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OCN Questions and Answers
Which of the following is most recommended for early detection of colorectal cancer in normal- risk persons?
- Fecal occult blood test (FOBT) every five years
- Virtual colonoscopy every 5 years
- Colonoscopy every 10 years
- Double-contrast barium enema (DCBE) every 10 years
According to a current theory of carcinogenesis, which of the following are required to transform normal cells into malignant ones?
- A carcinogenic initiating agent
- A promoter
- Both A and B
- Neither A nor B
The granulocyte colony-stimulating factor (G-CSF) filgrastim (Neupogen):
- May be given as a single dose before chemotherapy
- Stimulates both neutrophil and monocyte/macrophage production
- Is not indicated for patients receiving bone marrow transplants
- May be given by subcutaneous injection or short intravenous (IV) infusion
- A chemotherapy drug
- A steroid
- An antiemetic
- An antibiotic
An elderly cancer patient presents with abdominal pain. He appears dehydrated with abnormal vital signs. Emergency operation for a bowel obstruction is recommended by the attending surgeon. The patient seems somewhat confused and is unable to give a rational understanding and approval of informed consent. Which of the following would be the best first course of action?
- Delay the surgery until the patient is more rational
- Contact a relative or other valid representative to obtain permission
- Cancel surgery and attempt medical treatment
- Declare this an emergency and proceed with the surgery
Medical OCN Exam (Oncology Certified Nurse) Detailed InformationOncology Certified Nurse (OCN®)
Are you ready to enhance your professional credibility and enjoy the feeling of personal accomplishment that comes from being certified? If you meet the criteria listed below, take the test for an oncology certified nurse and become recognized for your specialty knowledge in oncology nursing.
View Eligibility Criteria for Initial Certification
A current, active, unencumbered license as a registered nurse in the US, its territories or Canada at the time of application and examination.
A minimum of one year (12 months) of experience as an RN within the three years (36 months) prior to application, and
A minimum of 1,000 hours of adult oncology nursing practice within the two-and-one-half years (30 months) prior to application. Nursing practice may be in clinical practice, nursing administration, education, research or consultation. To qualify as nursing practice, the role must require it be filled only by a Registered Nurse.
Completed a minimum of 10 contact hours of continuing nursing education in oncology or an academic elective in oncology nursing within the three years (36 months) prior to application. The contact hours must have been provided or formally approved by an acceptable accredited provider or approver of continuing nursing education. A maximum of five of the 10 required contact hours in oncology may be continuing medical education (CME) in oncology.
What is nursing practice?
Applying for certification
The certification test is a three-hour, 165 multiple-choice item test based on the OCN® Test Content Outline (Test Blueprint). The Blueprint was created after the results of a role delineation study of basic adult oncology nursing practice conducted in 2012.
The OCN® Test Content Outline includes nine major subject areas, each with a percentage assigned to it. Many nurses who have passed the test tell us the Test Content Outline was essential in helping them know what areas to study. Remember, only generic drug names are used on ONCC tests. Once you pass the test, your certification is valid for four years.
Save 30% on 2016 test applications!
Note: If you’re eligible to test, you’ll receive an Authorization to Test (ATT) within 4 weeks of applying. This ATT will open an almost-immediate 90-day testing window. You must take the test within that 90-day window. Be sure to review the Test Candidate Handbook for more information about testing.
Maintaining your certification
You should be very proud that you’ve passed the certification test! In order to keep your certification, you need to earn points for certification renewal by completing Continuing Education, Continuing Medical Education, Academic Education credits, or have work published in publications or give presentations. Follow this step-by-step guide to maintain your certification.
1. Determine where to log your information.
If you passed a test in 2012 or later, use your Learning Plan on LearningBuilder. If you renewed via ONC-PRO in 2012 to 2015, you must first take an assessment to determine how many points you’ll need. After you assess, you will be notified that your Learning Plan is available for tracking your points.
2. Plan your professional development.
Your assessment results or test score report will tell you the subject areas and number of professional development points – ranging from 25 to 100 – you’ll need to renew your certification.
