Explore the reality of nursing with a nurse practitioner for the phase one cancer clinical research program for Hackensack Meridian Health.

 

 

Episode Introduction 

 

The role of a nurse practitioner has changed in recent years. In this episode, Jim Cagliostro, VIE’s Clinical Operations Performance Improvement Expert, interviewed Walter ‘’Buddy’’ Elliott to discuss the benefits of previous ‘’hands-on’’ nursing experience for nurse practitioners, the critical role they play in enhancing the patient experience, and the support they offer physicians. 

 

Show Topics 

 

• ‘’Bedside nursing’’ experience is essential for nurse practitioners
• Identifying prospective patients for clinical trials
• The indepth knowledge required of cancer studies
• From cost savings to better patient care 
• Drawing on the expertise of more experienced nurses
• Nurse practitioners enhance the patient experience
• Achieving formal qualifications through multiple routes

 

 

Show Links

 

04:35 ‘’Bedside nursing’’ experience is essential for nurse practitioners

Based on his personal experience, Walter said hands-on nursing care provides vital experience for nurse practitioners. 

 

‘’I definitely feel it is essential as a nurse practitioner to have had experience in nursing because as a floor nurse, you have increased access to being able to see how care is carried out. From the orders that are placed and the management of the patients' care, being able to watch a patient's vitals and how a patient is reacting to a certain treatment and being that first line of being able to counter anything that would be negatively impacting the patient. Being able to have the access of seeing multiple different types of disease processes and modalities of care, I think definitely increases the experience for a nurse practitioner to be able to draw off of. So I definitely feel it is important to have had a couple of years or more of nursing, hands-on nursing care, before pursuing nurse practitioner roles just because it allows you to have that experience.’’

 

 

06:21 Identifying prospective patients for clinical trials

 

Walter outlined his involvement as a nurse practitioner in identifying patients for clinical trials. 

 

‘’Well speaking for myself personally, in research, my role as the nurse practitioner whenever a prospective patient is identified or referred to our program, my job is to help identify the appropriate enrolling study for their disease process and then to help evaluate their eligibility based off the criteria of the prospective trial. We work primarily in solid tumors so anything such as non-small cell lung cancer, colorectal cancer, those being examples of disease processes that we see, I help look at what's available for them because trials open and close based off of how many they've been able to enroll in a cohort and then I can say, "We have these three open trials that would be available for you. We would like you to review the consent, the process, of what you would be undertaking in this clinical trial." And then meet back up with the patient in the screening process to determine whether they would like to sign and then go on from there.’’

 

 

08:18 The indepth knowledge required of cancer studies

Walter outlined the complex nature of working as a nurse practitioner on cancer treatment trials. 

 

‘’I definitely feel now that there are a number of different roles that a nurse practitioner is able to help fill. The research role is in and of itself a different avenue that beforehand I wasn't aware of but intrigued me as I became more aware of what the position entailed, mainly because of the in-depth knowledge that's required of the available studies. What the study is comprised of, what the treatment modality is, what's being investigated, what criteria has been set up to find a patient. Sometimes there can be a criteria that's very restrictive and it's only a very small subset of people with a particular disease process that would be eligible for. Sometimes they're any and all solid tumors that come in and so just being able to know what each study entails is essential for my role. And then being able to understand how that study would impact the patient and identify any issues that could arise during their care.’’

 

 

12:11 From cost savings to better patient care

Jim said that the role of nurse practitioner leads to fewer emergency room visits and more cost effective treatment. 

 

‘’In recent research that I've done and I've been talking with some of our clients, the studies have shown that nurse practitioners, and it's pretty obvious most people would know this, that nurse practitioners cost healthcare systems less. They're less expensive to see for the patient and for the healthcare system, so that overall helps to decrease the cost of healthcare services.   And then I know you don't want to toot your own horn but I'll brag on nurse practitioners in this way, another study showed that patients who saw nurse practitioners had fewer emergency room visits, had shorter hospital stays, and overall lowered the treatment of their cost. So there's a number of things. And that could be a whole other podcast about the benefits of having nurse practitioners as part of a health system.’’

