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ONS Community Seed Question(s) CommentAcute & Critical Care 1. What should be the role of oncology nurses

related to the use of technology in their clinical setting?

2. Do you think oncology nurses assess for potential oncologic emergencies specific to their patient’s diagnosis?

3. Do you think it would be helpful to have education on what medications have the potential to increase the development of pancreatitis in cancer patients?

4. Do we need education on the role medications and cancer play in blood sugar levels?

5. What electrolyte results do you need more information on?

6. Is knowledge and evaluation of pulse pressure relevant in the assessment of the acute care patient?

7. What questions are most relevant in your practice related to vascular access?

8. What role does ECG readings plan in initial chemotherapy and/or immunotherapy treatments?

9. What should be some specific areas for assessment of potential sepsis in the cancer patient?

10. What is the optimal RN to cancer patient ration in critical care oncology and what is your current RN: Patient ratio?

Advanced Nursing Research 1. What ANR Learning Community values and methods would be supportive of a collaborative process for learning community activities/initiatives?

2. What are ways that the ANR members can help create intentional, integrative, engaging and transformational experiences for ONS members interested in research?

3. What are critical areas for ANR Learning Communities to bridge translational research

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into practice?4. What are ways in which Community members

can cultivate a research enterprise sustainable to support priority areas of research consistent with ONS’s mission to promote excellence in oncology nursing and quality cancer care?

5. Resources and institutional support for research vary from organization to organization. How do nurses develop a process or strategy to approach their organization’s leadership in obtaining support to conduct research?

6. What kind of resources would be helpful to get nurses started in research (e.g. protected hours) and how do we get them?

7. What about mentorship in research? What opportunities are available to nurses through ONS and other organizations to obtain mentored support?

Ambulatory/Office Nursing 1. Who does your survivorship planning in your clinic?

2. Who obtains your consents for treatment? Doctor? Nurse? Medical Assistant?

3. Do you have a cancer navigator in your clinic? What is his/her role? Who does the referrals to the navigator?

4. Do you have a genetic counselor in your clinic? Who does the referrals?

5. Who does the education? Nurse? Medical Assistant? NP? PA?

6. Fatigue Assessment? Do you have one? When do you use it? Each chemo Doctor apt.?

7. Are you in a big facility setting or private office practice?

8. What information are you wanting from this group?

9. Would you like to be more involved with this group?

Blood & Marrow Stem Cell Transplant 1. Does your institution have a BMT Survivorship /tt/file_convert/5aba37367f8b9ad1768b4573/document.docx

Clinic? Do you have any criteria for when patients

are seen in this clinic? Are these appointments in the General

Survivorship Clinic vs. BMT clinic? What type of care model do you follow? Describe the typical BMT Survivorship visit

regarding contributing roles and services. Do you give a Survivorship Care Plan (SCP)

to patients?-If so, who is responsible to develop each patient’s SCP?

Is the SCP recommendations only or do you order diagnostics and provide follow up?

How often do you see patients (once, annually, etc.)?

Does the frequency of follow up differ between autologous and allogeneic patients?

2. Does your institution perform outpatient BMT? Do you perform autologous only or offer

allogenic outpatient BMT? What is the criteria used to determine

candidacy for outpatient BMT? Do you have any institute policies

regarding outpatient BMT that you could share such as community lodging, readmission, and patient/family responsibilities?

Breast Care Will submit

Cancer Genetics J. Eggert may resign as leader.Chemotherapy & Biotherapy 1. UPS 800 has endorsed the use of the closed

chemotherapy system, which do you utilize? Both inpatient and clinics?

2. Do you utilize a separate chemotherapy consent or just a general permission to treat


consent?3. Do you obtain a new chemotherapy consent

each time treatment changes?4. How are the vinca alkaloids given – IVP or

IVBP? What is your technique?5. Do your patients utilize cold caps to reduce

alopecia? What is your process? Is there research to support?

6. Our center is starting EPOCH as outpatient treatment if your practice is administering this chemotherapy as a home treatment can you please share your process?

7. Do you use the ONS On-line Chemotherapy/Biotherapy course? If yes – what is your process? If you do not what is your course?

