Bridging the Cancer Care Gap

"When a patient arrives in the radiation department, Amanda is the familiar face who greets them," wrote Amy Hicks, D.N.P., RN, ACCNS-AG, NEA-BC

From left: Amanda Kelm, B.S.N., RN, OCN and Amy Hicks Amy Hicks, D.N.P., RN, ACCNS-AG, NEA-BC

Photo by Erica Hasenjager

Health care has become increasingly complex, and the care of patients with cancer is no exception. They are often seen by many different specialists and must navigate a multitude of appointments. It is also not uncommon for a patient with an oncology diagnosis to be admitted to the inpatient setting throughout their journey. Sometimes the treatment the patient needs most is radiation therapy, which is often located at an outpatient facility.

This was the case at our facility. Amanda Kelm, B.S.N., RN, OCN, stepped in and embarked on a new journey to oversee the navigation of inpatients in the outpatient radiation therapy center. With Amanda’s previous experience as inpatient oncology nurse, she was the ideal candidate for this new role.

Amanda quickly assimilated into the radiation oncology team, taking the lead in identifying and filling the gaps. Amanda joins the providers during consultations, where she establishes a relationship with the patients. She begins the education process and answers their questions. Amanda ensures that the patient and families have her contact information and puts them at ease.

Not only does Amanda build a rapport with the patient and family, but she also assesses the patient and determines their proper mode of transportation (hospital transport, medic, critical care transport, etc.). This assessment is crucial to ensuring patient safety and consistency of care.

The radiation therapists and physicians rely on her expertise and knowledge of radiation therapy and acute care to ensure the patient is safely cared for during the process. Amanda also has become a resource to the inpatient nurses. She works with them to coordinate the patient’s care, including the timing of medications for pain, anxiety and nausea to keep the patient as comfortable as possible during transport and treatment.

When a patient arrives in the radiation department, Amanda is the familiar face who greets them. Her presence is a comfort, and they immediately feel more at ease. She continues to answer all questions and assesses any ongoing educational needs. If the patient has any cognitive barriers, Amanda ensures she calls the family to educate and update them as well.

As the patient continues through their radiation treatment course, Amanda is there, checking on them, keeping them safe, providing emotional support and anticipating their needs.

She serves as a resource to the radiation therapists, bridging the gap for clinical questions and helping them to better care for the patient. For instance, when a new electronic medical records system brought new terminology for code status, Amanda identified this knowledge gap and educated the entire department on this critical change.

If the patient’s condition changes, Amanda is the first to know and communicate it to the radiation team. If a patient improves and being discharged home, she anticipates their needs and works closely with the inpatient team to mitigate any potential delays with radiation treatments. She ensures the patient and family are clear on the plan after discharge from the hospital. She helps arrange treatments close to their home and ensures a seamless transition.

Not only does Amanda serve a vital role in navigating the care of inpatients, but she also brings such positive energy into the department. Caring for patients with cancer can take its toll on the team. Amanda is intentional in planning activities for the staff, such as bringing in fun stress relievers and creating fun holiday activities all year.

She also coordinates tours of the departments for new oncology nurses who just graduated. Through this experience, the nurses gain valuable knowledge about radiation therapy and are better able to care for their patients who are undergoing this treatment. Amanda also leads the department’s interprofessional shared governance committee where representatives from each discipline come together to make improvements in patient care and their practice environment.

Amanda is truly an extraordinary nurse. The impact she has cannot be overstated. She has forged a new role in the department that has resulted not only in improved patient safety but also improved continuity. She has bridged the gaps in a complex environment and given the team and the patients and families peace of mind that someone is there who sees the whole picture. She also finds ways beyond patient care to make the department better. I am honored to write this nomination for someone who is as deserving as Amanda.

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