 

 

15:40 Drawing on the expertise of more experienced nurses

Walter said continued access to a mentor can help nurse practitioners to grow in their role. 

 

‘’I'm working closely with a nurse practitioner that has been with the John Theurer Cancer Center phase one clinical trial department for a number of years. And phenomenal amount of knowledge and experience that I reap from her. And with my previous position as well, I have worked with senior nurse practitioners that are just incredible assets to their practice because of their wealth of experience and knowledge. I do think it's important that newer nurse practitioners be able to have that access. And I know that with the John Theurer Cancer Center, I've seen that at play with precessing opportunities and just newer individuals in the field being able to work with established nurse practitioners. I definitely feel like it helps us grow in the position to be able to draw from somebody who's in the field themselves, doing well in it, and providing safe care for patients. So I definitely think it's important for continued access to be a part of the curriculum. And then also, just as getting a mentor especially as you move into the field to be able to reach out to and say, "Hey, this is something new that I'm dealing with." Or, "How would you troubleshoot this situation." 

 

 

18:53 Nurse practitioners enhance the patient experience

Walter said the ability to expand access to patient care and offer solutions influenced his decision to become a nurse practitioner. 

 

‘’I was intrigued at the additional level of care that these individuals brought to the patients' experience. I noticed that they had more of an ability to connect with the patients, be able to meet their needs. And their ease of contact as a provider, they were able to work more closely with the nursing staff. Which in my own experience, I was grateful for, because I could easily call someone and know that they would be able to help me in a particular situation. They would be able to provide a solution more quickly due to their designated role, and spend more time educating which I felt was exceptionally important in the role. Especially, for instance, after an individual had gone through say a life-changing situation such as a stroke, this new debilitating issue that they had. Recent cancer diagnosis, after having gone through major surgery, the nurse practitioner was there to be able to reiterate and reinforce the education that would help the patient succeed. But then also reassure them as they were going through this process.’’

 

 

21:49 Achieving formal qualifications through multiple routes

Walter said the diverse options available are helpful for people who are already in a full-time role. 

‘’I would say more nowadays, you have multiple options which is helpful for a full-time working adult. In the proximity of where I live, there is a university that offers nurse practitioner programs. So not only did I myself went to an online program but some of my coworkers went to the brick and mortar school. And I would say while they did have the advantage of being able to have more of a personal interaction with their professors, it seemed like some of our outcomes were similar. We were all in charge of putting together our own clinical experience. I felt like a lot of my education came from being in the clinical experience, being able to utilize what I was not only learning but also being able to draw off the experiences of those that I was having my clinicals with who were there in the local community working. So there are multiple avenues that an individual can pursue.’’

 

 

You’ll Also Hear:

 

Walter’s career path, from management degree to nurse practitioner, via positions as a floor and unit nurse, to nurse practitioner for a neurology group. 

 

The critical role of a nurse practitioner in the management of clinical trials for cancer, ‘’I evaluate patients on their treatment visits to help address any needs that they may have, manage any symptoms, as well as identify any adverse events that could be associated with treatment. ‘’

 

Giving hope to cancer patients - how new technologies benefit the nurse practitioner’s role ‘’Being on the forefront of new technologies that are coming out and seeing how they progress from phase one where they're first in humans to something that you're watching on television as being a new breakthrough treatment modality for a cancer that's bringing hope to people who are currently going through that process.’’

 

How nursing practitioners can help to expand access to care for all. ‘’It's a benefit for the patient because now they don't have to necessarily wait until the physician is available to be able to call them back, answer their email, or see them in person.’’

 

Why finding a mentor before pursuing a career as a nurse practitioner role brings clarity. ‘’There are multiple higher education roles that a nurse can pursue. Nursing education, like you said, nurse anesthetist. I would say try to find something that you feel more inclined to succeed in or love what you're doing….’’

 

 

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