Patient was 19 years or older. • Patient had a primary or secondary oncology diagnosis. • Inpatients spent more than 24 hours in the hospital. • Patient agreed to see the ONN. • Physician order was received for ONN visits. • Distress Thermometer question was answered on at least two separate dates during a single inpatient stay. Charts were excluded when patients did not provide answers to the Distress Thermometer question on two separate occasions during the hospitalization