3. Select the necessary subjects.
Use your score report or assessment results to see which subject areas you need further professional development. Then, refer back to the current Test Content Outline (Test Blueprint) to help you identify whether a program is in the subject area you need.
4. Enter your points on your Learning Plan on LearningBuilder.
Make sure you keep track of all of your information, as you earn the points, in your Learning Plan on the new online tracking tool called LearningBuilder.
5. Keep all documentation.
We strongly urge you to record your points as they are earned. Keep copies of all grade reports, copies of publications, program descriptions, educational objectives, and outlines, in case ONCC asks to review them.
OCN® Certification Review Bundle
Prepare for your OCN® certification exam with the ONS OCN® Certification Review Bundle. Based on the OCN® blueprint, you’ll receive four comprehensive online courses to ensure that you have all of the information you need to become an oncology certified nurse. Plus, you’ll receive an OCN® practice test to help refine your test taking skills.
This course series is designed for oncology nurses with some experience in oncology. You may take each course on its own or purchase the bundle of four courses plus a practice test at a discounted rate.
These courses are on demand. Instructions on how to immediately access the courses will be sent to you in an automatically generated email receipt after you register. You will enjoy continuous access for six months.
The following courses are included in the OCN® Certification Review Bundle. Registration of the bundle is discounted and includes a comprehensive practice test only available as part of the bundle. Each course may also be registered for individually.
Veteran’s Day Initiative | Greek Orthodox Ladies Philoptochos SocietyPublished with permission of The Greek Orthodox Ladies Philoptochos Society.
“Recently, National Philoptochos President Maria Logus, met a young soldier who had just returned from overseas. After learning about his experiences, she inquired about the needs of active service members.
His response was immediate and simple – prepaid phone cards.
As Veterans Day and the holidays approach, we encourage all chapters and members to reach out to our brave men and women who daily put themselves in harm’s way to preserve the liberties we hold so dear. These men and women are far away from their loved ones … their parents, their children, their spouses and their sweethearts. They would like to say, “I miss you” to a parent, “Good Night” to a child, “I love you” to a spouse or loved one. The question is how can we help them to fulfill those dreams?
The United Service Operation (USO) reports that prepaid phone cards to call home are the most requested items. USO Operation Phone Home delivers pre-paid phone cards to deployed troops free of charge. To participate in this worthy program and to make those much appreciated calls home possible, we urge you to make generous donations to the Phone Home project online at: .uso; via phone: (800) 901- 1501; or by mail: USO World Headquarters, PO Box 96860, Washington, DC 20090-6860 (with Operation Phone Home, O.P.H. written in the memo).
Phone Cards can be purchased in increments of $25 and a special message can be included with each gift card. Please inform us regarding your efforts (i.e., number of phone cards purchased and the amount of your gift) by communicating with us at 4RTroopsphiloptochos, so that we may share with our members how many lives of service men and women we touched through your generosity. We hope to continue with this program, not just up to or on Veteran’s Day, but through the festive holy days of Christmas as well.
Because we are Philoptochos, we can do even more. Please consider expressing our gratitude to our Veterans at this time of year. Some suggestions include:
With the assistance of Philoptochos members, Parish Sunday School Students, Youth, and their families can make cards, prepare meals, or complete some other service project for their local Veterans Administration Agency or VA Medical Center. Not only will their efforts brighten the lives of these veterans and their families, but will instill in our youth the true meaning of philanthropy.
Philoptochos Chapters or Individuals may also choose to support organizations like:
Fisher House Foundation (.fisherhouse) – Fisher House builds homes on the grounds of major military and VA Medical Centers that enable family members of the military to stay in a home close to their loved ones at a most stressful time during hospitalization. Hope for the Warriors (.hopeforthewarriors) – Provides a full cycle of programs, which support individuals, military families, post 9-11 service members, veterans, and families of the fallen at various points along their road to recovery, helping them find a sense of wellbeing and a fulfilling life.
Our brave service men and women have made great sacrifices to serve our country and to protect all of us. Let our service members, veterans, and their families know that we stand with them as they defend our nation and the freedoms that we cherish. It is important to express to them our appreciation for their sacrifice, that we care, and that we are eager to assist them in any way we can.”
