Chapter Connections 19 Years of Excellence

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1 Chapter Connections 19 Years of Excellence O F F I C E R S : President: Heather Laurent president@onsfoxvalley.org President Elect: Susan Hunt presidentelect@onsfoxvalley.org N O R T H E R N F O X V A L L E Y C H A P T E R O F T H E O N C O L O G Y V O L U M E X X I I I S S U E 1 N U R S I N G S O C I E T Y Navigation by Carolyn Vogel, RN-C, BGS, OCN Secretary: Amy Hammond secretary@onsfoxvalley.org Treasurer: Pam Amatore treasurer@onsfoxvalley.org Directors at Large: Pat McLain, Mary Lou Sylwestrak, Kathryn McIntyre Dir-at-large@onsfoxvalley.org Membership: Debbie Hudoba membership@onsfoxvalley.org Programs: Pat Marks programs@onsfoxvalley.org Website: Marie Lindsay website@onsfoxvalley.og Nominating: Janet Wessermann nominating@onsfoxvalley.org Newsletter: Josie Smudde newsletter@onsfoxvalley.org I N S I D E T H I S I S S U E : Navigation 1,6 Message from President Smoking Cessation 3 4 Mission Article 5 6 Highlights on Members 7 Recertification 8 In writing an article about Navigation, I want to explain about the unique Model of Care at the Cancer Treatment Centers of America. CTCA is a "Destination hospital. People come from all over the United States for evaluation and treatment. Our Standard" of care is our hallmark. Our holistic manner of care is well known and sought after. In addition to state of the art radiation, surgery, and chemo, CTCA offers highly qualified practitioners of chiropractic, naturopathy, nutrition, acupuncture, spiritual and mind body therapy. These individualized services are fully integrated into each person's care plan. All services, specialists, testing, procedures, and treatment modalities are under one roof. Patients come at all stages and phases of their disease. They stay for a period of 3 to 7 days for a comprehensive evaluation before the beginning of treatment. The Nurse Navigators follow the patient from before they arrive at the facility, until they start treatment. At that time they transition to the Care Management department, for close follow up as they continue into treatment and survivorship. The Nurse Navigator assesses the patient before his or her initial appointment by phone, and the assessment is very comprehensive. The patient's medical and cancer history is obtained, as well as his current physical status, treatment status, allergies, medications, etc. The navigator also assesses the patient's concerns, goals for his visit to CTCA and possible treatment. It is reassuring to the patient to know who his navigator will be. Questions are answered, fears are allayed. When the patient arrives at the facility, he is met by his navigator. He is seen daily, or more, depending on his needs. The navigator educates the patient about his cancer, the procedures and testing, about treatment, as applicable. Each patient, of course, is very different. A navigator is an RN, with experience, empathy, skills, and the ability to problem solve and refer to appropriate departments or practitioners. At our facility, navigators are encouraged to have or obtain advanced degrees, or certifications. We are encouraged to attend conferences and educational events. Patients are assigned to navigators according to the patient's specific cancer. For example, patients with GI cancers are my responsibility, along with another nurse, as the number of GI cancer patients is high. Being disease specific allows and assures that each navigator becomes proficient and knowledgeable in her own cancer area. Administration is very supportive of the navigation department. Cancer Treatment Centers of America has been very innovative in many areas of care and treatment, including navigation. (PG 6)

2 P A G E 2 Stay Connected! Stay in Touch via our Web Site! Sign up to receive: messages of announcements and events by sending an message to website@onsfoxvalley.org. Send announcements about interesting oncology-related news, job postings and events by sending an e -mail message to website@onsfoxvalley.org (it will be posted on the web site for you.) Reminder about Scholarships Scholarships provide great learning opportunities to further your education The Northern Fox Valley Chapter is pleased to offer two grants up to $500 each to chapter members seeking financial support for education. The purpose of the grant is to reward a Professional Registered Nurse who has demonstrated commitment to the chapter and meritorious achievement in oncology nursing at the local or institutional level. Applicants will be selfnominated and may only receive the award once. Application information is available on the