Empowering Oncology Colleagues to Meet Patient Needs

Caitlin Fanning, M.S.N., RN, OCN, is a clinical practice lead (CPL) for medical oncology, both inpatient and ambulatory care, at Fox Chase Cancer Center. She has more than 20 years of experience in oncology nursing, including intravenous chemotherapy and biotherapy.

In her CPL role, Caitlin is a mentor and resource for nurses at all levels. She transitioned to this role during a time of great change at Fox Chase, post COVID- 19 pandemic, in the face of growing patient volumes. As a younger generation of nurses entered the field with scant hands-on training, Caitlin stepped up to transform the onboarding process. Her revised program ensures that onboarding nurses are provided an education in cancer basics, and it reviews oncology-specific and other “new nurse” education with them on a regular basis. At the same time, Caitlin can be seen huddling with experienced nurses to determine the best way to pro- vide quality care in unique and challenging situations.

Caitlin also sits on Fox Chase’s Nurse Practice Council. Here, best practices are discussed, and policies are rewritten, amended or retired to align with current practice standards. As a policy is dissected, Caitlin shows passion and dedication in insisting that every nuance of the policy is clear and feasible for their nurses to use and shares these policy changes with the staff.

Caitlin focuses on empowerment. She consults with the inpatient care team daily regarding chemotherapy admissions to ensure that the nursing team feels prepared and supported to adequately care for patients undergoing chemotherapy. Caitlin works with individual nurses to go over tubing setup, describe each safety check, review how to manage a hypersensitivity reaction, and assist in administering morning medications and patient care, if needed.

She routinely introduces herself to patients and their families as part of the leadership team, and partners with the nursing staff to review care plans as well as medication side effects with patients and families. Caitlin also checks in with patients in the days following their treatment to ensure continuity of care.

Perhaps more than any nurse I know, Caitlin lives and breathes evidence-based practice. When she became CPL, Caitlin immersed herself in the policies and nursing standards related to chemotherapy and immunotherapy administration. In collaboration with our clinical pharmacy specialist and Nurse Practice Council, she revised the policies, nursing standards, procedures and reference materials for chemotherapy and immunotherapy administration to align with current National Comprehensive Cancer Network and Oncology Nursing Society guidelines. She also ensured that each nurse in the department knew where to locate the information they needed to deliver safer, quality care to oncology patients.

As a clinical practice expert, Caitlin’s actions and behaviors drive quality results. For example, our inpatient unit cares for post-drug administration phase 1 clinical trial patients. These patients require close observation for cytokine release syndrome (CRS) and can decline rapidly. Many of the nurses, however, did not feel comfortable assessing the subtle changes that can precede this decline. Caitlin realized this, and, in her usual style, sprang into action. She created a comprehensive online learning module on CRS and had it assigned to each RN on the unit. Once each nurse completed the online module, Caitlin met with them to explore their comprehension of the educational module and to answer any questions in real time. This was done on both weekday shifts as well as on weekends.

In another example, the clinical director of infusion services brought a training need to Caitlin’s attention: A new surgeon started a robust hepatic artery infusion pump (HAIP) program at the center and needed an infrastructure to support positive outcomes for these patients. Those coming in for HAIP refills had to wait for the limited number of specially trained nurses in the infusion room to access their hepatic pump, resulting in patient delays. Caitlin worked tirelessly with the pump company representative to get a training product mailed directly to her house so she could familiarize herself with the pump. She then trained more than 20 infusion nurses in the hepatic pump accessing process. She even met the HAIP patients to access the pump and teach them how it worked, to better prepare the patients for their next visit to the infusion room. Caitlin’s efforts have decreased errors and delays while increased patient satisfaction.

These are just two instances in a long list of accomplishments that describe how Caitlin has transformed practices at Fox Chase Cancer Center.

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