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by Steve Kirk

The countrys nursing shortage continueseven as the nations baby boomers andnursing workforce grow older, and the

need for health care expands. Although nursingcolleges and universities around the nation areworking to increase enrollment levels to meet therising need for nursing care, demand isoutstripping supply.

The United States is 10 percent short of thenurses it needs, according to Hospitals and Health

Networkmagazine. In California, the problem iseven more serious, with vacancy rates at healthcare organizations in the state approaching13 percent.

Despite such statistics, recruitment atCity of Hope was marked by a nearly 20 percentincrease in nursing staff for the one-year periodending February 2006, according to Larry Kidd,R.N., vice president of Patient Care Services andchief nurse executive. During the past year,100 new nurses have been hired, bringingCity of Hopes total number to approximately500, including staff nurses, nurse practitioners,

research coordinators, case managers, clinicalnurse specialists and nurse researchers. Kiddcredits the employee referral program, an effective

advertising campaign and City of Hopes long-standing reputation as a great place to work forthe success in recent hiring.

In addition to our status as a leading researchhospital, attracting nurses to City of Hope ismade easier by the institutions favorableworking conditions, Kidd said. These includelow patient-to-nurse ratios, flexible workschedules, better educational opportunities thanmany places, including up to three months ofon-the-job training, and an extensive array ofsupport staff for nursing teams, such as

attendants, clerks, therapists, transporters andpharmacies in every unit.

These factors also may account forCity of Hopes retention rate. The figure is betterthan that of many institutions, with a turnoverrate of 7 percent annually, significantly lower thanthe statewide average of 16.4 percent.

Low nurse-to-patient ratios help attract andretain staff. City of Hope employs about oneregistered nurse for every four patients in itsmedical oncology/hematology nursing units.In other areas, the pediatric ratio is approximately1-to-3, and the intensive care unit ratio is about

1-to-2. Using an acuity tool, nursing staff providesadditional support when needed by evaluatingpatient needs for ongoing patient care. If required,

JCAHO confirmsCity of Hope

SeeNursingpage 3

accreditationby Darrin S. Joy

The Joint Commission on the Accreditationof Health Care Organizations (JCAHO)issued a formal letter of accreditation toCity of Hope on Jan. 20, 2006. The letterfollows the Joint Commissions survey ofCity of Hope in September 2005 andconfirms the institutions compliance with

JCAHO standards for delivery of patient care.

JCAHO surveyors employed a new method-ology known as the tracer method duringthe September visit.

This method offers a new opportunity forJCAHO to work in partnership withCity of Hope to identify areas for improve-ment in our delivery of patient care, saidSteve Hartranft, vice president of QualityImprovement and Patient Safety forCity of Hope.

Along with confirming the institutionsexisting high standards of patient care andsupporting services, the survey identified somerequirements for improvement. Since surveyresults have been received, several teams ofCity of Hope staff have created andimplemented process improvements. Theletter indicated that JCAHO reviewed andaccepted these improvements.

All City of Hope employees are to becommended for their commitment in meetingand exceeding JCAHOs standards, saidJames Miser, M.D., chief executive officerand chief medical officer, City of HopeNational Medical Center. A special thank yougoes to those who worked diligently on therequired changes and enhancements to

our processes.Pointing to JCAHOs new system

of unannounced inspections, Hartranft

Quest for a Donor During a Feb. 6 interview at City of Hope, patient Christine Pechera (center) told KABC-TVsmedical producer Denise Dador (right) about her search for a bone marrow match. Pechera, who has lymphoma, alsodescribed the need for more Filipino donors in the national registry. She directed those interested in registering to herWeb site at www.christinepechera.com. Filmed in City of Hopes Japanese Garden, the segment aired Feb. 7 during the5 p.m. news hour.

Nursing recruitment and retention

remain top priorities for hospital

Hope NewsHope NewsV O L U M E 1 , N U M B E R 7 F e b r u a r y 1 3 , 2 0 0 6

SeeJCAHOpage 3

Helford Clinical Research Hospital at City of Hope

Darrin

S.

