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Thursday, April 2, 2015

April 2015, Medicinal Cannabis

At this time over 18,000 Illinois residents have started the patient registration process for the Illinois Medical Cannabis Pilot Program. This program is being regulated and managed through the Illinois Department of Public Health (IDPH).  Of the 18,000 applicants, approximately 1,600 approval letters have been issued by IDPH, Illinois Medical Cannabis Pilot Program .  Cancer is only one of the 37 debilitating medical conditions that would qualify a person to become eligible for the Illinois medical cannabis program.  With that said, the majority of patients that treat at CTCA at Midwestern travel over 400 miles, many come from states where medical marijuana has already been legalized.  So ready or not, this topic will come up and is here to stay.  The following article can help give the you some of the information you might need to answer basic questions your patients may ask about  Cannabis and Cannabinoids.

The following link is a good example of a medical cannabis dispensary, this one is in California where medicinal marijuana has been legal for years.  Please browse through Harborside for a glimpse into how cannabis is marketed and sold.

Questions
  • What is the federal law regarding medical marijuana?  What does this mean for patients who have been legally prescribed medicinal cannabis in other states, treating at CTCA at Midwestern?
  • Your patient is prescribed Dronabinol for nausea and vomiting, they ask you is this medication is oral marijuana.  What teaching points would you offer?

Discussion Questions

What was your favorite Journal Club article or topic posted this year?  What topics would you like to see posted next year?


Send your answers to melissa.luebbe@ctca-hope.com .  This was the final Journal Club post for this year.  You will need to have participated in all six articles to receive clinical ladder credit.  Please send your ACE verification sheets inter-office mail or drop them off at the Pain Management Office on the first floor.  Please include your department and a phone number that you can be reached at.  If you posted on the blog under a name that does not include your first and last name please include it with your verification sheet. I will get your signed forms back to you within 7 days.  This has been a great year for Journal Club and I hope that you have enjoyed being part of it!





122 comments:

  1. The Genetic testing article was the more informative and I enjoyed learning about that subject. Next year some topics for Journal Club could be survivorship department and their role for cancer patients; mind-body medicine; acupuncture; chiropractic care.

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    1. I liked and appreciated all of the articles. They were informative and I felt I gained something from each one, hard to choose just one. I also would llike to see more of the role of survicorship and how it plays with all the roles at CTCA. Thanks Melissa, for an informative year.

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    2. I agree with Courtney If , we could have more article about survivorship thank you very much Melissa for all this informative article.

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    3. I liked the genetic testing article as well. It was the topic I knew the least about going in, so I learned a lot from the articles and from others posts. I had not considered how difficult some of these decisions can be for patients...all in addition to their diagnosis and treatment. Thanks for sharing.

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    4. My favorite article was also the genetic testing. I was stretched and gleaned a wealth of information from this article.

      Next year I would like to see something about : alternative therapies for cancer,
      aroma therapy and dealilng with cancer as a long term illness

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    6. I also like the idea of highlighting the survivorship department and what they do. I think their areas of expertise are so diverse, that many of us to not know all that they do/provide for our patients.

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  2. Courtney! You and I have the same recommendations in mind! Survivorship was my weakest point when I took the OCN. Many of us don't know much about it and at CTCA we have great resources :) I would like to read/hear more about this!

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  3. Hi everyone!

    My favorite article was the last one, on medical cannabis. I first became intrigued by this topic years ago, when a patient in Infusion confided in me that no other pain medication worked for his cancer pain. Moved by the patient’s story, I later chose it as a research topic for my MSN. I admit that I am one of those people that was very much against it, initially—I had been absorbed in the fact that it was illegal, as is cocaine, for example. That is, UNTIL I did research and realized that this move was never based on scientific evidence! Since then, much legislation has passed to permit its use for certain qualifying ailments, but under state-by-state legislation.
    Ultimately, healthcare providers--especially nurses--are called upon to be advocates for the patients that they serve. This involves influencing social and public policy by applying scientific knowledge to patients’ experiences. Evidence shows that cannabis has therapeutic benefit and is safe. Federal and state regulation of any product should be based on science, and not ideology or long-standing social bias. As a research nurse, we should insist that the federal government conduct clinical trials to answer queries concerning its effects, such that all Americans are subject to the same medical options. In doing so, we nurses meet our ethical obligations to our patients, as well as remain responsive to advances in medicine.