chapter s home page at: northernfoxval.vc.ons.org/ (It is under Home, drop down, funding request.) ONS also provides many scholarships for furthering your education, attending ONS Congress. Also available is the Sandy Purl Mentorship Scholarship. Check out onsfoundation.org for further information. From the Editor Happy Spring! Finally! Having had two eye surgeries recently, I ended up on the other side of healthcare and was so impressed how everything went. I had excellent care. With all the changes in healthcare I was not sure what to expect. If anyone would like to contribute a story to the newsletter about some of the changes you personally have been through or witnessed where you work, please contact me. In this newsletter, Carolyn Vogel has written two stories, one on patient navigation and one on her personal experience doing medical mission work. I have written a short piece on ONS Individual Learning Needs assessment and filling out your Learning Plan. I have also included a cheat sheet on the categories our chapter s 2013 programs fulfilled. Thanks Juli Aistars, Kathryn McIntyre for contributing to this newsletter! Any ideas me at: jsmudde@nch.org Josie Smudde RN, MS, OCN C H A P T E R C O N N E C T I O N S

3 V O L U M E X X I I I S S U E 1 P A G E 3 Message from your Chapter President I was very excited to have a great turnout at our first meeting of the year. Special thanks go out to Scott of Genentech for hosting at a wonderful venue for us. I am really looking forward to the new year and hope to meet expectations that our members have. Our goals are to provide CEU's, networking for area nurses and to start up new friendships. One of national s goals is to have our local chapter out in the community, so please let me know of any fundraising events you are participating in throughout the year. I also want to keep sharing any recognitions and awards that our members receive. I know there are a bunch of nurses at CTCA working on their clinical ladder. Please keep me updated on achievements so that we can recognize you! A little about me: I have been working as an outpatient oncology nurse for over 10 years. I was just promoted to Clinical Supervisor of the Barrington office of Northwest Oncology and Hematology. I am married and have two children, ages 2 and 4 that I love to brag about and share funny stories. I have been on the board of the Northern Fox Valley Chapter for 4+ years, although I took a couple years off before becoming President Elect last year. I am a past treasurer and helped Josie with the newsletter for a year. I am always trying to think of new ideas for the chapter and look to all members to help. Please feel free to contact me throughout the year at president@foxvalleyons.org Best regards, Heather Laurent Heather with her Dad I was very excited to have a great turnout at our first meeting of the year Upcoming Events Next chapter meeting: Tuesday 4/15/14 6:15 pm Role of Integrative Oncology in Patient care Location: St. Matthew Lutheran Church community Center 720 Dundee Avenue Barrington, Il Contact education unit provided This chapter meets on the third Tuesday of the month, March to November. Dinner is provided. Please rsvp to each meeting rsvp@onsfoxvalley.org Next Meeting dates: May 20, 2014, June 17, 2014 Visit the web site calendar to get all the details (description, date, time, location, map) about our chapter meetings and the continuing education programs, at northernfoxval.vc.ons.org/

4 P A G E 4 What is the Impact of CT Lung Screening on Smoking Behaviors? By Juli Aistars, APN, AOCN,TTS Healthcare professionals are generally curious and often ask Why? We are busy and don t always have time to get answers to those burning questions that come up in our practice So what s my burning question? Are current smokers more likely to quit smoking if they are concerned enough to request or agree to CT lung cancer screening? Two of my responsibilities in developing the Northwest Community Hospital (NCH) Lung Program are facilitating CT lung screening and assisting our patients and community members who wish to quit tobacco use. I work in collaboration with other nurses and physicians for outcomes such as earlier diagnosis of lung cancer and reduction of risk through smoking cessation. CT lung screening is the use of low-dose (helical) chest CT scanning to detect lung cancer in early stages, before any symptoms appear. Other than about 25% of the dose, it is similar to a CT of the chest without infusion. It is non-invasive and takes about 5 minutes to perform. The Lung Cancer Screening Trial, which compared standard chest X-ray to a low-dose CT lung scan to screen for lung