Joy

JuliusShulmanandJuergenNogai

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Drug to give patients optionsInhaled insulin tested at City of Hope approved for market

Feng led a three-year trial at the Leslie andSusan Gonda (Goldshmied) Diabetes andGenetic Research Center from 2000 to 2003,evaluating the delivery method among patients

with type 1 diabetes.Nationwide, Exubera, a PfizerInc. product, was tested in

about 2,500 adults with type1 and 2 diabetes.

The inhaler delivers a puffof insulin as a dry powderdirectly to the lungs, organsrich with potential for drugdelivery. If all the lungs tinyalveoli were unfolded, thelungs would have nearly thesurface area of a tennis court;and at about one-half micronthick, the lungs lining forms

one of the bodys thinnest epithelial barriers.

Ive thought all along that this is a goodproduct; not necessarily for type 1 as much as for

by Alicia Di Rado

With the help of City of Hope physician WeiFeng and her colleagues, millions of people withdiabetes can now take a breather and get theirmedication at the same time.

On Jan. 27, the United States

Food and Drug Administrationapproved the first-ever inhalednsulin, called Exubera, for

adults with type 1 or 2 diabetes.But what is now a welcomealternative to injection was onceust an experimental insulin

delivery method in testing atCity of Hope.

Im excited about inhalednsulin getting out to those with

diabetes, said Feng, principalnvestigator for the inhaled

nsulin trial at City of Hope. It does give us morealternatives to treat patients; you can individuallyailor it to patients needs.

2 H O P E N E W S F E B R U A R Y 1 3 , 2 0 0 6

by Beth Hill

The American Nurses Foundation (ANF)

recently named City of Hope Research Specialist

Teresa Rojas-Cooley, R.N., B.S.N., in the

Department of Nursing Research & Education, a

Dorothy Reilly/ANF Scholar. Consequently, Rojas-Cooley received a $5,000 American Nurses

Foundation grant to fund a project called

Complementary and Alternative Medicine

CAM): American Nurses Knowledge.

The results of Rojas-Cooleys study will reveal

nformation on the knowledge and attitudes of

nurses toward CAM therapies, such as Reiki,

herapeutic touch and aromatherapy. The

National Cancer Institutes Office of Cancer

Complementary and Alternative Medicine defines

complementary and alternative medicine as any

medical system, practice or product that is notconsidered standard care.

One example of a complementary therapy is

aromatherapy, Rojas-Cooley said. According to the

National Cancer Institute, aromatherapy the

herapeutic use of essential oils from flowers, herbs

or trees can improve a persons physical,

emotional and spiritual well-being.

Cancer patients sometimes use aromatherapy to

help alleviate the stress and anxiety brought on by

conventional treatment. They look to other

reatments, such as massage or acupuncture, to

complement standard medical treatments. Their

ultimate goal is to improve their health and quality

of life.

ANF names COH nurse scholar, funds survey aboutcomplementary and alternative medicine

by Lisa Lyons

Thanks to a generous bequest from the estateof Marcelle S. Schwartz, the planned CITI(Cancer Immunotherapeutics & TumorImmunology) research center has received a$1.5 million gift. In recognition, the centersentryway will be named the Marcelle S.Schwartz Entry Plaza.

Schwartz, a breast cancer survivor, begansupporting City of Hope as a direct-maildonor. While not sizable, her donationswere consistent and formed the basis of arelationship with the institution that steadilygrew over the years.

Senior Gift Planning Officer SandeeZschomler first spoke with Schwartz and hersister, Ruth Cordish, in 2000. During thoseconversations, the sisters mentioned theirdesire to include City of Hope in their estate

plans. The two expressed an interest in cancerresearch and Beckman Research Institute, soZschomler encouraged them to come tocampus for a tour. Due to a number ofmedical and personal obstacles, however,Schwartz was unable to visit the campusbefore her death in 2004.

When Cordish called Zschomler to tell herof Schwartzs passing and that she had a$100,000 gift for City of Hope, Zschomlermentioned the CITI program and the plannedresearch center. Cordish was intrigued enough

hopes to receive responses in the spring,prepare an assessment of their learning needs andpublish the results by next year. She expects thestudy to show that nurses must be educatedto assist their patients in making informed

judgments for complementary and alternativemedicine and therapies.

Rojas-Cooley has held various positions atCity of Hope for the past eight years. She currentlyattends California State University, Fullerton, andthe University of California, Irvine, studying tobecome a family nurse practitioner.

