The Center for Outpatient Services Shows Commitment to Chemo Patients

By Rachel Young

In a sunlit room with murals of seascapes decorating the earth-toned walls, men and women work on their laptops or flip through channels on individual flat screen televisions from reclining chairs. They make coffee and help themselves to snacks stocked in a small kitchen. Except for the I.V. drips injecting doses of chemotherapy into their arms during sessions that can last as long as 10 hours, the cancer patients here go about their day much as they might at home.

At Stony Brook University Medical Center’s new Center for Outpatient Services, cancer patients have the use of services like free valet parking in a spacious setting. Previously, centers like the Imaging Center, which administers MRIs; the Center for Pain Management and the Outpatient Cancer Center were scattered around the hospital. All have now moved to the new facility, which is adjacent to the Ambulatory Surgery Center at 3 Edmund D. Pellegrino Road.

“The staff’s major complaint was that there wasn’t enough space [in the hospital] for the volume of patients they were seeing,” Jeanne Gaspard, the assistant director of nursing in outpatient cancer services, said. Now, some patients say they get lost in the 65,000-square-foot building, which opened Jan. 30.

To help curb this problem, Gaspard said, the staff is putting together an education program for people before they begin chemotherapy that will include tours of the facility. She said the center sees at least 200 patients per day, while the Imaging Center and the Carol M. Baldwin Breast Cancer Center each see up to 70 patients per day.

According to a "By the Numbers" document, the Center for Outpatient Services cost $24 million to construct and $16 million to equip with fixtures, furniture and computers. Gaspard said the money came from hospital funds, but she was unable to explain further where the funds specifically came from. The hospital budget director did not respond in time to a request for comment.

There are seven large flat screen televisions in the center where daytime shows like "The View" and CNN news programs are broadcast. In the Carol M. Baldwin Breast Cancer Center, patients can research their diseases on one of the four computers in the waiting room.

A notable feature of the cancer center is a “chemopharmacy,” a small, minimally-designed room with large windows and two Ansel Adams posters on the walls. It is staffed with three pharmacists, with chemotherapy drugs stocked in three SANYO Labcool refrigerators with clear doors. Before the center opened, the main pharmacy in the hospital, which services the entire medical center, acted as the chemopharmacy.

"When I was in training, Medical Oncology [where chemotherapy patients are treated] was on the fifth floor of the hospital, and the pharmacy was in the basement," said Joseph Restivo, a chemopharmacist. "When we finished something, we had to rely on transport to come and pick up the medication and bring it here. Now we can do it ourselves," he continued. "This gives us a little downtown and it benefits patients, because they get out on time."

Restivo, who said he has been a pharmacist at the hospital for one year, said the new chemopharmacy has enhanced patient-pharmacist relations. "We can speak to [patients] about problems [with medications] rather than telephone them, which can be aggravating. You become familiar with the patients," he said. "I recognize them by their faces when they come in."

Karen Smith is one such patient. "I'm very chatty," she laughed from a chair in the infusion treatment area, where patients receive chemotherapy.

A pleasant-looking woman with black-rimmed glasses and a shock of soft brown hair, Smith was wearing a cranberry-colored cardigan that evoked the crisp fall day outside. She said she has spent 10 hours a day since September receiving chemotherapy as part of a 10-week treatment. It was in June at a yearly physical that Smith, who lives in Holbrook and has two daughters, was diagnosed with acute promyelocytic leukemia, a rare type of cancer.

"I didn't even have symptoms, really," said Smith, an account liaison at HIP Health Plan of New York, a medical insurance company. "My co-workers joke that I'm the poster child for getting your yearly physical."

She said she has only had positive experiences in the center, which is part of the hospital's Major Modernization Project and has 28 adult and seven pediatric examination rooms. There are 20 adult chairs in the infusion treatment areas and six pediatric chairs.

“We used to only be able to accommodate 12 [adult] patients at a time,” Gaspard said. In the infusion treatment areas, curtains divide patients instead of walls, which Gaspard said helps patients feel less lonely. The New York State Department of Health has said this compromises privacy, but, Gaspard said, the center has no plans to remove the curtains and install walls.

“If they’re here for a long period of time, they don’t want to be isolated,” Gaspard said. "They like talking to the nurses."

"The nurses and I are always goofing around," Smith said. "It's like in Cheers when Norm would walk into the bar and everyone would say, 'Hi, Norm!' The nurses here say, 'Hi, Karen!'"

Gaspard said there are four private adult infusion treatment rooms and two semi-private pediatric infusion treatment rooms for patients who “are emotional or get upset," but Smith said she hates the private rooms. "They're like being in prison," she joked.

Smith read Joel Osteen's Become a Better You while receiving small doses of arsenic, which in recent years has been found to help treat her type of leukemia. She said that for her, being religious is important. "Faith helps, and it goes a long way," she said.

In the pediatric wing of the chemotherapy unit, which is separated from the adult wing, a 42-inch plasma screen television hangs from the wall, and toys surround two child-sized circular tables with wooden chairs engraved with suns. A large closet holds board games, and in "nourishment centers," patients can have their fill of the sugary candy and Tootsie Rolls that the nurses buy.

“The kids pretty much have free reign here,” Gaspard said.

Despite the amenities, the pediatric chemotherapy wing looks sterile, with a white tiled floor like the adult wing. “That’s one thing that probably should have been done a little differently,” Gaspard said.

Patients like Smith are grateful one of the center's main focuses is on interacting with them.

"I don't like that I have to come for this," said Smith, whose I.V. drip was half-empty. "But I have a lot of fun with the nurses. It's good to be out in the hustle and bustle. It helps take your mind off anything negative."