Errand Solutions Available to Patients

Errand Solutions is a new service available to patients at NYP. Errand Solutions is available to assist and support NYP patients with the tasks of daily life that can sometimes be challenging while being in the hospital.

Errand Solutions staff can help with everyday tasks like dry cleaning, auto oil changes and maintenance, gift shopping, trip and party planning and many other things that patients may need. Patients will still pay for the actual services they use, but there will be no charge for the errand solutions work in getting them done.

Patients can call *99 from their phone to access the Errand Solutions kiosk, located in the Starr Lobby.

Hours of Opperation:

M,W,F 7am-2:30pm

T, TH 10am-5:30pm

Hospice Chaplains Take Up Bedside Counseling

Hospice Chaplains Take Up Bedside Counseling

The New York Times
By PAUL VITELLO
Published: October 28, 2008

You’re Sick. Now What? Knowledge Is Power.

This is very releavant to our "intellectualizing" patient who cope by seeking information about their illness.

You’re Sick. Now What? Knowledge Is Power.
The New York Times
By TARA PARKER-POPE
Published: September 29, 2008

A Time When Listening Is ‘Sacred’

A Time When Listening Is ‘Sacred’

September 25, 2008, 12:09 pm
By Jane Gross
The New York Times

Taking Time for Empathy

Taking Time for Empathy

By PAULINE W. CHEN, M.D.
Published: September 25, 2008
The New York Times

Tender Loving Care Catologue

Dear Volunteers,

We now have catalogues available from "tlc," an American Cancer Society booklet where patients can order wigs and various hats and scarves. I will place the catalogues in the cabinet with the Knit for Nancy hats. Please feel free to distribute as needed.

TLC Tender Loving Care is a not-for-profit patient service of the American Cancer Society intended to make coping easier for women experiencing hair loss due to chemotherapy, radiation treatment or surgery. In addition to helpful editorial advice from the experts at the American Cancer Society, we offer a large selection of hair loss products for cancer patients as well as special products for breast cancer patients and survivors. Our attractive, comfortable and affordable headwear includes wigs, hairpieces (bangs, falls and sideburns), turbans (cancer caps), hats, head scarves, kerchiefs and other useful products. Our mastectomy products include breast forms, pocketed post-surgery bras, swim suits and camisoles.

http://www.tlcdirect.org/

Jen

Perhaps Death Is Proud; More Reason to Savor Life

Perhaps Death Is Proud; More Reason to Savor Life

By THERESA BROWN
Published: September 8, 2008
The New York Times

Language Services for Providers and Patients: A Collaborative Approach

Language Services for Providers and Patients: A Collaborative Approach

DATE: Thursday, October 16, 2008 8:30 a.m. - 4:00 p.m.

LOCATION: Morgan Stanley Children's Hospital of NewYork-Presbyterian166th Street and Broadway

This is the third annual one-day seminar in medical interpreting. Healthcare providers, interpreters, hospital administrators and others will be present to discuss progress, best practices, and burning issues in the delivery of healthcare to limited-English-proficiency patients.

Participants will get a chance to hear some amazing speakers, including the CEO of NewYork-Presbyterian Dr. Herbert Pardes. The keynote speaker for the conference is the Senior VP from Joint Commission, Dr. Paul Schyve. Students get discount-registration of $20 if they register before September 26th. Visit www.scps.nyu.edu/medical for details.

In Cancer Therapy, There Is a Time to Treat and a Time to Let Go

In Cancer Therapy, There Is a Time to Treat and a Time to Let Go

By JANE E. BRODY
Published: August 18, 2008
The New York Times

Having Cancer, and Finding a Personality

Having Cancer, and Finding a Personality

The New York Times
By RUTH PENNEBAKER
Published: August 11, 2008

Best Hospitals Honor Roll

Congratulations! For the eighth straight year, NewYork-Presbyterian Hospital has been ranked by U.S.News as the #1 hospital in New York, and for the third year, as the #6 hospital in the nation!

New York Hospitals Create Outcry in Foreign Deal

New York Hospitals Create Outcry in Foreign Deal

The New York Times
By ANEMONA HARTOCOLLIS
Published: August 5, 2008

New York City’s Health and Hospitals Corporation has signed a 10-year, $100 million contract with a profit-making medical school in the Caribbean to provide clinical training for hundreds of students at the city’s 11 public hospitals.

Pens!!

I would like to thank the Nancy Klauber Forest Foundation for their generous donation of pens. Please pick one up in the 10 South filing cabinet. They conveniently have a rope so you can wear it around your neck during your shift.

