Allegheny Health Network (AHN) is a large, integrated healthcare system that provides care to patients throughout western Pennsylvania. As part of this network, the AHN Cancer Institute (AHNCI), offers personalized, high-quality cancer care to patients at >20 locations in and around the Pittsburgh area. The institute uses the latest, most effective anticancer therapies, and through its partnership with Johns Hopkins Kimmel Cancer Center, can offer patients access to clinical trials as well as combined expertise when second opinions are necessary.
AHNCI has a holistic approach to cancer care that considers the emotional aspects of a patient’s journey. Its navigation teams contribute to the success of this approach by scheduling appointments, educating patients about their treatment options, assisting with healthcare-related paperwork, and providing follow-up to clinical care. Patients also have access to an After-Hours Clinic, which offers assistance with treatment-related side effects that may emerge late in the day. The institute’s team members also connect patients to vital support services, including pain management, nutritional counseling, rehabilitation, genetic testing, social workers, and support groups.
The Oncology Nurse-APN/PA (TON) spoke with Anna Vioral, PhD, MEd, RN, OCN, BMTCN, Director, Oncology Practice and Professional Development, AHNCI, Pittsburgh, PA, about her professional responsibilities and recent appointment to the Board of Directors of the Oncology Nursing Certification Corporation (ONCC).
TON: What are your main responsibilities at AHNCI?
Dr Vioral: Professional development, which encompasses a wide range of responsibilities, comprises approximately 50% of my time. We use the term “onboarding” to refer to the process of bringing in new staff, mentoring them, and using effective strategies to retain them. I currently have 4 professional development specialists who work with me; each one is responsible for a different geographic region.
We guide new hires through orientation and provide materials that go beyond educating them to enhancing their professional development. Our goals are to decrease turnover rates, increase retention, and improve the quality of care that our patients receive.
The remaining 50% of my responsibilities involve program development, including the implementation of courses on stem-cell transplantation, radiation oncology, gynecologic oncology, and medical oncology.
My team also conducts research, implements evidence-based practice and quality initiatives, facilitates conference participation and publications that align with our professional development goals, and supports regulatory and oncology-specific accreditations.
TON: How did you become an oncology nurse involved in professional development?
Dr Vioral: I have wanted to be a nurse since I was 14 years old. As a teenager, I decided to volunteer as a candy-striper at Allegheny Hospital, and after being placed in 5 different departments that were not a good fit for me, I was assigned to the oncology unit, which I enjoyed. The director asked me whether I was certain this was what I wanted to do. “I’m running out of places to put you,” she said.
I had a life-changing experience when a young mother who had breast cancer asked me to sit with her. For almost 2 hours, she talked about her terminal cancer diagnosis and her fears about leaving 2 young children behind. She thanked me for listening to her story. The volunteer leader was very surprised that I wanted to work with patients who had cancer.
I continued volunteering at Allegheny Hospital throughout high school and loved every minute of it. Then, in my junior year of college, I worked as an extern in the oncology unit. After graduating from college, I returned to the hospital and began my first nursing job in the same unit, where I continued to work for 18 years.
During those years in the oncology unit, I worked as a nurse, obtained a master’s degree in nursing, and moved into a staff development position. I was then given the opportunity to perform chart audits for quality oncology care. I was allowed to develop the position to fit my goals and became the Systems Oncology Quality and Education Specialist. I enjoyed this because we used the data to improve patient care. I eventually ended up in the role of Director of Oncology Practice and Professional Development, which I have been doing for the past 6 years. During this time, I also obtained a master’s degree in adult education and a postdoctorate degree.
I am very fortunate to have had wonderful mentors along the way, as well as the support of my professional development team and the leadership at AHNCI. All of these individuals have made it possible for me to be effective in my career.
TON: How has being on ONCC’s Board of Directors affected your career?
Dr Vioral: I discovered I have gifts that I did not know I had. As an educator, I am a firm believer in evaluation, testing, and certification. As a volunteer at ONCC, I learned how to develop test items and increased my knowledge of statistics and the value of certification.
I ran for the Board of Directors of the ONCC 3 times, at their encouragement. It was disappointing to not be voted in the first 2 times, but the board members continued to ask me to run. The third time I ran, I was elected in, which came at a better time in my life.
Serving on the ONCC Board of Directors has been a huge professional milestone and an honor. I have learned much more about strategy, including the financial component. I have become more aware of who we serve, what we do for constituents, and how our efforts affect patient care. One of my future goals is to become President of the Board.
TON: What do you consider the biggest challenge and the biggest reward in your role at AHNCI?
Dr Vioral: The biggest challenge is the size of the geographic region and the number of people that we serve. We serve 5 hospitals, 23 outpatient centers, and 4 divisions. We must ensure that we are reaching everyone, hearing their feedback, and making important changes in response to that feedback.
Making a difference is the biggest reward. I believe that if we can influence professional staff development, we will improve the quality of care we provide to patients. It is difficult to quantitate that improvement as a return on investment, but our experiences suggest that improved care is an indirect result of how we recruit, mentor, and retain our staff members.
TON: What are you excited about in the field of oncology right now?
Dr Vioral: I am excited about the tremendous growth in understanding molecular markers and the genomics of tumors that lead to changes in how cancer is diagnosed and treated. We have better science that enables our treatments to be more targeted to each patient’s cancer.
TON: Would you encourage a nursing student to specialize in oncology?
Dr Vioral: I teach part-time and have the opportunity to talk to students about joining professional organizations so that they can have a voice. Oncology is a small component of the nursing curriculum. Many students want to deliver babies or work in the intensive care unit. I tell my students how much I love working in oncology and that I highly recommend it.
I believe there is still a stigma about working in oncology. Some of my students ask me how I can work with patients who are dying, and I explain to them that, in many cases, cancer is a chronic disease. I also tell them that there are many interesting opportunities; the specialty has a lot of variety and is never boring.
TON: What would you do if you won the lottery?
Dr Vioral: I would do 3 things. I would donate funds to science to advance research on cures for cancer; I would travel to places I have not been to before; and I would continue to do what I do but would like to design my own schedule.