Page 38 - Johns Hopkins Nursing Magazine Fall 2020 - Johns Hopkins School of Nursing
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NEWS FROM JOHNS HOPKINS NURSING  Cancer Treatment to Go                                                                                                                              “Patients love it, and some                        NEWS FROM JOHNS HOPKINS NURSING



                                                                                                                                                                                             say they don’t ever want to


             Curbside Injection Clinics offer patients
                                                                                                                                                                                            go back to being seen in
                                                                      had to adapt to the circumstances and come up
                                                                      with a way to get them the care they needed while
             ‘drive-thru’ care with a side of COVID safety
                                                                      also protecting them from becoming infected
                                                                      an inexhaustible innovator, Olsen drew on her
                         On a hot, late-summer day, Lori Parker, oncology
                                                                      experience with field hospitals to focus on rapidly
                                                                                                                                                                                             To keep both [indoor and
                         RN, is calm and cool in scrubs, surgical mask, and   with the coronavirus.” A former Army nurse and                                                                the cancer center. We plan
                                                                      building an outdoor program that could match
                         face shield, dragging two mobile carts at once out   the level of quality care on the inside—and then
                          to meet a cancer patient’s car in the traffic circle   recruit nurses who were battle tested.
                         of Johns Hopkins Hospital’s Skip Viragh Building.                                                                                                                  curbside clinics] going
                         She checks him in using a wristband and bar-  Parker was among those hand-picked for the
                         code scanner and pulls up his chart on Epic, the   role. And on this day, she is showing why, fielding
                         electronic medical record system. He’s a first-time   phone calls from patients on their way to the                                                                after COVID-19 is over.”
                         user of a curbside injection program that allows   drive-up, spacing out the arrivals as she preps
                         patients concerned about COVID-19 exposure—   for the next one. She hustles in and out of the
                         or at risk due to compromised immune systems—  sliding glass doors to meet each vehicle, muscling
                          to be treated without ever leaving their cars. In 15   the carts across the pavement, treating each new
                         minutes or less, they are rolling on their way.  patient like the only person in the world.

                         Since April, more than 1,500 patients have   It’s like clockwork, mostly, until another first-
      36                 utilized Viragh’s Curbside Injection Clinic and   timer stomps angrily up to her station. He has                                                                                                                      37
                         a companion site across Orleans Street at Johns   misunderstood how the operation works and has
                         Hopkins Hospital’s Weinberg Center, according   been waiting impatiently for treatment … over
                          to MiKaela Olsen, DNP, APRN-CNS, FAAN, an   in the parking garage. Parker doesn’t blink or
                         oncology and hematology clinical nurse specialist   hesitate at his indignation, whisking him into a
                         and the driving force behind the service. Health   dedicated side room for treatment on the spot:
                         care centers nationwide have taken notice, calling   one more happy—or at least happier—and now
                         Olsen and her team for advice on setting up their   better-informed customer. “She’s a problem-                Lori Parker, RN, with her mobile carts outside the Skip Viragh Building
                         own versions of the clinics.                 solver,” explains Olsen. The side room is generally
                                                                      reserved for gluteal injections or other treatments
            “We had to adapt to the                                   that might leave patients feeling too exposed even                teaching before administering the chemotherapy.    hospital for part of each shift and says she doesn’t
                                                                      in their vehicles.
             circumstances and come up                                Viragh and Weinberg treat different types of                      At the curbside oncology clinics, patients may   worry about the approaching winter, or whatever
       JOHNS HOPKINS NURSING  FALL/WINTER 2020
                                                                                                                                                                                    weather comes. “Except the wind. That’s the worst,”
             with a way to get [patients] the                         cancers, those with solid tumors presented                        have blood drawn and receive injections of   she says. The medicines are likewise weather-
                                                                                                                                        therapy drugs, growth factors, or vaccines and
                                                                                                                                                                                    proof, with those that require refrigeration kept in
                                                                      by pancreatic or prostate cancer, for instance
             care they needed while also                              (Viragh), or “liquid” tumors (from leukemia                       have their vitals checked without ever leaving the   a “smart” cooler that alerts the pharmacy should
                                                                                                                                                                                    temperatures rise. And a security detail makes sure
                                                                                                                                        car, or whatever vehicle brought them. “We’re in
                                                                      or lymphoma) at Weinberg, where a sidewalk
             protecting them from becoming                            scale tracks a patient’s weight, which can affect                 an inner-city area, and people sometimes show   supplies don’t walk away and that nurses work
                                                                                                                                        up for treatments in Ubers and taxis,” Olsen says.
                                                                      dosages. At Weinberg’s injection clinic, where
                                                                                                                                                                                    worry-free.
             infected with the coronavirus.”                          the emphasis is more on chemotherapy, Olsen                      “Patients love it, and some say they don’t ever want   At both clinics, other common outdoor services
                                                                      chose hematologic malignancy RNs Joanna
                                                                                                                                        to go back to being seen in the cancer center. We
                                                                      Bautista and Erica Langton as champions. What                     plan to keep both [indoor and curbside clinics]   include flushing central line catheters and          MAGAZINE.NURSING.JHU.EDU
                                                                      could at times be a lengthy appointment for labs                  going after COVID-19 is over.”              performing dressing changes. “We’re still thinking
                         “Patients were afraid and were canceling     and a chemotherapy injection has turned into                                                                  of ways to treat more things curbside,” says Olsen. ◼
                         appointments for important care,” explains Olsen   a 30-minute drive-up visit. Nurses complete a               Parker loves the constant action, the variety of
                         of the impetus behind the sidewalk service. “We   full assessment, take vital signs, and do some               patients, and the freedom of being outside the
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