8. We are starting to use chemotherapy intraoperative – how do you clean the instruments? Will you share your process?

9. Chemotherapy spills can occur both in the clinics and hospitals – what are your processes and guidelines?

10. Do you have patient education and safety instructions for patients going home on chemotherapy? Can you please share?

Clinical Nurse Specialist1. What is your most difficult task as a CNS?2. What do you wish they would have taught you

in graduate school that would help you in your role today?

3. Are you licensed as a CNS in your state? Which state are you?

4. What are the core competencies necessary to be an oncology CNS? Have you looked at the ONS competencies for CNS?

5. What topics are staff asking for education on?6. What is your role as a CNS?

Inpatient/outpatient/staff education/teaching/tt/file_convert/5aba37367f8b9ad1768b4573/document.docx

7. What would you like to see covered at congress related to the CNS role?

8. What educational topics would you like to see on this site? Are you interested in presenting something?

9. Is your degree as a CNS or NP?10. What would you like to see different related to

competencies for CNS?11. Would you like to take part in forming this site?

Clinical Trial Nurses 1. What is your most difficult challenge as a CTN?2. How do you use the CTN competencies in your

practice?3. Do you feel valued as a CTN in your position?4. What would you like to see covered at Congress

related to the CTN role?5. What educational topics would you like to see

addressed on the community website?6. How will the new Scopes and Standards for

Clinical Research Nursing impact your practice? How will it impact the ONS CTN competencies?

7. How do you use the ONS Manual for Clinical Trials Nursing in your practice?

8. What is the biggest value of the CTN?9. How do you see CTN playing a role on research

related policy issues?10. What ways do you believe we can enhance and

support increase interactions between our members?

Complementary & Integrative Therapies 1. Are you using integrative therapies in your daily life that you believe would have benefit to share in your work practice? a. What Complementary therapies are you using? b. Do you recommend integrative therapies to patients? c. Which therapies are you using?

2. How can the ONS Community help you be more comfortable and competent in sharing


Complementary and Integrative therapies in your workplace?

3. What sources do you use for guidelines/ best practice evidence, and where do you get your resources?

4. Have you recommended meditation for sleep disturbance or for stress reduction? a. Do you have resources for sleep meditations or stress reduction meditations?

5. b. Do you give your patients resources to help them manage these problems (web sites, handouts, referrals)?

6. What physical energy therapies do you recommend for cancer patients? Do you ever recommend Yoga, Tai Chi, Qigong or traditional chinese medicine?

7. Can you think of integrative therapies that are naturally becoming part of your practice? (massage, meditation, art therapy, music therapy, animal therapy)a. How are they being integrated into the western model? b. What tools or resources would be helpful to start providing education on safe integrative therapies to use?

8. Can Aromatherapy be helpful in the infusion room, or is that contraindicated for patients getting chemo?

9. How can clinic nurses pilot integrative therapies interventions in their practice?

10. What nutrition tools are you using to incorporate complementary nutrition into your patient teaching? How do you advise patients who are trying CAM diets like the alkaline diet or paleo diet?

11. What CE programs have been useful for learning about and teaching integrative therapies?

Ethics 1. How do you respond to a patient/family who /tt/file_convert/5aba37367f8b9ad1768b4573/document.docx

insists on receiving treatment when it is not working anymore?

2. How do you address physicians who continue to treat when it’s not in the best interest (QOL) of the patient? i.e. from an ethical perspective physicians get paid to treat so there is financial incentive to continue treatments.

3. In this time of escalating drug costs how do we justify the exorbitant cost of chemotherapy/biologic agents when the outcome for success is < 30% or less?

4. Should we treat people who are not mentally competent to make their own decisions and lack a decision maker? For example, a developmentally disabled patient or a patient with mental illness who does not understand what you are doing to them.

5. How do we distribute limited cancer resources across the cancer continuum? Do we spend money at end of life, cancer prevention, and clinical trials?

6. How do we address the moral distress of nurses who feel that cancer treatment and patients’ quality of life is adversely affected by continuing treatment?

7. How do we address off label use of medications and alternative treatments (marijuana) for symptom management?

8. What do we do when patients are “pressured” into clinical trials?

Home Care & Palliative Care 1. How does your oncology practice determine if the patient needs a Palliative Medicine consult?

