Seminars in oncology nursing
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To provide an overview of access devices and infusion pumps available for pain management. ⋯ Nursing assessment is essential to develop an effective pain management regimen. Because patients are the best source of information about their pain, the nurse is in an excellent position to determine if the placement and use of an access device could be useful in controlling a patient's pain.
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Progress in cancer surgery and changes in philosophy have resulted in greater numbers of critically ill surgical oncology patients. The effects of cancer and prior exposure to cancer therapies increase the risks for postsurgical problems. Life-threatening cardiopulmonary sequela and patients undergoing liver resections and transplantation are examples of problems that require the knowledge and skill of critical care nurses. Critical care surgical nurses face new challenges by merging their surgical nursing expertise with principles of cancer care.
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The emergence of specialized oncology practices such as bone marrow transplantation has resulted in a higher incidence of critical complications and complex needs, which has led many oncology units to develop new strategies to care for the patients in the oncology unit. Designated oncology intensive care unit (ICU) beds and a dedicated trained staff is one method of delivery; other institutions transfer patients to existing ICUs, and some have equipped the entire oncology unit for critical care interventions. It is necessary to evaluate key issues when providing critical care to patients with cancer.
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The American Cancer Society sponsored a series of hearings to document the magnitude of the problems faced by the poor in seeking cancer care. The findings reflected that economically disadvantaged Americans are often forced to accept substandard health care services and face numerous problems when seeking preventive care and treatment. The glimpse from inside the circle of poverty (statements from the hearings) provides an opportunity to better understand the problems faced by the poor in accessing health care and to better recommend strategies for effecting a positive change.