Doctor and Patient, Now at Odds

Doctor and Patient, Now at Odds

By TARA PARKER-POPE
Published: July 29, 2008
The New York Times

A growing chorus of discontent suggests that the once-revered doctor-patient relationship is on the rocks.

Appreciation Day 7/23

Appreciation Day

Wednesday, July 23, 2008

Afternoon: 12:30-1:15pm

Evening: 8:30pm-9:15pm

10 Central Lounge

Refreshments will be served and we will be making paper flowers to give to patients and to decorate the unit. Please come to show your support for the program and to meet members of the Foundation that make this program possible.

Summer Lecture 7/17

Interested
in a Healthcare Career?

Come learn more about:
· Dietetics
· Occupational Therapy
· Physical Therapy
· Social Work

Volunteer Services presents a “Summer Lecture Series”
Date: Thursday, July 17
Time: 6pm Sharp!
Where: Cayuga Room
(in the back of the Garden Café in the Basement)

Games!

SCRABBLE AND MONOPOLY

games are available to play with patients

They will be kept in my office, so please see me if you would like to borrow them

Cancer as a Disease, Not a Death Sentence

Cancer as a Disease, Not a Death Sentence

By JANE E. BRODY
Published: June 17, 2008
The New York Times

Three Steps for Service Recovery

It can be difficult when a patient has a complaint. Below is an NYP service expectation guideline of how to handle this type of situation.

1. Acknowledge - Listen to all patients with empathy and thank them for bringing their concerns to me.

2. Apologize - Apologize on behalf of the hospital and take ownership of their concerns.

3. Amend - Act to resolve their concerns and keep the person updated on progress until the issue is resolved.

New Items for Patients

Calendars and puzzle books are now available to distribute to patients. They are located in the 10 South filing cabinet. If a patient will be here for treatment for awhile, calendars can help patients stay oriented and keep track of things. The puzzle books have crosswords, sodoku, and other fun trivia.

NYP's Mystery Shopper Program

Do you or your loved ones receive medical care at NYP?

• Evaluate Hospital staff on their service
• Receive gifts for returning completed surveys
• Never reveal your identity and all responses kept confidential
• Open to volunteers only
• Must Attend Orientation session (tbd)
• For more information contact Melissa Landanno, Coordinator of Patient Centered Care 212 342-1559

In New York City, Two Versions of End-of-Life Care

In New York City, Two Versions of End-of-Life Care

The New York Times
By ANEMONA HARTOCOLLIS and FORD FESSENDEN
Published: May 30, 2008

Meditation

Lotus Therapy

By BENEDICT CAREY
Published: May 27, 2008

This article published recently in the New York Times, talks about how mindfulness meditation can help relieve suffering. Please read over and think about how helpful it can be to practice meditation techniques with our patients.

In Hospitals, Simple Reminders Reduce Deadly Infections

In Hospitals, Simple Reminders Reduce Deadly Infections

The New York Times

By ANEMONA HARTOCOLLIS
Published: May 19, 2008

HAND HYGIENE!

Keep up the good work! Our Hand Hygiene numbers continue to rise...although we should be at 100%! Remember that volunteers are included in these numbers - special hand hygiene monitors on each unit keep track of who is washing their hands. Check the units for postings of oncology hand hygiene.

For the Elderly, Being Heard About Life’s End

For the Elderly, Being Heard About Life’s End

The New York Times
By JANE GROSS
Published: May 5, 2008

Grounded in research at the Dartmouth Medical School, slow medicine encourages physicians to put on the brakes when considering care that may have high risks and limited rewards for the elderly, and it educates patients and families how to push back against emergency room trips and hospitalizations designed for those with treatable illnesses, not the inevitable erosion of advanced age.

A Final Farewell

A Final Farewell

How Randy Pausch, a 47-year-old college professor, came to teach his family about love, courage -- and saying goodbye

By JEFFREY ZASLOW May 3, 2008; The Wall Street Journal

Commitments to Care

As part of the “We Put Patients First” effort at NYP, employees are making their own “commitments to care.” These commitments are individual promises to improve how we interact with each other and with those we are here to serve. These commitments are personal and powerful. And, together, as we all make and keep our commitment to care, we can create an environment that we will all be proud of.

