Cedars-Sinai Blood & Marrow Transplant Program: Providing Care During the COVID-19 Pandemic

TON - August 2020, Vol 13, No 4
Cedars-Sinai Medical Center, Los Angeles, CACedars-Sinai Medical Center, Los Angeles, CA

The Cedars-Sinai Blood & Marrow Transplant (BMT) 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 (FACT) 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, CNS, Hematology/Oncology/BMT Clinical Nurse Specialist at Cedars-Sinai Medical Center. Ms Rome discusses her roles and responsibilities as part of the Blood & Marrow Transplant team, as well as some of the protocols her department has instituted to ensure the safe and effective care of patients during the ongoing COVID-19 health crisis.

TON: Can you discuss some of the factors that led to you becoming 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 in the same unit where I had volunteered, and subsequently went on to obtain my master’s degree in oncology nursing.

TON: Describe for us your role as a Clinical Nurse Specialist in the Blood & Marrow Transplant Program at Cedars-Sinai.

Ms Rome: 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. I also have a variety of administrative duties I perform as needed.

TON: What are some of the protocols your department has instituted to ensure the safe and effective care for patients during the COVID-19 health crisis?

Ms Rome: Within the Cedars-Sinai Medical Center, we are all screened daily for symptoms upon entry. We also wear masks and face shields at the bedside of our patients.

All patients scheduled for chemotherapy need to have COVID-19 testing 1 to 2 days prior to admission; we know these patients will be immunosuppressed (eg, for stem-cell transplant), so they are tested again at admission and before any myelosuppressive treatments are initiated. We also limit visitors to one per patient during visiting hours, and we ask that these visitors do not walk in the hallways.

If a patient has been previously screened for COVID-19 and the test came back negative, but they then develop symptoms, we rapidly screen them and take appropriate precautions until COVID-19 is ruled out. If there is a strong clinical estimation that the patient is now positive, we transfer him or her to a COVID-designated unit even before the rapid test shows a positive result.

TON: What are some of the challenges the nurses in your department face in light of the current pandemic?

Ms Rome: I think all healthcare professionals realize that we must do our part to minimize exposure for ourselves, as well as our colleagues, patients, and families. One challenge for me is wearing a mask and face shield all day. When I wear a mask, colleagues cannot see my face; this makes me feel a bit separated from others at times. As nurses, we know that we cannot compromise safety but we must still give our very best when it comes to providing care to our patients. The responsibility of caring for others is truly a blessing, but the stressors that sometimes come along with caring for very ill patients have not gone away.

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!

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