    For next year, my suggestion for a topic is genomic testing for cancer therapy.

    Theresa Minniear - Clinical Research

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    1. I agree Theresa that at first I saw it as a drug like many others until I began hearing the beneficial effects in certain circumstances. A recent show on TV regarding medical marijuana mentioned they are looking into a test to determine if someone is currently under the affects or not.... unfortunately there have been individuals treated with medical marijuana and were fired from their jobs because they tested positive on a drug test but reportedly were not under its affects at work. Since the drug can be detected for roughly 40 days after its use - I would hope the test to determine the current state of its affects happens sooner than later so that patients that use medical marijauna can continue to provide a life for themselves if still possible.

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    2. Thank you Theresa, this topic Cannabis and Cannabinoids is a great teaching and information for us, as I have encountered patients who are taking Medical marijuana and it really works on there N/V and appetite.

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  4. I enjoyed learning more about Genetic testing! I often draw labs for various tests and feel I know very little on the topic. Reading the article gave me insight and a better understanding on such a revolutionary option. I would like to see more articles on palliative/end of life care as well as cancer patient resources.

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    1. I agree that palliative and end of life care would be a good thing to look further in to. It is an unfortunate part of what we do but it is a fact of life and something that we deal with more often than we would like to admit.

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    2. I agree with Jessica. I think cancer patient resources would be a great thing to learn about

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  5. I think that the article about cancer related pain was a good topic, especially because this is something we deal with on a daily, even hourly basis. For next year, I have thought of two topics that I thought would be good to look more into. Oncologic emergencies would be something worthy of taking a closer look at. As well as sexual function and dysfunction related to cancer and treatments.

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    1. I agree with you Lauren about the oncologic emergencies. That is always a good topic to brush up on so that we better know how to recognize and handle those types of situations.

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    2. I agree with Lauren regarding topics on sexual dysfunction. I know that I lack knowledge and comfort level in being a resource for patients in this area of practice.

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    3. Lauren,
      I agree that sexual function is an important key in our patients. For some patients, there is no issue as there cancer has made them impotent or unable to have sex for some physical reason. However, for others whose cancer is new, sexual dysfunction can be devastating and affect their self image. Being an Infusion Nurse, I find that it is very easy to talk about abstaining from sex for 48 hours after chemotherapy or the importance of protection. I sometimes feel that it is hard for the nurse to talk about this topic but if you do it in a professional and educational way then patients feel more receptive to it.

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    4. Agree Lauren, First thought that came to my mind was a topic on sexual dysfunction and issues related to chemotherapy. As a nurse that worked maternal child health education, I spoke alot on this topic but lack the knowledge in the oncology world.

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  6. I have enjoyed many of the articles for various reasons so it is truly hard to pick an absolute favorite. Great Job Melissa for choosing relevant articles for us all to enjoy! The Genetic Testing article was one of my favorites since I have been supportive of close friends that recently made some big decisions in their lives based on genetic testing.

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  7. I thought it was hard to pick a favorite topic since I feel all these topics from this year really related to our patients and provided great insight into providing care for them. But if I had to pick a favorite it would probably be this last one on cannabis. I feel there is a stigma associated with it and it is an interesting subject to learn about, especially because of CTCA's care model.

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    1. I agree Amy. It's just one more way we can take away the pain and suffering for our patients.

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  8. Next year I would like to see an article on caring for family members of cancer patients... because sometimes I feel this is more of a challenge for me than caring for the patients themselves.

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    1. I agree! Caregivers are frequently neglected and it is important for medical providers to be aware that they often suffer very much along with their loved one. With the time we are allowed to provide care to patients, it is not always easy to acknowledge this or do anything about it. I would love to learn more about the topic, as well.

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    2. I totally agree as well! Sometimes I find myself unsure of how exactly to go about caring for the family because they are so out of their element being away from home and so vulnerable. I would really enjoy articles like this as well.

