Nursefriendly.com: Chemotherapy Side Effects

Friday, April 1, 2011

Cancer patients get better care than patients in primary care

Why do my patients with cancer get better care than my patients in primary care? As the senior resident on my hospital’s inpatient leukemia service recently, this question troubled and intrigued me daily.
Despite the sheer complexity of treating leukemia (administration of chemotherapy, bone marrow biopsies, stem cell transplantation), the resources required (transplantation routinely costs $1 million), and the severity of the illness (patients with little to no functional immune system), I couldn’t help but marvel at how coordinated, integrated, and patient-centric the care was.
From the first day I saw that things in leukemia worked differently. Most inpatient ward teams consist of an attending, a senior medical resident, one or two interns, and medical students. Each member of the team is “on service” for 2-4 weeks after which they rotate to different parts of the hospital or to the outpatient or research setting. As a result a patient admitted to general medicine today is taken care of by a completely different team than took care of her 3 months earlier when she came in for the same problem. On leukemia, our medical team included an advanced practice nurse (APN) who did not rotate off and on service.

via kevinmd.com

Click on the "via" link for the rest of the article.

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Monday, March 21, 2011

A Day in the Life of an Oncologist: “How Do You What You Do?” | GRACE :: Coping with Cancer / Social Work

On the rare occasion I’m in a social situation with people who aren’t in medicine (yes, I’m sure you know I don’t get out much, so this is largely from remote memory), the most common question that follows my answer to what I do for a living is, “How can you do what you do?”.   People imagine the obvious low points of telling people about a new cancer, about delivering bad news and discussing people’s difficult cancer-related symptoms and potential to decline despite our best efforts. It’s fair to wonder what keeps us going. So I thought I’d provide a brief sketch of a day in my clinic, which offers several ups along with the downs everyone might envision as dominating life in the oncology clinic.

   Work starts at about 7AM. At least the drive in avoids the big traffic. I review my schedule, briefly reviewing the recent records of the people coming in that day, including a more detailed review of the records of new patients, including reviewing their scans that are usually delivered in anticipation of their arrival in my clinic. Check e-mail, sign head shots in response to fan mail*, etc. (*in truth, it is perhaps technically more accurate to say that I sign dozens of orders for prescription refills and lab orders).

   Before clinic starts, I head to the hospital to round on inpatients of mine in the hospital. One is a young man with testicular cancer who is doing fine on his chemo, though he’s grown weary of the hospital food after three admissions lasting 5 days each for inpatient chemo. Fortunately, this is his last planned round of chemo, so the end is in sight. And he knows I’m not responsible for the food. At least his nausea is so well controlled that he’s interested in eating.

via cancergrace.org