LETTER TO THE EDITOR: Staff cuts at Ellis Fischel impact quality of patient care

Thursday, August 29, 2013 | 6:00 a.m. CDT; updated 4:54 p.m. CDT, Thursday, August 29, 2013

The University of MissouriHealth System has decided to make a budget or staff cut in the Ellis Fischel Cancer Center. The cut is in the Advance Practice Nurses that give direct care to cancer patients and their treatment.

Four important positions that give consults and guidance to patients and their caregivers were cut one month ago with a two-week notice.

Patients received a letter in the mail telling them the service would no longer be provided. Patients were left to wonder what to do and who to call if they have a reaction to their treatment or simply have a question about what to expect from the procedure.

The question I would like to ask is what is to be accomplished? Does the cut make care more efficient? How is that, when now we have to contact the doctor for a prescription change or any change in the follow-up care? The doctor may be in surgery or not on call. Then do we go straight to the emergency room? Incur a hospital stay? Have an unscheduled appointment and wait?

The Nurse Practitioners saved time and money it would seem to me. They are able to prescribe or stop medications when reactions occur. They are available by immediate contact on the phone or by text.

Sometimes the simple reassurance you are doing the right thing is all that is needed to calm the anxiety of a patient and caregiver.

Have you ever been diagnosed with cancer? Just the word brings anxiety to a family.  Health care today is about prevention. Preventing unnecessary visits, hospital stays, emergency room appointments and preventing exposure to other infections by simply visiting a waiting room. Cancer patients undergoing treatment are vulnerable to infection. They experience anxiety every day.

It seems that this was an action taken without thinking about preventative care. The health care industry today is about outcomes rather than fees for service. Cancer care requires a team approach. A team that can incorporate all aspects of human care. We were asked where we wanted to receive our chemo here in Columbia. We told MD Anderson we wanted Ellis Fischel simply because of the team approach they had. This included Advance Practice Nurses. We would rethink that decision now given the current circumstances.

Dale and Karen Metcalf are Columbia residents. Dale Metcalf is a cancer survivor; Karen Metcalf is a caregiver.

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Mike Martin August 29, 2013 | 8:45 a.m.

During our three year tussle with breast cancer, my wife and I enjoyed the care of several Ellis Fischel nurses, and I completely agree with the sentiments in this letter.

I remember many of them by name, in particular Nurse Mary, Dr. Michael Perry's long-time partner-in-care; and Nurse Dawn, whose breast cancer expertise was second to none.

Nurse Dawn's gentle, informed conversations convinced us to join a long-term study of various chemotherapy combinations that are now helping other women.

Nurse Mary's gentle hands, gentle voice, and no-nonsense demeanor -- a powerful combination in cancer care -- guided us through some of the most agonizing moments in our journey: the whole body physical exams where the nurse or the physician carefully palpates the patient, looking for enlarged lymph nodes or any other signs of cancer's spread or return.

I wrote about our experience several times, and recall this passage:

"When the tumor started to shrink after Alison's first round of chemo -- the drugs Adriamycin and Cytoxan -- Nurses Mary and Dawn couldn't restrain their delight. 'And you haven't even met Taxol!' Mary said, referencing a chemo to come."

"Months later, during pre-planning for surgery, Alison's MRI and other imaging data was so clean, medical students and radiology fellows gathered to look at the pix, inspiring and educational windows into the heart of modern medicine and the soul of a powerful team."

--from "God and Medicine at Ellis Fischel"

This Youtube video from survivor Lori Taube expresses similar sentiments:

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