ONCOLOGY NURSES OFTEN CARE FOR THE SICKEST OF THE SICK, WHICH CAN BE STRESSFUL AND EMOTIONALLY DIFFICULT. BUT EVERY NURSE WHO WORKS WITH CANCER PATIENTS SHARES THE COMMON DENOMINATOR OF PASSIONATE CARE FOR PATIENTS, SAYS CHRISTINE RIMKUS, RN, AN ONCOLOGY CLINICAL NURSE SPECIALIST AT THE ALVIN J. SITEMAN CANCER CENTER AT BARNES-JEWISH HOSPITAL AND WASHINGTON UNIVERSITY SCHOOL OF MEDICINE.

“As an oncology nurse, you’re usually working with specific patients for a long time and form relationships with them. I’m always humbled by what I learn and gain from my patients. The patients are what I enjoy most about my job.”

Rimkus didn’t begin her career wanting to work with cancer patients. “Now I wouldn’t think of going anywhere else,” she says. “The field of oncology tends to pick you. Oncology care is challenging, and there are always new things to learn. For example, three to five new drugs are released every year with varying routes of delivery. We have to be on top of that and learn everything about these new medications.”

UNIFYING THE TEAM TO IMPROVE CARE

Oncology nurses at Siteman receive extensive training beyond nursing school. After they become registered nurses, they can choose from numerous oncology classes as they further their skills. Nurses also must be trained to administer chemotherapy and infusion therapy.

Barnes-Jewish Hospital and Siteman oncology care spans five floors and includes gynecologic oncology, medical oncology, stem cell transplant, radiation oncology, inpatient nursing, a breast cancer outpatient area and the 24/7 Cancer Care Clinic. This level of care requires more than 300 oncology nurses.

To unify oncology nursing team care, Rimkus developed a Clinical Practice Review Committee nearly three years ago that represents nurses from all areas of oncology care.

The committee looked at best care practices and determined how they can best use these guidelines to improve patient care. “Since cancer patients generally navigate the whole system at Siteman and Barnes-Jewish, we’ve made sure all the same practice guidelines are in place across the spectrum,” Rimkus says. “Our goal is to make a big place seem smaller both for patients and for nurses.”

This effort also fosters better communication that results in more coordinated, seamless patient care. “We encourage inpatient and outpatient oncology nurses to know each other because we work with many of the same patients,” Rimkus says. “We’re kind of a tag team of oncology nurses.”

PREVENTING COMPASSION FATIGUE

Oncology nurses often develop relationships with their patients because they see them so frequently. “It can be extremely hard on nurses when their patients die,” Rimkus says. “This can lead to stress, burnout and compassion fatigue that ultimately affects patient care. That’s why it’s important that we help these nurses through an intervention program.” Compassion fatigue is a relatively new term described as the “cost of caring” for others in emotional pain.

The Barnes-Jewish Hospital Foundation recently funded a program that incorporates tools to reduce compassion fatigue and stress for oncology nurses. Staff members from Barnes-Jewish Hospital will be trained as facilitators to continue delivery of the program into the future.

Research has demonstrated a correlation between compassion fatigue and burnout and patient satisfaction. “Throughout their cancer treatment, patients need the nurse’s physical and emotional strength and empathy,” Rimkus says. “If a nurse is overwhelmed and disengages, the patient knows it. Intervention will help both patients and nurses.”

SUPPORTING EDUCATION AND EMOTIONS OF ONCOLOGY NURSES FOR BETTER PATIENT CARE

Oncology nursing is demanding. Nurses must stay abreast of the latest treatments and must deal with the emotional stress that can occur when caring for very ill patients.  The Barnes-Jewish Hospital Foundation helps with this through donor gifts in several areas.

For example, the Oncology Nurse Professional Development Fund supports education for oncology nurses, and oncology certification for clinical and advanced practice nurses. In the past year, this funding enabled nurses to attend professional meetings to learn more about solid tumors, stem cell transplant, palliative care and survivorship. Nurses who attended shared this education with their colleagues.

Several nurses were also able to present at national meetings. “Participation at these national meetings is a valuable opportunity to share knowledge and expands oncology nurses’ expertise by learning from other institutions,” says Chris Rimkus, RN, oncology clinical nurse specialist.

She adds that having more educated nurses translates to better patient care. “Today, patients have access to more information and are more knowledgeable than ever. Nurses usually spend more time with patients than doctors can, and patients often ask nurses questions. With continuing education, our nurses are able to answer many of these complex questions about thelatest treatments.”

To give to oncology nurses, please call David Sandler at 314- 286-0599, e-mail

[email protected] or visit www.givingbarnesjewish.org.