Anne Gross, MS, RN, CNAA
A chance to shape the future at Dana-Farber
 Anne Gross (pictured above), vice president of adult ambulatory services and director of adult ambulatory nursing at Dana-Farber Cancer Institute. |  |
By Laurie Fronek | June 19, 2007
Anne Gross is vice president of adult ambulatory services and director of adult ambulatory nursing at Dana-Farber Cancer Institute. She talked with On Call's Laurie Fronek about nursing at DFCI and also discussed the impact of the shortage of nursing teachers on the profession.
Q. What impact has the nurse shortage had on staffing at Dana-Farber Cancer Institute?
A. We've been very fortunate. We have very little turnover here, and we have not had trouble hiring nurses. So we haven't felt the impact much. But it is a serious issue across our profession, and we are constantly looking at ways to recruit and retain nurses.
Q. Can you talk a little about your approach to recruitment and retention?
A. In recruitment, we look for specific qualifications - a fit in terms of clinical experience, education, and preparation. To help retain nurses, we work hard to maintain a collegial and collaborative environment, where nurses have a chance to grow and to advance professionally. We work very closely with each other, of course, but also with other disciplines - our physicians, social workers, pharmacists, nutritionists, respiratory therapists, and others. That makes the professional environment both stimulating and rewarding.
A lot of our nurses are continuing their education. Others are young mothers working part time, and we try to create flexible schedules for them. Also, we have a shared-governance model in our department of nursing and patient care services. We all sit at the table together, including staff nurses and those who are taking care of patients at the bedside, to plan what we need to provide the highest quality care. The staff nurses guide and inform the decisions we make that impact patient care and the practice environment.
"Part of what is feeding the nurse shortage is a shortage of nursing faculty. Around 30,000 to 35,000 qualified candidates were turned away from nursing schools in the last year." |
Q. What are some of the roles nurses fill at Dana-Farber?
A. We have a variety of roles for nurses, from nurse practitioners to infusion nurses to nurse educators, research nurses, and nurse scientists.
Our approach to care is multidisciplinary, so nurses, nurse practitioners, physicians, pharmacists, social workers, and others all work together to manage patient care. The nurse practitioners have advanced degrees and work with their physician colleagues in treating and managing the care of patients through their illness. Infusion nurses are the nurses who administer treatments, such as chemotherapy and biotherapy, to patients while they're here. The nurse treats the patient and provides a lot of supportive care. We treat the whole patient and the family. Cancer patients and their families have many needs. Infusion nurses help their patients manage the various challenges they face during their treatment through to survivorship and/or end of life.
Our research nurses work with the many patients here who are on clinical trials. They help screen patients for eligibility and make sure patients who are on trials are able to adhere to the requirements of the protocol. They also provide education to the staff who are administering the treatments on each step of the protocol and help manage patients' symptoms during treatment.
The role of nurses in many areas is to help manage the side effects of treatments and symptoms of the disease as well as the impact it has on their daily lives. Research nurses do that, as do our program nurses, who work in specific disease centers. The program nurses spend a lot of time on the telephone with patients, triaging symptoms and providing supportive care. In radiation oncology and imaging, nurses also support patients through diagnostic and therapeutic procedures and treatments.
Nurses in our department of care coordination coordinate the patients' needs at the time of discharge or as a patient is anticipating being admitted for surgery, a bone-marrow transplant or another procedure. Our nurse educators and clinical nurse specialists orient and train new staff, as well as provide support and education to current staff around new therapies, equipment, or treatment approaches. We also have a center for nursing research here, where doctorally prepared nurses conduct their own research in their areas of interest. Many of them focus on quality-of-life issues for patients.
And then we have nurse leaders who lead and oversee clinical care with their physician colleagues. They make sure that our units are well staffed and that the staff is trained and has the equipment, supplies, and other resources they need to care for patients safely and expertly on a daily basis.
Q. Aside from the nurse shortage, what other big issues do you see confronting nursing now?
A. Part of what is feeding the nurse shortage is a shortage of nursing faculty. Around 30,000 to 35,000 qualified candidates were turned away from nursing schools in the last year because there were not enough slots for them in schools of nursing. So it is not that there are not men and women interested in entering the profession. It is that we do not have enough faculty to train them.
Q. Why the faculty shortage? Is there a lack of interest in teaching?
A. It's expensive to get an advanced degree - a master's degree or a PhD. Master's and doctorally prepared nurses are required to train new nurses, and doctorally prepared nurses are required to train advance practice nurses, but there is not enough funding available to subsidize education for nurses. So we need more funding, more money put toward loans and scholarships for people who want to further their education.
Q. Besides your collaborative approach, what makes nursing at Dana-Farber unique?
A. Because this is also a research institute, we have the opportunity to participate, through our clinical research center, in testing new, approved cancer drugs with patients who consent to enroll in a phase-one clinical trial. Some of these drugs go on to become standard treatments that are helping patients live longer and survive their cancers. In this way, we play a role in shaping the hope for the future for cancer, our patients, and their families.
Laurie Fronek is a freelance writer who lives in Seattle and a regular contributor to On Call. She has done the interviews for On Call for the past nine years.