To read the Veterans Day letter from Philoptochos’s leadership (Maria Logus, President & Katherine Siavelis and Peggy M. Vranas, New Philanthropic Initiatives Co-Chairs), please click below.
Editorial note: The Orthodox Christian Network frequently highlights acts of kindness. Pamela Collins, Board Member of the Orthodox Christian Network, suggested the note above be published as an reminder of the role we can all serve in giving back. Mrs. Collins offers her gratitude and honor to be associated with such a fine organization as Philoptochos.
ABOUT THE GREEK ORTHODOX LADIES PHILOPTOCHOS SOCIETY
The Greek Orthodox Ladies Philoptochos Society is the philanthropic arm of the Greek Orthodox Archdiocese of America and has offered 85 years of philanthropy through a multitude of programs that make a difference in the lives of people in the United States and throughout the world.
Philoptochos fulfills its mission through its National and Metropolis Boards and its 26,000 members and more than 400 active chapters, nationwide. In 2015, National Philoptochos distributed $1.74 million in philanthropic aid.
Major initiatives include the Feeding the Hungry, Aid to Greece & Cyprus Campaign, support of St. Nicholas Greek Orthodox Church and National Shrine, Domestic Violence services, Children’s Medical Fund Luncheon and many other programs.
The National Philoptochos Society mission is to charitable, benevolent and philanthropic outreach to preserve the sanctity of life and family and to perpetuate and promote our Orthodox faith and traditions.” The organization is led by His Eminence Archbishop Demetrios, Chairman, His Grace Bishop Sevastianos of Zela, Spiritual Advisor, Maria Logus, President, Arlene Siavelis Kehl, First Vice President, Evangeline Mekras Scurtis, Second Vice President, Jeannie Ranglas, Third Vice President, Christine Karavites, Secretary, Martha Stefanidakis, Treasurer, Georgia Vlitas, Assistant Treasurer and Aphrodite Skeadas, Advisor. The organization’s Director is Helen Lavorata.
Click on the following link to make a donation online directly to the Philoptochos.
Look for the National Philoptochos on Social Media: FACEBOOK, TWITTER, LINKEDIN, YOUTUBE and soon on INSTAGRAM
ABOUT THE ORTHODOX CHRISTIAN NETWORK
The Orthodox Christian Network (">OCN) is an official agency of the Assembly of Canonical Bishops of the United States of America originally commissioned by SCOBA to create a national, sustainable, and effective media witness for Orthodox Christianity and seekers around the world through media ministry. CLICK HERE to download our brochure.
This 5013 is recognized as a leader in the Orthodox Media field and has sustained consistent growth over twenty years. ">OCN shares the timeless faith of Orthodoxy with the contemporary world through modern media. We are on a mission to inspire Orthodox Christians Worldwide. We have reached 5.7 Million People in One Week. Much like public radio, the Orthodox Christian Network relies on the support of our listeners, readers, and fans. If you are interested in supporting our work, you can send your gift by direct mail, over the phone, or on our website. Your gift will ensure that ">OCN may continue to offer free, high-quality, Orthodox media.
Do you find it hard to keep focused on Christ when you’re on the go? ">OCN makes it easy! Give today to help you and your Orthodox community stay connected no matter the location.
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Hospital Nurse Wins State Nurse Educator AwardNursing and education – Yolanda Hyde has a passion for both, so much so that she works part time as a patient placement coordinator at FirstHealth Moore Regional Hospital while also fulfilling a variety of teaching, mentoring and administrative duties at the University of North Carolina at Greensboro.
By way of explanation, consider the impressive list of professional and academic abbreviations behind her name: Ph.D., R.N.-BC, ">OCN, CNE.
In recognition of Hyde’s commitment to nursing and education, the North Carolina Nurses Association (NCNA) recently named her NCNA Nurse Educator of the Year. The award was presented at an awards luncheon during the organization’s 109th convention in Winston-Salem in October.
“It’s such a great honor,” Hyde says. “It’s amazing to me when I think of starting as an ADN nursing student and coming up in the ranks. I can’t believe it. I’ve been mentored by all these great people, and it’s coming to fruition. I definitely thank the people who were there for me.”
