Hospital care evolves to include pleasure, not just sterile pain

Posted: Wednesday, February 25, 2004

The wonderful smell of freshly baked bread isn't something one expects when arriving at the Central Peninsula General Hospital's Oncology Department for chemotherapy, but with the hospital's focus on patient-centered care, that's just one of the newly added pleasures people find there.

"As part of Planetree, we try to make the patient as comfortable as possible," said Kathy Lopeman, oncology nurse, who runs the department with the help of oncology technician Glenna Bragg.

Planetree is a philosophy of care geared toward personalizing, humanizing and de-mystifying health care for patients and their families.

While bread baking customarily is not one of the many skills required of registered nurses, Lopeman happily performs the task, which she says enables patients to recall memories of their moms baking bread when they were younger.

"People identify with the smell as a pleasant thing," she said.

"I've seen their pulse rates and respirations decrease as soon as they smell it."

The nurse, who has run the cancer-treatment department since it became a full-time service at CPGH in 1997, said to make the treatment as comfortable as possible for the cancer patient, something pleasing must be found, whether it's an aroma, something visual or a sound.

"During chemotherapy, often people's tastes change. Some will actually go completely opposite.

"Where they liked sweet things, now they prefer sour," she said.

Some of the medicines patients use also can cause things to have a metallic taste, she said.

Chemotherapy involves the use of drugs anti-neoplastic agents that attack and kill cancer cells. The drugs can be administered intravenously and orally and can be injected into the bladder, the spine or into muscles. They may also be injected directly into a tumor, according to Lopeman.

A nurse since 1978, Lopeman first became interested in helping cancer patients while her own mother underwent treatment for colon cancer in 1990.

"Her care was atrocious. There was no concern for patient comfort. They did nothing to treat the nausea that came with her treatment," she said.

"That's when I decided to learn about it."

Lopeman, who first hired on as a nurse at the hospital in 1984, went to Providence Alaska Medical Center in Anchorage to complete a 40-hour course in oncology and became certified in 1995.

Initially she worked four hours a week in oncology, while performing other nursing duties in the hospital's Medical-Surgical Department.

The next manager she worked for, allowed her to spend 16 hours a week in oncology.

In 1997, the position of oncology nurse became full time.

"We had one closet-sized room in the corner of Med-Surg," she said.

Today the Oncology Department includes a central room where three patients can receive chemotherapy drugs simultaneously and three additional single-patient rooms.

The department that treated six cancer patients a month in 1997, now averages between 125 and 150.

"My patients become my extended family," said Lopeman.

"If I can just help them with the nausea, or help them understand what's going on ... people need to know about their treatment," she said.

"We joke with them, we laugh and we cry."

The mother of two grown sons and one stepson, Lopeman finds inspiration in her patients, and even transformed a man she describes as the rudest patient ever, into her husband.

"One inspiration is a woman who was here with ovarian cancer nine years ago," Lopeman said.

"She was told to go home, get her house in order. She refused. She said, 'I'm going to live.'"

The woman went to another doctor for a second opinion and started chemotherapy.

"She just turned 50 and moved to Texas," Lopeman said.

"I love my job and I just love people, but one day I'd like to find myself unemployed because they found an injection we could give to prevent cancer."

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