The Bone Marrow Transplant Unit (BMTU) at Thomas Jefferson University Hospital lives the mission to put people first, be bold and to think differently. The patient population on this unit is unique and consists of severely immunocompromised individuals with varying levels of acuity. The average length of stay for these patients range between three to six weeks but depending on complications could be even longer. Receiving a Transplant is not the end of the journey for most of these patients, frequently these patients need to be readmitted for various complications. These hospitalizations are extremely tough, emotionally and physically, for both the patients and their caregivers. These difficult hospitalizations have fostered the building of strong relationships between patients, their loved ones and the care team. Our nursing team is made up of caring, compassionate and innovative individuals who are committed to providing high-quality patient care. As a nurse on this team, I cannot begin to describe how lucky I am to be a part of this team.
A year and a half ago the Transplant team began a new project and created the Bone Marrow Transplant Patient and Caregiver Education class. The need for this class came when both the inpatient and outpatient nursing teams noted that patients and their caregivers were extremely anxious about the transplant process and they did not fully understand what to expect before, during and after their transplant. The team believed that patients and their caregivers would benefit from standardized education prior to their transplant admission. This month marks the one-year anniversary of the first class. The Bone Marrow Transplant Nursing Team works with the Transplant Coordinators, the Outpatient Social Workers and The Cancer Welcome Center staff continue to work together to enhance the educational materials given to these individuals, to schedule the classes and to recruit patients to attend the classes. When reviewing the survey results from a quality improvement survey that is given out in the classes, patients have stated that these classes are very informative and that they have enjoyed meeting members of the nursing team prior to hospitalization.
The BMTU nursing staff understands that transplant patients receive complex discharge instructions while in the hospital. In order to increase patient confidence and preparedness when returning home post-transplant, the Bone Marrow Transplant Nursing Team changed their discharge process. The team created discharge bags for patients which include items to help reinforce the discharge instructions patients received. Nurses distribute these bags to patients once their white blood cell counts began to recover and they are approaching discharge. The staff educates patients on the importance/significance of each item.
Patient satisfaction was measured and compared, through HCAPS scores, prior to and following the discharge bag process. A 6% increase in patient preparedness for discharge and education on symptoms was noted. Providing discharge bags and the including components showed great improvement in patient confidence with their transition home post-transplant.
The nursing team on this unit is always putting patients first. Birthdays and weddings are both joyous occasions in which people plan to spend with loved ones in places outside the walls of the hospital. Many of the transplant patients are unable to celebrate these occasions, as they would hope to. One birthday celebration that was extremely special on our unit was for a patient who was hospitalized for several months. He was fearing the failure of his transplant and experiencing multiple infections. Seeing the days go by without a discharge in sight, a group of nurses wanted to make this patient have the best birthday that he could ask for. The nursing team brought in streamers, balloons and birthday hats to prepare for the special occasion. The team presented the patient with a card signed by all of the staff to help the patient celebrate his day the best way possible. The patient was forever grateful for the kindness and compassion the team showed him.
Another event that should be highlighted is a wedding that took place during a snowstorm this past winter. A patient, who had relapsed after receiving two transplants was emergently readmitted to the BMTU for respiratory distress. When readmitted the patient could not stop bringing up that her last wish was to get married. The entire unit came together to make a beautiful wedding happen within hours. The patient's room was transformed into an area for the wedding ceremony; the room was decorated with artificial candlelight, artificial flowers, and wall decorations. The staff provided the patient with wedding slippers, a wedding cake, sparkling cider, and champagne flutes. The CNS made a beautiful veil with crystal embellishments on it. The Critical Care Technician added a special touch and captured the wedding moments through his photography and videography that he presented to the patient as a gift. The above two patient stories are some examples of the greatness that is found within the BMT unit.
The nursing team on this unit is also dedicated to improving the lives of individuals in our community with a cancer diagnosis. For the last several years, the BMTU staff have helped to raise money and participated in the LLS's Light the Night Walk in Philadelphia. Through the unit's community service group, our staff has also hosted a dinner for the occupants at the Hope Lodge for the last two years.
These nurses are a rare, but wonderful, group of individuals who treat patients as family and advocate accordingly. A simple dance, a walk down the hall, or a trip outside, however short that might be, are all things nurses on BMT have done to make life enjoyable for patients during transplant. These nurses are happy to complete these activities to provide comfort and hope in those they take care of.
BMT nurses truly embody the saying "no one fights alone". These nurses live the mission to improve the lives of the patients that they serve. Countless cards come in as a token of thanks for the nurses making an otherwise traumatic process bearable. Teamwork, compassion, commitment- all qualities that make an outstanding team. All qualities that the TJUH BMT unit possess.