Clinical journal of oncology nursing
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Effective communication, particularly at the end of life, is an essential skill for oncology nurses, but few receive formal training in this area. ⋯ Nurses' confidence in discussing death, dying, and end-of-life goals of care increased significantly after attending the workshop. Nurse participants indicated satisfaction with the module by agreeing or strongly agreeing to all six items assessing satisfaction 90%-98% of the time. Nurses' CST in discussing death, dying, and end-of-life care showed feasibility, acceptability, and potential benefit at improving confidence in having end-of-life care discussions.
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Fatigue is one of the most distressing symptoms experienced by people with cancer receiving radiation therapy. ⋯ Red blood cells, hemoglobin, and hematocrit levels were highly intercorrelated and, therefore, were grouped as one composite variable termed heme. Heme levels at baseline and androgen-deprivation therapy (ADT) were significantly correlated with worsening of fatigue symptoms from baseline to midpoint and endpoint. ADT alone did not have a significant correlation with fatigue, but it indirectly affected fatigue levels by influencing heme markers as treatment progressed. These findings provide evidence that hematologic markers and the use of ADT assist in predicting radiation therapy-related fatigue and guide symptom management.
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The emotional work of oncology nurses is complex. Inherent in our job is the requirement to be exquisitely empathic. We must look after, respond to, and support numerous patients and their families. ⋯ Intermittently, we must either display or suppress our emotions. All of this takes place in an occupational environment where support for the nurses' emotional well-being is nonexistent. Lacking are opportunities to vent emotions, sufficient time to grieve patients' deaths, and resources to help nurses cope with work-related stress.
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Objective To assess the effect of a diary versus no diary during a patient's recovery from admission to the intensive care unit (ICU).
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Reliable and valid outpatient oncology acuity-based staffing systems are lacking. The existing staffing model in a midwestern cancer center demonstrated inefficiencies related to unpredictable patient flow, treatment regimen complexity, and physician practice variation. ⋯ Resultant changes included scheduled nurse time (preparation, charting, lunch breaks), revised acuity-based patient scheduling, and a revised nursing care delivery model. Implementation of the acuity-based system provided consistent staffing, improved efficiency, reduced overtime, and improved patient and staff satisfaction. Recommendations include adaptation of the acuity-based system to other outpatient settings and development of staffing level benchmarks.