2. How often do you assess for depression in your practice and how do you determine a need for psychologist or psychiatrist to intervene?

3. When your patient requests information or discussion about Marijuana and Marijuana products, what information do you give them?


4. 67 year-old male with a history of rectal carcinoma and has had surgery and radiation. He is clinically in remission but he is experiencing severe rectal pain. He wants to continue to work so he does not want to take oral narcotics. This is the only thing that has helped him. He takes 10 mg of oral morphine before bed and this works. He needs something for the daytime. Help!

5. Have you been trained on advanced directives? When do you talk to your patient's about advance directives?

Lymphedema Management 1. Does anyone have a clinical situation they would like to discuss regarding lymphedema? Please don’t use a patient’s name.

2. Is exercise good for lymphedema? Let’s discuss your thoughts.

3. What can be done to help prevent lymphedema?

4. Does manual massage help with lymphedema?5. What makes a person at high risk for

lymphedema development?6. Is a breast cancer patient always at risk for

lymphedema development?7. What types of psychological issues are you

seeing with lymphedema patients?8. What type financial issues are you seeing with

lymphedema patients?9. Are your lymphedema patients experiencing

social issues? 10. Which antibiotics are best for cellulitis

development from lymphedema? 11. What financial issues are you finding regarding

lymphedema?Neuro-Oncology No leaderNeutropenia 1. What type of infection do you see most in your

practice?2. What medications do you use to prevent/treat

neutropenia?/tt/file_convert/5aba37367f8b9ad1768b4573/document.docx

3. What treatment regimens are more\higher risk for neutropenia?

4. What type of patients do you see have neutropenia more often i.e. sex, age, ethnicity?

5. What side effects most commonly do you see from colony-stimulating factors?

6. What tips would you give the patient and family about being outside to prevent neutropenia?

7. What tips would you give the patient and family about being inside to prevent neutropenia?

8. How does marijuana effect neutropenia?9. How would you explain dangers of crowded,

public places?10. What happens if there are young kids in the

home with infectious diseases?Nurse Leaders & Program Development 1. Welcome to the Nurse Leaders and Program

Development Community. Please provide us with feedback on how you see this platform being used.

2. Please tell us about yourself. Are you aa. ONS Chapter Leaderb. ONS Community Leaderc. Charge Nursed. Emerging Nurse Leadere. Administrator for the service linef. Nursing Supervisorg. Directorh. CNOi. Nurse Manager, Unit Leaderj. Other, please specify

3. What challenges would you like this community to help with?

Nurse Navigator 1. What role do your navigators play in your institution’s community needs assessment?

2. How do you train your navigators to their role, /tt/file_convert/5aba37367f8b9ad1768b4573/document.docx

what are your resources?3. How are you tracking the data from the

services your navigators provide? Excel/manual collections, electronic medical records, or web based programs? Does this capture the return on their investment?

4. What outcome measures are being utilized to evaluate your program and how do you show return on investment?

5. Do your navigators accompany patients to MD visits? What is the criteria used?

6. Our cancer center is participating in CMS oncology care model (OCM) and we are hiring a nurse to navigate our Medicare patients? Does anyone have any navigation experience with this model and can you share your process/job description?

7. We just implemented an acuity scale in our navigation software. For navigators currently using acuity scales, would you please share any improvements or success stories you had by using data from acuity scales?

8. My institution is considering NPs as nurse navigators so they can bill for services. Are other organizations doing this?

9. How many of you are losing staff RNs who may be navigators or coordinators from outpatient practices and having them “replaced” with medical assistants or NPs?

10. How do you ensure that ALL cancer patients receive a distress screening?

11. My institution is looking at adding lay navigators to the navigation team. Does anyone have experience working with lay navigators as part of a navigation team?

12. What entry points into navigation are used in your institution? (e.g. path reports, external referral, internal referral, tumor board, etc.)?

13. My institution is looking into purchasing /tt/file_convert/5aba37367f8b9ad1768b4573/document.docx

navigation software. Does anyone have any experience using OncoNav, NurseNav or any other?

