On March 9, 1992, nurse practitioner Pamela Paplham, DNP, AOCNP, FNP-BC, FAANP, FAAN, started working at what was then called Roswell Park Memorial Institute. Exactly 30 years later, she retired from what is now called Roswell Park Comprehensive Cancer Center. Pam recently shared some recollections about Roswell Park and her passion for patient care, teaching and forging new paths.
What brought you to Roswell Park?
Both determination and sheer luck. I always wanted to be a nurse. After becoming a registered nurse in 1987, I worked in the intensive care unit (ICU) at a busy Rochester hospital. But I noticed that I was most fulfilled when I worked with cancer patients.
Over the next few months, I worked on the Monroe County Terminal Care Team. I also went back to school and got my master’s degree as a family nurse practitioner in 1992. My goal was to work with patients in a blood and marrow transplant (BMT) unit. Back then, however, the role of the nurse practitioners (NP) was somewhat new and undefined, especially in cancer care. But I saw the need for someone in the care team to collaborate with the doctors and assist in coordinating and executing medical decisions.
The hospital where I worked had no interest at the time in hiring an NP in the cancer unit. My sister lived in Buffalo, so I applied to Roswell Park, where my application was promptly rejected. A few days later, a nursing leader happened to see my paperwork at the top of a stack of applications. She phoned me and asked about my experience. When I told her my thoughts on how NPs could play an important role in bridging critical gaps and improving the quality of care for cancer patients, she said, “Exactly! This is going to be the wave of the future!” She asked to meet and I ended up spending the whole day at Roswell Park. The next day I was hired as one of the first two nurse practitioners at Roswell Park, in my dream job in the BMT service.
What changes at Roswell Park have you witnessed in the past 30 years?
The physical campus downtown has changed a lot. When I first started, I was in the old building that had a duck pond inside the hospital, next to the BMT clinic. In 1993, work began on the new hospital across the street, which opened in 1998. We became a public benefit corporation in 1999, which gave Roswell Park the benefit of administrative autonomy and financial support from New York State. And in 2016, the Scott Bieler Clinical Sciences Center opened. The reach of Roswell Park’s expertise has also expanded over the years, with satellite clinics and regional care affiliations with hospitals and medical groups throughout New York State and Pennsylvania.
Advances in blood and marrow transplant and supportive care techniques have led to improvements in long-term survival after transplant. Roswell Park’s BMT program is now part of an expanded Transplant and Cellular Therapy Center that provides revolutionary cellular therapies and exclusive clinical trials.
Improved survival meant more patients were living longer, and the need for a much more concerted effort at Roswell Park to meet the long-term needs of cancer survivors became apparent. I oversaw the specialized long-term care and survivorship clinic for transplant patients for the last 11 years.
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As one of the first NCI-designated comprehensive cancer centers, Roswell Park has long valued collaboration in clinical care, research and education. One great example of this in BMT care happened in 2019, when John R. Oishei Children’s Hospital relocated near Roswell Park’s main campus and UBMD Pediatrics, facilitating the creation of the Roswell Park Oishei Children’s Cancer and Blood Disorders program.
Pediatric patients, their families and medical personnel now have easy access between outpatient chemotherapy, infusion treatments and radiation therapy at Roswell Park’s Pediatric Hematology Oncology Center and inpatient care for surgeries, blood and marrow transplants and critical care at Oishei.
On a more personal level, a big change is one that I helped implement: the acceptance and understanding of the vital role of advanced practice providers – including nurse practitioners and physician assistants – at Roswell Park and all around the country. Quite simply, I believe our medical institutions could not function without them.
What have been some of the highlights of your career?
The bonds and friendships I’ve forged with so many of my colleagues and patients have enriched me beyond measure.
I’ve been at the bedside of hundreds of patients at the most vulnerable times of their lives, and it has been an honor. I’ve kept in touch with many patients over the years. So many of my patients have told me how grateful they were to live and realize their personal and professional goals. I know that our care made it possible for them to achieve some of their dreams. I’ve been to the weddings of some of my former pediatric and young adult patients, and I’ve shared in the joy of so many others who have survived and watched their families grow. I’ve had the great fortune to hear some of my patients share their stories at national BMT conferences, thereby helping to inspire and teach care providers.
As for my own professional and personal goals, in 2009, while working weekends at Roswell Park and raising my young children, I went back to school to get my doctorate in nursing practice. In addition to working in Roswell Park’s long-term care and survivorship clinic, I have also been the assistant dean to the MS/DNP programs and a clinical professor in the UB School of Nursing for the last 11 years. I’m proud of the role I’ve had in training and coaching hundreds of students who are now nurse practitioners all over the country, including many who are now on the staff at Roswell Park. I’ll continue to train and mentor NPs in my new role as the Associate Dean of Clinical Programs at UB.
What’s something your former patients may not know about you?
I am a cancer survivor myself. In 2016, a routine mammogram detected a Stage 0 ductal carcinoma in situ breast cancer. I had a lumpectomy and one month of radiation at Roswell Park, and just two weeks ago, after five years, I took my last dose of Tamoxifen. Hearing the words “you have cancer” gave me whole new lens into providing care for patients. I personally experienced a patient’s fear, along with the compassion and expertise of my Roswell Park colleagues.
What kept you at Roswell Park for so long?
I loved what I did — taking care of cancer patients at a world-class cancer center.