Award recipients reflect on quality care
Cancer care providers receive Lane W. Adams Quality of Life Award
When 5-time cancer survivor Sister Rita Jarrell walks into a patient's room, “they immediately know I understand,” she says,even if she does not tell them about her personal experience with the disease.“You go where they are, and you speak their language.You don't try to change them, and you're not there to preach. I use the question approach by asking things like, ‘What are your concerns? What do you like to do? What's on your mind?’”
Jarrell's special way with cancer patients not only caught the attention of colleagues but also of the American Cancer Society (ACS), which honored her and 9 other cancer care providers across the country with the 2010 Lane W. Adams Quality of Life Award. The award honors people who have made a difference through innovation, leadership, and consistent excellence in providing compassionate, skilled care and counsel to persons living with cancer and their families.The providers received their awards at a ceremony in Atlanta on May 6, 2010.
“Going above and beyond the call of duty to extend the ‘warm hand of service’ to cancer patients is a top priority for these dedicated individuals,” notes Alan G. Thorson, MD, national volunteer president for the ACS.
The award has been given annually since 1988. It honors Lane W. Adams, a former ACS executive vice president who coined the term “the warm hand of service,” which called attention to the importance of compassionate care. “Cancer Scope” interviewed 7 of the recipients about their oncology careers.
Sister Rita Jarrell, OSUMA, BCC
In addition to her work as a hospice chaplain at Hosparus in Louisville, Kentucky, Jarrrell runs a cancer recurrence support group, advocates for the underserved, and is a long-time volunteer with the ACS's Reach to Recovery program. She also trains volunteers in the patient assistance program. She has survived cancers of the breast, skin, and colon. However, that has not stopped her from spending multiple hours providing pastoral care to the dying and seriously ill.
“I sit with people every day—some are agnostic or atheist,” she says. “Sometimes we read poetry, and I help support the family. It's spiritual care—it's more than just God, it's our spirit,who we are.”
Jarrell also teaches a Living Well With Cancer class that includes positive thinking, exercises, imaging, and stress management. “We have to learn to deal with cancer because it never really goes away,” she says.
Linda Bulone, RN, OCN, CCRC
When Bulone,who is clinical trials manager at the Queens Cancer Center of Queens Hospital Center in Jamaica, New York, arrived at the center in 2004, her charge was to increase enrollment in clinical trials. The hospital has one of the highest rates of latestage disease in the nation and treats mostly low-income patients. No matter how much administrative work she has, Bulone says she is always available for patients with questions. “I feel very close to them. They're like Christmas presents—each one is different,” she says.
“I have the ability to work with very sick patients without falling apart,” she adds. “Although the illness and the outcomes get to me, I still feel very passionate about what I'm doing, and I know I've done the best job I can.”
Empathy and compassion are important elements of cancer care, along with knowledge of the latest treatments and studies, she adds. She relays the story of a patient in home hospice care.The familywas reluctant to give the patient medication, and Bulone had to help them understand why it was important to do so. To gain their trust, she asked them to show her some photographs and share stories about their mother's life.
“I was in their house until 2 AM, going through every photo album—it was very sweet and touching and an honor that they took me into their lives. The woman later passed away on Mother's Day, and the son called me and said, ‘You're my mommy at Queen's Hospital.’” It is moments like these that matter most to Bulone.
Ahmed Nadeem, MD
“Anybody can prescribe chemotherapy, but there are a lot of emotional and social aspects to cancer treatment,” notes Dr. Nadeem, medical director of the outpatient infusion center at Landmark Medical Center in Woonsocket, Rhode Island. “My style is to talk to patients and get to know their lives, their families, their interests.” Equally as important as being compassionate, however, is being up-to-date on the latest oncology information,he adds.
Dr. Nadeem credits his team with ensuring that patients are not just numbers at his facility.As evidence, approximately 300 patients attended Cancer Survivor Day at Landmark Medical Center—the largest turnout of any facility in the state. In nominating Dr. Nadeem, Phyllis Kelliher, nurse manager of the Northern Rhode Island Hematology/Oncology Program, noted, “Every day I receive calls or visits from patients and families who tell me how they will never forget this wonderful physician who took such great pains to care during such an awful time in their lives … on a daily basis, he gives of himself in ways that continue to touch my heart and soul.”
Stefan Balan, MD
Dr. Balan, who is currently clinical director of hematology and oncology at the Norris Cotton Cancer Center at Dartmouth—Hitchcock Medical Center in Manchester, New Hampshire, was in the middle of changing jobs when he learned that he had received the award, so it was “a bittersweet moment,”he says.“The award was very special because the nominations came from a number of people I worked with,”he says, adding that this honor is different from typical measures of physicians' success, such as publications in academia or salaries in private practice. “Receiving this award for doing a good job—that's extraordinary.”
Originally from Bucharest, Romania, Dr. Balan first specialized in gastroenterology but was drawn to oncology because of a mentor. “What I like about oncology is it gets very personal,” he says. “As a scientist, you want to keep your distance, but by nature cancer has to do with death and spirituality, and there's noway you can do that without getting personal.”
