Rutgers Cancer Institute of New Jersey

TON July 2015 Vol 8 No 4

The Rutgers Cancer Institute of New Jersey (CINJ) is the only National Cancer Institute (NCI)-designated comprehensive cancer center in the state of New Jersey. CINJ is dedicated to improving the prevention, detection, treatment, and care of patients with cancer, through the transformation of laboratory discoveries into clinical practice. CINJ delivers advanced comprehensive care to adults and children, including access to clinical trials, and conducts cutting-edge cancer research.

The NCI designation is awarded on a competitive basis to only 41 such centers nationwide and is granted to institutions characterized by scientific excellence. To gain a “comprehensive” designation, the highest ranking given by the NCI, a center must meet rigorous criteria in cancer care, research, prevention, and education.

The leadership at CINJ includes internationally recognized distinguished researchers and physicians who meet with each other regularly to exchange information and ensure that laboratory discoveries are refined and applied to clinical care as quickly as possible, that clinical observations reach laboratory researchers on a continuing basis, and that prevention strategies are interwoven with all research programs.

The Oncology Nurse-APN/PA spoke with Carla Schaefer, BSN, RN, OCN, Nurse Manager in the Adult Treatment Area of the Rutgers Cancer Institute of New Jersey, New Brunswick, about her responsibilities.

What is your role at CINJ?
Carla Schaefer (CS):
I am a nurse manager in the adult infusion area, overseeing the day-to-day operations. I supervise 20 nurses, in addition to medical health technicians and a unit clerk. I also oversee our nurse helpline, which is staffed by 4 nurses during business hours (weekdays 8:30 am to 5:00 pm). After business hours, the answering service puts callers in touch with the nurses. I am also responsible for hiring new people to staff the unit and the helpline.

What would you say is your biggest challenge?
CS:
Coordinating everything that goes on in the infusion center and the helpline. We have between 70 and 90 patients per day who get chemotherapy for most types of cancers as well as patients on clinical trials. We also see patients pre and post bone marrow transplantation. The nurses in the infusion center work in multidisciplinary teams, with a pharmacist, social worker, and radiation and/or medical oncologist.

On a daily basis, my biggest challenge is to be sure we are appropriately staffed for a variable number of patients we are seeing that day. Our goal is to provide patients with an appointment that is timely and efficient. Patients may have to see their medical oncologist and/or radiation oncologist and then come to us for chemotherapy. We want to coordinate these visits and prevent delays in treatment while providing the patient with safe care.

What are your biggest rewards?
CS:
My biggest satisfaction comes from being able to help people on a daily basis. I have a lot of patient contact through education and new patient orientation. I meet with patients and help reduce their anxiety levels before treatment by addressing all the “what ifs.”

Nurses are the eyes that see, the ears that listen, the smile that cheers, the hugs that reassure, and the shoulders that are cried on. We impact a patient and his/her family’s experience from our first contact with them when they walk through the door. Nurses have the opportunity to influence the oncology patient’s experience. I once read a quote: “People may not remember exactly what you did or what you said, but they will always remember how you made them feel.”

As a nurse manager, the caliber of nurses that I hire for my team impacts the patient and family in numerous ways. During each step of the hiring process I am not only looking for competent and qualified candidates with a broad oncology knowledge base (although that is extremely important), I am also looking for people who are caring and compassionate. I hire the type of people I would want to care for me or a family member who needs cancer treatment.

You are also involved in research. I note that at the recent annual congress of the Oncology Nursing Society you had a poster on adapting the LEAN approach from industry to problem-solving and reducing inefficiencies at CINJ.
CS:
Yes. That poster was a project we did at CINJ focused on the infusion center. The key purpose of the project was to increase efficient use of patient chairs and decrease delays. We aimed to shorten the duration of time for the patient’s visit and increase patient satisfaction.

We were successful in achieving our goals. We were able to increase the number of patients seen per day, bring more services to the chairside, and increase patient satisfaction.

We are currently working on another project using the LEAN approach to improve inefficiencies. This project is focused on how to shorten combination visits. As I mentioned, patients have to have doctor visits and get their chemotherapy at the infusion center on the same day. The goal of the current project is to decrease inefficiencies, improve patient safety, and improve physician and treatment scheduling templates.

What made you choose your career path?
CS:
It was serendipity. I graduated from nursing school at a time when there was an oversaturation of nurses, and the first full-time job I landed was as an oncology nurse. I did not choose oncology nursing—it chose me. I fell into it and fell in love with it.

It is now my passion. I am lucky to work at Rutgers Cancer Institute of New Jersey with such an incredible, elite, and amazing team of the most dedicated professionals anywhere. The team members who come together each day at CINJ are not only staff but also a family.

What do you love about being an oncology nurse?
CS:
Our knowledge is power. We can translate our knowledge to improving patient care, and that extends beyond the cancer. We care for patients’ emotional well-being, we help with issues like transportation and access to medications, tying that into adherence. We educate patients about self-care and we help patients deal with the diagnosis of cancer. We also educate families.

I have grown with CINJ over the last 13 years and become more proud of what we have accomplished as well as what we can and will accomplish for the patients who walk through our doors each day. Many people enter our lives for just a little while, and some pause and plant flowers in our hearts that continue to bloom forever. The staff of CINJ plant flowers with our care and hope. This makes Rutgers Cancer Institute of New Jersey so special.

What advice would you give to someone who wants to enter the field of oncology nursing?
CS:
You have to have a good general medical/surgical nurse background. The side effects and complications that occur with cancer patients are not always due to the cancer itself; they can be due to the treatment and to comorbidities. Being an oncology nurse is a continual learning process. You have to stay on top of your game by attending lectures, conferences, and reading journals.

What would you do if you won the lottery? Would you still be an oncology nurse?
CS:
Well, I am very interested in photography. I would expand the amount of time and energy I devote to photography and see where that takes me. I would try to make it more than a hobby.

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