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Columbia Missourian

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

By Dale and Karen Metcalf
August 29, 2013 | 6:00 a.m. CDT

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.