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Integrative health team member highlight: Teresa James

Aug 26, 2016


Can you describe your role at Massey, how long you’ve been in it and how it’s changed?

I began my role of nurse manager for the Dalton Oncology Clinic (Dalton), one of VCU Health’s largest ambulatory clinics, in January of 2015.  As nurse manager, I am responsible for daily clinic operations, human resource issues, budget, staffing and future growth.  The clinic is comprised of a 24-chair treatment room and 33 exam rooms.  I’ve been with Massey since graduating from nursing school in 2007.  I started as a care partner on North 6, the inpatient oncology unit at that time (now located in Critical Care Hospital 2), then continued to work as an inpatient bedside nurse. After two years, I transferred to Massey’s Stony Point clinic where I worked as a clinical coordinator. I was there for four-and-a-half years before coming to Dalton. I have only worked with Massey and don’t plan to work anywhere else!

I work hand-in-hand with Theresa Melville, nurse clinician, and Jenny Salomonsky, nurse manager support assistant, to manage the day-to-day operations of the clinic.  Our goal is to enhance the patient experience by improving throughput, processes, efficiency and satisfaction. 

My passion is building strong teams while looking for ways to improve safety, clinical care and the overall patient experience. When I first started in this role, one of the first things we accomplished was creating additional leadership positions and filling existing ones.  As clinical coordinators overseeing the clinic and treatment room, Susan Keen and Amanda Starling are responsible for managing daily flow and scheduling.  Theresa is our educator and organizes orientation, in-services, certifications and professional advancement.  It truly takes a village to successfully implement and sustain change.  I couldn’t do my job without the support of my colleagues as well as the support of both Massey and hospital administration.

We now have a solid team in place with one shared vision – to deliver the best patient care possible.  We are working on multiple initiatives to improve the patient experience, from clinic renovations to scheduling, our nursing model, workflow and more.

Did you always want to be a nurse? 

Actually, the thought never crossed my mind when I was going to college. I don’t believe there are any nurses in my family. 

However, when I was 16 years old, my sister, who was four years old at the time, was treated at Massey for Wilms’ tumor, a rare form of kidney cancer.  Her tumor weighed eight pounds!  She underwent weekly chemotherapy for 56 weeks when the ASK Pediatric Hematology Oncology clinic was located in the North Hospital.  I remember parking in a lot where Massey’s Goodwin Research Laboratory stands today.

I had just gotten my driver’s license and I remember the nurses not only cared for my sister, they expressed concern for me as a new driver commuting back and forth to Southside holding down the “fort” so my parents could stay at my sister’s bedside.  They were making sure I was doing alright as well.  They cared for the entire family—that’s what I remembered about the oncology nurses. My sister will be 28 years old on October 2; she is married and is doing great.  Even after that experience, the thought of being a nurse still hadn’t crossed my mind.

I attended VCU and graduated with Bachelor of Fine Arts in Graphic Design.  I worked in the design world; I worked freelance; I worked for a printing company; I moved to Toronto.  While in Toronto and working for a printing company, one of my accounts was a pharmaceutical company.  They recruited me into a sales position.  I truly enjoyed the job because I felt I was making a difference for the patients who benefited from my products.  What I didn’t like were the games you had to play in order to get face time with the doctors!

Three years later, I returned to Richmond and became director of PR and marketing for the Valentine Richmond History Center. I always knew I wanted to get a masters degree but I wasn’t sure what I wanted to pursue. One evening, I was watching my husband play recreational softball and there was a woman behind me studying. As it was mid-summer and most schools were on break, I asked what she was studying and she said she was in nursing school.  I asked her additional questions, discussed the possibility with my husband on the way home and decided that it could be a potential career.  I knew at that moment that if I became a nurse, the only place I’d want to work was Massey. I returned to VCU and earned my Bachelor of Science in Nursing and again to receive my Masters of Science in Nursing Administration and Leadership.

How do you get staff buy in?

