Public Health Issues
Public Health Issues
ONS closely monitors the following public health issues to benefit the oncology nursing community.
The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General found that although there was a sharp decline in the incidence of adult smoking in the decades since the historic 1964 Surgeon General’s Report, smokers today are at a far greater risk of developing lung cancer. This outcome is the result of changes made during that time in the design and composition of U.S. cigarettes. For the first time in U.S. history, the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) gives the Food and Drug Administration (FDA) the authority to require changes in the content and design of cigarettes “appropriate for the protection of public health."
In March 2014, ONS joined our coalition partners in submitting a letter of support that urged the FDA to use its broad statutory authority to reverse the dangerous changes in cigarette composition. We cannot afford to give the tobacco industry another 50 years to make cigarettes even more addictive than they are today. ONS is committed to maximizing the potential that nurses, the largest group of healthcare professionals, have in reducing adult and youth tobacco use, promoting cessation, actively protecting all people against secondhand tobacco smoke, and helping to increase access to tobacco-use prevention and cessation services.
ONS has maintained a longstanding position statement regarding cancer pain management, where one of the tenets posits that “regulatory, legislative, economic, and other barriers to effective cancer pain management must be eliminated.” When it comes to public health regulations and policies, officials should understand the impact that new restrictions on pharmacies and prescribers may have on patients with cancer. Patients experiencing cancer pain don’t have the luxury of waiting for prior authorizations, mandatory wait times, and dose or packaging restrictions. Congress and regulatory officials should make policy exceptions for patients with cancer to prevent unnecessary suffering and improve quality of life.
Discoveries for novel treatments and cures of disease, especially cancers, are often completed through clinical trials. The National Institutes of Health (NIH) defines a clinical trial as “a research study in which one or more human subjects are prospectively assigned to one or more interventions (which may include placebo or other control) to evaluate the effects of those interventions on health-related biomedical or behavioral outcomes.” New drugs, surgeries, devices, or regiments might be found to be more effective—and safer—through these trials. Clinical trials can also provide insight and procedures to increase quality of life, particularly for people with chronic diseases.
However, federal initiatives often seek to curtail the investment and research goals of some clinical trials. ONS tracks and responds to these issues, educating decisionmakers on the implications of restructuring research possibilities. It is imperative that appropriate levels of public funding are accessible to scientists and researchers without contrived constraints. In May 2014, ONS submitted a letter of support to the NCI regarding continued access to clinical trials for patients with cancer. Read NCI Director Harold Varmus' favorable response.
Prevention and Detection
Access to quality cancer care is the right of all people. Yet without services targeted at reducing cancer risk, morbidity, and mortality, patients with cancer may suffer from decreased quality of life or less-than-optimal outcomes. These essential services are prevention, early detection, risk reduction, clinical trials, treatment, psychosocial care, and survivorship. The federal government’s funding of agencies such as the NIH, FDA, CMS, and CDC assists in this effort.
Strong support for the NIH is essential in conquering the devastating collection of more than 200 cancerous diseases, ensuring that current and future generations of researchers will be equipped to continue this mission and keep the U.S. economy at the forefront of global medical research. Even with tremendous progress, cancer remains a formidable opponent. A number of cancers, including pancreatic, liver, lung, ovarian, and brain cancers, have an extraordinarily high mortality rate and very low survival rates. Racial and ethnic minorities, as well as low-income and elderly populations, continue to suffer disproportionately in cancer incidence, prevalence, and mortality.
ONS joins many coalition partners in asking the U.S. Congress to continue to invest the nation’s resources in research and development of prevention and treatment options for patients.
Year after year, public polls indicate that nurses are the most trusted healthcare provider. As the population and the rate of cancer incidence increases, creating and maintaining a safe and appropriate working environment for these trusted professionals is paramount. Although the number of nurses continues to fluctuate, concerns remain about having a stable and prepared nursing workforce in the United States—especially with understaffing and Baby Boomer generation retirements remaining as top factors.
The Institute of Medicine’s 2010 report The Future of Nursing: Leading Change, Advancing Health specifies three nursing workforce concerns.
- "The healthcare marketplace, and payers in particular, have not offered sufficient incentives for healthcare employers to demand a nursing workforce that aligns the skills of RNs more effectively with needs of patients and the healthcare system."
- “As currently designed, primary nursing education prepares nurses to function in discrete settings rather than across settings and as individual clinical providers rather than team members. Team-based care and care coordination are not meaningfully integrated in primary nursing educational pedagogies. Reorienting nursing education to incorporate these themes will require significant redesign of both classroom and clinical education."
- “Workforce planning and forecasting will likewise require a comparable paradigm shift. Forecasting models based on current RN demand will not produce useful estimates to guide future policy, i.e., the capacity of the RN workforce to meet the needs of future models of health care services. The current RN workforce is deficient in a number of dimensions to support health reform. Moreover, without a national, integrated approach to workforce planning, one that includes and obligates the critical stakeholders to the goals of an evidence-based and effectively-deployed health care workforce, forecasting efforts will produce estimates that cannot guide future workforce planning."
Without sufficient investment in a robust nursing workforce, coordinated care will be limited and patients with cancer will suffer through an ineffective healthcare system. ONS is engaged in making each IOM recommendation a reality.
ONS strives to work with federal agencies and congressional staff to better educate decisionmakers on the rights and responsibilities companies have in providing medication in a timely and efficient way. Prescription medications are often not as readily available as patients and providers are led to believe. Even as oncology nurses use their considerable resources to prevent or postpone gaps in medicinal regiments, these shortages still wreak havoc on patient treatment plans.
The FDA is responsible for reviewing the process for submissions, reviews, and approvals of current, new, and generic prescription medications. It cultivates an open process with manufacturers to help communicate the latest updates regarding specific medicines. To that end, the agency seeks information from consumers, providers, and patients. Read more on the FDA's drug shortages page.