Duke Homecare and Hospice now has a clinical care coordinator, focused primarily on hospice services, assigned full-time to the Duke Cancer Center. This past July, long-time nurse and nurse manager Cecilia Thornton Wood, RN, BSN, MA, transitioned from assistant director for home health at Duke Homecare and Hospice, to the position of Duke Cancer Center Clinical Care Coordinator.
Previously, Duke HomeCare and Hospice shared a care coordinator with all the Duke Hospital-based clinics.
Now, with a dedicated hospice coordinator at Duke Cancer Center, patients, their families and caregivers can learn about and set up hospice care in a timely and convenient way; when patients are already at the cancer center clinics for other appointments.
The new chief nursing and patient care services officer for Duke University Hospital (DUH) Tracy Gosselin, PhD, RN, AOCN, whose oncology nursing career at Duke has spanned two decades, was instrumental in creating this new position in collaboration with medical oncologist Hope Uronis, MD, MHS.
“Cecilia is the bridge,” Gosselin said. “She can meet patients and families in the building and help them understand what hospice provides, which is hope for a peaceful death. Having Cecilia available at the clinic to call on may help alleviate their feelings of emptiness, uncertainty, and mixed emotions as they leave the building to go home.”
If needed, providers, nurses, and staff from the palliative care team can connect with Wood face-to-face on referrals instead of across a fax line. She’s typically available during cancer center clinic hours, Monday through Friday.
Since her arrival, Wood has been shadowing staff in the cancer center clinics, including gynecologic, breast,
Cecilia Thornton Wood, RN, BSN, MA, (at right) goes over a patient referral with nurse practitioner Yeshu Conn, NP, MSN, MBA.
thoracic, hematology, and urology, to get an up-close understanding of the services they provide. She’s also been meeting with patients, families and caregivers several times a week.
“I carry a pager as well as my cell phone so that clinicians can reach me quickly,” said Wood. “I will be on-site to see patients within 30 minutes. Most of the time I’m there within five to 10 minutes.”
As oncologists and nurses see patients and recognize that they need more assistance, such as palliative care and symptom management, or that the patient’s condition is deteriorating, they’ll broach the idea of hospice.
If patients are open to considering this option, they are referred to Wood. Some are just on a fact-finding mission and that’s the way she approaches it with them.
“I’ll say, ‘I understand you have some questions, what can I help you understand about hospice and the services that are provided? Where are you right now? What are you thinking?’” Wood explained. “They tend to open up after that and talk to me, working through any barriers.”
Hospice services can be provided in the patients' homes, nursing homes, assisted living facilities, hospitals, and the hospice inpatient facility in Durham. Working together as a cohesive unit, their interdisciplinary team can provide physical care, psychological care, and spiritual care.
Wood has a 30-plus-year nursing career, which has included many years of hospice care. Before Duke, Wood worked as director of clinical services, clinical manager and visiting home health nurse at People’s Home Health in Florida, and she also served in a number of nurse management roles at Santa Rosa Medical Center in Florida and Dubuis Hospital in Louisiana.
Working with patients making end-of-life decisions hasn’t taken the emotional toll that some outsiders might think. Wood said she comes to the new position mentally prepared, with “a very positive outlook.” She said she's ready to play her part in having the conversations related to end of life choices.
“We look at hospice as a benefit for the patient,” said Wood. “How do we make the most out of their last days, weeks, and months? What is their goal? And then we work toward helping them to achieve that goal as a celebration; how to celebrate and enjoy the time they have left.”
Wood wants to change how people look at hospice.
“For too many years hospice has borne a very negative connotation—‘it’s where I’m going to die’” she explained. “We want to try and get everyone to understand that our goal is to help patients and their caregivers face the end of life with comfort, dignity, and compassion. The earlier we can get patients with end-stage diagnoses in hospice, the more benefit they will truly see from hospice.”