Beth Faiman, PhD, APRN-BC, AOCN, is an author, presenter, and educator on the topics of multiple myeloma, general cancer diagnosis and treatment, and management of skeletal and other cancer-related complications. She is currently a Nurse Practitioner, Department of Hematologic Oncology and Blood Disorders, Taussig Cancer Center, Cleveland Clinic, OH; a member of the Nurse Leadership Board, International Myeloma Foundation; Associate Editor, ASH Clinical News; and the Editor-in-Chief of The Oncology Nurse-APN/PA (TON).
TON spoke with Dr Faiman about her role at the Taussig Cancer Center, her research interests, and her concerns regarding burnout among oncology nurses.
TON: What is your role at the Cleveland Clinic?
Beth Faiman: My primary role is in the diagnosis and management of patients with multiple myeloma, amyloidosis, and other hematologic disorders.
I am pleased to report that I work at the number 1 cancer center in Ohio, and the number 2 hospital in the United States, according to the U.S. News & World Report ranking. This status allows us to attract cases that are difficult to diagnose. It is very rewarding when someone comes to you with an uncommon illness and you are able to improve their health by working with the multidisciplinary team. Each person I work with in Taussig seems to care about the well-being of the patients, from the check-in staff, to the clinical or study nurses, scheduling team, social workers, physicians, or our institutional leadership—which is very unique.
These patients have often been seen by several other doctors before they are referred to us. At times, I see patients for their initial consultation, and then help manage their illness. They may live far away, and, if so, I work with their local physicians. Patients will come back to see me or the physician every 6 or 12 months.
I am fortunate to work as part of a multidisciplinary team in a patient-centered culture. In fact, we have a whole department, Patient Experience, dedicated to collecting surveys from patients. We then share these survey data with practitioners to make sure that we are achieving patient satisfaction with our care.
Having completed a PhD in 2014, the further education allows me to conduct clinical research. My research focus is in the areas of symptom assessment and management, as well as quality of life.
TON: What areas of work at the Taussig Cancer Center do you find most promising?
Dr Faiman: At the Taussig Cancer Center, we are conducting clinical trials in patients with many cancers, but I am most excited about the trials in patients with amyloidosis, which is an extremely rare condition. Our amyloidosis partners work with other specialists in the management of amyloidosis to provide comprehensive care. Early clinical trials with a monoclonal antibody called NEOD-001 are particularly promising; this drug represents the first attempt to eliminate built-up proteins (ie, amyloids) around the myocardium and possibly in other areas of the body.
TON: What are some challenges that oncology nurses faced in the past year?
Dr Faiman: Oncology nurse burnout is a big problem for older and younger nurses alike. Younger nurses often dive in and work for long hours with patients who are dying. We have people leaving the field because of burnout. My institution and other cancer centers are working to combat nurse burnout with support groups, retreats, and social occasions to celebrate our successes. I am lucky that my job is diverse and involves clinical care and research, which allows flexibility in clinic hours, and, as a result, does not leave me feeling burned out.
In addition to burnout, it is a challenge for oncology nurses in a busy oncology clinic to stay on top of all of the new drug approvals. We need more educational opportunities and funding to increase nurse knowledge about new oncology drugs.
To give you some idea of the scope of this problem, 15 new drugs have been approved for multiple myeloma since 2000, and this does not include the numerous drug approvals for other indications.
TON: Has the current opioid crisis affected the approach to pain management at your center?
Dr Faiman: The opioid epidemic affects people of every race, age, and income level, including those with and without cancer. More than 52,000 people died of drug overdoses in 2015, a more than 2-fold increase since 2002.
At the Cleveland Clinic, we have convened a panel to discuss this crisis. In June 2017, the Clinic began internal efforts and increased education for patients and prescribers of opioids. Our institution has implemented a monthly educational series for safe prescribing of opioids, and a reporting system for the safe dispensing of opioids. We have grand rounds on patient diversion strategies, and are careful about making sure the pain is cancer-related before we prescribe opioids. We have contracts with patients to make sure that they are getting appropriate medications, and we routinely evaluate pain and opioid use.
TON: What areas related to cancer treatment need more attention in 2018?
Dr Faiman: Two CAR T-cell therapies have recently been approved for the treatment of leukemia and lymphoma, respectively, and more approvals will probably follow. In general, these are promising treatments that appear to cure previously incurable cancers—however, we still need longer follow-ups and better education about how to use these drugs and manage their associated adverse events.
In addition, we need more research on amyloidosis and rare cancers and the effects of newer drugs on these diseases.
TON: What are you excited about in the field of oncology right now?
Dr Faiman: I am excited about the new drug approvals for multiple myeloma and amyloidosis, and about CAR T-cell therapies.
Multiple myeloma represents an area in which nurses can educate patients and colleagues about how new drugs work and how they should be used. These new therapies have led to increased survival in patients with the disease, which is very encouraging.
I am also excited about the opportunity for further clinical trials in supportive care and symptom management for amyloidosis and other hematologic cancers.
TON: What is the biggest reward related to your job?
Dr Faiman: One of my biggest rewards is working with patients who have chronic disorders and helping them to live longer and with a better quality of life.
Small actions can make a big difference to patients. For example, I try to help my patients with financial assistance, as there have been some patients who had to pay extra out-of-pocket costs for diagnostic tests, and in turn had to cut down on their electricity use at home. Often, patients do not want to tell their physicians that they are having financial stresses. I always ask my patients about their insurance coverage, and then try to find ways to help them. Sometimes, just being accessible when patients have questions can make a difference and ease their minds. I am fortunate to be able to help.