Rising to the Occasion During the COVID-19 Pandemic

Nurses across specialties continue to play a key role in the response to the COVID-19 pandemic. Oncology nurses are no exception. In response to COVID-19 and other healthcare issues, nurses have established core competencies. These core competencies allow us to mentor others if we simply step up and take the lead.

One of the goals of the American Nurses Association (ANA, 2020) 2020–2023 Strategic Plan is to evolve the practice of nursing to transform health and health care. A key objective is to develop nurses to lead and innovate. Mentorship is integral to achieving this objective and is a core competency of oncology nursing (Gaguski et al., 2017).

As an oncology nurse for more than 35 years, I see the talent and expert mentorship of the oncology nurses at my institution firsthand. Here are just a few contributions that oncology nurses have uniquely applied to the care of patients during the COVID-19 pandemic.

Infusion skills: Oncology nurse competencies related to infusion skills include managing adverse events, managing multiple treatment regimens, and taking care of seriously ill patients whose health status can quickly change. When antivirals and monoclonal antibody therapies were issued emergency use authorization during the pandemic, oncology infusion nurses at our cancer institute were called on to mentor nurses in other areas who were caring for patients in need of these treatment options. Their mentoring included mastery of clinical tasks, such as inserting IVs, role modeling as patient educator or patient advocate, and making clinical judgments using nurse’s intuition and patient assessments.

Care delivery: Chemotherapy treatments have not necessarily been put on hold for patients with COVID-19 who have mild symptoms, such as loss of taste and/or smell, headache, or minimal fatigue. Therefore, many patients with cancer have continued to require therapy and supportive care. Oncology nurses at our cancer institute demonstrated creativity in designing a designated space to treat patients with COVID-19. An example of their creativity included establishing a special precautions unit, which limited exposure to one location rather than exposing team members and patients in all outpatient office locations. The special precautions unit has treated an average of four patients per day, with one nurse caring for these patients. Ample social distancing guidelines are followed, with appropriate spacing of chairs and the use of private rooms. In addition, a specified route in and out of the special precautions unit was created to limit contact with staff and other patients.

Clinical trials: Research protocols can be extremely complicated and challenging given the regulatory requirements and multiple patient assessments that are often required throughout the duration of the study. Implementing clinical trials, including collecting, processing, storing, and shipping multiple biospecimens, is routine at our cancer institute. Oncology research nurses routinely assess and manage toxicities and coordinate study-related tests that are necessary for understanding how new drugs may affect patients. Research nurses play an important role in the informed consent process by educating patients prior to and throughout their participation in clinical trials. Therefore, it was no surprise that oncology research nurses and other research team members stepped in to assist with COVID-19 clinical trial protocols in the inpatient and outpatient setting. They mentored the nurses who were responsible for overnight blood draws for special research laboratory tests, assessed for side effects of study medications, and documented patient symptoms, such as nausea, vomiting, and diarrhea.

Psychosocial patient support: This support, a well known and well established competency of oncology nurses, has continued to be provided in-person and has expanded to telehealth during the pandemic. Because of visitor restrictions, our oncology nurses became liaisons between patients and their caregivers. They helped patients to call family members, placed them on speakerphone during visits as needed, and quickly became master troubleshooters, ensuring proper connections between smartphones and tablets. When that was not possible, they relayed information over the telephone to family members, providing an accurate, comprehensive summary of the visit with the right touch of warmth, heart, and concern. And of course, oncology nurses effortlessly demonstrated how to support patients when bad news was delivered and to celebrate with patients in times of positive reports.

Oncology nurses are ready and equipped to serve as exceptional mentors. As the pandemic continues, the asks of oncology nurses are ever increasing. And still, I watch the nurses in our cancer institute expertly rise to the occasion day after day. How will you mentor a nurse colleague today?

About the Author(s)

Julie C. Martin, DNP, AOCN^®, FNP-BC, is the director of cancer research at Prisma Health in Greenville, SC. Martin can be reached at julie.martin@prismahealth.org, with copy to CJONEditor@ons.org.