Top 10 Commitments to Care-Taken from our employee retreats

“I promise to not let people upset me. When they are upset I will not let anyone make me frown.nec”
“I commit to looking while listening.”
“I will go beyond my job responsibilities to aid patients.”
“I promise to say "Is there anything else? Because I have the time."”
“I'm going to try to smile and keep calm while I am dealing with a families that are upset and attempt to help them resolve their problems.”
“I will listen to the patient's request and follow through with a response.”
“I will use kindness and humor with patients.”
“Every time I meet a new patient I will treat them like a family member.”
“I commit to controlling my mood and attitude at work and remaining positive and professional.”
“I commit to not be frustrated with family members asking the same questions over and over.”

Surviving Cancer Doesn’t Lead to Healthier Lifestyle

A recent story in the New York Times suggests that cancer survivors do not exercise any more than the rest of us. Interesting, considering that several studies have linked exercise to lower cancer risk and improved cancer survival.

Surviving Cancer Doesn’t Lead to Healthier Lifestyle
The New York Times
Published April 21, 2008
Tara Parker-Pope

Also, see her podcast featuring Leslie Bernstein, a noted cancer and exercise researcher from the City of Hope cancer center in Duarte, California.

The Well Podcast: Cancer and Exercise
The New York Times Well Blog
April 25, 2008
Tara Parker-Pope

At Bedside, Stay Stoic or Display Emotions?

At Bedside, Stay Stoic or Display Emotions?

By BARRON H. LERNER, M.D.

New York Times
Published: April 22, 2008

image by Serge Bloch

Dogs on Call

Do you have a patient that missed the regular Dog Team visit on Thursday? Do they miss their own pet terribly?

What do you do? Call the Dogs on Call (DOC) program. At the front desk of the main entrance to the hospital is a binder to request a pet therapy visit for patients. The requests can be made at any time - the dog team in for that day will check the binder before going to their assigned floor.

Just call down to the front desk using ext. 64690. Please ask the clerk on the unit for the number if you need it during your shift =)

Hand Hygiene March

We are improving! Good job! Our compliance has increased to 75% from 70% last month. Here is a reminder of hand washing protocol:

1. Alcohol-Based Sanitizer Protocol

A. When to de-germ hands with alcohol-based hand sanitizers:

• Before and after patient contact.
• After touching patient care equipment or environmental surfaces.
• Before performing invasive procedures.
• After removing gloves.

B. How to use the alcohol-based sanitizer:
Apply enough gel to entirely cover all surfaces of hands and fingers, including under the fingernails, (about 3ml, or one "pump" of the dispenser, or a golf ball sized amount of foam solution).
Spread the solution onto all hand surfaces (between fingers, backs of hands, thumbs, up to wrists).
Continue rubbing hands together until dry (approximately 15 seconds).

2. Hand Washing Protocol

A. When to wash hands with soap and water:

• At the start of a shift.
• If hands come in contact with blood or body fluids.
• When hands are visibly soiled.
• If hands are sticky after multiple applications of the alcohol-based hand sanitizer.
  After caring for a patient who is on Contact Isolation for Clostridium difficile diarrhea, antiseptic soap (e.g., 2% chlorhexidine or its equivalent) and water.
• After using the bathroom.

Annual Volunteer Recognition Reception

Volunteers: We Put Patients First

You are cordially invited to attend
NewYork-Presbyterian Hospital’s
Annual Volunteer Recognition Reception
honoring volunteers of
Columbia University Medical Center,
Morgan Stanley Children’s Hospital,
Weill Cornell Medical Center,
and The Allen Pavilion.


Monday, April 28, 2008
5:30 p.m. to 7:30 p.m.
Tavern on the Green
Central Park West at 67th Street

Ticket is REQUIRED for admittance.

Please call 212-746-4396 to request a Kosher meal. Due to limited space, we are unable to accommodate guests.

**If you did not receive an invitation, please let me or the volunteer department know.**

CPR Training

Great news! The volunteer services department is offering CPR training to volunteers! I will most likely be present at the one at Cornell. You can attend either training, but you must sign-up! Space is limited. See below for details.

CPR Training @ Columbia:
Wednesday, May 7
*4:00-8:00pm
EMS Training Center
600 West 169th St, Apt. 61 above Coogan's

Sign-up with Iraida
(212-305-2542)

CPR Training @ Cornell:
Wednesday, May 14
*4:00-8:00pm
EMS Training Center
Greenberg Pavilion, 1st Flr Ambulance Ramp

Sign-up with Elaine
(212-746-4396)

REGISTRATION REQUIRED!!
*Classes start promptly at 4pm.
You may be refused entrance if you are late.