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    3. I agree with you on this Amy. More often than not, its always the family that are the problems not the patient.

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    4. Good idea Amy! Family members deal with so many emotions, fear, anger, grief etc. And what about the ones who try to control every aspect of the patient's care, the ones who don't let the patient make decisions for themselves.

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    5. Agreed! Sometimes your just in a loss of words. This would be helpful.

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    6. This is a great topic to consider as well. Sometimes it is difficult dealing with some family members. Consideration must be given to what they are also going through during this difficult time, and things we can say or do, or not say or do to help them during this difficult time.

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  9. its hard to pick favorite topic because they are all very educational but if i have to pick i choose the genetic testing because of the big impact it does with the patient and their family. for next year im interested about survivorship.

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  10. I had several this year, but enjoyed the topic of noise in the hospital setting as well as the genetic testing article. Cannabis was also interesting. Next year would like to read more on actual processes the state of Ilinois has in place for pts obtaining their medical marijuana, integrative therapies being utilized at other centers, basic overview of chemo for those who do not work with it, and hormone therapies.

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  11. I think there were many good articles, but have to go with the one on Cannabis. It was quite an education for something regarded as an illegal recreational drug for so long. To have it broken down to see it's uses and possibilities is exciting. Still concerned about the effects of the smoke on the lungs, but if I were a hospice patient and it helped with all those things, would it matter?

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  12. Almost forgot! I like the idea of articles on hospice care and there are a lot of good article in the INS (infusion) journals about central line issues.

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  13. I enjoyed all the articles and found them to be relevant.
    I didn’t necessarily have strong feelings one way or the other regarding the article but loved the discussion that took place regarding the analogy of nurses as angels. The discussion really provoked some thought filled responses!
    I think there is great value in the Cannabis article. As professionals we need the facts. Hopefully we can be open minded enough to see the scientific basis for its usage and not merely be influenced by personal opinion. The article was interesting to me as I acquired facts I did not have before. I have seen the effects of Cannabis first hand with a patient experiencing pain that could not be relieved with ANY pain med. As a nurse I feel better prepared when they look at me and ask “why is Cannabis not believed to have any medical use?”

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    1. I agree with you Debbie, I did not particularly like the article nurese as angels, but the discussion was very interesting. The various ideas and perceptions was awesome.It did brings the intelligent analogy on the matter.

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  14. This is my first time participating in Journal Club and I enjoyed every topic. They were all applicable to my daily practice. My favorite topic was bone pain because so many of our patients suffer from it. It was a good reminder of the importance of thorough assessments and strong advocacy by nurses for their patients, quality medical management and even simple comfort measures. It is good to have these things reinforced once in a while. For next journal club, I would love to look at specific side effects of cancer treatment (both radiation and chemotherapy) and discuss in depth assessment techniques and interventions that nurses can use to help their patients remain on their therapy for the entire course of treatment.

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    1. I agree with your suggestion for future topics Meg! All nurses could use a reminder - even if it seems like the basics - related to chemotherapy related side effects. There are several tips and tricks I have learned throughtout the years that other nurses have taught me. Having a discussion about side effect management in the blog might help a nurses learn something new.

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    2. AGREED, i really like the blog idea Brittney..that would be such a great idea. So much cross knowledge could be provided that way. Very interested on what different techniques and interventions are out there!

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  15. Melissa I enjoyed every article you did. Again KUDOS for all the hardwork. I am so gratefull. As far as my favorite, it will be the last one , Cannabis and Cannabinoids.
    It is very controversial and very timely to bring it to us. I admit I have mixed feelings about it. After reading the article, It gave me more understanding what medical indications and outcomes for our patietns especially for those unresponsive of standard treatments for pain or for severe nausea and vomiting. The article is very interesting for it helps me acqiured scientific knowledge. I just hope more studies to be conducted to see its usage in preventing the growth of blood vessel that supply tumors and ths other possible effects that was mentioned in the article. For next years article I would like to see article of " Life after Cancer both patients & care givers"

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    1. I like your topic on Life after Cancer-it could cover employment, discrimination, emotional distress, worries of recurrence.

