Nursing At the Frontline of Oncodermatology at Memorial Sloan Kettering Cancer Center

July 23rd, 2015 in Reflection

by Kathryn Ciccolini & Anna Skripnik Lucas, Memorial Sloan Kettering Cancer Center, New York, United States.  ISNCC EGFR Inhibitor Skin Toxicity Treatment Working Group Members.

At Memorial Sloan Kettering Cancer Center (MSK), there lies a unique nursing role within the dermatology service: Oncodermatology. Sparse in nature, nurses in this specialty are privy to exclusive knowledge, skill, expertise and access to this patient population therefore must be experts in both difficult comprehensive fields.

Oncodermatology embodies a full scope creating a larger picture in the oncologic and dermatologic healthcare worlds. This unified field focuses on diagnosis and management of various conditions such as skin cancer precancerous skin lesions, nonmelanoma skin cancer and melanoma, cutaneous lymphoma, cutaneous metastasis, hypersensitivity reactions, autoimmune diseases, common benign skin dermatoses, vascular disorders, skin infections, lymphedema, emergency dermatology and complex wound care, respectively. In fact, the field of oncodermatology encompasses a wide spectrum of advanced disease processes that requires an allembracing approach in tying together both oncology and dermatology. In the past decade, the field has gained considerable attention regarding dermatologic adverse events (dAE) to cytotoxic chemotherapy, targeted and immunotherapy, radiation therapy, surgery and therapeutic transplants with MSK being at the forefront. Additionally, evolution of computerized imaging has transformed care for monitoring atypical lesions, total body skin examinations, routine skin cancer surveillance monitoring, wounds, post surgical scars, adverse skin reactions.

At MSK, there are various world-leading established novel programs within the service dedicated to the distinct oncodermatology patient population such as the ones alluded to earlier. All teams are multidisciplinary with the nursing role being recognizably positioned on the front-line of evidence-based care. Multidisciplinary members include licensed independent practitioners (LIPs), nurses, patient care technicians, pharmacists, nutritionists, oncologists and administrative staff. On the forefront, nurses specialize in providing the highest quality care through the cancer care continuum. As members of a multidisciplinary team, nurses at MSK are committed to nursing excellence and their dedication in doing so extends beyond skin deep. Oncodermatology nursing expertise requires substantial knowledge of both advanced oncology and dermatology anatomy, pathophysiology, disease processes, pharmacokinetics, pharmacodynamics, comprehensive assessment, teledermatology, coupled with education and research.

As vital members of the multidisciplinary team, we collaboratively practice using the primary nursing and relationship based care (RBC) professional practice model. Patients are cared for with synergistically created care plans focusing on quality of life concerns, psycho-socio-economic status, coordination of care and team decision-making. Nurses also participate in valuable oncodermatology research by optimizing patient accrual, reducing attrition rates, patient outcomes, patient education, and are consenting professionals to important protocols.

As nursing specialists at MSK, we have defined oncodermatology nursing standards in terms of nursing policies, procedures, patient education, assessment, documentation, telephone triaging and practice. Through RBC professional practice model, oncodermatology nurses unite to fulfill the MSK nursing mission of to “provide compassionate, evidence-based nursing care to patients and families living with cancer in a healing and innovative environment.” To contact authors please email: Kathryn Ciccolini RN, BSN, OCN, DNC and Anna Skripnik Lucas RN, BSN, DNC at: ciccolik@mskcc.org or skripnia@mskcc.org

Anna Skripnik Lucas (left) and Kathryn Ciccolini (right) at Memorial Sloan Kettering Cancer Center.

Anna Skripnik Lucas (left) and Kathryn Ciccolini (right) at Memorial Sloan Kettering Cancer Center.

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