Among those on hand to see Hyde accept the NCNA award were Karen Robeano, chief nursing officer and vice president of Patient Care Services at Moore Regional Hospital; and Dee Anna Johnson, administrative director, Moore Regional Emergency ServicesPatient Flow.
“Yolanda is the epitome of nursing excellence,” Robeano says. “She is a lifelong learner with endless energy and positivity. She is so deserving of this award, and we are truly blessed to have her as a nursing leader at FirstHealth.”
Another supporter is Corrine Cochran, nursing research coordinator and Magnet program director at Moore Regional. “Yolanda is an inspiration to all nurses and exemplifies the essence of professional nursing,” she says.
Hyde was inspired to become a nurse by the nursing professionals who saw her younger daughter, now a 25-year-old commissioned officerlawyer serving as a U.S. Air Force JAG, through a serious illness when she was just 3 weeks old.
“I had a great nursing staff who worked with me,” Hyde recalls. “I decided this was something I was meant to do. I wanted to give back for what they did for my daughter.”
Soon afterward, Hyde entered Richmond Community College, where she received an Associate Degree in Nursing (ADN) and later an Associate in Science (A.S.) degree. After deciding to further her education, she earned a Bachelor of Science in Nursing (BSN), Master of Science in Nursing (MSN) in nursing education and Doctor of Philosophy (Ph.D.) from the University of North Carolina at Greensboro (UNCG), where she is now an associate professor and coordinator of the MSN Nursing Education Concentration.
She joined Moore Regional Hospital in 1995 as a new graduate nurse on the Tufts medicalsurgical nursing floor. As a patient placement coordinator, her role since 2007, she is part of a seven-nurse team that coordinates patient admission, discharge and transfer.
An NCNA Leadership Academy graduate, Hyde received the Teaching Excellence Award from UNCG in 2014 and a Great 100 Nurses in North Carolina award in 2015, and was recognized with the Sigma Theta Tau’s Gamma Zeta Chapter’s Excellence in Nursing Leadership Award earlier this year.
While admitting that the combination of teaching and hospital nursing can be a challenge, Hyde says she has been energized by the combination of careers.
“I felt like I could do so much more, working inside as well as teaching,” she says. “I found a way to collaborate and make it work. Teaching has kept me abreast of what was going on in the hospital, but FirstHealth is home.”
Light Up A Life For IU Health Hospice BloomingtonTerri Shedd, RN, BSN, ">OCN, Regional Director, IU Health Hospice of South Central ... A unique partnership with Indiana University School of Medicine - one of the nation's leading medical schools - and the depth of experience from the most complete network ...
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2 Meet the Suffolk County Board Heidi Bentos-Pereira, RN, MSN, MBA-HCM, ">OCN President, Suffolk County Chapter of the Oncology Nursing Society I am an RN with 22 years of oncology experience, held staff and leadership positions in oncology nursing services at the New York Presbyterian Weill Cornell Medical Center, Clinical Nurse Specialist for the Cancer Institute at St Francis Hospitalthe Heart Center, and currently serve as a Nursing Professional Development SpecialistNurse Educator at Memorial Sloan Kettering Cancer Center. I am Oncology Certified and an adjunct faculty member at Adelphi University. I have a passion for teaching and advancing quality cancer care for oncology patients. Jeanmarie Piotrowski RN, BSN, ">OCN, CBCN Treasurer, Suffolk County Chapter of the Oncology Nursing Society A Registered Nurse with 30 years of experience in intensive care, post-anesthesia care and oncology. Current certifications include oncology as well as breast care and chemotherapy biotherapy. Currently practicing in the area of breast care as a surgical coordinator. Published team member in breast cancer diagnosis disclosure, mammosite radiation infection rates and sentinel node mapping rates. Special interests include quality improvement and assurance. A candidate for MBA-Health Care Management in Julie Ann Plantamura, RN, MSN, FNPc Program Chair, Suffolk County Chapter of the Oncology Nursing Society Julie Ann Plantamura, RN, MSN, FNPc, is a Board-certified Nurse Practitioner with North Shore Hematology-Oncology Associates, P.C. (NSHOA) in East Setauket, New York. At NSHOA, which she joined in 2001, she provides direct care and