While undergoing chemotherapy last January for Burkitt lymphoma, a rare and aggressive form of blood cancer, Enrique Rivera started to run a fever one evening — a risky situation for a man with a weakened immune system. He knew it was important to get care quickly.
When he called the office of his hematologist/oncologist, Timothy Fenske, MD, to ask about the best course of action, Dr. Fenske referred Enrique to the 24-Hour Cancer Clinic at Froedtert Hospital. There, he received care quickly from providers who specialize in oncology.
“At the 24-Hour Cancer Clinic, I received IV fluids for dehydration, medication for fever and a blood transfusion right away,” said the 29-year-old Milwaukeean. Enrique was diagnosed on Christmas Eve 2016, two weeks after starting work as a technician at the Clinical Cancer Center. “The staff worked closely with my oncologist. After I was stabilized, I was admitted to the hospital, and I stayed for a week.”
“Prompt treatment is essential for patients who have suppressed immune systems,” Dr. Fenske said. “Infections can spread rapidly and this clinic allows patients to be seen by a cancer clinician to begin treatment right away. 24-Hour Cancer Clinic staff provide specialized, urgent care for cancer patients that is particularly helpful when a test, antibiotics or a blood transfusion are needed.”
Disease-Specific Urgent Care
The Froedtert & MCW Cancer Network recognized the need to manage urgent care symptoms after-hours. Since opening in November 2016, the 24-Hour Cancer Clinic has handled more than 750 after-hours visits from cancer patients.
“There are so many nuances and complexities to being under treatment for cancer — some expected, some unexpected,” said Tina Curtis, DNP, RN, the Clinical Cancer Center’s executive director. “The advantage to having a clinic like this is patients have access to an oncology expert 24 hours a day.”
During the day, care is guided by a patient’s cancer team as usual. After business hours, oncology nurse practitioners and physician assistants provide care in the 24-Hour Cancer Clinic, consulting with oncologists as needed. The 24-Hour Cancer Clinic is not like an urgent care center where patients can arrive without an appointment. Patients must contact their oncologist for guidance on where to seek care.
“We focus on complications from cancer treatment, such as nausea, vomiting, pain, fatigue, weakness and fever — situations where patients need a little additional support,” said Elizabeth Malosh, MSN, RN, the clinic’s assistant nurse manager.
The 24-Hour Cancer Clinic does have some limitations. Serious conditions, like heart attack or stroke, must still be addressed in the Emergency Department.
“We can do what is appropriate for them, unless it is a situation that truly requires emergency intervention,” Curtis said.
Oncology Patients in Front of Oncology Providers As Much As Possible
“Patients visiting the 24-Hour Cancer Clinic do not have to go into a lot of detail about why they’re having certain symptoms. We just know,” Malosh said. “We know what to look for post-chemotherapy; we know the intricacies of their ports, pumps, drains and tubes.
The nurses in the 24-Hour Cancer Clinic are cross-trained to work in different areas of the Clinical Cancer Center. Throughout the week, they float among outpatient infusion areas, inpatient oncology floors and the 24-Hour Cancer Clinic.
“We may administer a patient’s chemotherapy on Monday and see them Wednesday in the clinic if they are experiencing side effects,” said Stephanie Armstrong, RN. “We know the treatment plan; we speak the cancer patient’s language. We are really keyed in to their care.”
A Stress Reliever for the Patient’s Family and Caregivers
“It’s less stressful for them than staying at home and suffering all night through the symptoms,” Malosh said.
The familiarity with cancer patients and their care has resulted in lower diagnostic costs to the patient in the 24-Hour Cancer Clinic, and a lower hospital admission rate. Treatment in the 24-Hour Cancer Clinic also minimizes the risk of exposure to other ill patients in the hospital, who could pose a risk to cancer patients who already have weakened immune systems
“We’ve received amazing feedback from patients who needed urgent care,” Curtis said. “They’re so relieved to know we are always there.”
In February, Enrique again visited the 24-Hour Cancer Clinic, this time, for a blood transfusion. And today, after several months of recovery, he’s back at work.
“I’m really grateful for the 24-Hour Cancer Clinic,” he said. “The staff is amazing. Their passion for what they do is outstanding. On a scale of one to 10, I’d give them a 10.”
Learn more about the 24-Hour Cancer Clinic.