cancer, found a 20% reduction in mortality for those patients diagnosed by CT versus chest X-ray. The sample size was 53,000 people, between the ages of 55 and 74, current smokers or quit within the last 15 years, with no symptoms of lung cancer. Research continues, but this was the first national, randomized, controlled trial which provided evidence to support screening with low-dose chest CT scans. It has been a controversial screening tool since its inception because there can be both harms and benefits. It takes about 320 CT lung scans to diagnose 1 early lung cancer, which is less than the number of mammograms it takes to diagnose 1 breast cancer. However, it can lead to unnecessary testing since not all lung lesions are cancer. There is some risk involved in frequent imaging or biopsies. A negative scan can also be harmful if it allows the person still smoking to feel they have dodged the bullet and can continue smoking if there is no sign of lung cancer on the scan. About 60% of the patients we have screened at NCH were currently smoking when they made their appointment for lung screening. Besides the scan, they have a basic lung function test (spirometry) in the Pulmonary Function Lab at NCH. Those who still smoke are assessed for readiness to quit and are offered individualized counseling and resources at Northwest. It is emphasized that screening will not reduce their risk of lung cancer but quitting smoking will. Lung cancer screening is a teachable moment where smoking interventions may be more effective than in the general population of smokers. Poghosyan, H, Kennedy-Sheldon, L, & Cooley, ME. The impact of computed tomography screening for lung cancer on smoking behaviors. Cancer Nursing, 2012;35(6), Hospitals Achieve Magnet Status Three of our member s hospitals, associated as places of member s employment, recently achieved Magnet status in Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Centegra Health System in McHenry, and Advocate Good Shephard Hospital in Barrington, all were granted Magnet Recognition for excellence in nursing by the American Nurses Credentialing Center (ANCC). They join a total of 37 Magnet organizations in Illinois. All three had to pass a rigorous and lengthy review process that involves widespread participation from hospital leadership and staff. The three hospitals had to meet specific standards and submit an exten- sive written document as proof to ANCC. Congratulations to all the nurses at these hospitals for making the grade and demonstrating excellence with Magnet recognition!

5 Mission Article by Carolyn Vogel RN-C, BGS, OCN What I did this past fall and how this might someday change the face of Cancer Care P A G E 5 How do I begin? Where do I start about an amazing adventure? Though I have traveled numerous times doing "medical mission work", in the fall of 2013, I was fortunate enough to spend 2 months "in the field". As a nurse and as a Christian, I see these journeys as a calling, as a means to serve but there is so much more that spurs my travel, and what comes as a result of, these travels. It allows me to escape the frantic pace, the busyness and excess of my life at home, and perhaps offer a service that only a medical person can give. As a result of many medical journeys, we have been able to form relationships with the local people and missionaries working there. The country is our neighbor, Mexico. The state is Chiapas, the southernmost state in Mexico. The town is Ocosingo. The villages are too numerous, and too remote to note. As a result of this relationship and of the dream of the Tzeltal people, we were able to raise money and built a clinic. The health care of the people in this beautiful, but rugged part of the world is paltry to say the least. In the mountains, there is no medical care whatsoever. The people, humble and gracious, live much as they did 2000 years ago. They are descendants of the Mayan Indians, who thrived here in 900 AD or so. There are 112 different Indian groups, each with its own language, customs, etc. Most have never seen a physician, have never received a medication of any sort. They have been mistreated by the Mexicans and the Mexican health care system, such as it is. I have returned here many times in the past 10 years. We bring a medical "Caravana" to treat and serve thousands of people. The Caravana this year, held in the Clinic building, saw 1212 patients over 2 weeks. What a blessing for those people! We see various maladies, that range from the serious emergency, to the mundane. Infections are common, and the result of untreated infections is apparent. Many ailments are the result of unclean water and