This event is FREE to all active and compliant volunteers.

Spanish basics for Volunteers

There are many Spanish speaking patients on the floor. Please do not let this stop you from visiting with them! I know it can be a little intimidating when there is a language barrier, but please do your best. Remember there are other ways to communicate without using words. Here is a helpful website for your reference if you want to brush up on some spanish basics. This site is great because you can click on a sentence and actually hear it being said out loud.

Practice Spanish

HAND HYGIENE!

It is EXTREMELY important that you all practice perfect hand hygiene. Studies have shown that over 100,000 people die every year from infections they acquired while in the hospital.The NUMBER ONE thing we can do to prevent infection is very simple—wash our hands!

NYP requires that everyone who has patient contact MUST wash their hands before and after patient contact. This includes volunteers! Hand washing stations are located around your workspace. In addition, Purell containers are also throughout the hospital. This alcohol based gel works extremely well in killing germs and only takes a few seconds to do. Washing hands is not an option—we ALL have to do this for our patients’ safety.

Please Purell before and after entering a patient's room, even if you are just stopping in! There are undercover monitors on the floor checking up on each of you and I have already had reports of certain volunteers not Purelling. Do not let this be you!

Milkshakes

FYI - Milkshakes are suspended for the moment. Ralph, the milkshake man is taking a break from his program. Although we have found a new volunteer to take over his duties, it will be a few weeks until she is cleared to start. I will keep you posted, but for the time being please do not make promises of milkshakes that you can't keep!

For Top Medical Students, an Attractive Field

For all you pre-meds out there...

For Top Medical Students, an Attractive Field

The New York Times
By NATASHA SINGER
Published: March 19, 2008

Getting into med school is difficult as it is, but depending on what you would like to be when you "grow up," your residency match can be even more challenging. The term "ROAD to success" is something I have heard before. ROAD is an acronym for the medical specialties that have the highest salaries and the easiest schedules. It stands for Radiology, Ophthalmology, Anesthesiology, and Dermatology. These fields are attractive because the nature of the work means few emergencies and therefore a more dependable work schedule. This also makes them much more competitive.

CancerCare: Glioblastoma

Glioblastoma is cancer of the brain. This cancer rarely spreads from the brain to other areas of the body. Glioblastoma is classified as "high grade" because it is "fast-growing" and one of the most aggressive types of cancer.

Headaches and seizures are common symptoms of glioblastoma, as well as problems concentrating due to pressure buildup in the brain. The location of the tumor plays an important role in the symptoms that a patient experiences. For example, if the tumor is near the occipital lobe, the patient may have problems with their vision.

Surgery is a common treatment for glioblastoma. A surgeon may decide to perform a craniotomy, which is the opening of the skull to see and remove the tumor. A physician may also decide to use stereotaxis to perform a biopsy. This is the use of a scanning device to more accurately localize where the small hole in the skull will be made. A needle will be passed through the hole to the tumor and then the sample is taken to pathology for tests.

A shunt may be placed if the tumor blocks cerebrospinal fluid (the fluid surrounding the brain and spinal cord). Glioblastoma can cause an excess of this cerebrospinal fluid in the ventricles, and the shunt is placed to drain it and thereby relieve excess pressure.

Besides surgery, radiation, chemotherapy, palliative care, and clinical trials are available for treatment.

Patient Safety Fridays: SBAR

When you see nurses reporting to each other when they change shifts, they must be sure to communicate effectively with one another to reduce the chance of medical errors and protect the safety of patients.

• Effective communication is tied to the National Patient Safety Goal to "Improve the effectiveness of communication among caregivers."

• An effective communication method at NYP is SBAR:

o Situation – Describe what is going on with the patient.
o Background – Describe the clinical background of the patient.
o Assessment – Describes the findings.
o Recommendation – Describe the actions needed to correct a problem.

SBAR is a clinical tool, but take a moment to think about how you can use SBAR as a volunteer when describing your interaction with a patient and documenting your visit in the binder.

What was going on with the patient when you visited them? How did they feel? What was their mood? What did you learn about their background? Was there any problem? How did you address it? Any recommendations to other volunteers?

PET Scans and Cancer

Positron Emission Tomography (PET) can help physicians effectively pinpoint the source of cancer. This is possible because many cancer cells are highly metabolic and therefore synthesize the radioactive glucose (sugar) that is injected in the patient prior to the exam. The areas of high glucose uptake are dramatically displayed in the scan imagery, as opposed to the anatomical imagery of CT or MRI, which cannot detect active, viable tumors.

