Top E1. A Community-Centered Approach to Early Breast Cancer Treatment Through Patient Navigation E2. Development of a Tool for Assessing Patient Barriers to Care E3. Utilizing a Nurse Navigator to [ Read More ]
August 2015 VOL 6 NO 4
Oncology Nurse Excellence Award Finalists
It was a difficult process, but we have selected 4 finalists from among the peers you nominated for the Fifth Annual Oncology Nurse Excellence (ONE) Award of the Academy of Oncology Nurse & Patient Navigators (AONN+). All the nominees were outstanding, but these 4 individuals stood out for their display of leadership and compassion, and for their commitment to evidence-based practices. Now it’s your turn. After you read about each finalist, please go to www.TheOncologyNurse.com/award and tell us your pick for the ONE Award. We will announce the readers’ choice during the Sixth Annual Meeting of AONN+ on October 1-4, 2015, in Atlanta, GA.
Guiding and Inspiring Staff and Patients
Barbara Antolino-Smith, RN, BSN, CPN, Pediatric Oncology Nurse, Penn State Hershey Children’s Hospital, Hershey, PA, was chosen as a finalist for the ONE Award thanks to her outstanding contribution to patient care.
“Barb is not only compassionate and hardworking when it comes to caring for her patients and families, but also in how she interacts with her fellow staff members and orientees. Barb represents the professionalism, class, and knowledge base that embody the art and science of nursing,” her colleague, Alycia Nygard, RN, Clinical Head Nurse, Pediatric Hematology/Oncology, Penn State Hershey Children’s Hospital, Hershey, PA, said. “The words that she shares with others in times of triumph, challenges, and great sadness lead our unit and epitomize Barb’s career as a nurse.”
Barbara first received a degree in history, but after volunteering to care for newborns at a local hospital she knew she wanted to become a nurse like her mom. “I had to do something that mattered. I wasn’t going to leave my kids and go off and just do a job. I had to impact people’s lives,” she said.
Now, Barbara is a senior staff nurse. “I work an odd shift. I work 11:00 am until 11:30 pm. In the evening, you can get a lot of teaching done. There’s a quiet that settles in the pediatric unit. You can really target some of the needs that don’t get addressed during the busy day.”
Barbara is a Clinical Ladder IV nurse, where she has a wide scope of responsibility in her unit. She is also in the Integrated Council at Penn State Hershey Children’s Hospital, where she helps to implement necessary changes in her practice. Barbara is also a leader who organizes assignments for the nursing staff and troubleshoots issues. She gets involved quickly and sets the tone for the unit by staying calm and focused. “My coworkers, I’m not saying this glibly, are truly my heroes. I’m an older person. They are young; they work tirelessly; they have an incredible attitude toward life. I can’t say enough about them. I want them all to succeed not just in nursing, I want them to succeed in life. Everyone sets a precedent of really understanding that it’s not the individual. It’s all of us. Boy, that is what nursing is about.”
Barbara is especially proud of the mentoring program she set up in her unit, which allows her to pass on the support she received from her mentors. She helped set up a nursing survival guide to provide practical information for nurses, and set up an individualized preceptor program. She enjoys being a preceptor for new staff and graduate nurses, and uses her background in history to understand cultural dynamics in the hospital setting. “An appreciation of the diversity of people has got to be understood if you’re going to work with people and families,” she said. “I did a program on the cultural and religious aspects of care of the hospitalized Muslim child. There are a lot of misunderstandings and assumptions made that should not be made.”
Barbara also takes pride in guiding children and their families through new diagnoses. “You get a lot more back than you give, when I sit down and think about it. Taking a family through one of the most devastating things that has ever occurred and will occur to them, and getting them to the other side, that’s really rewarding.”
Barbara has learned valuable lessons working as a pediatric oncology nurse, such as to trust her instincts and never make assumptions. She learned “to always stand up for what works for nurses, because nurses are very smart cookies.”
She added, “The job I have in my pediatric unit in oncology is how I want the world to be, where people trust each other, where they help each other. That goes for not just the patients, but it goes for the staff, the fellow nurses and aides, and all the people that support the kids and families at the hospital.”
Developing the Role of the Oncology Nurse Practitioner
Brenda Brien, MSN, CNP, Toledo Clinic Cancer Centers, OH, was nominated for the ONE Award for her outstanding contribution in practice solutions and developing the nurse practitioner (NP) role in oncology.
