Neuro-Oncology Team
March 2019
Neuro
Center
Neuro-Oncology
Children's National Medical Center
Washington
,
DC
United States
Katie McHugh, MSN, RN – Neuro-Oncology Nurse Coordinator;
Lauren Hancock, RN, MSN, CHPPN, CPNP-AC – Neuro-Oncology NP;
Marsha G. Smith, RN-BC, CCM, CHPPN – Nurse Case Manager;
Deborah Lafond, DNP, PPCNP-BC, CPON, CHPPN – PANDA Palliative Care Team NP;
Christine Thomas, MSN, CPN, CPNP-PC;
Lin Whetzel, BSN, RN, CPEN;
Julia Mascia, BSN, RN;
Eugene Hwang, MD – Neuro-Oncology attending;
Sharon Fyffe, LICSW – Neuro-Oncology social worker;
Roger Packer, MD – Neurology attending;
Elizabeth Wells, MD – Neurology attending;
John Myseros, MD – Neurosurgery attending;
AeRang Kim, MD – Oncology attending on service;
Lana Mukharesh, MD - Resident;
Mary Mollta, MD – Resident;
Catherine Habashy, MD – PANDA Palliative Care Team attending;
Risi Idiokitas L.Ac., DAOM – Acupuncturist;
Mariagracia RivasBerger – Music Therapist;
Maria Arroyo Moor, MD – Pulmonary Medicine, Fellow;
Hollis Chaney, MD – Pulmonary attending;
Thomas Chang, MD – Physical Medicine and Rehabilitation attending;
Hannah Leu, RD – Nutrition Services;
Katherine Kundrat, PT – Physical Therapy;
Marie Nelson, MD;
Brian Rood, MD;
Lindsay Kilburn, MD;
Matt Ladra, MD

 

 

 

The Neuro-Oncology Team (Neuro-Onc) is a well-established interdisciplinary team in the Center for Cancer and Blood Disorders. The team encompasses staff from multiple departments, including Oncology, Neurology, Physical Medicine & Rehabilitation, Endocrinology, Nutrition, Clinical and Research Pharmacies, Neurosurgery, and Neuropsychology. Staff includes many different disciplines: physicians, nurse practitioners, registered nurses, social work, clinical research associates, clinical dietitians, and many others. In any given clinic, this represents approximately 20-30 patients and families. The brain tumor population requires complex coordination of care and attention to critical details, which can present a challenge. There are patients receiving complex treatment regimens, enrolled in clinical trials, receiving collaborative care at outside institutions, and enrolled on hospice services. Patients are seen throughout the hospital but are also seen within a comprehensive multidisciplinary clinic involving oncology, neurology, physical medicine, endocrinology, nutrition, palliative care, and social work.
The Neuro-Onc team would not be able to function as well as it does without the leadership of their Nurse Coordinator, Katherine McHugh RN. Katie manages the Neuro-Onc staff, patients and families with a wealth of knowledge, a toolkit of exceptional skills and an outstanding attitude for compassionate care. She skillfully connects the right provider to the right patient at the right time, meeting families where they are in the trajectory of a serious illness. Katie is the guiding force within a team that deals with complex health care issues for a wide variety of patients. Katie, in particular, will go above and beyond to help families - offering to go out of her way to make sure tests and procedures are done in a timely fashion and offering clear communication to families and between multiple teams at Children's National in order to facilitate the best possible care for families.
Cancer does not discriminate. It strikes infants, toddlers, school-age children, adolescents, and young adults, requiring a multidisciplinary team that attends to all aspects of suffering: physical, emotional, psychosocial, spiritual and environmental. I have witnessed this team extend grace, compassion, and kindness with the same expertise they provide skilled medical care. They attend to the whole person and the whole family.
One example involves a mischievous 4-year-old little boy with an infectious smile. He had been diagnosed with DIPG (diffuse intrinsic pontine glioma), a rare and typically fatal brain tumor. The patient and his family enjoyed wonderful support from their community in his home state, but the travel to DC for treatment was also incredibly difficult. The neuro-oncology team met him initially following his diagnosis to discuss the cutting edge clinical trials available at Children's National; he underwent surgery before returning home for radiation therapy. Following his radiation therapy, he was enrolled in an innovative clinical trial at Children's National that required frequent trips to DC. This necessitated thoughtful coordination of care and communication with his medical team in his home state in order to facilitate a streamlined care experience for the family between the two institutions. After the patient's tumor started to progress and he was experiencing a clinical decline, his parents, ever fierce advocates for his care, wanted to pursue therapies to give him more time. After many thoughtful conversations, the patient and his family moved to DC for another round of radiation therapy, and he became hospitalized for a period of time. In order to coordinate a safe discharge, the neuro-oncology and PANDA Teams (Marsha Smith, RN) worked closely with a local hospice to provide services to our patient while he was in DC and also secured support for a pediatric patient from a hospice near his home in another state. Once our patient completed his radiation therapy, he was able to safely return home, where he received a hero's welcome from his local community.
The coordination and logistics of caring for a patient across multiple states and care providers required thoughtful communication with the patient's family and collaboration across multiple healthcare providers and settings. Thanks to this collaboration, he was able to return home to his older brother and his beloved dog, and he experienced a peaceful death at home surrounded by a family who knew they had fought until the very end for their sweet warrior. This would not have been possible without the coordination of care between institutions, between teams, and careful collaboration to orchestrate all logistics.
This team demonstrates commitment, connection, and compassion every day for every patient. The PANDA Palliative Care Team is honored to collaborate with them in caring for children with brain tumors.