HAWAII ONS NEWS A Newsletter for the Members of the Hawai i (Oahu) Oncology Nursing Society Chapter Winter 2009 Welcoming... Francisco Conde, RN, PhD, AOCN. as the new Hawaii ONS President PRESIDENT S MESSAGE Francisco Conde, RN, PhD, AOCN I am privileged to serve as President of our chapter. During these next two years, my goals are to build the capacity of oncology nurses, at the staff and advance practice nurse (APRN) levels, promote oncology nursing research, and outreach to members living in the neighbor islands. As a way to increase the number of oncology nurses, my plan is to re-establish the nursing student mentorship program. This is a one-year program in which nursing My trip to the ONS Institute of Learning (IOL) in Seattle, on November 14 th, was an awesome experience. It provided not only a wide range of learning opportunities, it also gave me an opportunity to network with colleagues new and old. My home town of Seattle continues to offer great dining experiences, not to mention the charm of Pike Place Market, the Space Needle and of course, the downtown shopping! students, entering their last year of nursing school will be asked to apply to the mentorship program. If selected by the program s committee, each student will be partnered with an experienced oncology nurse mentor. Together, they will work on various oncology-related activities and projects, such as assisting with our annual ONS conference and attendi ng community events and program dinners. Students will also be able to observe what oncology nurses While there is a popular focus on the importance of ECO-friendly in our daily lives and national patient safety goals in our professional lives, hazardous drug exposure and personal safety can get pushed onto the backburner at work. Safe practice regarding hazardous drug handling and administration in the outpatient setting may not be a sexy as saving the planet, but nurses need to continue to protect themselves. With so much focus on the do (e.g. chemotherapy administration, teaching, research). Students who participate and complete this program will hopefully enter oncology nursing upon graduation. As a staff nurse, I have listened to cancer patients living in rural areas and the neighbor islands of Oahu who expressed difficulty with receiving adequate cancer care and treatment. They shared their multiple challenges, such as lack of immediate services, costs and amount of travel time to Honolulu (cont on page 2) CHEMOTHERAPY SAFE HANDLING Suzanne Ditter, RN, BSN, OCN patients and the planet, who is going to look out for us? Chemotherapeutic agents can be genotoxic, carcinogenic, teratogenic as well as toxic to reproductive and other organs. There is a constant risk for exposure through inhalation, ingestion, dermal exposure and injections. Known side effects can include an increased incidence of infertility, miscarriage and menstrual dysfunction. Acute exposure can lead to dizziness, headache, (cont on page 6)
With limited number of oncologists practicing in the rural areas and the neighbor islands, there is a growing need for oncology APRNs in these areas. PRESIDENT S MESSAGE to receive cancer treatments, and being away from their families and friends while undergoing therapy in Oahu. With a limited number of oncologists practicing in the rural areas and the neighbor islands, there is a growing need for oncology APRNs in these areas. To increase the number of oncology APRNs, we will work with local universities to establish oncology NP and CNS programs. Currently, there are none offered in the state of Hawaii.. cont To promote oncology nursing research, we will look into the possibility of our chapter offering a research grant in the amount of $1,000 to $2,000 per year to research investigators and other scholarly activities, such as journal clubs. Lastly, we have to reach out to members who live in our neighbor islands, so that they too can enjoy the programs we offer here on Oahu. One solution may be the use of distance. learning technologies, similar to those used in colleges and universities who offer online courses. Program presentations may be broadcasted live in other areas through these technologies. Costs and logistics will need to be investigated. It is my honor to serve as your President. These are tremendous and important goals over the next 2 years. The Board and I can not do it alone. We will need your help and together we can achieve them! THE FALL INSTITUTE Alison Matsuo, RN, BSN, OCN I had the opportunity to attend the ONS Fall Institute in Seattle this year and it was wonderful. I was able to network with other nurses from across the country and also attend some wonderful lectures. The one particular lecture that I found very interesting was on Cancer Rehabilitation. This is a program that is from a facility in Colorado and the goal is that every cancer patient that is on treatment is assessed for rehab services, i.e. PT, OT, dietary needs, Social Services, etc It is a standard part of the treatment