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    2. I would also like to have an article regarding " Life after Cancer". There are many facets that could be addressed for the patient and caregiver, sexual relationships, changes in roles from wife/ child to caregiver and as Mary stated worries of recurrence.

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    3. I definitely would like to see articles on survivorship.

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  16. I also had difficulty picking a topic. They all were excellent in providing us with information that is so applicable to our jobs. If I had to pick one, I think I would go with the one about nurses, as angels. I think it challenged us to think outside ourselves, or, the way we like to think of ourselves. It would be hard to imagine that a nurse could be therapeutic, when she/he thinks of themselves as, first and foremost, doing a job. Or, maybe we just don't like to think of ourselves, in that way.

    One might argue that the two are not contrary; that the nurse who works to do a good "job" might be a very effective nurse. If you take it a step further, a nurse that thinks of nursing, first, as a job, might lobby for better working conditions for nurses. Wouldn't that impact patients, in a positive way, in the end?

    I think most of us, who read this article, could identify with the author, in some small way. At the very least, it challenged us, to look at nursing, from a perspective, different from the way most of us were taught.

    As for future topics, I would like to see something on the recent changes in healthcare coverage (i.e., Obamacare) and it's potential and future impact on care of the cancer patient.

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  18. I believe that this article was very interesting and therefore my favorite. I was unaware of all of the medical benefits of medicinal marijuana and the number of states utilizing it. I hope that in todays culture of addiction it is not abused legally. I would like to see articles that discuss legalities in nursing practice. I went to a seminar taught by a nurse/lawyer and it was very enlightening.

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    1. I agree with you Mary! I would be very interested in learning more about the nurse/lawyer profession and ways to protect our license. I have always wanted to attend a seminar on the same topic.

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    2. I also found this article intresting. I have watch various news reports about families and the benefits of medical marijuana and the challenges getting it for those in need. I know there will be a lot more information to follow. We may need to bring this topic up again in a year or two.

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    3. I really enjoyed all the articles as well but I felt like this month's article was most helpful to me in my day to day practice. I feel like many patients are asking the nurses the question about cannabis and it helps to have this information. Thank you Melissa for all your hard work and thanks to everyone else for contributing as well. enjoy the summer!!!

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  19. I agree with Meg and the importance of treatment for bone pain. Patients that are in chronic pain tend to get depressed and lose the energy to fight their illness. Diminishing pain helps patients treat more effectively, in my opinion.

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  20. Like many other posters, I liked the articles regarding pain and a quiet atmosphere. I feel like both were so relevant to my department in the hospital and I was really able to take away ideas from those articles. I agree with Mary Oskielunas in regards to seeing articles about the legalities in nursing practice. I think that would be a great topic to touch on to help us see how to better document and form a more thorough process when charting.

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  21. I really enjoyed the genetic verses genomic journal club posts. I feel much more confident in identifying what the difference is between the two. I enjoyed leaning about the services we offer our patients regarding these tests.

    For future topics I would like to learn more about job satisfaction among nurses in different specialties; including what factors support happy nurses!

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    1. I agree with you Brittney. It would be interesting to learn more about job satisfaction and happy nurses.

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    2. I agree, Brittney, understanding the differences between genetic and genomic as it relates to our patients was very informative!

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  22. I liked the article on genetic testing. I learned a lot.
    I would like to read an article on HIPEC

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  23. My favorite Journal Club post this year was “I’m No Angel”. I found this article very interesting and I had a lot to say about it. I also truly enjoyed the article about pain management. I found that I had a patient complaining of a new onset pain and he was sent to OICC, I just didn’t feel right about how he was explaining his new pain. It turns out that his tumor had increased and was causing increased pain. The oncologist saw the scans and changed his chemotherapy in a matter of hours (otherwise he was there to get the same treatment that was no longer effective for him). I think that after reading the article about new onset pains it made me think more about what could be going on a prompted a different response.
    For future Journalphoria topics, I would like to see an article about Holistic Nursing or like topics such as self-care techniques or aromatherapies. I would like to see new trends that are happening in the medical field. Also, I would like to see different technologies that are being used in the medical field today and how nurses are adapting.