treatment to hematology and oncology patients. Ms. Plantamura is an active member of the Oncology Nursing Society, the Nurse Practitioners of New York, and the Sigma Theta Tau International Nursing Honor Society. She is also a sub-investigator for various clinical trials of cancer treatment drugs offered at NSHOA. In addition, Ms. Plantamura is a speaker for Amgen Oncology, AstellasMedivation, Janssen Biotech, Novartis, and Millennium. She is a member of the ONS Edge Expert Panel as well. She lectures on therapies for a variety of cancers, including Ph+ CML, Multiple Myeloma, Prostate cancer, Breast cancer, and Colorectal cancer. She has been published by the Anemia Management Institute as well as the International Oncology Network. 2
3 Meet the Suffolk County Board Mary Ferrara, BSN, RN, ">OCN Vice President, Suffolk County Chapter of the Oncology Nursing Society Mary Ferrara, BSN, RN, ">OCN is a Nurse Manager at a Magnet designated organization, John. T. Mather Memorial Hospital in Port Jefferson, New York and an active member of the Oncology Nursing Society. Ms. Ferrara's responsibilities include managing both the inpatient Medical Surgical Oncology Unit and the Out- Patient Infusion Center at Mather Hospital. In her role as Nurse Manager, she provides both leadership and guidance contributing to the professional development of Mather's nursing staff. Ms. Ferrara was instrumental in the development of an academic partnership Dedicated Education Unit (DEU), an Oncology Interdisciplinary Practice Council and an oncology focused Patient Family Advisory Council at Mather Hospital. She was Mather Hospital's Nurse of Excellence Nominee for 2014 for the Nassau-Suffolk Hospital Council and the recipient of the Long Island Business 2015 Health Care Hero Award. Ms. Ferrara is currently pursuing a Masters degree is nursing. Dr. Sylvia K Wood Director at Large & Chair of the Nominating Committee Suffolk County Chapter of the Oncology Nursing Society Dr. Sylvia K. Wood is an adult nurse practitioner, with more than 35 years of nursing experience. She has practiced in oncology for the last 25 years with an emphasis in hematologic malignancies, bone marrow transplant, breast cancer, and palliative care. She has also developed the Oncology Nursing division of the Oncology Consortium bringing Clinical, Research, and Academic Oncology Nurse Leaders to expand resources and program development. Dr. Wood's research interests include clinical trials in areas of bone marrow transplant, hematologic malignancies, and solid tumors. Dr. Wood's focus is translating best evidence in clinical practice toward improving patient outcomes. She works with the Oncology Nursing Society in Putting Evidence Into Practice to support oncology nursing education and best clinical practice. In addition to her work as a clinical consultant and instructional designer, Dr. Wood is a faculty member in the Department of Nursing for Professional and Graduate Studies at St Joseph s College. She has lectured extensively and is the lead author of articles on treatment-related side effects of cancer published in peer-reviewed journals. Dr. Wood received her Bachelor of Science degree in nursing at Roberts Wesleyan College in Rochester, NY and her Master of Science, Adult Nurse Practitioner and Doctorate of Nursing Practice at Stony Brook University in Stony Brook, NY 3
4 Meet the Suffolk County Board Faiza Zafar, RC, MS Member Chair Assistant, Suffolk County Chapter of the Oncology Nursing Society Faiza Zafar has been a Physician Assistant for the past 15 years. She is currently a Clinical Nurse Consultant with Celgene Corporation. Prior to joining Celgene, she was with the Multiple Myeloma Center for Excellence at Cornell Weill Medical Center and the department of hematology and oncology at NSUHLong Island Jewish Medical Center. She is the author of several publications within the multiple myeloma field. She spends most of her free time on the soccer field with her husband Imran, watching their 2 sons Omeir (age 9) and Aayan (age 6) games.. Watch for more Suffolk County Board Member introductions in our Winter Newsletter Edition Featuring. Mary Ann Vagnini, Secretary Judy Zellinger, Secretary Assistant Danielle Kyrillidis, Membership Chair Nancy Clavin, Editor 4
