Pacing the standard of nursing practice in radiation oncology

Radiotherapy frequently is used to treat both breast and lung cancers. Because of recent technological advances, radiation oncologists can deliver increasingly higher amounts of radiation to these areas. Inevitably, some patients requiring radiation therapy will have histories of cardiac disease and temporarily or permanently implanted cardiac pacemakers. Pacemakers are not immune to radiation; damage to their internal circuitry can occur if safeguards are not in place. A recent informal telephone survey of radiation oncology departments in Pennsylvania, as well as four nationally recognized cancer centers, yielded varied and inconsistent nursing practices in caring for these patients. A review of the literature found recommendations that were developed originally in 1989, then updated in 1994 and 1998, to be incomplete from a nursing perspective. Radiation oncology nurses must take a proactive role to deliver quality consistent care, while minimizing their liability, when working with this patient population. This can be achieved by implementing a nursing policy that incorporates the 10 recommendations described in this article.