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  24. I enjoyed all the articles this year. Thank you Melissa for your dedication and hard work. This last article was very interesting. We do get a lot of questions from patient's regarding medicinal cannabis. There are many benifits to promote the legalization for medical use for our patients across the nation.

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    1. I agree as well! Its great that it can be used for alll of these side effects: Antitumor activity,stimulating appetite, nausea and vomiting anxiety/sleep and pain relief. In future studies perhaps we will see more things that are being done with medicinal cannabis.

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  25. Well this was my first time participatin gin journal club and i have to say i learned quite a bit and each topic was unexpected and interesitng. I cannot think of anything specific at this time to suggest but i can say i definetly would like to be a part of it next year and continue to read other nurses thoughts and ideas. It really opens your mind to read through these articles and here different view points. As far as the most rewarding article i would have to say the one regarding the viewpoint of what a nurse is as oppose to being called an angel, that was very positive viewpoints to hear from everyone. I have enjoyed the reading and look forward to next year.

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    1. Great to have you join! And I agree, there was great benefit and wonderful information on all the articles. It's a great way to connect with peers and take time to stretch ourselves to learn something new and unexpected.

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  26. I think the article about hospital noises was my favorite. I think I needed the little reminder to remember where I am at all times and to control the volume around me and the patients when I can and to control my volume.

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  27. I would like to see an article about cancers of unkown orgins. This is a topic that really intrests me and I know that there is testing now to try to determine what the orgin of the cancer is.

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    1. Excellent suggestion Patricia - seems we are seeing more of these and they are so intriguing.

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    2. I agree with you Patricia, cancer of unknown origin??? Nowadays we are seeing a lot of this on the floor and sometimes it makes you think how can a certasin type of cancer be given the right treatment if we dont know the origin...it just make make think and wonder?

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  28. I think my favorite topic this year was a tie between the discussion about genetics and also the nursing angel discussion. They were both great topics thats sparked a great amount of conversation. Next year, I would love see a topic about the battles of being a acncer patient care giver or maybe a discussion on palliative care!

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    1. Kristin, take this a step further - how about an article of working at a cancer faciltiy and battling the disease yourself either presently or in the past. Do you tell patients? Patient reactions....

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  29. This was my first year in Journal Club,it was great! I really enjoyed all the knowledge i gained. Its hard to pick a topic, since most were very interesting. I really liked the last one on Medicinal Cannabis. In my oppinion I like the fact that medicinal cannabis is kind of a jack of all trades if you will: Antitumor activity,stimulating appetite, nausea and vomiting anxiety/sleep and pain relief. Basically touches on all of the areas our patients somtimes go through during /after treatment. I would love to see more articles on different naturopathic medicine, topics/treatments.

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  30. Definitely the nursing angel conversation. This conversation made you look at your career, love and passion for nursing. I would like to see articles on HIPEC and pt outcomes mentally and physically and the same for ostomies. I would like articles on wound care such as "we are not reimbursed if there is a HAC pressure ulcer...". Articles on cancer support groups and how this helps or does not help the patient.; Thanks Melissa for all of your hard work - appreciated! Last request - spellcheck LOL!!!

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    1. I think that articles on HIPEC would be very interesting. Wound care would be another great area to explore.

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  31. My favorite article was the "nursing angel" article. Although I didnt agree 100% with the author, it was still refreshing to hear another point of view. Most of all, I enjoyed reading Pat Dillows perspective. And wow, what adose of reality that was. :)

    I would like to see an article on compassion fatigue, can always learn things from grief/emotional strains of the patients we serve, and a specific article on breast cancer.

    Thanks Melissa! You totally rock!

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    1. Hi Kari, I agree with you. The "I'm No Angel" article really got me thinking, so I would have to consider that one my fave, eventhough I did not agree with the writer on most points. A good debate article!
      Christi A, IR - x1517

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  32. It's hard to believe another year has gone by. First of all I would like to commend you Melissa for doing such a fabulous job leading this club.