The Dorothy Reilly/ANF Scholarship was namedfor Dorothy Reilly, an internationally knownnurse, educator and scholar.

Generous supporterremembers CITI project

with $1.5 million gift

An artists rendering depicts the striking architectureof the planned CITI building.

Other well-known and respected U.S. cancercenters using CAM to treat patients includeDana-Farber/Harvard Cancer Center in Boston,UCLA Collaborative Centers for IntegrativeMedicine in Los Angeles, and the University of

Texas M.D. Anderson Cancer Center inAustin, Texas.

Rojas-Cooleys new study will follow up asimilar project she led last year, which focused onthe knowledge and attitudes of direct-careoncology nurses toward complementary andalternative medicine.

The results showedthat oncology nursesin direct patient caredid not know muchabout complementaryor alternative

medicine but werevery interested inlearning more if ithelped their patients,Rojas-Cooley says.Many nurses areuncomfortable bringing up the subject ifpatients seem to know more about it than theydo, and the problem is magnified when thenurses are unable to discuss complementarytherapies because of negative reactions by theirhealth-care-provider colleagues to their out-of-the-box thinking.

In the new study, researchers will mail a surveyto a random sample of 3,000 registered nursespracticing in the United States. Rojas-Cooley

Wei Feng

Mark

ieRamirez

Teresa Rojas-Cooley

SeeSchwartzpage 3

SeeInhaled insulinpage 4

MarkieRamirez

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H O P E N E W S 3H O P E N E W SF E B R U A R Y 1 3 , 2 0 0 6

by Kevin Koga

Two years ago, Jorge Hernandez, then asophomore and a varsity football player atEl Monte High School in the San GabrielValley, received very difficult news. He wasdiagnosed with Hodgkins lymphoma.However, two months ago, in full remissionfrom his disease following treatment atCity of Hope Cancer Center, he wasawarded the prestigious CaliforniaInterscholastic Federation (CIF) Spirit ofSport Award.

The award recognizes excellence in scholasticactivities, community service and leadership.According to CIF Executive Director Marie M.Ishida, the award is presented to studentathletes who have demonstrated great sports-manship, the purest form of competition.Recipients understand that a positive attitude

and teamwork should exist throughout sports,and they realize that winning at all costs is notreally winning. The same spirit they show inathletics carries over into all aspects of life.

Last year, while receiving treatment,Hernandez was regularly on the sidelinescheering for his team. Then last April, hisphysician, Cancer Center Associate DirectorSmita Bhatia, M.D., M.P.H., gave him thenews he was awaiting. He was cleared to rejointhe team for his senior season. Last fall, thelinebacker was third on his team in tackles,with 75. Today, he competes for his schools

varsity wrestling team; he has also participatedin track and field.

Through his treatment, Hernandez remainedinvolved in the schools Academy Program and

maintains a 3.5 grade-point average. He haspreviously received his schools PerfectAttendance and Scholar-Athlete Awards and,last year, he received the City of El MonteLeadership Award, which was presented by thetowns mayor.

Hernandez is using his experience as a cancersurvivor positively, mentoring junior highschool age cancer patients at City of Hope. Iwant kids to have the opportunity to talk tosomeone their age about their diseases andtreatments, said Hernandez.

A few days before the Bowl Coalition SeriesChampionship Game held at the Rose Bowl,Hernandez and several City of Hope pediatricpatients spent time talking with head coach ofthe National Champion University of TexasLonghorns, Mack Brown, and Rose Bowl MostValuable Player Vince Young, as well as USC

Head Coach Pete Carroll and USCAll-Americans Reggie Bush and Matt Leinert.Both coaches told Hernandez that they wereinspired by his story.

ratios may be adjusted in any area and nurses may carry even fewer patients.

Despite the number of new hires and relatively low turnover, the need formore nurses remains strong. The vacancy rate at City of Hope now stands

at 12 percent annually, created by the addition of many new positions.Staffing needs for Helford Clinical Research Hospital at City of Hope, forexample, are extensive. We are near capacity during the weekdays, evenafter opening up additional beds in East Unit A (formerly Wing V), Kiddaid. We now have a staffed available bed capacity of 154, and will incre-

mentally open more as we are able to recruit and train additional nurses.

