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Oncology Team Resiliency

How To Build a Resilient Oncology Team

To help members of the cancer care team better manage stress and improve their overall well-being, ACCC 2021-22 President Krista Nelson—and several special guests—hosted a virtual Mindfulness Meditation series. Through meditation, we cultivate an awareness of the present moment and train the mind to better understand how and why we think and feel the way we do.
View Meditations

Results from Mini Z Burnout Survey

2019-mini-z-results-700x424

To gauge the level of burnout in the multidisciplinary cancer care team, ACCC surveyed its membership in 2019 using the clinically validated Mini Z survey developed by the American Medical Association. While only a small number of respondents (14.9%) report dissatisfaction with their current job, burnout and stress levels are significant.

Download Survey Infographic

 

Cancer Buzz Podcast

  • [MINI-PODCAST] Ep 74: The Business Case for Hiring Oncology Social Workers
    Jan 18, 2022

    Hear from ACCC 2021-2022 President, Krista Nelson, MSW, LCSW, OSW-C, FAOSW, as she talks about two new resources (a business case brief for hiring and a benchmarking survey) coming from ACCC that demonstrate the value oncology social workers play in cancer care.

  • [MINI-PODCAST] Ep 71: Leading with Gratitude
    Nov 23, 2021

    In this special podcast episode, we talk with oncology social worker and ACCC President Krista Nelson, MSW, LCSW, OSW-C, FAOSW, about finding opportunities to practice gratitude each day for colleagues and patients.   

  • [MINI-PODCAST] Ep 68: Supportive Care in Radiation Oncology
    Sep 21, 2021
    Early in the pandemic, members of the Stanford Health Care Radiation Oncology Department created an internal podcast for their department to creatively address the need for connections among onsite and remote staff, acknowledge the emotional and psychological toll of caring for patients during this challenging time, and support the well-being and mental health for oncology staff.
  • [MINI-PODCAST] Ep 67: Coping with Pandemic Grief
    Sep 14, 2021
    In this special podcast episode, we talk with oncology social worker and ACCC President Krista Nelson, MSW, LCSW, OSW-C, FAOSW, about the overwhelming grief of the pandemic and its toll on cancer care professionals.  
  • [MINI-PODCAST] Ep 64: A Summer of Disconnect for Cancer Professionals
    Jul 20, 2021
    In this episode, we focus on the mental and emotional toll that COVID-19 continues to have on cancer care professionals—while much of the public experiences a “summer of joy” due to rising vaccinations.
  • [MINI-PODCAST] Ep 14: COVID-19 Self-Care
    Mar 31, 2020

    Krista Nelson, ACCC President 2021-22, shares self-care resources for cancer team members during the COVID-19 outbreak and guides us through a brief mindfulness exercise.

  • [PODCAST] Ep 02: Fostering Cancer Care Team Resiliency & Well-Being
    Jul 31, 2019
    Learn how organizations like Vidant Health and The Outer Banks Hospital are creating a healthier, more rewarding workplace by making employee wellness a strategic priority.

From the ACCCBuzz Blog

Combatting Fatigue with Exercise: A Pilot Study


April 11, 2019
jf19-providing-psycho-education-to-combat-fatigue

Although physical and emotional fatigue is the most common side effect of cancer treatment, it remains underreported, underdiagnosed, and undertreated. Yet the exhaustion patients experience can significantly interfere with their daily functioning, and fatigue can persist for months or even years after treatment ends.

Of the non-pharmacologic interventions for cancer-related fatigue, researchers have found exercise to have the strongest potential to produce a therapeutic benefit. Exercise improves a wide range of biopsychosocial outcomes in patients with cancer. Studies have demonstrated that patients who exercise are less tired, less depressed, and sleep better.

Of course, this can be counterintuitive for patients, who often reduce or stop exercising when undergoing fatigue-inducing treatments such as radiation. To counteract this impulse, oncology social workers at Mount Sinai Downtown Cancer Centers in New York City developed a quality improvement initiative to teach patients about the positive effects of exercise during treatment.

