{'fraction_non_alphanumeric': 0.021224086870681145, 'fraction_numerical': 0.0024679170779861796, 'mean_word_length': 5.345511482254698, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Role of Onco-Trained Nurses in a Tertiary Care Cancer Institute

Submit Manuscript | http://medcraveonline.com radiation, surgical, medical, gynaecologic, and paediatric oncology wards. They are involved in direct patient care and practice at the grass-root level, with 43% working at hospital level, 24% in the outpatient setting, 11% in physician offices, and 3% in hospice or home care [1]. Their involvement in outpatient and home care setting has increased as more patients are being treated out of the hospital setting. This mini-review discusses the role of the onco-trained nurses in patient care, coordination of care, patient education, management of symptom, and supportive care.


Purpose and Justification
The purpose of this mini-review is to focus on the role of onco-trained nurses employed in a tertiary cancer care centre. We discuss in brief their involvement in a patient's initial and supportive care. She provides an invaluable service to patients and their relatives by coordinating and communicating with different diagnostic or therapeutic centre personals. We hereby try to illustrate how diverse their role can be and its utmost significance in cancer care not only related to patients but also in administrative setting.

Discussion
The onco-trained nurses play an important role in coordinating the complex technologies commonly employed in cancer diagnosis and treatment. They are expected to act as the patient's first line of communication as it can provide an invaluable service to patients who may be confused and frightened. This coordination can encompass documentation, organizing referrals to specialists, constant counselling throughout diagnostic workup, therapy and follow-up. Ideally, the patient and family should feel free to contact the oncology nurse by phone during the entire treatment program. It allows continuous patient communication, early recognition of emergencies, and regular emotional support. They are expected to draw a nursing care plan [2] in response to the particular needs identified from the assessment of patient's understanding of cancer therapy goals, treatment schedules, and side effects of therapy. These plans may aid in patient's physical and psychological preparation for therapy.
Trained nurses are expected to assess a patient's physical and psychological status and also both the patient's and their family's knowledge of cancer and its treatment. They review the treatment plan daily with the treating oncologist and are aware of the expected adverse effects of treatment. She is expected to know the results and implications of all relevant laboratory and pathology reports. The delivery of RT and administration of chemotherapy on an outpatient basis has increased the necessity of the nurses to understand the possible side effects of RT and chemotherapeutic agents. Patients are more concerned about the treatment related side-effects and their management.
An important responsibility of onco-trained nurses is to deliver correct chemotherapy regimen in correct dose through correct route to the patient as complex regimens of lethal drugs are generally used in a day-care centre as errors do occur. These errors included errors in dosing, incorrect drugs exhibited or drugs administered by an incorrect route, and errors in administration and preparation [3]. Tertiary care cancer centres have written policies for RT delivery, chemotherapy administration, handling and disposal of drugs safely, and management of adverse reactions. Nurses deal with the numerous complaints of patients and their families encounter during treatment. These nurses contribute

Introduction
Onco-trained nurses working in a tertiary care cancer institute practice in different settings including acute care, day care, significantly in managing the side effects of RT and chemotherapy. For example, nausea and vomiting are two of the most common symptoms associated with RT and chemotherapy and controlling these symptoms have been a nursing priority [4]. The use of anti-emetic 5-hydroxytryptamine-receptor antagonists has helped a long way in controlling these symptoms [5]. Increase in healthcare costs worldwide and reduced financial resources have challenged radiation and medical oncologists to evaluate the cost-effectiveness of medical and nursing treatments.
The most distressing adverse effect reported by patients on radiation treatment or chemotherapy is fatigue and nurses have played a major role in managing this symptom [6]. Nurses spend more time with cancer patients than the treating physician himself and are expected to have knowledge about pain assessment and pain management in order to provide good pain relief when required [7]. However, there are misconceptions and fear among the onco-trained nurses about radiation side effects like grade III skin reactions, chemodrug tolerance, and respiratory depression with opioids. There is also lack of knowledge about pain assessment and analgesic administration which sometimes result in under-treatment. This can be attributed to traditional undergraduate nursing curricula where pain management is not taught as a separate subject. Fortunately, these problems are now being addressed, and the education programs and resources available have improved considerably.

Conclusion
Oncology nursing care should be aimed to promote patient comfort, pain control, provide information about side effects of radiation and systemic therapies and promote compliance of patients, their families with therapy and further follow-up. The nurses should devote time for patients and their next of kin to explain the rationale of treatment and hear out the patient's and family's questions. The nurse should monitor the effectiveness and side effects of therapeutic interventions, respiratory and bowel status as well as psychological and cognitive functioning of cancer patients. The patient and family should feel free to contact her in case of an emergency. Overall, an onco-trained nurse should be the pillar of strength and support to these ailing patients.