A PET scan can be used in early diagnosis, assisting physicians in determining the best method for treatment. A whole body PET scan may detect whether cancer is isolated to one specific area or has spread to other organs before a treatment path is determined.*

*Copyright © 2008 Siemens Inc. petscaninfo.com

Look Good...Feel Better

THURSDAY, MARCH 6th 3-5 PM 10 CENTRAL LOUNGE

Look Good. . . Feel Better is designed to help cancer patients undergoing chemotherapy and radiation cope with the appearance related side effects of their treatment.

The Volunteer Services Department sponsors the program as a free, non-medical product-neutral program in partnership with the American Cancer Society.

Trained cosmetologists teach women how to handle skin changes and hair loss using cosmetics and skin care products donated by the cosmetic industry. Free cosmetic kits are provided as well as advice on wigs, scarves and other accessories to disguise hair loss.

Please reach out to women on the unit to see if they are interested in attending. Space is limited. Must register in advance to attend: 212-746-3947

Boundaries

Just a reminder...As a Nancy's Friends volunteer, you have a special role. You are there for patient's week after week and surely have created a special bond with some patients who have been here for an extended amount of time. It is very important to remember that you can not give out your personal information to patients or their families. If someone asks you, and you have any questions about how to handle the situation, please let me know. You are here as a friend, but also as a professional.

Knit for Nancy Hats

Dear Volunteers,

In addition to the knit hats donated by volunteers, we have received a new shipment of Knit for Nancy hats! These hats are donated by the Nancy Klauber Forest Foundation from their annual fundraising event in the fall. These knit hats are very special, as each one was hand knit in memory of our program namesake, Nancy, who was a patient here on Greenberg 10. The Knit for Nancy hats are mostly all in colors of baby pink (Nancy's favorite color), white, and purple and have a flower that is reference to our logo.

Please distribute all Knit for Nancy hats in a Knit for Nancy bag with tissue paper and a card that says "Knit for you with Love." These materials can be found in our cabinet in the 10 Central Lounge. It makes a big difference to give out a Knit for Nancy hat all wrapped up - patients love receiving presents!

CancerCare: Metastatic Breast Cancer

What does Metastatic mean?

Metastatic means that the cancer has spread from its point of origin (in this case, the breast) to other parts of the body.

What types of treatment are available?

There are three subcatagories of treatment for metastatic breast cancer.

1. Hormonal: Estrogen therapy. This affects selective estrogen re-uptake inhibitors.
2. Chemotherapy: Agressive therapy that often involves multiple drugs and many side effects.
3. Targeted or Biologic: using an antibody to target cells that overexpresses a protein.

Angio-genesis inhibitors can also be used. These cut off blood supply to tumors, and therefore block the ability of the tumor to feed itself.

What are some side effects of treatment for metastatic breast cancer?

Side effects can be caused not only by the disease itself, but by the specific treatment for the disease.

Pain, fatigue, nerve damage, anemia, and psychological concerns are all common side effects. It is important that every patient communicate with their care team and take control of their treatment and focus on wellness.

• Remember that volunteers NEVER share medical information with patients! This is for your personal use only and should never be discussed with patients. If patients have questions or concerns about their treatment, please encourage them to bring it up with their medical care team. =)

Dog Visit Lists - Paws for Patients

As many of you already know, our pet therapy program is very popular! Once a week, patients are able to get dog visits at the bedside. This is an incredibly theraputic activity for patients, and always brings a smile to everyone's face. =)

I am leaving a folder in the 10 South Filing cabinet with blank pet therapy forms. If a patient requests dog visits, please make a note in the binder and also add their name to the formal list that the Paws for Patients people use. This list is kept in the 10 Central Report room on the bulletin board behind a picture of some cute canines!

Nurse Practitioners

A Nurse Practitioner (NP) is a registered nurse who has completed specific advanced nursing education (generally a master's degree) and training in the diagnosis and management of common as well as complex medical conditions. Nurse Practitioners provide a broad range of health care services.

Nurse Practitioners provide care in offices, family practice offices, urgent care centers, and rural health clinics, and in some states must maintain collaborative working relationships with physicians while in other states the term "collaboration" is used in a broader sense. In the US NPs are licensed by the state in which they practice, and have a national board certification (usually through the American Nurses Credentialing Center or American Academy of Nurse Practitioners). Nurse Practitioners can be trained and nationally certified in areas of pediatrics, geriatrics, family, psychiatry and acute care.