poor sanitation. Children whose parents complain that they do not want to eat, and present with big bellies and diarrhea, suffer from worms, parasites, amoebas. We treat many of these! People must be taught to boil water, to build latrines away from the house, to keep animals outside the house, to wear shoes, and of course to Hand Wash! It is often Nursing 101 that we do here. We try in our limited way, to treat chronic diseases, like high blood pressure and diabetes. With the clinic and a permanent physician in place, we can provide the medication and necessary follow up. Who knows? Maybe someday we can provide some screening, diagnosis, and treatment for cancer. We see patients in advanced stages, and patients die quickly, if a diagnosis is even made. While cancer care is improving in the U.S., the cancer burden is high in developing countries. Breast cancer rates are rising and people are seen in advanced stages. Stomach cancer rates are rising in Latin America due to chronic gastritis and H Pylori infections. Priority is given to killer infectious diseases like TB and Malaria. It is difficult for nurses to improve detection and treatment for cancer. (continued on page 6)

6 P A G E 6 Mission Article by Carolyn Vogel RN-C, BGS, OCN continued from page 5 In Chiapas, where I served, there are essentially no cancer detection methods, nor treatment. There are no colonoscopies or mammograms. Occasionally, a government mobile unit passes to provide Pap smears. The clinic is located outside Ocosingo, a dusty, decrepit town, with lively markets and lots of bustle and trade. There is one ultrasound machine in town, but no one to read or interpret the results. People must travel 2 hours to the next biggest city. The next largest city is Tuxtla, the Capitol of Chiapas, but I hear there really is no chemo or radiation there either. I have joined the International Society of Nurses in Cancer Care. One goal is to collaborate, network, and educate nurses on how to change the face of cancer care internationally. There is a Florence Nightingale initiative for a Healthier World by 2020 that hopefully will increase global awareness and world health in general. One way is to develop international partnerships that will improve health and decrease disparities in access to health care. There is an increased interest in service trips and cross cultural Christian medical missions. There are exciting opportunities for nurses! There are international symposia, research initiatives, opportunities for travel and networking. How awesome if we could spread the resources and information that we have in our country, to those parts of the world that have neither. Editors note What a role model you are Carolyn and thank you for writing about your experience! Josie Smudde Navigation by Carolyn Vogel, RN-C, BGS, OCN continued from page 1 (Nurse Navigator at Cancer Treatment Centers of America ) There has been a full navigation department for more than 8 years. Our Patient Satisfaction rate is 97% or better. In part, this is due to the complete inclusion of Navigation in every patient s care. Navigation is a fairly recent concept, born out of the case management movement. The case management system was initiated as a result of constraints in insurance coverage. With navigation, it has been proven that patients fare better, their level of satisfaction is higher, and outcomes are improved. Navigation has to be incorporated into the cancer care continuum, to assist patients in traversing a fragmented health care system. There often is a significant lag in starting treatment in a timely manner when patients have to travel several places for testing, specialists and treatment. It has been shown that Navigators can eliminate many of these barriers. They generally are cost effective, as well. Different health care settings organize Navigators differently. They need to define where Navigation is to begin and end, depending on their own care system. Their role and duties should be clearly defined, although the very nature of navigation and the cancer patient journey make this difficult to delineate. There are opportunities for nurses to research and study the effects and outcomes on patients, when navigation is instituted. Evaluation measures can be developed, and further verification of the effectiveness of navigation on a patient, can be done. There are professional organizations: Academy of Oncology Nurse Navigators (AONN), the Oncology Nursing Society (ONS), National Coalition of Oncology Nurse Navigators (NCONN), who use evidence based practice to assist navigators to guide their patients through the journey of diagnosis, treatment, and survivorship. These organizations can share and disseminate best practices. They can foster networking and continued education, and navigators can find support. In the meantime, we continue to care, and to grow, so that our patients can benefit by receiving timely care, and comfort, as they traverse the scary, rocky road of cancer. C H A P T E R C O N N E C T I O N S

