The theme of the 2015 Nursing Annual Report, “Our Journey Toward Excellence,” fits well with changes occurring at Norton Cancer Institute. One significant change is the development of the nurse clinician role in an oncology outpatient setting. The journey has brought challenges, as each new nurse clinician has not had a defined model to follow, and as a result, each role is noticeably different. The goal at Norton Cancer Institute is to discover the most meaningful work process and standardize the nurse clinician role.
The primary focus of a registered nurse is patients and their families. When defining the work process for a Norton Cancer Institute nurse clinician, the question is, “How does the nurse clinician best serve patients and families?”
Patients and families need a primary care coordinator to navigate their oncology care. Having a nurse clinician as one point of contact ensures patients and families that someone is in control of their care when often patients and families feel so out of control. Nurse clinicians answer questions, provide education and facilitate patients’ multiple care needs. Nurse clinicians prepare records and assess patients prior to physician visits, thus enabling physicians to spend more quality time with patients and families. Additionally, nurse clinicians address concerns from patients through telephone calls, arrange for ordered testing and verify schedules.
Norton Cancer Institute has expanded from one nurse clinician, Laura L. Cummins, R.N., OCN, who has been in the role for 10 years, to eight nurse clinicians. Cheryl L. Martin, APRN, vice president, patient care services, and chief nursing officer, Norton Cancer Institute, is a staunch advocate for the role.
“Our oncology nurse clinicians are the center of activity between our providers, patients and families. The nurse clinician is focused on coordination and collaboration, which results in greater satisfaction for patients and providers,” Martin said.
Patrick Williams, M.D., medical director, Norton Cancer Institute, said the nurse clinician “contributes greatly to the efficiency of my care team. I can see more patients and complete my documentation in a timelier manner.”
Nurse clinician Sandy Stencavage, R.N., MSN, OCN, describes the nurse clinician role as one that “allows autonomy to provide a wider scope of services for the patient.”
And according to nurse clinician Margaret T. Whelan, R.N., BSN, OCN, the role is “challenging and rewarding and there is something new to learn every day.”
Norton Cancer Institute has 10 oncology practice locations: Downtown; Pavilion; Norton Audubon Hospital campus; Norton Healthcare – St. Matthews campus; Norton Brownsboro Hospital campus; Shelbyville, Kentucky; Shepherdsville, Kentucky; Corydon, Jeffersonville and Scottsburg, Indiana; as well as the Multidisciplinary Clinics at Norton Cancer Institute – Downtown and three radiation therapy centers. Three locations currently have nurse clinicians on staff.
Norton Cancer Institute nurse clinicians have extensive experience in oncology nursing and are expected to maintain or obtain oncology nursing certification (OCN). We look forward to continuing our journey to excellence by developing the nurse clinician role to its full potential.
Norton Cancer Institute nurse clinicians
Audubon: Bobbie L. Hughes, R.N.; Theresa A. Dyar, R.N.
Downtown/Pavilion: Margaret T. Whelan, R.N., BSN, OCN; Meghan M. Workman, R.N.
St. Matthews: Laura L. Cummins, R.N., OCN; Jaime M. Bradley-Miller, R.N.; Sandy M. Stencavage, R.N., MSN, OCN; and Christine B. Siebel, R.N.
Laura Cummins, R.N., OCN, explains a therapy program to a patient.
The Kosair Children’s Medical Center – Brownsboro Outpatient Lab is a full-service laboratory serving residents throughout Louisville and the surrounding areas. It is currently the only pediatric-specific outpatient service facility of its kind in Kentucky. When the facility was designed, the planners felt that the outpatient services process could productively flow through our 24-hour Pediatric Emergency Department.
However, over the past five years since the medical center opened in May 2010, our facility’s overall volume has grown substantially. In addition, the lab has repeatedly proved its success with “best in class” results and increasing numbers. Along with these successes came flow and efficiency disruptions in the Outpatient Lab and Pediatric Emergency Department.
“As our numbers were growing, patients and families were frequently experiencing much longer wait times,” said Debra Taylor, R.N.
In May 2015, leaders felt it vital to re-evaluate the process of conducting outpatient lab services within our building. We set our goals to minimize patient wait times and disruptions, facilitate efficient and productive flow and improve overall patient experience and satisfaction. Within this process and productivity analysis, leaders developed a plan to make better use of available space on the ground floor. With the help of several key players, including Engineering, Laboratory, Diagnostic Imaging and the Pediatric Emergency Department, planning and renovating began and two dedicated outpatient lab rooms were developed.
“Since the change, I feel our patients and families are much more satisfied. We get them in, we get them seen and back out the door smoothly,” Taylor said.
This journey has proved the importance and benefit of reassessing current processes to better accommodate our growing patient volumes. Since the Outpatient Lab renovation, our treatment populations for growth hormone stimulation and Remicade infusion have nearly tripled, and the department has seen a substantial increase in the number of new or returning patients.
The changes made to the Outpatient Lab have added an ongoing benefit to our facility and helped Kosair Children’s Medical Center – Brownsboro continue the journey to excellence and providing satisfactory care to our patients every day.
Lisa Long, R.N., (left) and Lisa Moss, R.N., work closely together in the outpatient laboratory, the only pediatric-specific outpatient service facility of its kind in Kentucky.
From left, Debbie White, BSN, CPN, CPON, RN-BC; Pat Welsh, MSN, RN-BC; and Mary Beth Wright, BSN, RN-BC
Faith community nursing is the specialized practice of professional nursing that focuses on intentional care of the spirit as part of the process of promoting wholistic health and preventing or minimizing illness in a faith community. A faith community nurse follows practices set forth in the book “Faith Community Nursing: Scope and Standards of Practice” published by the American Nurses Association. A faith community nurse possesses not only competence as a registered nurse, but also an understanding of a faith community’s traditions, and uses both to integrate care of mind, body and spirit. As trends in health care continue to focus on maximizing wellness, this specialty will continue to grow.
The Office of Church and Health Ministries works with a network of churches and other faith communities to assist them in ministering to members at every stage of their lives. The office is honored to announce an educational partnership with the International Parish Nurse Resource Center. This partnership enables staff to teach the “Foundations of Faith Community Nursing” curriculum, a course that prepares registered nurses for the specialty practice of faith community nursing. The curriculum weaves spirituality throughout each module and includes topics such as spiritual care; prayer; self-care; ethical issues; behavioral health; health promotion; care coordination; and handling violence, suffering and grief.
Board certification by portfolio for the faith community nurse specialty is available online through the American Nurses Credentialing Center. A cohort of experienced faith community nurses from the Norton Healthcare Office of Church and Health Ministries network, many of whom are Norton Healthcare employees, is pursuing this new certification.
Faith community nurses can have an important impact on improving health literacy, disease and injury prevention, and enhancing the health resilience of individuals and families. If you are called to faith community nursing, contact the Office of Church and Health Ministries at (502) 629-2700 for more information.