Nurse Practitioners treat both acute and chronic conditions through comprehensive history taking, physical exams, prescribing medications, physical therapy, ordering tests and therapies for patients, within their scope of practice. Many NPs have a DEA registration number that allows them to write prescriptions for federally-defined "controlled medications". Nurse Practitioners may also bill insurance companies for services performed. An NP can serve as a patient's "point of entry" health care provider, and see patients of all ages depending on their designated scope of practice. The core philosophy of the field is individualized care. Nurse Practitioners focus on patients' conditions as well as the effects of illness on the lives of the patients and their families. Informing patients about their health care and encouraging them to participate in decisions are central to the care provided by NPs.*

* Taken from Wikipedia.com

New Isolation Precaution Signs

Hi all!

Although many of you have already seen these signs on the unit, I wanted to bring it to your attention that the signs to indicate isolation precautions have recently changed. Not only does it list the precaution you should take, but now there are pictures indicating what should be worn (for example a duck-billed mask in respiratory isolation). I think the new signs are a big improvement!

Thriving After Life's Bum Rap

Sometimes coping with a serious illness can cause you to think about the positive things that are in your life. Nancy's Friends volunteer Arline wanted to share this article posted in the NYTimes. Jane Brody writes about how cancer can cause you to see things from a different perspective.

Thriving After Life's Bum Rap

The New York Times

By JANE E. BRODY
Published: August 14, 2007

American Cancer Society / NYP-Weill Cornell Quarterly Breakfast

YOU'RE INVITED!

Who: Nursing staff, nutritionists, social workers and volunteers
What: Breakfast with the American Cancer Society
When: Thursday, February 7th at 7:30am
Where: 10 Central Patient Lounge

Come learn about the ACS Hope Lodge ACS outreach programs, NYPH oncology outreach activities, and meet some of the New York ACS staff members.

Please RVSP to me (Jen) if you would like to attend.

Thanks!

New Additions

Hi Everybody!

I wanted to let you know we received some new items to distribute to patients.

• We have new knit hats and even a scarf available (next to DVD cabinet)


• A calendar should anyone ask (10S filing cabinet)


• Playing cards (10S filing cabinet)


• Classical CD (next to DVD cabinet)


• CD "Music to Heal the Mind, Body, and Soul" - perfect for anxious or depressed patients. (Please sign out - I will leave in DVD cabinet)

I also want to remind you all that there are still pillowcases that can be distributed! They were decorated by children at the annual "Knit for Nancy" event this past fall.

Jen

C-Diff And What You Can Do To Prevent Outbreak

What is c-diff?

C-diff (Clostridium difficile ) is a bacteria that colonizes in the human intestine and colon. People who have c-diff will have diarrhea and abdominal pain. It is spread when someone touches their infected stool. C-diff is resistant to most antibiotics.

C-diff is a nosocomial infection, also known as a hospital-acquired infection, which means that it is often a result of treatment in a hospital. Patients in a hospital usually have a weakened immune system and are on antibiotics to treat a primary disease. This makes them more susceptible to c-diff.

As you learned in orientation, you must always follow the proper isolation procedures. C-diff is very common in hospitals and there are patients that we visit that will have it. This is why it is so important to wear a gown and gloves when patients are on contact precautions. You should ALWAYS wash your hands with soap and water (not just purell) if you were wearing gloves and have just left a contact room.

This is not only for your safety, but for the safety of all the patients on the floor. You do not want to be the one responsible for an outbreak!! The nurses may let you know if a patient has c-diff, please do not hesitate to visit that patient. If you follow the proper protocol, there is minimal risk – this is why the isolation procedures are in place!

CancerCare - Chronic Myelogenous Leukemia (CML)

CancerCare is a national nonprofit organization that provides free, professional support services for anyone affected by cancer.

Today, I listened along with over 850 other participants to a CancerCare Telephone Education Workshop describing updates on Chronic Myelogenous Leukemia (CML) from the American Society of Hematology (ASH) Annual Meeting. Below is a summary of what I learned.

Chronic myelogenous leukemia (CML) is a form of leukemia linked to a chromosome abnormality. This blood cancer occurs when genetic material is displaced from one chromosome to another. Parts of chromosome 9 and chromosome 22 switch places. This chromosomal translocation is known as the Philadelphia chromosome.

