Greenville Health System Center for

Integrative Oncology and Survivorship

Internship Kendall Phelps-Polirer

Health Science InternAugust – December 2016

Clemson University

900 W. Faris RoadGreenville, SC 29605

Student Internship Introduction

As a Health Science major at Clemson University, I am required to complete a 180 hour internship in a healthcare field of choice. With a strong interest in the field of oncology, I had the privilege of being a student intern at the Greenville Health System Center for Integrative Oncology & Survivorship (CIOS) in the fall semester of my senior year. I was responsible for various clinical and administrative duties, and experienced firsthand how CIOS provides holistic, patient-centered care. This PowerPoint will serve as a guide to display my experiences interning at CIOS. A description of the site and department I worked in, my roles and responsibilities, and descriptions of the projects I completed as a student intern will be presented.

Greenville Health System

• Greenville Health System (GHS) is a nonprofit, patient-centered, teaching and research institution.

• With 500 employees located among 10 sites of service, GHS is committed to providing patients with comprehensive health care.

• With the Center for Integrative Oncology & Survivorship (CIOS) opening its doors in 2012, GHS has become the most comprehensive cancer program between Duke and Emory with a staff of 60 oncologists

 

Mission, Vision & Values

• “Our vision at Greenville Health System is simple...to transform health care for the benefit of the people and communities we serve.”

• Mission: Heal compassionately. Teach innovatively. Improve constantly.

• Vision: Transform health care for the benefit of the people and communities we serve.

• Values: Together we serve with integrity, respect, trust and openness.

Center for Integrative Oncology and Survivorship

• As a student intern this fall semester at the Greenville Hospital Center for Integrative Oncology & Survivorship (CIOS), I have experienced the delivery of “patient-centered care” firsthand.

• The program has been described as the first of its kind by many of its staff. Located on the first floor of the Cancer Institute, the center houses the multidisciplinary team of health care providers dedicated to caring for all aspects of the patient. Center for

Integrative Oncology

and Survivorship

Oncology Rehab

Cancer Genetics

Smoking Cessation

Lung Low Dose CT

Screening

Social Work

Lifetime Clinic

Lymphedema Physical Therapy

Integrative Therapies

Nutrition

Sexual Health

Clinical Trials

• The center provides patients with different complementary therapies that addresses any physical, emotional, and social needs.

What is Integrative Medicine?

“ Medicine that integrates the therapies of alternative medicine with those practiced by mainstream medical practitioners”

The goal is to treat the mind, body, and spirit, all at the same time. Below are some of the forms of integrative medicine offered at CIOS:

• Integrative Classes• Yoga• Acupuncture

• Music Therapy

• Massage Therapy• Nutrition Counseling

• Individual Counseling• Writing Classes

• Integrative Education Classes for staff

Merriam-Webster

A Typical Day• I start every Tuesday and Thursday morning meeting with my

preceptor, Maggie Thomas, in our office to get my schedule for the day. I split my time at CIOS between administrative and clinical observations. Maggie provides me with any materials I need to complete my administrative duties and organizes the times I can meet with different health care professionals to interview and shadow. After I spend time observing in the clinic or conducting an interview, I report back to the office for my next duty. I end the day checking in with Maggie to ensure all tasks were completed and to learn of any important notifications before my next shift.

Roles & Responsibilities

Shadowing• As part of my internship activities, I

spend time shadowing the multidisciplinary team of health care providers to see how the dedicated staff works together as a team to address the person as a whole.

• I have been able to observe Integrative Oncology and Survivorship (IOS) visits, Moving On visits, Lung Cancer Screening visits, Smoking Cessation Program visits, the Lifetime Clinic, Physical Therapy for lymphedema, and Music Therapy classes.

IOS Visit

I shadowed Nurse Practitioner LeAnn Perkins and Nurse Practitioner Gina during their IOS visits to present patients with a Survivorship Care Plan (SCP).

An SCP is a comprehensive plan for care that gets reviewed with the patient and becomes a permanent part of their medical record.

The accrediting institution, the Commission on Cancer (CoC), requires that 25% of eligible patients receive an SCP to maintain compliance, so informing patients and other healthcare providers of the importance of this visit is crucial to maintaining CIOS accreditation.

Moving On Exercise Program

Moving On is a free 12-week Oncology Rehabilitation Program that focuses on increasing physical fitness

The program is held in the Life Center Gym so that patients are taught how to use the equipment in a real gym atmosphere.

I was able to shadow Nurse Practitioner Doug McCormick and see the process of evaluating and referring a patient to the program

I also interviewed Nursing Program Coordinator, Noreen D ,on her role supervising the program and working to find what motivates each patient.

Lung Cancer Screening & Smoking Cessation Program

• I shadowed Nurse Practitioner LeAnn Perkins during a Lung Cancer Screening visit in which the patient is referred for a free, low-dose CT scan for patients that meet the criteria. The radiology reports from these scans often detect unknown cancers in other organs that are included in the radius of the CT, and this early detection means more treatment options are available.