plan. It really reminded me of the Cardiac Rehab services that all CABG patients go through. The goal of the program is to start the patient prior to starting chemotherapy and not later than starting the second cycle. They have found that starting PT decreases fatigue and also helps with neuropathies. They are using massage therapy to also decrease neuropathies. The rehab program is tailored specifically to patient needs. The medical facility has worked with the insurance companies and is receiving reimbursement for the services. As oncology nurses, we are always seeking ways to improve the cancer journey. I am really hoping to pursue this model for our cancer program at the Queen s Medical Center. We have many of the components in place but I would like to have a more coordinated process to ensure that we are optimizing our resources to meet the needs of our patients. I would encourage all of our ONS members to attend a National Conference. Page 2
A Grandfather s Anguish The call came early in the morning. My wife was calling for what I thought was an update on her visit to our grandkids and her return to Hawaii. But it was not. It was to tell me that our eight year old granddaughter, our first, was transferred by ambulance from a hospital in the suburds to Childrens Memorial Hospital in Chicago. Then the dreaded words: our granddaughter has leukemia. The world changed at that moment; priorities readjusted and a multitude of questions arose beyond just why? When I got off the phone, I sat alone in the office with a flood of thoughts along with a huge flood of emotion that I had never felt ~ uncontrolled tears. I needed information, so I contacted a colleague who heads oncology. She provided me with a whole bunch of facts, but also great advice. This was going to be a long process which would impact the entire family. She also urged me to have my daughter call her so they could talk Mom to Mom, as her grown daughter also had leukemia when she was a child. What an unselfish offer of help! Fortunately, I was able to get to Chicago quickly through a friend who offered me her companion passes for travel. When I arrived at the hospital, I received more disturbing news. My granddaughter had a rare chromosome factor called a Phildelphia Chromosone, which could reduce her survival chances from 90% to 50-60%. Such a chromosome is found in only 2-10% of children. She would need a bone marrow transplant. Then I saw my granddaughter and she looked fine. She said HI, Grampie as if nothing was amiss. She knows she has cancer, but what she understands I m not sure. Every time the nurses and doctors came in, she listened very attentively to what they had to say. When they told her she would lose her hair and they gave her a hat, she was upset, but smiled when I put it on her head. Not sure if that smile was to calm her or me. Was she telling me to hang in there. I ll get through this, Grampie? When Angelina returned to the hospital for her chemo treatments, it was hard for me to see other kids with their hats, knowing this was my granddaughter s future, so she could have a future. The nurses at the hospital were a special group, as all nurses really are. How can they deal with sick children so well is beyond me. They were positive, professional and focused completely on my granddaughter. They responded to her every need and concern. When Angelina s five year old brother had to be tested as a potential bone marrow donor, he was a challenge. Although it took four nurses and me to pin him down, they never showed any frustration and rewarded him with a lollipop for being so brave. Oddly, once the needle was inserted, he was calm. Guess even with a child, it s the anticipation. (cont on page 6) Page 3
O N S 2 0 0 8 Christmas Party Members were greeted by Aleta Flor and Jean Imler at the sign-in table. Debbie Gaines, Debbie Gallipeau, and Kanani Oberholzer Lori Conley, Jean Quigley, Kristen Thompson, Joyce Wong, Jessie Fonseca, and Darren Ishii Paula Imaoka, Ann Kleminski, Faith Inoshita, and Sheryl Ikeda Kanani Chan, Heidi Nixon, Meagan Mulligan, and Juval Tomas Page 4
Mary Nakasuji, Noelani Ajime, and Shun Chan Cindy Kaneshiro and Christine Radcliffe Back: Shun Chan, Roxanne Yanke, and Lauren Brown Front: Kristen Tome, and Elin Tabuyo Brenda Keith, Christine Radcliffe, Jean Imler, Aleta Flor, Cindy Kaneshiro, Anna Zimmerman, and Ryan Iwamoto Page 5