14. Do navigators participate in palliative care team consults? If so, when is the best time to have conversations around advance care planning?

15. I am looking for a way to streamline the development of survivorship care plans. I have tried some of the online programs but find it can take up to an hour to complete. How are others managing this within their institutions when this is included in the role of the ONN?

16. What departments within your health system and cancer center utilize nurse navigators?

17. What are the ration of navigators to patients?18. How does your organization determine the

workload of navigators?19. Does anyone utilize care coordinators as their

title for nurse navigators?Nurse PractitionerPain Management 1. There are many complementary alternative

medicines (CAM) that can help with pain management. How comfortable with (CAM)s and which ones do you use most frequently in your practice?

2. How serious of an issue is the addiction crisis and how much is it affecting pain management for oncology patients?

3. What are you doing to address pain during bone marrow aspirations?

4. What is your comfort level with calculating patients’ pain breakthrough medication needs?

5. What is the proper process for the administration of naloxone injection for opioid induced toxicity?

6. How are clinicians using Burse Ketamine and SQ Ketamine for uncontrolled cancer pain towards the end of life?


7. How often are you documenting a pain assessment in the outpatient setting?

8. For inpatients how often do you document for PCA/PCEAs amount of medication infused?

9. How comfortable are you with methadone?10. How comfortable are you with ketamine?11. What pain education topics would you like the

community to explore and what format would you like to receive them in?

12. Do you monitor your patients’ level of sedation secondary to opioid administration? If so, how often do you assess opioid-induced sedation? What tool do you use?

13. Under what situations are oncology patients having an “opioid rotation”? Do you have a protocol for rotating or switching an opioid?

Pharmaceutical/Industry NursingPrevention/Early Detection 1. What are the most common cultural and

socioeconomic factors affecting cancer screening?

2. Why is there so much controversy over the latest USPSTF recommendations for breast and prostate cancer screening?

3. What is the latest recommendations from ACS and NCCN related to site specific cancer screening (site specific e.g. breast, cervical, lung, prostate, skin).

4. What topics about cancer screening as an oncology staff nurse should I discuss with my patients?

5. How can I develop an outreach plan for my community related to cancer screening and prevention?

6. Who needs genetic screening for cancer?7. Do e-cigarettes or vaping increase cancer risk? 8. What is known about extending the use of


immune-based cancer therapies to prevent cancer in those at increased risk?

9. What is the role of aspirin and metformin, which are used safely and effectively to treat other conditions and are known to affect molecular pathways involved in cancer, in halting the development or progression of cancer?

10. What is the role of diet in cancer prevention?

Radiation 1. What is your institution’s policy/procedure for the insertion of eye shields for EBRT treatment?

2. What is the nursing care model followed in your Department?

3. Do you have a policy/procedure for mucositis prevention and management and do you have an algorithm?

4. Do you have a policy/procedure for weight loss prevention and management and do you have an algorithm?

5. Do you use ONS PEP guidelines for the management of radiation dermatitis?

6. How is a patient’s acute pain managed in your Department during simulation or treatment?

7. What type of sedation is used during T & O or T & Ring High Dose Rate (HDR) brachytherapy procedures?

8. What evidence based patient education tools do you give your patients?

9. What are the nursing quality measurements, patient safety goals or quality improvement projects that you monitor?

10. How do you meet your professional development needs in radiation oncology?

Spiritual CareStaff Education


Surgical Oncology 1. How do you manage intractable nausea/vomiting? What protocols do you use?

2. What techniques do you use with post-operative patients with uncontrolled post-operative pain, including non-narcotics interventions?

3. What barriers do you have in your surgical oncology practice?

4. Discuss your interventions with patients to reduce anxiety?

5. What interventions do you successfully utilize to deal with delirium and dementia?

6. What new products or procedures do you need insight and education?

7. What techniques do you use to assist post-operative patients to adjust to altered body image?

8. What systems do you have in place to reduce readmissions?

9. How do you envision this community supporting you in your surgical oncology practice?

10. What web-n-r's would you like to see uploaded to the virtual community?

Survivorship, Quality of Life & RehabilitationTranscultural Nursing Issues

Rev. 10/7/16


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