“If not for the credibility of Brenda, the implementation of the NP role in our practice would have failed,” said her colleague, Peggy Barton, RN, Practice Administrator, Toledo Clinic Cancer Centers, OH. “Over the years, her role has evolved building on her management, clinical, and program development skills. Today, our NP staff contributes in these 3 areas. Brenda has developed the clinical role for the NPs for different practice settings. As the first NP in our practice, Brenda provides the leadership needed to help position the practice for the future.”
Brenda began her career as a nursing assistant in an extended care facility. She has been in practice for about 45 years, and is now a chief nursing officer, NP, staffing coordinator, triage nurse, chemotherapy nurse, and any other role she is needed for. “I knew I wanted to help patients, not only with their medical issues but to help them deal with their spiritual well-being and provide them with emotional support,” she said.
One of Brenda’s best accomplishments was developing the NP role in the oncology outpatient area of the Toledo Clinic. “When I became an NP, I had been an oncology nurse for years. I went to one of our physicians in oncology and inquired about a position as an NP, and he told me they would never use an NP in oncology. Five years later, he called me and asked if I wanted a job, and I have been here ever since!”
Brenda then worked to further develop the role of an NP in oncology. “I was hired as an NP to cover offices when no physician was available, and the role expanded to seeing patients and coordination of care. The physicians at first were reluctant to use an NP, and as the role developed, they realized the importance of how it facilitated the care of the patient.”
Brenda also helped develop other programs at the Toledo Clinic, including a quality oncology practice initiative certification, preparation for the National Committee for Quality Assurance Specialty Medical Home certification, depression screenings, a smoking-cessation program, and oral chemotherapy management. “The development of these programs included research guidelines, education of staff and physicians, as well as the development of numerous policies and procedures. My motivation was recognizing the importance of these programs in providing quality care to patients and their families,” she said.
Based on her experience, Brenda realized that it is possible for nurses to help all patients cope with cancer. “I can’t change the ultimate outcome of what cancer can do to a patient and their family, but I do know that what I can do for them one day at a time may make a difference in their life and what they are dealing with a little better,” she said.
“Being a nurse means not only dealing with patients and their disease, but knowing where they’re at in their life, their goals for the future, and how the illness and disease affects them and their family. Nelson Mandela said that being courageous is not the absence of fear but the triumph over it; it has been a privilege to work with the many courageous cancer patients that battle cancer every day.”
Improving Nurse Navigation and Implementing Palliative Care
Peggy Malone, RN, BS, OCN, Oncology Nurse Navigator, OSF Saint Anthony Medical Center, Center for Cancer Care, Rockford, IL, was nominated for her outstanding contribution to research in oncology. “She has been instrumental in initiating and expanding research in the Center for Cancer Care, working directly with research associates,” according to her colleague, Lisa Bruno, RN, BSN, OCN, also of OSF Saint Anthony Medical Center, Center for Cancer Care. “Peggy easily transitioned into her role as navigator for lung and colon cancer patients in early 2014 from an over 20-year career in medical oncology, bringing her love of research to the role.”
Peggy has been in practice for 28 years. “I started as an RN on a 10-bed inpatient oncology unit in 1987 ‘BZ’—before zofran,” she quipped. One of her greatest accomplishments, she said, was working while attending nursing school and caring for her 2 and 3-year-old children.
Peggy has actively participated in research projects at OSF Saint Anthony Medical Center, including writing an abstract within her first few months there titled “Development and Evolution of an Oncology Nurse Navigation Program: From Foundation to Fruition” and presenting it at the 2014 annual Academy of Oncology Nurse & Patient Navigators meeting. “The aim of the abstract was to give other organizations a real example of the steps required to start an oncology nurse navigation program,” Peggy said.
She also created a survey tool, obtained Institutional Review Board approval, and is conducting surveys about patient satisfaction with the nurse navigator program. She plans to publish the data and use the results to implement changes to the program. “The Commission on Cancer and the newest payment model out of the Centers for Medicare and Medicaid Innovation has recognized that the core functions of oncology nurse navigators are essential to efficient, high-quality care in oncology. We wanted to measure the impact our own program was having on the patient population we serve,” she said.
