How We Practice

Our patients have highly complex clinical, psychosocial and educational needs and Roswell Park nurses are a critical part of meeting these needs at every stage of cancer care, from diagnosis, through treatment, to survivorship.

Mission

To deliver quality, evidence-based, holistic nursing care to all patients and their families that is grounded in ethical decision making, nursing science and autonomous nursing practice. We achieve this through a commitment to our patients and their families, nurses’ personal and professional development, and nursing excellence.

Vision

To provide exemplary nursing care founded in evidence-based practice, science, and holistic care with compassion for patients and their families, as we face the challenges of cancer together.

Values

  • Innovation: Drive the development of evidence-based practices to achieve quality outcomes as innovators in oncology nursing care.
  • Commitment: Prioritize a patient-centered approach to treatment while taking pride in the care that we provide our patients.
  • Integrity: Commit to being thoughtful, informed, honest, transparent, and ethical in all the decisions we make.
  • Compassion & Respect: Commit to providing nursing care with respect for all patients, family members, and colleagues embracing differences in culture, beliefs, and values.
  • Teamwork: Collaborate with the multidisciplinary team, including the patient and family at the center, while providing exceptional care and achieving quality outcomes.
  • Quality & Safety: Strive to deliver care in a purposeful and consistent manner by incorporating quality and safety into every patient care decision.

The role of the Roswell Park nurse

Nursing at Roswell Park involves a wide range of diagnoses and treatment approaches, encompassing these key areas:

Our nurses provide direct, comprehensive care to patients from pre-diagnosis to post-treatment. Ambulatory nurses are equipped with special skills and knowledge to follow patients through their journey at Roswell Park.

Ambulatory nursing roles include:

  • Solid Tumor Medicine/Surgery Clinics. Nurses in these clinics (Breast, Gynecology, Gastrointestinal, Head & Neck, Neurology, and Sarcoma/Melanoma) provide comprehensive care for medical and surgical patients and are skilled in recognizing medication side effects and surgery complications.
  • Liquid Tumor Clinics. Nurses in these clinics (Leukemia, Lymphoma, Multiple Myeloma, Infectious Disease and Transplant & Cellular Therapy Center) are skilled in hematological treatment regimens, performing blood product transfusions and IV conscious sedation for bone marrow biopsies, providing wound care, and recognizing side effects and oncologic emergencies.
  • Dermatology. Dermatology nurses are knowledgeable about skin cancer prevention, skin related cancers and treatments.
  • Chemotherapy & Infusion Center. Nurses in this center are knowledgeable about many cancer types and skilled in administering chemotherapy and biotherapy regimens.
  • Supportive Services. These nurses work closely with our pain, palliative care and psychosocial teams to care for and support cancer patients.

Roswell Park Inpatient nurses care for oncology patients of all ages within specialized disease-specific units with specific nursing ratios and nurses trained for that patient population.

Nurses work in a multidisciplinary team that includes providers, pharmacists, social workers, dietitians, case managers, and therapists (OT/PT/respiratory). Nurses on these units are key to supporting and educating patients and caregivers to safely continue recovery and care at home. Our inpatient units include:

  • Medical/Surgical Units. Our 18 bed Medical/Surgical units serve patients and their caregivers in the post-operative phase of care through discharge. These patients include those recovering from surgeries for neurological, breast, GYN, head and neck, thoracic, genitourinary, and gastrointestinal cancers, with some medical patients.
  • 5th Floor. Our 14 bed units serve patients and their caregivers with leukemia, lymphoma, myelodysplastic disorders, and post bone marrow transplants. Treatments include chemotherapeutics, adoptive cell therapies, autologous and allogeneic blood and marrow transplant, system management and supportive care.
  • 6th Floor. Our 18 bed medical units specialize caring for patients with a variety of solid tumors and hematological malignancies, who are undergoing medical therapy or have issues that arise from their cancer treatment. Nurses on these units administer chemotherapy, biotherapy and observe patients receiving radiopharmaceuticals.
  • Critical Care Services. Our two units include 18 critical care beds and 10 intermediate care beds for patients with a variety of medical and surgical care needs. Registered Nurses on these units have advanced training in cardiac and respiratory management, and are responsible for ventilator management, cardiac and hemodynamic monitoring, use of invasive lines, administration of vasopressors and cardiac drips and provide emergency care when needed. Candidates must have a solid background in an acute care setting which includes medical/surgical experience. Certification in ACLS and previous experience in cardiac monitoring and step-down care is preferred. 

