St. Joseph’s/Candler Health System was established through a joint operating agreement between 2 religious institutions—St. Joseph’s, a Catholic hospital, and Candler, a Methodist hospital. It is the only faith-based healthcare system in southeast Georgia. St. Joseph’s/Candler takes a holistic approach to healing, with a mission statement that reads, “We treat illness and promote wellness for all people.”
The Nancy N. and J.C. Lewis Cancer & Research Pavilion, located in Savannah, GA, is part of St. Joseph’s/Candler and comprises radiation oncology, medical oncology, and infusion services. It is a national Community Oncology Research Program, as selected by the National Cancer Institute, giving patients the opportunity to access advances in treatment and research that would otherwise not be available in their community.
The Oncology Pharmacist spoke with Nancy M. Nix, PharmD, BCPS, BCOP, coordinator of oncology clinical pharmacy services for St. Joseph’s/Candler, and of ambulatory infusion and retail pharmacy services located on Hilton Head Island, SC. We asked her about the various “hats” she wears.
What are your job responsibilities?
Nancy M. Nix (NMN): I am the oncology pharmacy clinical coordinator for the entire St. Joseph’s/Candler Health System. Even though I am responsible for day-to-day patient care at the Hilton Head Island infusion practice, electronic communication allows me to coordinate despite geographic separation.
My first responsibility is to the outpatients at my ambulatory infusion center. We treat between 15 and 40 patients per day, both oncology and nononcology patients. For example, we give intravenous infusions to nononcology anemia patients and to patients with osteoporosis.
In addition, I am responsible for coordinating approval of all chemotherapy regimens ordered for the system—both inpatient and outpatient. I also run an outpatient chemotherapy specialty pharmacy, and I teach and precept students for 3 different colleges of pharmacy. I work with students during their last year of the doctoral program, providing Advanced Pharmacy Practice Experience.
What are some of the challenges and rewards of your work?
NMN: My biggest challenge is not having enough time. Also, I have a strong belief that people should not be stagnant, so I am always assigning to myself and my students projects that stretch us beyond our presumed capabilities. I am very invested in being educated and providing education. I enjoy being challenged.
My biggest rewards depend on which “hat” I am wearing. Regarding patient care, I feel rewarded whenever I can counsel patients and help provide a level of comfort and understanding about their treatment. I want my patients to feel cared for and to know there is someone looking over them.
Regarding my work with students, I feel rewarded when they are able to accomplish something beyond their expectations on day 1. For example, I recently helped a student through the process of writing a journal article by breaking it down step-by-step so that she was able to complete this article within 4 weeks and submit it for publication. I’d like to think she learned to overcome perceived limitations to benefit her as she continues her career.
As clinical coordinator, I am rewarded whenever I program a new order set into the electronic health records. Doing this is a huge process. We have several hundred order sets and many new approvals. Oncology is an ever-changing specialty—probably the most changing medical specialty there is today.
What are you excited about in your job?
NMN: I have collaborated with Unlimited Systems in Cincinnati, OH, to develop a software program called Looking Glass. This program documents at the time of compounding all National Drug Code numbers, lot numbers, and expiration dates of compounded products for administration at our center using barcode scanning and technology.
Is this an advance? Why is this needed?
NMN: Looking Glass grew out of limitations I saw in our software. I expressed my concern to the folks at Unlimited Systems about inadequate software not suited for clinical use. This led to a collaboration with them to develop the software program.
Looking Glass was developed as a companion product to document our dispensing records, as well as to permit chair-side scanning of barcoded products. Many insurance companies require documentation of what was actually dispensed to the patient in order to reimburse.
We have been using this software for 13 months, and several other oncology centers have adopted it as well.
What advice would you give to
a person entering the field of oncology pharmacy?
NMN: Find a good mentor. I had 3 different mentors who influenced me, inspired me, and challenged me. The first 2 showed me that oncology doesn’t have to be depressing. The third one taught me how to use available resources to stay current with oncology information and to participate in specialty listservs. He encouraged me to spend at least 30 minutes every day reading to learn what is new, and changing, in oncology.
What would you do if you won the lottery?
NMN: First I would homeschool my 8-year-old daughter and travel with her to different countries to study other cultures. That would take up about another 10 years. Then if I still had unlimited funds, I would devote my energies to helping children who don’t have sufficient encouragement, good parenting, or resources to go beyond their limitations. Maybe I would be a missionary.