Bridging the GAP: How to Maintain Continuity of Care for Our BMT Patients While Maintaining a High Quality of Life for Our Nurses

Abstract

Topic Significance & Study Purpose/Background/Rationale At our academic comprehensive cancer center (CCC) we perform approximately 450 bone marrow transplants (BMT) a year. Much of the care for BMT patients is delivered in the ambulatory clinic with few hospitalizations. It is imperative to have specialized BMT nurses to manage these high acuity patients with multiple comorbidities. The clinical care mandates triaging phone calls, performing critical assessments, medication management, monitoring lab values, and assessments of psychosocial and spiritual needs. Patients are assigned a team upon arrival, comprised of an attending physician, an advanced practice provider, and the nurse. The nurse remains constant throughout the trajectory of BMT acting as the primary contact for the patient. Work life balance is crucial for BMT nurses who are caring for patients often undergoing their last line of therapy and requiring immense clinical and psych-social support. It is imperative for our team nurses to have flexible schedules and the ability to take time off to recuperate and rejuvenate. Methods, Intervention, & Analysis Our patients spend 1-4 months on the BMT team. To facilitate BMT nurses’ quality of life without sacrificing the continuity of care of our patients, we have developed a role for a “float” or “vacation relief” nurse for sick, or vacation coverage. Findings & Interpretation These “vacation relief” nurses are full time nurses specialized and experienced in transplant. The intense training and orientation undergone by “vacation relief” nurses is months in duration with Team nurses fulfilling the role of preceptors. Along with this training, we have weekly team meetings between team nurses and the vacation relief nurses to address challenges and care issues. This communication ensures that our BMT patients are safely cared for and experience the best possible outcomes. Discussion & Implications The “vacation relief” role is one that maintains continuity of care of our patients. It also provides flexibility in schedules and appropriate time off work, without compromising our patients’ safety. The results of this role have been an increase in retention of our nurses, thus, creating a team of exceptionally experienced and expert BMT nurses, ultimately, promoting the highest quality of care for BMT patients.