The Cedars-Sinai Blood & Marrow Transplant Program, Los Angeles, CA, has performed more than 2200 stem-cell and bone marrow transplants since its inception in 1990. The program is accredited for autologous and allogeneic transplant by the Foundation for the Accreditation of Cellular Therapy and is a National Marrow Donor Program/Be The Match Transplant Center. It has also been recognized as a Blue Cross Center of Medical Excellence, a designation awarded to select hospitals that meet evidence-based standards and provide high-quality care for patients.
In this issue of The Oncology Nurse-APN/PA (TON), we feature an interview with Sandra Rome, RN, MN, AOCN, Hematology/Oncology/BMT Clinical Nurse Specialist at Cedars-Sinai Medical Center. Ms Rome discusses her long-standing commitment to caring for patients with cancer, her roles and responsibilities as part of the Blood & Marrow Transplant team, a few of the exciting advances in the management of patients who must undergo transplantation, and what she feels are some of the ongoing challenges—as well as the rewards—of her profession.
TON: Can you tell us about your career path and what led you to become a clinical nurse specialist with a focus on hematology/oncology?
Ms Rome: I knew since I was in high school that I wanted to pursue a career in healthcare. When I became a student at the University of California, Los Angeles (UCLA), I felt drawn to enter the nursing program. While I was still an undergraduate, I became a volunteer at UCLA and was assigned to the hematology/surgical oncology unit. I worked very closely with the nurses on that unit and developed a strong sense of admiration for what they did. I felt that the work was very rewarding, and I enjoyed the interaction with the patients.
After graduating from nursing school, I was fortunate enough to be hired on the same unit where I had volunteered, and subsequently went on to obtain my master’s degree in oncology nursing.
TON: Can you describe for us your role as a clinical nurse specialist in the Blood & Marrow Transplant Program at Cedars-Sinai?
Ms Rome: Certainly. I am involved in several aspects of the program, such as providing direct care to patients, mentoring and teaching nurses on our unit, and participating in research initiatives. As a member of Cedars-Sinai Medical Center’s Institutional Review Board, I also provide assistance in the implementation of research protocols and review continuing studies. In addition, there are a variety of administrative duties I perform as needed.
TON: What are some of the advances in transplantation that you feel particularly excited about at your center?
Ms Rome: We are one of the few centers in the United States that treats Jehovah’s Witness patients, which means that we can offer these patients bloodless autologous stem-cell transplants, which is a very valuable service. We also perform haploidentical transplants, also known as half-matched transplants, for patients who are unable to find a closely matched donor. Our ability to offer this option broadens the pool of potential donors, which is extremely important because it expedites the transplant process, which translates to better outcomes for our patients. I am also excited to see how newer CAR T-cell therapies can be integrated into treatment.
TON: What would you say are some of the current challenges related to your job?
Ms Rome: I think that cost containment is an ongoing issue that we must contend with, because oncology treatments are expensive for patients and their families. We are continually trying to find ways to expedite the transplant process, while keeping the highest standards of care and safety for our patients, so that they can return home and continue with their lives. In addition, given the emergence of so many novel therapies, we are always striving to stay current on the most effective ways to use these treatments and implement necessary interventions to combat any treatment-related toxicities.
TON: What do you find most rewarding about your work as a clinical nurse specialist?
Ms Rome: There are 2 things that immediately come to mind. It gives me tremendous satisfaction to be directly involved in patient care. I find it so rewarding to be at our patients’ bedsides, where I can offer support to them as well as to their families. The transplant process is very complex and can be challenging to them on many levels—physically, financially, mentally, and emotionally. I do my best to use my skills and knowledge to help them through the process.
I also find it very rewarding to serve as a mentor to the dedicated nurses at Cedars-Sinai; to work alongside them and help them to succeed in their day-to-day work of caring for our patients. I love being a part of an exquisite team!