Proactively Managing Patients on IO Over Holiday Weekends and Beyond
Kristin Daly, MSN, ANP-BC, AOCNP, shares advice for preparing patients for possible adverse effects outside of clinic hours.
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This week’s episode brings more insights from Kristin Daly, MSN, ANP-BC, AOCNP, on caring for patients receiving immunotherapy who require medical attention for adverse effects (AEs) of immunotherapies.
Reflecting on the evolution of immunotherapy in oncology, Jakel recalled that in the past, patients often dealt with spiking blood sugar, colitis, and severe diarrhea. Daly emphasized that a variety of AEs of immunotherapy can be managed with steroids, which is not always known when patients visit emergency departments (EDs) outside of clinic hours.
“Our joke in the early days of immunotherapy was to say ‘Just get it tattooed inside your arm: Please give me steroids,’” said Daly. “I had patients who went to local EDs, and it’s not that the care wasn’t good, but they weren’t aware of immunotherapy, and patients had diarrhea and weren’t treated with steroids.”
Instead, shared Daly, patients were tested for other infections and viruses; without the cause of the diarrhea being understood, colitis worsened.Daly also shared that when educating patients, it is important to be mindful that they will likely need re-education and re-enforcement.
“I ask a million questions, yes. But I’ll try to sum up at the end of visits…the 3 most important things for the patient in front of me,” Daly emphasized. “If you overload people with information, they absorb almost nothing, so you want to focus on the most important things that they need to know today, and give them an avenue to contact somebody with the answers if other questions or issues come up.”
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