She completed training as a performance improvement lead for Six Sigma in 2014, and was the lead registered nurse for a project on outpatient oncology/palliative care integration. She said, “Studies continue to show that early integration of palliative care into oncology programs improves quality of life for patients and caregivers. Our cancer center did not have access to outpatient palliative care, so we initiated a performance improvement project to integrate palliative care to the outpatient setting.”
Peggy was also an active team member with the American Society of Clinical Oncology (ASCO) Virtual Learning Collaborative, a nationwide research initiative that aims to integrate palliative care with oncology care. “I was part of the ASCO-sponsored team at my organization that worked in collaboration with cancer centers across the nation, each center networking about similar process improvement projects. The groups worked for a 2-year time frame together. Our project was based on palliative care referral processes.”
Peggy is passionate about her work, and encourages her peers to fight for the causes they believe in. “I love the science of oncology nursing—how the medications act, the role of genetics, how each cancer behaves. It is an ever-changing landscape,” she said. “Nurses, as a group, should strive to be more politically active. There are 3 million of us. If we all got together and stood behind a cause, we could change the world.”
Creating a Community of Support
Theda Shaw, RN, MSN, is the Genitourinary Program Coordinator at the Penn State Hershey Cancer Institute, Hershey Medical Center, Hershey, PA. She is one of the finalists for the ONE Award for her outstanding contribution to education.
Since she was a little girl, Theda wanted to become a nurse. Her brother had mastoid surgery as a child and, even at age 10 years, she helped dress and clean the large wound behind his ear. This experience led her to pursue opportunities in the medical field. During her teen years, Theda knew that being a nurse was something that she had to do. Her high school was conveniently located near the local hospital. After school, she walked up to volunteer as a candy striper and enjoyed passing out water or doing simple tasks for patients.
Theda graduated as a licensed practical nurse (LPN) after finishing high school. Theda then transitioned to an admissions and marketing position for a nursing home. During those 15 years, she did many different things that maybe she would not have had exposure to had she stayed as an LPN working with patients at the bedside. In 2002, at age 49 years, Theda completed a registered nurse program, which she considers one of her greatest accomplishments. Coming from a blue-collar family, she was the first to attend college. After gaining clinical experience, Theda went on to receive her BSN degree from Penn State University in 2005. With determination and long days, Theda ultimately graduated with her master’s degree in 2011.
With her background in administration and marketing, Theda has been instrumental in rolling out several support groups at Penn State Hershey Medical Center. When she started this position, there were only support groups for breast cancer and leukemia. Her work on initiating the Bladder Cancer Support Group was extremely successful. The group had 100 patients and families at its first meeting. It holds formal meetings every other month, and a patient newsletter is sent out to more than 500 patients. The template for the Bladder Cancer Support Group is being used to roll out additional support groups. The Penn State Hershey Medical Center now offers support groups for prostate cancer and ear, nose, and throat cancer. Support groups for patients with melanoma or pancreatic cancer will soon be established as well. Because her mother had bladder cancer, Theda understands the importance of family support. She is passionate about giving back and improving the resources for patients and their families.
Theda also leads a bladder cancer walk, a family fun day, and a health fair. This year, the health fair grew to include sponsorship by the Bladder Cancer Support Group, the Cancer Institute, and the university fitness center. The health fair focuses on traditional medicine as well as natural health remedies. Theda educates patients about complementary medicines, such as tai chi, yoga, and Reiki. The health fair attendees are able to try them for free. On average, the age-group for patients with bladder cancer is 72 years, and they may not get exposed to these options without the health fair. The patients learn about how they will benefit from these complementary medicines to help control their nausea, pain, stress, and sleepless nights.
Theda’s work and passion has been noted by her colleagues and patients. Belinda Frazee, RN, MSN, Bone Marrow Transplant Program and Nurse Coordinator, Penn State Hershey Medical Center, Hershey, PA, said it best: “Theda has exemplified the kind of work ethic and professionalism that is recognized by her peers and patients. She is caring and compassionate when dealing with her patients and families on the phone and in the clinic. The calmness in her voice brings them reassurance as they deal with such a difficult diagnosis and treatment. She goes above and beyond to support families emotionally.”
We are into the final countdown with just a few weeks before our Sixth Annual Academy of Oncology Nurse & Patient Navigators (AONN+) Conference in Atlanta! This issue of the [ Read More ]