    My favorite article was on hospital noise. There is so much truth to the amount of hospital noise that affects not only the patients and caregivers but staff themselves.

    For future articles, I would like to see more on holistic nursing as well as survivorship, including caregiver fatigue and stress.

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  33. I enjoyed the genetics and genomic article information. It really put things into perspective. Reviewing topics, all of the above I am interested in. It sure is hard to pick just one or a few! Some topics of interest include: HIPEC; thermal scan (instead of mammograms) and how nurses can be involved; using insulin to reduce a patients blood sugar to increase tumor sensitivity to chemo and how we as nurses can assist in this; nutrition and improving nurses quality of life; nutrition and improving patients' quality of life; how to properly support a patient detoxifying (whether that is from chemo/radiation/heavy metals/herbicides/pesticides) and how this helps the patient heal from therapy. Melissa, thank you so much for your hard work, I have enjoyed journal club and look forward to next year!

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  34. What was your favorite Journal Club article or topic posted this year? Genetic Testing and Ethics in pain management were interesting and helpful. What topics would you like to see posted next year? I would like to see a topics on Specific chemo regimens. Thanks Melissa for all the great articles, I pick up interesting tidbits from all the articles!

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  35. My favorite journal article was genetic testing as I am interested in genetic topics and new info. The most controversial was "I'm No Angel." That article sparked many differing opinions and emotions. A future article I wish to read would involve evolution of nursing over the generations, where we were and where we are. Especially like to read about the changes in nursing practice related to various generational characteristics, i.e. Gen X, Gen Y, Baby Boomers, etc, and how we work together and/or have conflict. Also would like an article on balancing a profession, homelife, family, friends, and volunteer work. How professionals successfully achieve balance and satisfaction. Thank you, Melissa, for taking on Journal Club month after month.

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    1. The article "I'm No Angel" was controversial and very interesting because of that. I like the idea for an article about work life balance. I think especially in this profession that balance is incredibly difficult at times.

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  36. There were lots of good articles this year. It really is hard to pick one that I liked the most, but if made to, I would have chosen genetics vs genomics. I really found the Canabis article informative and will be useful with upcoming patients.

    I would like to see articles on surviorship, HIPEC, compassion fatigue.

    Thanks for a great year Melissa.

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    1. I agree with Tina about genetics vs genomics.

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  37. There were a lot of good topics this year so it was difficult to choose. I liked the articular on Radiation Therapy and medical marijuana the best. I think I learned the most personally from those two articles. I would like to see articles regarding immunotherapy for cancer treatment, and vitamin C. Thank you Melissa for hosting this.

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    1. Yes, I enjoy the information on radiation as well. It would be nice to learn more surgical procedures like HIPEC and microvascular surgical interventions.

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  38. One of my favorite article of the many journals that we did was the substance abuse and cancer related pain. Sometimes we as nurses tend to be judgmental at times. When patient complains of pain sometimes we think they just wanted it for the sake of what will make them feel afterwards but not realizing the agonizing pain that cancer has inflicted on them. Yes in our practice we've seen many people who just love pain medications just because, but the cancer related pain is not something that we can just underestimate. Pain will always be subjective no matter what and mutual respect is always needed because like what I always said in the past, I don't feel the pain of my patients and I trust them so much to tell me how they are feeling. On the other hand, there are those patients that look at the time all the time, sleep for an hour or two and when it's time for the pain medication again then they are wide awake and will ask for more even if in your assessments they are telling you that their pain is already acceptable or even lower than what's their acceptable level. In this case, I always use my discretion, is it time to reeducate my patients or are there any problems that exists aside from pain like insomnias, anxiety or others to name a few and they are just using the pain medications because it is what make them sleep or relax? My role as a nurse is to overlook on all of these problems so that in the end it's not only pain medication that is utilized versus other problems.

    One topic that I will love to see is Euthanasia. I know it is not legal in this state but for us who are treating cancer patients, what is our stand on this?

    Melissa, I would like to congratulate you for an amazing topics and learning from this club. This is my first time here, but I felt this is one of the best learning experiences that I've had. Reading others thoughts and comments was a joy.