5 Community Happenings... North Shore- LIJ to Change Name to Northwell Health Eighteen years after the merger that created North Shore- LIJ Health System, it's Board of Trustees has unanimously approved a name change for New York State's largest private employer and health care provider - Northwell Health.. The Northwell Health name will be the centerpiece of a broad rebranding and marketing campaign that will launch in The 21 -hospital network's president and CEO has stated "the Northwell Health name is a reflection of our past and a beacon of our future. It's unique, simple, and approachable, and better defines who we are and where we are going". North Shore HematologyOncology Associates have opened a new Cancer Center 1145 Montauk Highway suite A West Islip, Suffolk, NY The Leukemia & Lymphoma Society Speaker: Colleen DeGaetano, RN, MHA, ">OCN Organization Affiliation: Monter Cancer Center DATE : Tuesday, November 3, 2015 TIME: 6:00pm Registration and Dinner 6:30pm- 8:00pm Program LOCATION: Hilton Garden Inn Melville 1575 Round Swamp Road Plain view, New York Complimentary dinner will be served Pre- registration for this free program is required Please contact Jaime LaMarca, LMSW , 5
7 Clinical Corner You may be hearing from patients I ve been on chemotherapy for a number of cycles- I heard there are chemo pills to treat cancer. How come my doctor won t prescribe them for me? Chances are, your patient is talking about targeted therapy. Do you know how to address you patient s question? Targeted therapy, according to the American Cancer Society (2015) is a relatively new approach to attacking cancer cells while sparing healthy cells. Certainly promising for cancer patients, however, the targeted therapy only works on cancer cells that exhibit a specific mutation or protein expression. Some examples are monoclonal antibodies, hormone inhibitors, anti-angiogenesis drugs, and immunotherapy drugs. Therefore, not every cancer will present with the DNA mutation, hormone expression, or angiogenic effect that ideally makes the cancer cell vulnerable to targeted therapy. Keeping the conversation simple and providing written literature will be helpful for patients. The more patients understand their disease process and treatment plan and treatment options will strengthen their autonomy and trust with the health care team. Nurses play a critical role in this process. Evidence Base Practice In an effort to support oncology nurses critical education needs and keep current with oncology nursing focused research our Suffolk ONS Chapter intends to inform our members on EBP topics. Emphasis will be placed on creating a user-friendly interface and presentation style summarizing key research findings which highlight ONS publications topics. Links to ONS publications and ONS PEP resources will be promoted to assist oncology nurses in translating research into practice. 7
8 Upcoming Events The Suffolk County Chapter is actively planning educational meetings for members during the months of... November December January April May We want to know your interests and ideas! Watch for an from us in November and participate in our survey to help us provide the best possible educational, professional development, and patient advocacycommunity service experience for everyone! For more information please visit us at ONS Information 2016 Elections will run from Jan 4 Feb 12, 2016 for information about the candidtates, please visit Not a member...join By joining the ONS, you are supporting the future of oncology nursing and benefiting the local chapters. When you join, please enter CHAP- CHAL on the online application. ONS 41st Annual Congress April 28 May 1, 2016 San Antonio, Texas Registration opens in November for Early-Bird Pricing 8
9 Did You Know??? Non-profit organizations and pharmaceutical manufacturer companies offer programs to financially assist patients with their care. Patient Advocacy Assistance Programs are listed here for your reference. Non-Profit Organizations Cancer Care Co-Pay Assistance Chronic Disease Fund Healthwell Foundation Leukemia & Lymphoma Society Patient Access Network Patient Advocate Foundation Patient Services Pharmaceutical Manufacturer Companies Amgen First Step AstraZeneca (AZ & Me) Bristol Myers Squibb Celgene Patient Support Commitment To Access Connection To Care First Resource Genentech Co-Pay Assistance GSK (GlaxoSmithKlein) yteCares Johnson & Johnson Merck Access Program Novartis NO Pfizer The Reach Program RX Outreach Safety Net Foundation Sanofi 9
10 Suffolk County Chapter on & Twitter Please visit us suffolk.vc.ons. org 10
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Medical Marijuana: A Nurse’s PrimerJulianna Paradisi, RN, ">OCN, is an oncology nurse navigator and writes a monthly post for this blog.