At the 48th annual ASH (American Society of Hematology) meeting that took place in December, leading hematologists presented the latest findings in research. CML can be treated with tyrosine-kinase inhibitors and there are exciting new findings about the success of clinical trials. Sometimes mutations occur that cause resistance to the tyrosine-kinase inhibitors used to treat CML. To overcome this resistance and to increase responsiveness to inhibitors, agents have been developed to block several cancer causing proteins.

Side effects of treatment include fluid retention and pleural effusion (fluid in the chest cavity), as well as fatigue and gastrointestinal problems.

Comfort Zone

image: Copyright © 2008, TIMOTHY MCCONNACHIE Embrace









Part of being a Nancy's Friends volunteer is providing support to patient's families. Having a loved one living with a serious illness and being hospitalized is a huge responsibility for the patient's caregivers. Making trips back and forth to the hospital is a tremendous stress for some. Taking care of pets, keeping finances in order, and getting medications are just some of the responsibilities that friends and relatives may have to take over.

The Comfort Zone is another volunteer program at New York Presbyterian - Cornell that offers caregivers support, information, companionship and rest. It is free of charge and is located on the 4th Floor of the Greenberg Pavillion. If you meet family members on our unit that you feel will benefit from this service, please refer them! I will leave additional information on the Comfort Zone in the binders.

Physician's Assistant

What is a Physician's Assistant (PA)?

PAs obtain medical histories and perform examinations and procedures, order treatments, diagnose illnesses, prescribe medication, interpret diagnostic tests, refer patients to specialists when appropriate and first-assist in surgery. PAs may practice in any medical or surgical specialty, and have the ability to move to different medical and surgical fields during their careers.

PAs are licensed to practice medicine with physician supervision, which may be either in person, by telecommunication system or by other reliable means. The physician supervision, in most cases, need not be direct or on-site, and many PAs practice in remote or underserved areas in satellite clinics. Their scope of practice and autonomy are only limited by their supervising physician's scope of practice, the physician's comfort level, and the PA's clinical experience.*
*Quoted from Wikipedia

Physician's Assistant was selected as one of the Best Jobs in America by Money Magazine in 2007. For details: Money Magazine

For information on historical background, Current State of PA Education, and Future Directions and Controversies:
Physician Assistant Education in the
United States
P. Eugene Jones, PhD, PA-C
Academic Medicine, Vol. 82, No. 9 / September 2007

CHANGES TO DOCUMENTATION BINDER!!

Thank you to those volunteers who were able to attend the Focus Group last Thursday - it was a great success! Several points were made regarding documentation and the following changes have been made as a result:

• The coordinator will be the only person to add new Friends (F) and Acquaintances (A) to the patient census.
  o Volunteers will continue to carry over Friends and Acquaintances from last census to updated census.

• If a nurse or other staff member makes a recommendation for you to visit a patient not marked on the census, please fill out Documentation form and add to “Recommendations” tab in back of binder.
  o I will follow up with the recommendation and make notes or enroll accordingly.

• Documentation forms should be filled out for ALL patients visited (Friends and Acquaintances).

• The Documentation form has been revised. Check off box when you complete an intervention and elaborate on what you did with the patient under Visit Notes in space provided below.
  o Please check off if the patient has any needs and if the patient was receptive to your visit.

• Notes to Fellow Friend has been edited to include those patients visited and not visited.
  o This page is for brief notes of why a patient was not seen (sleeping, off floor, etc.) or for recommendations for a patient to be visited again later in the day.
  

Patient Safety Fridays

Beginning Friday, January 11, 2008, all Fridays are set aside as Patient Safety Days across NewYork-Presbyterian. This is to ensure that every member of New York Presbyterian is doing their best to "Put Patients First." Between 9am-11am, you may see management staff going around the unit and checking for various issues of Patient Safety. These will include Environmental and Clinical Tracers such as Fire Safety and HIPAA compliance. Please make sure you are up to date on RACE and PASS protocols. =)

CancerCare - Marrow or Cord Blood Transplant as a Treatment Option

CancerCare is a national nonprofit organization that provides free, professional support services for anyone affected by cancer.

Yesterday, January 17th I listened in on a Telephone Education Workshop discussing transplant. There were over 900 people listening in on the call from all over the world!

A bone marrow or cord blood transplant (also called a BMT) replaces diseased blood-forming cells with healthy cells. Diseases that may be treated with a bone marrow or cord blood transplant include: Leukemias and lymphomas, Multiple myeloma and other plasma cell disorders, Severe aplastic anemia, Sickle cell disease, and Myelodysplastic syndromes

I wanted to share with you some of the information that I learned:

There are two types of transplant:

• Autologous - stem or blood cells are collected from an individual and are given back to the same individual. Also know as "full-dose" or traditional transplant.
• Allogeneic - stem or blood cells are collected from another individual (donor). Also called "reduced-intensity" or mini-transplant.