• The QuitSmart Smoking Cessation Program provides patients with the necessary tools to stop smoking. I shadowed both Nurse Navigator Stephanie Hoops and Nurse Practitioner LeAnn Perkins during their visit with a patient. The program allows the healthcare providers time to ensure all the patients needs are met and discuss how to overcome hardships one may have during this time. The visits are very informative and comprehensive, with the whole person being taken into account and not just the acute issue.

Lifetime Clinic

I was able to observe Nurse Practitioner LeAnn Perkins during a few Lifetime Clinic visits with patients that had been in remission for several years but had ongoing survivorship needs. Nurse Practitioner LeAnn Perkins provided information on all of the services provided by CIOS that could be of benefit to the patients. This new model of long-term follow-up care for cancer survivors ensures that all post-treatment issues are addressed during the hour long visit, and the patient can be followed up by the Lifetime Clinic for the rest of their lives

Supportive Therapy Classes

I shadowed Physical Therapist Kathie Beldon during a Lymphedema Management Program visit. I observed how she manually drained the lymph nodes in a breast cancer patient’s arm to decrease swelling and relieve pain.

I attended the Music Therapy Classes on Tuesdays at 2:00pm with Music Therapist Meredith Bowden. Meredith used music, instruments, and lyrics to teach the group ways to build self esteem and confidence, improve memory and cognition, and utilize relaxation techniques. The class included open discussion that addressed issues some of the women faced and created a close-knit support network amongst the group.

Tumor Board Meetings and MDC Observation

• I was given the opportunity to attend the Multidisciplinary Breast Center (MDC) Tumor Board Meetings on Thursday mornings that focused on the diagnosis and treatment of breast cancer.

• The MDC allows for collaboration between the medical, surgical, and radiation oncologists and other specialties including radiology, pathology, fertility specialist, genetic counselors, and access to clinical trials and research.

• The patient’s images, pathology report, and medical history are all reviewed as the healthcare team decides possible treatment options and formulates an individualized treatment plan specific to each patient. Following the Tumor Board Meeting, I was able to observe each physician’s consultation with the patients discussed.

• This advanced breast cancer care helps to eliminate the delays many cancer patients experience in the course of diagnosis to treatment. Many of the patients I observed were scared and uninformed about the details of their cancer diagnosis, and the oncologists spent as much time as each patient needed in order to understand their treatment plans. The time the doctors spent with their patients allowed for trust to be established, which is important for ensuring a patient will agree with and adhere to the treatment plan.

Administrative Duties

Contacting patients with scheduled therapeutic events and appointment reminder phone calls

keeping the pamphlets, patient resource binders, boards, and flyers around the floor current and relevant

Entering patient data from CIOS programs:

Input of the Low Dose CT Lung Cancer Screening Program data into REDcaps and Microsoft Access

Input of Body Composition Data into REDcaps

Input of Lymphedema Measurement data into LVP60 Program

Internship Projects

Informational Interviews

• I interviewed the different health care providers such as nurse practitioners, project and research associates, nurse navigators, music therapists, social workers, and nutritional therapists to gain an insight of their career and the part they play within the CIOS team.

Patient Resource Documents

Scholarship Information for Childhood Cancer

Survivors

Internet Based Patient

Resources

I collaborated with my preceptor, Maggie Thomas, to put together a comprehensive Internet Resource Guide to help patients find online support groups and in-depth information about their cancer. 

I worked on creating a document with current information on available scholarships for social worker Kerri Susko to provide to her patients  

Patient Resource Documents

QuitSmart “QuitKit”Checklist

Mindfulness PowerPoint

I worked to develop a PowerPoint on Mindfulness. The presentation covered an explanation of the practice, benefits, and ways to implement mindfulness into survivorship. This presentation will be incorporated into a Nurse Navigators overview of CIOS and Mindfulness to a local cancer support group

A checklist for items to be included in the “Quit Kit" for smoking cessation patients

Woman to Woman• Woman to Woman is a new support network program at

GHS that pairs women in treatment for gynecological cancer with trained volunteer survivors to provide one-on-one advice and support

• I was very excited for the opportunity to assist with the coordination of this program and worked alongside social worker Candace Sprouse.

• My role was to identify patients in the EPIC electronic medical record system with gynecologic cancers, then call to inform them of the new program and ask if they would be interested in joining.

• We held the first comprehensive volunteer training meeting to teach the mentors what they can do to provide the best support to the newly diagnosed patients. This was an 8 hour session in which the women were taken on a tour of the hospital, educated by guest speakers, and role played different mentoring situations.

Internship ReflectionFrom participating in program offerings, I have seen firsthand how CIOS provides holistic, patient-centered care that focuses on the entire well being of the patient. I have learned that cancer does not just impact the place where the tumor originated, but rather invades and affects a person and their family both psychologically and emotionally. Completing this internship at Greenville Health System Center for Integrative Oncology & Survivorship has allowed me to reach many personal goals and has provided me with unique, lifelong skills that I can bring with me to succeed in my journey through medical school.

I can confidently communicate my decision for pursuing a career in the field of oncology

I can define how the Center for Integrative Oncology & Survivorship provides a holistic approach to the treatment of cancer.

I am able to articulate at least three core values and skills necessary to become an effective and patient-centered health care professional

I have implemented a program that will help CIOS continue to provide the most effective and patient-centered care.