Because oncology is such a rapidly evolving field, he finds it an intellectual challenge to learn all the new information that is generated every year. Specific guidelines are black and white, but there is a huge gray area that requires oncologists to know their literature extremely well, he says. “Cancer is so complex, and you need to work with somany departments,” he says, noting that at his former job at the Veterans Administration Medical Center in White River Junction, Vermont, he soon realized that patients needed something beyond medical treatment because nearly every cancer patient is depressed. Assembling a team that included a psychiatrist, chaplain, nutritionist, and social worker, he aimed to address “the anxiety and angst that explode when cancer comes.”
The award “is probably the highest honor of my professional career,” says Crawford, who is operations director of oncology services at OSF Saint Francis Medical Center in Peoria, Illinois. “I tell everyone that if you got into healthcare for any other reason than to help people, you're in the wrong line of work,” he says.
When Crawford entered the oncology field as a radiation therapist nearly 40 years ago, he learned that you can help almost any patient you treat, whether you are relieving their pain, helping control their tumor, curing [their disease], or prolonging their life. “If you think you can cure everyone, it will be extremely depressing,” he adds. “You can't change a stage IV into a stage II.”
Crawford says he tries to be as visible as he can to patients and staff, offering assistance on everything from billing to insurance and scheduling to helping staff members get a patient on an examination table. The administrative duties, he notes, can always be done in the evening after everyone else is gone.
Crawford credits his radiation oncology colleagues with remembering to treat the person and not the disease. That personal approach applies to the treatment side, as well. Particularly in radiation oncology, which has become increasingly automated, the human touch is still necessary, Crawford stresses.
“You still have to think about what you're doing and use critical thinking,” he says. “I don't think there will ever be a time when there isn't human intervention in the treatment process.”
Rios, a case manager at Westside Community Health Services in St. Paul, Minnesota, helps coordinate a state program that provides free mammograms and breast examinations. Her clients struggle with language barriers and have difficulty getting to their medical appointments because they lack transportation or child care. Lack of insurance is another problem. She also started a support group for Latinas in Minnesota. The group, which meets monthly, is known as The New Hope or, in Spanish, La Nueva Esperanza. It began with 6 members and now has 48. “These women need to come in and talk to people in their own language,” she says. “I have to be really creative to help them get through their treatment. I try to help them with paperwork, and I bring people in from the community to explain things like memory problems after chemotherapy.”
Because hospital interpreters do not always provide enough information or support, patients turn to Rios and the support group, she says. Even when the group's budget dwindles, someone always comes through with a donation to sustain it. In addition, the ACS provides wigs, hats, prostheses, and support materials. The women gather, eat traditional foods, and laugh, much like a family, Rios says. “They are now able to call each other to ask questions and ask for rides instead of just calling me like they did in the beginning,” she notes.
Peg Nelson,MSN, APRN, ACHPN
Peg Nelson, director of the pain and palliative care service at St. Joseph Mercy Oakland Hospital in Pontiac, Michigan, helms a program called No One Dies Alone, which recently won the hospital award for volunteer excellence from the American Hospital Association.
Program volunteers, known as comfort companions, support patients who are dying when their families are unable to be with them. “About 10% of patients don't have anyone with them when they're dying,” Nelson notes.
Receiving the Lane W. Adams Award means a great deal to Nelson because it shows that the “ACS recognizes how important palliative care is to the treatment of cancer,” she says.
Recognizing the need for better pain care and end-oflife support, Nelson helped launched the palliative care program at St. Joseph Mercy Oakland Hospital. Oncology in particular becomes extremely complicated at the end of life, she says. “There is such an opportunity to find peace and healing during this time,” she says. “It's not all doom and gloom. There is a remarkable amount of joy in these scenarios.
“One of the sweetest things I experienced was a patient whose daughter was pregnant. We had her daughter lie in bed with her, and we did an ultrasound introducing the grandson to his grandmother.” Seeing families come together at the end of life and providing comfort care, such as homemade “love” blankets and special music for the patient, help create an experience that will begin and ease the grieving process, she adds. “I feel privileged to be in a hospital that has supported me and my team for many years—it's not the norm,” she says.
The other 3 award recipients were:
Pam G. Hodges, BSN, MSN, a clinician at North Mississippi Medical Center in Tupelo, Mississippi, has been an oncology nurse for more than 25 years. She is known for going to great lengths to deliver hands-on care and to counsel patients and families on palliative care.
Frederick J. Meyers, MD, MACP, executive associate dean at the University of California at Davis School of Medicine, is a leader in the field of pain management and palliative care and is known for his innovative medical education programs and mentoring. His programs are models for compassionate end-of-life care at the national level.
Gwen Carriere, ARNP, CHPN, a cancer program coordinator at North Florida Regional Medical Center in Gainesville helps cancer patients and their families connect with community resources and was instrumental in establishing a cancer resource center in her hospital.