We have a great team of extremely talented and knowledgeable nurses, many of whom I worked side by side with in the treatment room when I was clinical coordinator at Stony Point. I believe it’s all about relationships.  When implementing change, it’s important to explain the “why.”  If team members understand how the change will positively affect the patients, it’s easier to sustain. Rapid cycle change improvement strategies – where changes are made and evaluated over short periods – are very helpful to review change on a small scale. With new team members, I believe it begins at the interview. We discuss where we’ve been, where we are and where we are going. We explain the vision for the cancer center and the type of team member that will help us get there—it must be about the patients.

What are some of the most challenging aspects of your job?

It’s difficult to make decisions that I know won’t please all team members but will benefit the patients or enhance processes.  Managing staff is often the most rewarding and challenging aspect.  This includes abiding by hospital policies to hold team members accountable and familiarizing myself with HR standard operating procedures.  Trying to stay on top of my job requirements, meeting outcomes, communicating with team members, checking in with providers, handling patient concerns, implementing change…it’s all difficult.  At the same time, you have the day-to-day demands and challenges to handle.  Prioritizing all of this can be extremely difficult, and at times I feel like nothing has been accomplished.  That’s when I have to step back and look at the big picture.  I have to look at all the change we have accomplished and the amazing team we’ve established.  That’s how I’m able to keep going!

What is the most rewarding part of your job?

My favorite part of my job is when patients take the time to formally recognize the nursing care they’ve received at Massey.  Our nurses are the face of Massey.  When patients are done with treatment, they frequently comment on the nursing care they received.  When the patients feel they have received world class care at Massey, it makes me enjoy what I do.  The team knows the kind of impact they make on the patients’ lives, my job is to support the team so they can continue doing just that.

How has the treatment environment changed?

It seems we’re always under renovations of some sort.  The treatment room recently underwent a renovation to create a more calming atmosphere for the patients along with enhanced privacy.  The individual alcoves include space for a family member to stay along with a private television. The colors were chosen to be calming and inviting.  We worked with a group of extremely dedicated volunteers to hang art thought the treatment area and clinic, which has been met with very positive feedback.

One part of the environment that I’m interested in changing is the smell. This also adds to the patient experience.  Smell is tied to memories and influences how patients feel the moment they walk through the door.  This is why I’m interested in doing a pilot project on the use of aromatherapy.  Vanderbilt completed a study that showed aromatherapy can improve attitudes and reduce stress among staff in their emergency department. It made me wonder how changing the smell in Dalton could impact the experience of our patients.  This could be one additional way we support the patients and staff.

What got you interested in aromatherapy?

I was introduced to it by a friend while our children were playing.  My daughter approached me complaining of a sore throat and had a swollen lymph node on her neck.  My friend gave me an essential oil blend and told me to “rub it on the bottom of her feet.”  I looked at her like she was crazy!  I figured worst case scenario her feet would be oily and smell good.  The next day, her sore throat was gone.  Was it the oil? At that point, I wasn’t sure, but it intrigued me enough to look into it more.  I began reading, reviewing literature, and educating myself while at the same time gathering a large collection of pure, high quality oils.  Now I’m even making all my own skin care products, including lip balm!

As a nurse, I have a background grounded in science.  I’ve always believed integrative and complementary approaches can make you feel better, however, I wasn’t quite aware of their full potential.  In grad school, I had done an evidence-based poster on the role of acupuncture in the reduction of chemotherapy induced nausea and vomiting. So, I was aware of evidence supporting complementary practices. Though used heavily in eastern medicine, integrative health practices aren’t well researched in western cultures.  Most studies state “additional studies are needed to prove efficacy.” That’s why I’m interested in pursuing an aromatherapy study in Dalton.

Is there anything else you want people to take away from this Q&A?

I can’t stress enough that I couldn’t perform well in this position if it weren’t for the support of our leadership team support and our highly skilled nursing staff. From our clinic nurses, nurse clinician, clinical coordinators and up through hospital administration, it takes a strong team to successfully run and implement change in a clinic a as complex as this one.  While we still identify areas of opportunity, I believe we have the right people in place to make Dalton the premier destination for oncology patients in Virginia and beyond!

Written by: John Wallace

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