Roswell Park performs an average of 10,000 surgical procedures each year ranging from lumpectomies to complex thoracic and neurological procedures.

Our Perioperative nurses play important and active roles at each step of care in each the perioperative arena. From preoperative screening to postoperative recovery care, our nurses care for patients of all ages for multiple surgical services including:

  • Breast
  • Plastic & Reconstructive
  • Head & Neck
  • Gastrointestinal
  • Interventional Pulmonology
  • Soft Tissue
  • Gynecology
  • Genitourinary
  • Thoracic
  • Advanced Endoscopy
  • Neurosurgery

Perioperative nursing roles include:

  • ASC RN. Admits and prepares patients for surgery; instructs and discharges patient post-procedure.
  • OR Circulator. Assists in the operating room; advocates for patient while under anesthesia.
  • PACU RN. Recovers patients from anesthesia; prepares for discharge or admission.
  • Endoscopy RN. Assists in endoscopic procedures; advocates for patients while under anesthesia.
  • Multispecialty RN Coordinator. Each area has at least one MSC; manages day to day patient schedule; maintains instrumentation and equipment lists for procedures; coordinates staffing.
  • Endoscopy RN Coordinator. Provides pre-procedure instruction for Endoscopic procedures; maintains quality metric database, provides post-procedure support and patient follow-up.

The Oncology Nurse Coordinator role makes access to comprehensive cancer care appear seamless by improving communication and care coordination with patients and their care teams. These nurses are the one constant for patients throughout the cancer journey.

The nurse coordinators ensure follow-up calls and clinic visits are appropriately scheduled. Symptom management is handled timely and expertly, referring to the ATC if needed, decreasing unplanned hospital readmissions.

Nursing quality

At Roswell Park, we value integrity, quality and safety as key core values that directly impact care delivery and outcomes. Integrity ensures we maintain honesty and transparency, and perform our jobs based on the highest standards of care. Quality and safety are directly related to integrity in that we deliver the safest and most effective care possible. This also relates to safety event reporting.  All events are reported, with or without anonymity, and are without repercussion.  Event reporting is critical in the delivery of safe, effective care. 

In addition, we collect, monitor and report data specific to nursing care. These measures, called Nursing Sensitive Indicators (NSIs) reflect the structure of care delivery, the processes by which we deliver care, and the outcomes of the care delivered. Examples of structure measures include nursing hours per patient day, nurse degree level and certification, and skill mix measures.  Process measure examples include job satisfaction and pain assessment. Outcome measures include falls, hospital acquired pressure injuries (HAPI), catheter associated urinary tract infections (CAUTI), central line associated blood stream infections (CLABSI), and ventilator associated events and infections (VAE and VAI).

NSIs which were developed by the National Database of Nursing Quality Indicators (NDNQI). This agency defines and collects data from multiple healthcare facilities to create a benchmark, or goal that we use to know how well we are doing with a particular measure.

Bedside nurses are represented on all nursing quality councils and are at the forefront of care delivery innovations and decision making regarding these measures. Nursing quality councils are part of our professional governance structure and meet monthly and report issues and outcomes ultimately to Nursing and Medical Executive Leadership and the Board of Directors.

Professional governance

Professional governance is an organizational model whereby nursing staff are involved in making nursing practice decisions that previously were made only by management.  Professional governance shares power with administration in matters such as nursing practice, management, quality outcomes and education. Research has shown that professional governance improves staff satisfaction and patient outcomes in participating hospitals.

Roswell Park’s professional governance structure empowers nursing staff at all levels to partake in councils and committees that range from staff and patient satisfaction to nursing quality outcomes. Clinical nurses, nurse practitioners, and patient care technicians collaborate to improve patient clinical outcomes and satisfaction. Staff are invited to participate in the councils to be the voice for patients and their nursing units. When serving on the councils and committees, staff can bring current opportunities for improvement to the table for resolution or innovation.

We have a one-day meeting assembly, known as the Day of Progress. Unit based councils meet to discuss topics related to their individual nursing units, while quality councils work on specific quality measures such as patient falls or catheter associated urinary tract infections. All meetings occur throughout the first Wednesday of the month, and staff members and managers plan schedules and patient assignments to foster attendance at the council meetings. The structure further supports same day reporting to the Executive Nursing level who work to remove barriers and facilitate movement on staff presented concerns.