Nancy Lee Grant
June 2018
Nancy
Grant
,
BSN, RN, OCN
Brighton Satellite
Dana-Farber Cancer Institute
Boston
,
MA
United States

 

 

 

Since December 2014, I have been cared for by a team of providers from Dana-Farber in the Department of Hematology and Oncology at St. Elizabeth's Hospital (Brighton Satellite). Nancy was the point-person on the team when I began to receive chemotherapy for Multiple Myeloma. She provided the doctors with essential information that I shared with her, and was the nurse who administered, in consult with the lead physician, the chemical treatment.
Nancy, at all times, has come across as an experienced nurse, indeed a consummate professional with great technical skills, sound judgment, and palpable compassion for me as a patient. Lately, I felt, more than once, a bit sad that her unique personal qualities, from which I so royally benefitted, were perhaps taken for granted in the high-energy environment, where mostly every employee - regardless of position - seems excellent in his or her own right. Not long ago, I began to look for an outlet where I might highlight my patient experience with Nancy. The DAISY Award with its emphasis on "extraordinariness" was brought to my attention. I thought it to be a perfect venue.
During the seven or eight weeks prior to meeting Nancy, I had alternately been admitted to local nursing homes and the hospital, for tests and specialized treatments, while the disease was raging incessantly. To assess my chances of survival, I had only available the deeply sad expressions on the faces of heroic personnel trying desperately to save my life. The radiation treatment too had come to an end on a somber note-making chemotherapy the final recourse. That's when I met Nancy.
In our initial conversations, she made it clear, in a friendly way, that I was very sick and advised me to try hard to improve my health on my own. I could barely hear what she said, let alone understand her words. The chemo-sessions were largely uneventful, that is, the infusions were painless, proceeded usually smoothly, although slowly. Gradually I began to appreciate her rigorous, extensive questioning into my health status. Sloppy answers were not accepted. [When I gained a better understanding of my own health condition, I began to question myself with similar rigor]. While entering information into the computer, she sometimes jotted down notes if an issue needed further attention. More importantly, my trust in Nancy grew tremendously when it dawned on me that she unfailingly, in a very disciplined way, consulted the lead physician or fellows on all issues regarding my treatment and well-being. From my point of view, she became a reliable, trustworthy rapporteur to the treating team, as I found my words and intentions faithfully reflected in the doctors' views.
Six weeks into the chemo-treatment an aggressive cancer attack unfolded in the lower spinal column requiring my re-hospitalization followed by a temporary stay in a nursing home. The first attempt at chemotherapy had failed, therefore, different medication would be attempted. It was at this very moment that I decided to fight back but would need help from and have trust in somebody like Nancy. A few weeks of administering the new medication noticeably reduced the pain in my ribcage, so I requested permission to practice using a walker under the tutelage of a physical therapist in the nursing home. Not surprisingly, the experienced oncology nurse she is, Nancy knew that my femurs were extremely brittle but miraculously free from a micro-fracture. She was indeed very worried but instructed me to learn everything I could, not only about walkers but also about swollen legs, ankles, appropriate diuretics, medical socks, leg positions during day- and nighttime, and so on. The move from the nursing home to my apartment was earlier upon me than expected. Hence, many more items were included in her list of questions during the patient-intake, occurring twice every week. She demanded that in addition to the Visiting Nurse of Boston, the home- and travel conditions would also be inspected by the Stewart HomeCare, as a matter of independent verification. The challenge to me was, of course, to get an A+ from all these inspectors. For encouragement, every time I left the Hematology/Oncology Clinic, she slipped with or without my knowledge, one or two Glucerna bottles and/or a plastic urinal in my bag, then, pushed me in a wheelchair to the main exit. Once, another great nurse substituting for Nancy (who was on vacation) whispered that she had received a list with questions to ask me and other special instructions. The informal whisper in a way confirmed that Nancy had indeed become a guide and help in my struggles.
About eight months into the treatment with the new medication, a new pain presented in my legs. It emerged, I thought, not from the bones but the muscles. Over the course of several weeks, I kept telling Nancy a story about the rapid incredible shrinking (atrophying) of my leg muscles in the very first week of the cancer attack. The pain was unbearable and an in-house doctor at the nursing home prescribed Gabapentin, which, amazingly, melted the pain away. Ever since the drug had a fixed place on my list of medications. When the new pain worsened, I suggested a bit nonchalantly to Nancy that since my muscles were coming back perhaps to time had come to pull Gabapentin. There was, undeniably, a sparkle in her eyes; she left the room and returned after a considerable time with the lead doctor, with whom I had an excellent relationship. The doctor smiled and said without further ado: "Let's try it". The pain literally vanished after Gabapentin was pulled. From then on, my diet was thoroughly changed to favor neuronal and neuro-muscular activity using numerous lists of products, provided by Nancy, that contained needed elements. Given my increased vulnerability to viral and bacterial infections due to the chemotherapy, I was masterfully guided through the dietary changes by her. I began to look splendidly healthier, but, of course, still had a long way to go. Of great concern to me then were also the high levels of prescribed narcotics: morphine and oxycodone. As I gradually started to reduce the narcotic intake to zero, in close consultation with the medical team, Nancy made sure that I kept oxycodone pills, at all times, within reach. Without her guidance or presence, the reduction might not have been so robust.
Now that I again parsed my interactions with Nancy, I can state frankly that it is virtually unimaginable that I would have been better served by anybody than I was by Nancy Grant in the past three and a half years. To me, she is a very Extraordinary Nurse.