Since I wrote “Marijuana Legalization and Potential Workplace Pitfalls for Nurses Who Partake” in July 2014, a few things have changed. For one, Measure 91 passed in Oregon, making it the third state to legalize recreational marijuana. Medical marijuana, however, has been legal since 1998 in Oregon, currently one of 23 states nationwide.
Also, when I wrote the earlier post, I was an infusion nurse—now, as an oncology nurse navigator, I’m asked about medical marijuana often, and I need to know the answers, as do all nurses practicing in states with legalized medical marijuana. Nurses working in oncology, emergency departments, pain management, infusion clinics, and pediatrics have high exposure to patients with medical marijuana cards.
By ‘knowledge,’ I don’t mean knowing everything, but knowing where to find what you need to know. In Oregon, for example, information about medical marijuana is found at the Oregon Medical Marijuana Program (OMMP). The Web site includes qualifying diagnoses, a downloadable handbook, an application packet with instructions, and a list of approved dispensaries. While retail issues surrounding recreational marijuana are still being sorted out, medical dispensaries in Oregon sell recreational marijuana to clients aged 21 and older.
Patients using medical marijuana are as diverse as the illnesses and side effects they use it to treat: PTSD, seizure disorders, chronic pain, inflammatory illness, and of course the adverse effects of chemotherapy, including nausea and vomiting, anxiety, sleeplessness, anorexia, and hot flashes associated with endocrine suppression therapy.
As they must with all prescribed medications, nurses caring for patients using medical marijuana need to become familiar with potential adverse effects. Oncology patients experience a host of treatment-related effects—teasing out which medication they may arise from is difficult. For instance, medical marijuana is commonly used to treat chemotherapy-induced nausea and vomiting. But nausea and vomiting can also be symptoms of marijuana toxicity. Hypotension, a symptom of dehydration common with chemotherapy, can also be a sign of marijuana toxicity.
When smoked, cannabis enters the bloodstream rapidly; since patients can feel the drug’s effects in minutes (or less), they may find self-regulation easier in terms of dosage and other factors. Edible forms of marijuana, however, can take from 30 minutes to three hours to enter the bloodstream. This lag time may prompt some patients to repeat dosing sooner than recommended, leading to drowsiness, muscle weakness, hypotension, disorientation, or nausea and vomiting. Edibles are absorbed faster on an empty stomach—counsel patients with anorexia or other potentially relevant conditions accordingly. A single baked good, like a cookie, may contain several doses.
Like all medications, cannabis products should be stored in their original containers, clearly labeled, with dosages noted. And as with all medications, alcohol, and tobacco products, they must be kept out of the reach of children.
With the legalization of recreational marijuana, patients may be inclined to forgo medical marijuana cards and purchasing from a dispensary. While there are no studies I know of to prove this to be harmful, molds can grow on marijuana. Product can also be contaminated with E. coli from soil.
In Oregon, medical marijuana dispensaries are required to test their products for mold, bacteria, and pesticides. While some questions have been raised about the adequacy of existing tests for certain pesticides, marijuana not purchased at a dispensary will not be tested at all and its strength and proper dosing will not be verifiable. The testing used by dispensaries provides an extra layer of safety for patients with compromised immune systems and oncology patients with neutropenia.
Hospital policies. Cannabis, medical or recreational, is still prohibited on hospital campuses, even in states where it is legal, in keeping with their policies on alcohol and tobacco. Nurses should become familiar with each employer’s policies for medical marijuana and how to handle encounters with patients expecting to use it during appointments or hospitalizations. Hospice workers may have a different set of rules about its use in their facilities.
The reality is that education for patients using medical marijuana is not vastly different from that for prescribed narcotics, the social responsibility not vastly different from that for imbibing alcohol. With any of these, overuse can cause symptoms of toxicity.
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