Contributing to the future demand is the maturity of City of Hopes ownnursing staff, reflecting a national trend. About 62 percent of the institu-ions nurses are between 40 and 60 years old; the typical City of Hope nurses 46. While we have been able to attract a significant number of nurses,

most have just graduated from nursing school or have entered into nursingas a second career, so the need to retain our experienced staff members forboth staffing and training is great, he added. Therefore, one of the goalsof the nursing leadership team in coming months is to make further stridesn nurses working conditions at City of Hope, including addressing the

needs of the more experienced nurses that have been here for many years.

Its not only about recruitment, butalso retention.

Kidd said a number of opportunities for

improvement exist that, when in place,will make working at City of Hope evenbetter for all nursing staff. Including suchprofessionals on more committees andinvolving them in decision-making,assessing nurses satisfaction with theirwork environment and addressing theirconcerns quickly, and engaging them inthe development and design of educationalprograms will help.

Regarding day-to-day operations, improving on-the-job communications withadvanced technology will keep City of Hope among the best places to work.Currently, some nurses are visiting other hospitals to learn about wirelesscommunications devices to identify the best ones to pilot at City of Hope,Kidd said. Our nurses will also have input into the selection of a computerizedinformation system, or CIS.

Jorge Hernandez tackles cancerCity of Hope patient wins state Spirit of Sport award

Nursing: Medical Center focuses on recruiting and retaining nursing staff

Nurses Kathy Ilagan (left) and HollyBengtson confer about a patient.

to ask for more information, so a personalizedproposal was presented to her. Cordish then calledto say she might have a lead on a significantly largerdonation for CITI.

The lead turned out to be Schwartzs estate,which had set aside funds in trust for a number ofcharitable foundations. However, Cordish was soimpressed with the CITI proposal and the

programs stated aim of revolutionizing thestandard approach to cancer research andtreatment that she decided to give the entire$1.5 million to City of Hope.

When it came to selecting an appropriate recog-nition for Schwartz, Zschomler and Cordish bothfelt that the entry plaza to the planned $60 millionresearch building would be an ideal spot for avisual testament to Schwartzs philanthropic legacy.

What is so amazing to me about this bequest isthe rapid progression from a modest direct maildonor, to a $100,000 gift, then to a donation of

$1.5 million, said Zschomler. It really showedme that even the smallest gift, if properly nurtured,can grow into a major gift when the time is right.

Schwartz: Bequethes to CITIContinued from page 2

JCAHO: Verifies COHs qualityContinued from page 1

City of Hope patient Jorge Hernandez gives theHookem Horns sign with Texas Coach Mack Brown.

AmyCantrell

MarkieRamirez

Continued from page 1

cautioned City of Hope staff to remain vigilantabout future surveys.

It is important to remember that underJCAHOs new process, a spontaneous visit ispossible at any time. This calls for us to remainvigilant in maintaining our high standards of

patient care and compliance with the JointCommissions standards.

An independent, not-for-profit organization,the Joint Commission is the nations predominantstandards-setting and accrediting body in health care.

7/31/2019 Hope News Feb 13 2006

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Monday, Feb. 13

4 to 5 p.m.

Platt 3 Conference RoomSeminar. DNA Repair and Cancer: A

Model for Estimating the Role of Genetic

Variation in Risk of Common Disease

Following Exposure, Harvey

Mohrenweiser, UC Irvine

Info:Saundra Hilton, ext. 62737

Thursday, Feb. 16

9 to 10 a.m.

Library Conference RoomSeminar. Regulating Homologous

Recombinases in Meiosis and Beyond,

Hideo Tsubouchi, Yale University

Info: Devina Caggiano, ext. 63344

6 to 7:30 p.m.

Platt Conference CenterAsk the Experts Lecture. What You

Need to Know About Prostate Cancer

Info and reservations: ext. 65669

Monday, Feb. 2011 a.m. to noonCooper AuditoriumSeminar. Estrogen-related Receptors asKey Regulators of Cardiac and SkeletalMuscle Energetics: Implications forMetabolic Disease,Janice M. Huss,Washington University Schoolof MedicineInfo:

Eileen Sepulveda, ext. 62833

Tuesday, Feb. 216:30 to 8:30 p.m.Helford Hospital Main LobbyHands-on-Harps Concert and WorkshopInfo:Jeanne Lawrence, ext. 63971

Wednesday, March 1Noon to 1 p.m.Needleman 1Conference Room*CME Seminar. Peripheral Neuropathyin the Oncology Patient,Harry Openshaw, COHInfo: ext. 65622

Thursday, March 25:45 to 8:20 p.m.