The cancer centers—which include three outpatient oncology practices within one hospital system—used the PDSA (plan, do, study, act) quality improvement tool to gauge behavioral change in patients during the study. This tool works by testing a change (plan), carrying out the test (do), observing and learning from the consequences (study), and then determining what modifications should be made to the test (act).

Exercise during treatment

At the start of the initiative, oncology social workers at Mount Sinai met with patients within their first 10 days of radiation treatment. The social workers gave the patients aerobics DVDs tailored for people with cancer, educational information about fatigue, and information on free exercise programs offered onsite and in the community. During this initial meeting, the social workers asked the patients if they exercised.

When the social workers met with the same patients a second time one week after they completed their radiation treatment, they asked several questions about the patients’ exercise routines while being treated. The social workers used the Brief Fatigue Inventory (BFI) to measure patients’ self-reported fatigue. The BFI assesses the severity of fatigue and its impact on daily functioning in patients with cancer. Patients were asked to rate their level of fatigue from 0, which indicates no fatigue, to 10, which indicates the worst fatigue imaginable. A global fatigue score is obtained by averaging all items on the BFI.

Measuring fatigue

Social workers gathered complete data for 38 patients. Patients who reported exercising during treatment had an average initial BFI score of 2.0 and an average post-treatment score of 2.5. Patients who reported not exercising during treatment had an average initial BFI score of 3.1 and an average post-treatment BFI score of 2.9.

The results indicate that patients who exercised while receiving radiation treatment had lower average BFI scores than patients who did not exercise during treatment. This is consistent with the findings of other cancer-related fatigue studies, although it is not statistically significant.

The data also indicates that patients who exercised during treatment had an increase in fatigue post-treatment, whereas people who did not exercise had a decrease in fatigue post-treatment. One could infer that having a lower baseline BFI score might make patients more susceptible to experiencing fatigue during treatment and that exercise may prevent them from becoming as fatigued as they would have had they not exercised.

Looking ahead

At many cancer programs, exercise and wellness programs are offered free of charge, and patients should be made aware of the availability of these and other community resources. Oncology social workers, patient navigators, and advanced practice nurses often have access to information about these programs and should share it with patients. Oncologists should explain to patients the role of exercise in cancer prevention, treatment, and survivorship and emphasize the health benefits associated with exercise during treatment.

A future direction for this initiative may include collaboration with additional providers, such as nurses, to increase the dissemination of information to patients and provide important clinical perspectives. Although this pilot project was limited by its small sample size, it has yielded enough encouraging information to recommend a larger study.

This post is adapted from “Providing Psycho-Education to Combat Fatigue,” an article by Shannon Morton, LMSW, MA; Alison Snow, PhD, LCSW, OSW-C; Anthony H. Bui, MS3; and Manjeet Chadha, MD. It first appeared in the January/February 2019 issue of Oncology Issues.

From Oncology Issues

Building a Resilient Oncology Team: Issues and Solutions

Burnout is on the rise as oncology becomes increasingly complex with new treatment options, growing financial toxicity, an aging patient population, and an increasingly burdensome healthcare system. It has received much media attention, with some calling it an epidemic.

Thomas A. Gallo, MS, MDA, ACCC President, selected his 2018–2019 president’s theme: Reflect, Renew, Reignite: Creating a Resilient Oncology Team in Your Community, in order to shed light on the pain points that frustrate physicians, nurses, social workers, administrators, pharmacists, and all of the other professionals who collaborate to provide the highest level of patient care.

The ACCC 35th National Oncology Conference, October 17 – 19, in Phoenix, AZ, featured stories and strategies for fostering resilience and a healthcare culture that mitigates burnout among all members of the cancer care team. Three featured speakers inspired while providing practical strategies to help increase engagement, transform your work culture, and embrace experimentation. 

6 essential standards for a healthy work environment

ACCC is committed to identifying shared strategies and solutions to help combat the burnout and frustration that many of its members experience. This Building a Resilient Oncology Team: Issues and Solutions infographic details key findings on clinician burnout and a bevy of solutions to help you mitigate stress and bring the joy back to your workplace. 
Download as PDF
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