7 Highlights on Members P A G E 7 Hello, my name is Kathryn McIntyre RN and I work at Cancer Treatment Centers of America as a Nurse Navigator. I am honored to serve as Director at large for ONS Fox Valley Chapter. Service and community involvement is something that I feel strongly about. A couple of days ago I was able to give away $ split between two students who are returning to school in pursuit of a degree. I believe that we are all stewards in helping each other. I went through nursing school piecing together scholarships. Every day I would run to the mailbox and I did receive many no we are sorry letters. But every once in a while there would be a yes you have been awarded $200, $500 or $1000, it all added up. Someone made a comment to me that they should have more scholarships. We are all part of they so I created a donation based scholarship at the same time while I was struggling to pay for school. It is called the DAM scholarship. Stands for Determined Academic Moms because every day I would go to the mailbox and say I hope the d*** scholarship is here. It continues to be donation based and I am able to review and award applicants. I continue to pay it forward and built into one of the requirements is that the applicant must be involved in some type of community service that they do not directly benefit from. If we all do a little something it adds up to something huge. Recently I have been accepted into the Holistic Nursing cohort II where I work, CTCA. This is one of my passions as I am Reiki and Healing Touch certified. Self care is something that we studied in the first session. As Director at Large I plan on exploring this and hope to bring a valuable event to my colleagues at ONS. Every ONS meeting I come to I gain something hopefully I can give something back. Kathryn McIntyre RN, OCN The Northern Fox Valley Chapter of the Oncology Nursing Society has the following goals: Help meet the educational needs of professionals working in oncology. Provide opportunities for peer support, networking and socializing. Provide a forum which supports current advances in oncology clinical practice and research. Membership Full membership is open to any RN working in or interested in Oncology Nursing. Full membership is also open to interested nursing students who are enrolled full time in an RN program. Associate membership is open to other healthcare professionals including LPNs, Pharmacists, Physicians, Social Workers, and Pharmaceutical Representatives. In order to become a chapter member, one must be a member of the national ONS.

8 Page 8 Recertification by Josie Smudde RN, MS, BC, OCN To recertify for OCN in 2016 or later, you must take the Individual Learning Needs Assessment (ILNA) online. It takes about 2 hours and cannot be saved but must be completed in one sitting. From the results, you will find out what areas you need to get your points from the 11 categories of content area (see below). You will need between 25 and 100 points, most nurses average about 40 based on how you did on the ILNA, but you need to pay attention what content area is required. You can earn ILNA points by completing your choice of CEU (from an acceptable provide like ANCC), CME, Academic education, Publications and or Presentations. Each activity completed is then logged into the Learning Builder. Do not use ONC PRO! Many resources are available on ONS website. Please see examples below from our list of 2013 chapter meetings. NFVONS Chapter Meetings 2013 Content Area 3/19/13 Grief or 10 4/46/13 Wound and Skin Care in the Oncology Patient 5 5/21/13 Adherence with Oral Oncology Medications: Implication 4 for Nurses 6/18/13 Palliative Care 10 7/23/13 Management of oral Mucositis 5 8/20/13 What oncology nurses need to know about the other 2 hereditary breast cancer syndromes 9/7/13 Meeting the Educational Needs of the Oncology Patient 9 10/15/13 Small cell and Non small cell lung cancer 4 11/19/13 Multi Gene Panels NO CEU Content Area: 1. Health Promotion and Disease Prevention 2. Screening, Early Detection and Diagnosis 3 Scientific basis for Practice including Research 4 Cancer Treatment Modalities 5 Symptom Management 6 Psychosocial Dimensions of Care 7 Oncologic emergencies 8 Sexuality 9 Survivorship 10 End of Life Care 11 Professional Performance