Things to consider when thinking about transplant as an option: disease type, timing during treatment, age, any other medical problems, and reactions to prior treatments.

Advances in treatment have improved outcome for transplant:

• Improvement in supportive care such as growth factors to encourage blood cell growth and recovery of white blood cell counts.
• New antibiotics
• Anti-fungal agents
• For allogeneic transplants, donor options have improved - donors can be someone other than a patient's relative (although relatives are preferred).

One risky side effect of transplant is Graft vs. Host Disease (GVHD). In GVHD, the donor immune cells (T-cells) recognize the patient's cells as foreign and try to attack it. It can happen anywhere in the patient's body and its severity can range from mild to life-threatening.

As volunteers, you should keep in mind that the patient is away from home for an extended amount of time (usually several weeks). In some cases, a patient who has come to NYP for a transplant may live somewhere far away because a transplant center is not available near their home. That means that friends and family have to travel long distances to see their loved one. As volunteers, you lead an important role of being there for the patient when they are alone during this difficult time.

HIPAA Reminder

In light of an incident yesterday, where patient information was found in the volunteer locker room, it is necessary to remind everyone of the hospital confidentiality policy. According to the Health Insurance Portability and Accountability Act (HIPAA) not only can you not talk about patients to others, you must be extra careful to shred all documents containing patient information.

When you write down which patients you are going to see, be sure not to leave the list in your smock pocket or in your locker. There are big gray "Shred-It" boxes with a slit that you can slip in the paper to be shredded. You can find these boxes by the copy machines on the unit in the report room. There is also one located in the volunteer department waiting area.

In addition, remember not to mention patient names in public places of the hospital (the elevator or the hallway).


Thank you!

Focus Group

All volunteers should have received an e-mail that a date has been set for the focus group:

Thursday, January 17th at 7:00pm in the Conference Room next to my office on Greenberg 10.

The purpose of this focus group is to discuss the following topics: changes to the Documentation Binder, this blog, informational sessions on topics of interest (oncology, medical professions, etc.) and anything else that you feel needs to be addressed.

I am excited to get active Nancy’s Friends volunteers together to discuss how the program can move forward in 2008. This meeting is an important opportunity to provide your input based on your volunteering experience. Even if you are new to Nancy’s Friends, I encourage you to get involved!

Please RSVP as soon as possible via e-mail or phone!

For Cancer Patients, Empathy Goes a Long Way

In keeping with the theme of empathy...this article was brought to my attention. The topic of this article is how physicians may feel empathy, but have trouble communicating it to their patients. Some physicians could not read between the lines and ended up rambling in technical terms when all the patient wanted to know was "Am I getting better? or worse?" Interestingly, researchers also found that cancer patients did not always share their emotions with their oncologists.

The New York Times
By DENISE GRADY
Published: January 8, 2008

For Cancer Patients, Empathy Goes a Long Way


See below for the research paper published in Journal of Clinical Oncology, Vol 25, No 36 (December 20), 2007: pp. 5748-5752© 2007 American Society of Clinical Oncology.

Kathryn I. Pollak, Robert M. Arnold, Amy S. Jeffreys, Stewart C. Alexander, Maren K. Olsen, Amy P. Abernethy, Celette Sugg Skinner, Keri L. Rodriguez, James A. Tulsky

Oncologist Communication About Emotion During Visits With Patients With Advanced Cancer

Cancer patients find strength in numbers

Click the link below to view the article that NF volunteer Linda suggested.

Cancer Patients Find Strength in Numbers

By Marilyn Elias, USA TODAY

Understanding Empathy

I wanted to share this article with you from the New York Times. The author is a physician here at Weill Cornell Medical School. As volunteers, you are learning to interact with and understand patients. What appeals to me about this article is that the author points out, "What is critical to understanding someone is not necessarily having had his or her experience; it is being able to imagine what it would be like to have it."

As you volunteer, you develop empathy as you listen to people tell stories of their struggle with illness. Being an empathetic person is not only important if you are looking to develop your bedside manner, but is essential in forming connections with others.

Do you agree with what this doctor has to say? How does volunteering influence your understanding of empathy?

Understanding Empathy: Can You Feel My Pain?

By RICHARD A. FRIEDMAN, M.D.
Published: April 24, 2007