Winship Cancer Institute of Emory University

TON - June 2013, Vol 6, No 5 — July 10, 2013

The Winship Cancer Institute of Emory University is Georgia’s first and only National Cancer Institute–designated cancer center. As part of Emory University, Emory’s Woodruff Health Sciences Center, and Emory Healthcare, Winship provides state-of-the-art cancer care and is heavily involved in clinical trials on research for prevention, diagnosis, and treatment of cancers, with the goal of cure.

The Oncology Nurse-APN/PA spoke with Charise Gleason, MSN, NP-BC, AOCNP, about her role at Emory as an advanced nurse practitioner in the Bone Marrow Transplant Center, where she specializes in treating patients with multiple myeloma.

Tell me about your role at the Bone Marrow Transplant Center at
Winship Emory Healthcare.

Charise Gleason (CG): I am a nurse practitioner [NP] in the bone marrow transplant and myeloma program here at Emory. I specialize in multiple myeloma and complications from transplant. I see patients for return visits, follow their lab test results, order diagnostic studies, and manage situations that arise in the infusion center. For example, I am consulted if a patient getting treatment develops a new side effect, and also nurses will come to me with questions or issues that arise. I am the lead in my group, so I also have administrative responsibilities.

What approach does your center take to treating patients with
multiple myeloma?

CG: Our practice is patient centered and focused on the individual.

We have a multidisciplinary team approach that includes nurses, NPs, PAs [physician assistants], physicians, social workers, and clinical pharmacists. We see more than 1000 patients each year in our myeloma program.

We are an academic center, and clinical research is part of our mission. This setting gives us multiple treatment modalities to offer our patients. Any patient who comes here gets a thorough diagnostic workup, and then we offer that patient the most appropriate treatment plan. That could include conventional treatment and/or a clinical trial.

We offer up-front clinical trials for newly diagnosed patients as well as clinical trials for relapsed/refractory patients with multiple myeloma. As a myeloma center, we have multiple trials to offer at any time.

How does the approach to care at your center translate to better outcomes for your patients?

CG: We offer a multidisciplinary team approach that focuses on the individual patient. Patients and family members meet the team members at consult. We are committed to providing the latest, most innovative techniques and treatments as well as supportive services. We have resources to help the family and trained supportive staff to manage side effects. We believe this approach does lead to better outcomes.

How has the role of the nurse practitioner changed in the past 5 years?

CG: There is a growing population of advanced practice providers, both NPs and PAs, in healthcare in general. Here at Winship, NPs and PAs are an integral part of the care teams. We provide care to patients in the clinic, infusion center, and inpatient setting. There is also more opportunity to participate in research and develop NP/PA-run clinics. Survivorship clinics are growing and are frequently managed by NP/PAs. There are also more teaching opportunities. In Georgia, PAs were recently granted prescriptive authority. This varies from state to state.

What inspired you to become a nurse practitioner and to specialize in
multiple myeloma?

CG: I went to nursing school after I had children and was drawn to oncology from the start. I had a rotation on the hematology/oncology floor and loved it and stayed there. After NP school, I joined the Bone Marrow Transplant service and eventually specialized in myeloma. I started with the myeloma program about 10 years ago with Sagar Lonial, MD, and over time the program has really grown.

The landscape of myeloma has changed so much over the last 10 years that patients now have more treatment options leading to better outcomes. We see our patients frequently and therefore get to know them, as well as their family members. I feel very privileged to work in oncology.

What is a major challenge in your job?

CG: Getting patients what they need. Appointments are not always available, and getting medications can be a challenge for some patients. Time can be an issue. NPs are involved in multiple working groups, and most of us are involved in academic endeavors as well. Maintaining a work/life balance can be an issue.

What advice would you give to a person entering oncology as a nurse practitioner?

CG: I would recommend taking the time to develop a solid medical foundation, especially for new practitioners. Most of us tend to specialize, so a strong medical background is essential. It is important to have a mentor for support and guidance. We need to continue to expand our expertise by attending professional meetings and participating in education courses.

If you weren’t a nurse practitioner, what would you be doing?

CG: Traveling and writing about my traveling experiences.

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