planned and implemented from May to September 2021 via web-based delivery using ICT. Results: The learning needs for refractory cancer palliative care nursing were included 1. COVID-19 at the home care, 2. ACP and 3. Nutrition Care. Based on our understanding of the above learning needs, nurses participated in the ICT for the intractable cancer nursing study session. Conclusion: As for training opportunities for visiting nurses, home care nursing stations do not have sufficient support systems for learning. In recent years, the number of cancer patients who wish to receive treatment at home has been increasing. The study sessions will be continued in order to obtain outcomes that improve visiting nurses‘ ability to practice cancer nursing through interventions for intractable cancer.

Decreasing Hospital-Acquired Clostridioides Difficile in Patients With Cancer.

Patients with cancer are particularly susceptible to Clostridioides difficile infections because of their exposure to antibiotics, serious underlying chronic illnesses, advancing age, immunocompromising conditions, and extended lengths of stays in the hospital setting. In addition to suboptimal hand hygiene, other potential sources for bacterial transmission in the hospital setting include high-touch surfaces within the patient's immediate environment. Payers, such as the Centers for Medicare and Medicaid Services, continue to prioritize the reduction of healthcare-associated infections.

How Do You Start an Oncology Nursing Career During the COVID-19 Pandemic?

My passion for oncology started when I was just eight years old. My mother sat with me and shared that my dad had cancer. I saw my father cry as I heard the news, so I immediately knew something was very, very wrong. My father was diagnosed with mantle cell lymphoma and was given only six months to live. He fought for five long years and left a legacy of love, laughter, and Kenny Chesney sing-alongs. Fast-forward 15 years, and I landed my first nursing job on an oncology unit. My dream of working with patients with cancer was finally coming true, or so I thought.

Oncology nursing in the Global South during COVID-19.

In mid-2020, a call was made to oncology nurses in the Global South to share their experiences managing patient care during the coronavirus disease 2019 (COVID-19) pandemic. Eighteen submissions were received from 16 countries across Latin America, Africa, Europe and Asia. Three were research-based and 15 were personal narratives on the psychosocial impact of COVID-19 on the nurses, colleagues, patients and families. Three narratives were from oncology nurses working with cancer-related non-governmental organisations locally or, in one case, internationally. A simultaneous literature search for publications (including grey literature) was performed to identify themes of COVID-19's impact in these 16 countries and specifically on oncology nurses and patients/families. Four themes were identified: a) interruptions to care; b) support/resource shortages; c) psychosocial impact on nurses and patients and d) staffing and nursing role impacts. The three research-based studies describe oncology nursing in-depth efforts to explore the impact of COVID-19. Findings in the 15 narratives are briefly presented according to the four themes identified in the literature. Due to the severe shortage of physician adult and paediatric oncology specialists, oncology nurses in the Global South often shoulder much of the care for patients with cancer and even more so during COVID-19 with attendant oncology nursing shortages due to reassignment to COVID-19 units. It is important to hear from these critical members of the oncology nursing workforce who often lack the time, resources or training to publish in peer-reviewed journals in English, particularly in the middle of a pandemic. Giving voice to these nurses documents the reality of their work and ability to continue to provide care despite the chaos and rapidly changing guidelines and government action. Lessons learned by these nurses to improve mental health and psychosocial support of the nurses as well as their patients/families will be essential for the next global pandemic.