Having institution guidelines are important, but guidelines will not protect us if no one follows them! CHEMOTHERAPY SAFE HANDLING cont contact dermatitis and eczema. So, how do we protect ourselves? Personnel Protective Equipment (PPE), including gloves, gown, goggles and mask are all devices we can be use to help prevent exposure to hazardous chemicals. Other work environments practices that help reduce exposure are using Luer-lock or other needless systems, priming IV tubing with NS or dextrose, good hand washing, and changing sharps container when ¾ full. In my outpatient clinic setting we had an inpatient nurse helping administer chemotherapy. She did not follow her usual practice of gowning during admin-istration of chemo, and a leak in the chemo bag caused a potentially serious exposure. This is just one example that accidents do happen! Having institution guidelines are important, but guidelines will not protect us if no one follows them! As oncology nurses we must be aware and educated about long-term exposure, potency and toxicity to chemotherapy. ONS and NIOSH have recommendations for maintaining safe workplaces and handling hazardous medications such as spill response, waste disposal and decontamination. Remember, wearing the blue chemo gown, funky colored gloves, and protective glasses may not be sexy, but neither is being injured on the job or suffering a damaging exposure. Nurse, protect thyself!! (Contributor to the composure of this article, Mike Meyer, RN, BSN) A Grandfather s Anguish cont At home now, Angelina, is subject to a huge display of medication which all have specific amounts of dosages and times to administer. She takes them all like a trooper even though there is some discomfort at times. Some of the medication she receives through a PICC in her arm, others orally. My daughter will be going to Angelina s school to explain to her classmateswhat leukemia is and to hopefully let her classmates know they can t catch it. My granddaughter s life has changed as has it for all of us around her. I just hope she gets to be a kid again. I held Angelina the day she was born and was speechless. When I held and kissed her when I left her in Chicago, I was again speechless. Grandkids can do that to us Grampies. When she was born, I wanted to be there for her wedding. Now I just want her to live and be a survivor. We may need to seek a bone marrow donor from the National Registry for her transplant, so if we come calling, please answer for Angelina. Hug you kids a bit tighter for they are our most preciouspossession and things can change when we least expect it. Just ask me. Submitted by Alison Matsuo, RN, BSN, OCN. Page 6
N e w s F r o m N A T I O N A L ONS 34th Annual Congress Registration Now Open Get ready to head to San Antonio, TX, April 30-May 3 to get the best oncology education around at the ONS 34th Annual Congress. Plus, you'll get to celebrate your profession and the difference you make in the lives of patients and their families. Make your plans now to connect to 5,000 of your colleagues, get the latest cancer-care information, and enhance your career. Save $100 when you register by March 19! http://ons.org/meetings/congress09/register.shtml Order Your Copy of the New Edition of the Chemotherapy Guidelines! Available in mid-february, you can now order your copy of Chemotherapy and Biotherapy Guidelines and Recommendations for Practice (3 rd Ed). This latest edition of this best-selling resource has been revised and updated to represent the latest information in your specialty. http://esource.ons.org/productdetails.aspx?sku=inpu0590 New Resource Available from ONS! Look for two new books from ONS! The Advanced Oncology Nursing Certification Review and Resource Manual can be used as both a study guide for advanced oncology nursing certificationand a clinical resource. http://esource.ons.org/productdetails.aspx?sku=inpu0581 New! Oncology Clinical Nurse Specialist Competencies This document outlines specialty entry-level competencies for Oncology Clinical Nurse Specialists (CNSs) who care for adult and late adolescent patients throughout the continuum of cancer care. http://www.ons.org/clinical/professional/qualitycancer/documents/cnscomps.pdf Page 7
2009 CHAPTER OFFICERS & BOARD MEMBERS President Francisco Conde, RN, PhD, AOCN fconde@hawaii.edu Treasurer Jeanne Foster, RN, BSN, OCN j.foster@kuakini.org Program Chair Alison Matsuo, RN, BSN, OCN amatsuo@queens.org Board Members Sharon Shigemasa, RN, MSN sharon@crch.hawaii.edu President-elect Cindy Kaneshiro, RN, OCN c.kaneshiro@kuakini.org Past President Jacqui Mitchell, APRN, MS, AOCNS mitchellj012@hawaii.rr.com n Newly appointed Membership Chair Dorothy Coleman, RN, MSN dorothy@crch.hawaii.edu Nominations Chair ~currently vacant~ Co-Secretaries Chris Radcliffe, RN, BSN cradcliffe@queens.org Lori Conley RN, MS, CPON, FNP conleylori@hotmail.com Paula Imaoka, RN, OCN imaokap@hawaii.rr.com Newsletter Editor Anna Zimmerman, RN, BSN adzimmerman@hawaii.rr.com Webmaster Stephanie Guy, RN, BSN, OCN StephanieGuyIV@gmail.com MESSAGE FROM THE EDITOR Anna Zimmerman, RN, BSN Aloha, my name is Anna Zimmerman, and I have the pleasure of taking over for Christa Braun-Inglis as newsletter editor. Thank you for your patience as I transition into this new position. I would like to take this opportunity to send out a big MAHALO to Christa for all her hard work and wish her all the best in her future endeavors. Please feel free to submit articles, information to pass on, and most of all suggestions for future newsletters. Mahalo HAWAII ONS NEWS 2115 ALA WAI BLVD ~ Ste 404 HONOLULU, HI 96815