Visitor Center*CME Dinner Meeting.Advances in

the Surgical and Systemic Treatments of

Advanced Bladder Cancer,

Timothy Wilson and Przemyslaw

Twardowski, COH

Info: ext. 65622

Calendar of Events

The San Jose Mercury Newsfeatured Barry M. Forman, M.D., Ph.D., in a Feb. 7 article abouttesting for performance-enhancing drugs at the Winter Olympics.

KABC-TVfeatured City of Hope patient Christine Pechera in a Feb. 7 segment about her searchfor a bone marrow match and the need for more Filipino donors in the national registry.

The Feb. 4 Pasadena Star-News, San Gabriel Valley Tribune and Whittier Daily Newsshowcased City of Hopes mural in the Visitor Center as an example of the 1930s New Deal legacyin California and the San Gabriel Valley. The San Gabriel Valley Tribune featured a photo ofthe mural.

The Inland Valley Daily Bulletinfeatured City of Hope pediatric patient Nicole Schulz in aFeb. 1 article about a blood drive organized for her benefit.

Hope News is written and produced by the CommunicationsGroup. Copies are distributed throughout the City of Hope campus.

Permission to reprint articles with attribution is freely given.

Phone: 626-256-4673, ext. 62356Fax: 626-301-8462

E-mail: HopeNews@coh.org

Darrin S. Joy, Steve KirkCo-editors

Brenda MaceoSenior Vice President, Communications

Fred LeeCreative Services

Toni PogueWeb Services

Contributors:Laurie Bellman Alicia Di Rado

Beth Hill Kevin KogaLisa Lyons

Next Issue: February 20

COH in the News

02-12208.HopeNews.0206

NON-PROFIT ORG

US POSTAGE

PAIDCITY OF HOPE

Inhaled insulin: Approved for useContinued from page 2

type 2, Feng said. As she explained, people withtype 1 diabetes need to fine-tune their insulindelivery. Injected insulin may be delivered in dosesas precise as a half-unit, while inhaled insulin isprovided in one-unit doses at the smallest.

Type 1 diabetes patients suffering from needle-phobia, however, may benefit, she said, and ourtype 1 patients who used the inhaled insulin were

happy with their glycemic control. The inhaledinsulin might be helpful for type 1 patients as areplacement for short-acting insulin taken withmeals, she added. However, patients with lungproblems should not use the inhaler.

Physicians have had a hard time getting manypeople with diabetes to meet their blood-sugarcontrol goals, but this medication may help, Fengnoted. Insulin has shown effectiveness in controllingdiabetes, yet it has been a barrier for some of thediabetic patients to administrate injected medica-tion, she said. Inhaled insulin has showed equaleffectiveness in controlling blood glucose as a regular

insulin dose, but with improved quality of life.

1500 East Duarte RoadDuarte, CA 91010-3000

Deadline for calendar submissions is noon on the Tuesday preceding publication. Three weeks advance notice isrecommended. Timely submission does not guarantee items will be printed. Send calendar items toHopeNews@coh.org or fax to Lorena Avila, Communications, at 626-930-5363. Submissions must include day, date,time, title, speaker first and last names and affiliation (if applicable), location and contact information (contact name,phone and/or e-mail).

*City of Hope National Medical

Center is accredited by the

Accredi tation Counci l for

Continuing Medical Education

(ACCME) to provide CME for

physicians. City of Hope desig-

nates the above activities for 1.0

hour Category 1 Credit each

toward the AMA Physicians

Recognition Award, unless

otherwise noted.

That about covers it Articles by City of Hope inves-tigators recently made the covers of two scientific journals.The cover of the Jan. 1 issue ofClinical Cancer Researchfeatured an article and laboratory image by Richard Jove,Ph.D., associate director of the Cancer Center, aboutStat3 activation in breast cancer.Meanwhile, a review article co-authored by DonDiamond, Ph.D., director of the Laboratory of VaccineResearch, about CMV vaccination appeared on the coverof the Jan. issue ofTrends in Molecular Medicine.