Premature menopause after cancer treatment.

PURPOSE: The purpose of this report is to examine the impact that cancer therapies have on ovarian function. OVERVIEW: Symptoms of and conditions due to estrogen deficiency after cancer therapy are described, and interventions are proposed. The consequences of short-term as well as prolonged estrogen deficiency-including vasomotor instability, infertility, genitourinary atrophy, coronary artery disease, and osteoporosis-are discussed. CLINICAL IMPLICATIONS: Symptoms and conditions associated with premature menopause may cause additional stress for women who undergo cancer therapy. Knowledge about what happens to these women can enable healthcare providers to help them make decisions about cancer treatment, engage in self-care activities, and explore options for preserving fertility.

Continuity of care: a challenge for ambulatory oncology nursing.

Continuity of care has many facets and challenges both as a philosophy and in practice. In an abstract sense, it represents an ideal to which health care professionals strive. It is becoming a professional and consumer expectation that each health care professional contribute to continuity of care. Although a variety of organizational models for providing continuity of care have been established in which nursing plays a prominent role, recent research suggests that some frontline nursing personnel may not fully understand their responsibility to continuity of care. There is a need for nursing curricula in both basic and continuing education programs to address continuity of care concepts, models, and methodologies to strengthen awareness of patient care needs across the disease continuum and across care settings. Performance expectations that include professional accountability for continuity of care also encourage greater attention to this issue.

Improving ambulatory oncology nursing practice. An innovative educational approach.

To meet the educational needs of ambulatory oncology nurses, an innovative and flexible program was created at a major cancer institute in Canada. Utilizing adult learning principles, standards of nursing practice, and departmental goals, the Clinical Nurse Specialists and Clinical Teachers creatively approached the need for extensive education. Five site specific educational workshops were provided to the nursing staff utilizing a self-directed learning style to capture the varied experiences, educational background, and motivations of the staff. This paper highlights the necessary program elements, implementation of, and evaluation of the educational program.

Evaluation and time documentation for the clinical nurse specialist.

This article introduces a time documentation tool designed to gather and record information on the many facets of the role of the CNS. A review of the literature provides background information on types of evaluation, time documentation, and the need for qualitative as well as quantitative accountability. Because existing tools did not meet the documentation needs of the authors, they designed a system that could accommodate six domains of the CNS role and provide a means to document quantitative and qualitative activities. Three CNSs pilot tested the tool for 2 months and provided a critique of the instrument for the authors. The evaluations have been summarized, and comments for individualization and frequency of use have been noted. Suggestions for future study include the need for measuring outcomes of care and documentation methods for qualitative interventions.