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    1. Richie,
      I agree on your views on being judgmental regarding a patient's pain. It can happen where we just assume that to be in tremendous pain the person has to be very emotional or not as stoic, and we can't assume that they are drug seekers. I think at this moment we just need o remind ourselves that everyone is different. For example, when I'm in pain I am quiet and want to be left alone but I wouldn't want people to assume I'm not in pain.

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    2. Richie,
      yes, would be good to see an article on end-of-life issues and assisted suicide. I would imagine that some of our patients have thought about it. Would be interesting to read an article on it and then have some good discussion on the topic.

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  39. Although my favorite article was the genetic testing, I enjoyed each and every article, and so appreciate all the hard work and dedication it takes to get this to us each month. THANK you Melissa ! :) Awesome job

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    1. Agree with you Judy-genetic testing was one of my favorite articles.Again THANK YOU Melissa.

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  40. I actually think that the medical cannabis was a great topic. Maybe this is because it's so controversial and I think at first you want to be skeptical and immediately be against it. The truth is that there is a lot of positives to it according to research and the fact that it's becoming so accepting in certain states. I have had several patients that have expressed either their interest in the medicinal use of marijuana or have been using it and expressed how well it works. At first you are shocked but then in a way relieved that it has helped them. Certainly an interesting topic.

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    1. This was a very interesting read. I have had patients that want to use marijuana and have asked me if it would help them and i was never able to give them a clear answer. Reading about how there are studies, if only a few, done on the use of cannabis for certain diseases has been interesting.

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  41. Hi Melissa,thank you for another great year.All of the articles were interesting,but my favorite was The Genetics and Genomics,learned a lot from it.For the next year i would love to see something about naturopatic medicine since it pays important role in cancer treatment of CTCA patient's.

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  42. I enjoyed reading the article on genetic testing. The other articles were interesting also. Thanks Melissa for a great year.

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  43. I found the article on pain / chemical dependence to be very insightful. It really made me question my own views on patients and pain and how I react to them. I feel it opened my eyes to possible preconceived notions I had about the use of pain medication and our patient population.
    We've covered so many great topics, I can't think of anything else I'd like to see for next year at this time... :)
    Thanks for another great year, Melissa!

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    1. I thought all of the articles were really good. My favorates were the one on hospice because I have a hard time when patients get to that point and on drug dependence because I feel patients with an addiction history are usually under medicated.

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  44. Melissa, I liked the last article on medical marijuana. I have had multiple pt aske me about the IL card and how to apply. I really liked the article and actually shared it with my family. I would love to have a article about sexual concerns. Prostate issues with pumps ect. Mary P might be a good resource for that. Thanks again for a great year.

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  45. I really enjoyed the medical marijuana article. I remember a patient telling me one time that it has anti-tumor properties. I didn't believe them! I hope more research is done on medical marijuana.
    As far as next year's articles, I would like to see something on team building and communication between healthcare workers. Our department has done some team building exercises and get-togethers which has strengthened our team. I feel that interdepartmental team building and communication exercises would be beneficial for our team as a whole.

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    1. I like the idea of learning about team building and communication. We spend so much time with our co-workers and that can really make the team stronger.

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  46. My favorite journal post was the most recent. I really enjoyed reading about the marijuan article because it is so important to so many of our patients. It is also interesting because of all the positive results marijuan can yield. I would like to read more about maybe genetics of particular cancers or rare disease that can result in cancer.

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  47. All the journal articles were interesting and informative. To select just one for this posting, I would choose this month’s Cannabis and Cannabinoids article as the most interesting to learn about. Especially since Illinois state will be able to dispense marijuana in the near future. I think articles on how to take better care of ourselves as oncology caregivers, without feelings of guilt would be valuable. Learning how to find that right balance between work and home life. Melissa, thank you again for all your efforts and great job with keeping Journalphoria. It's a good tool for us to learn and share ideas with each other.

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    1. I agree with Gail, we should have articles regarding the care of the self, when it comes to working in this emotionally challenging field. That is the buzz words these days, Work life balance also important for all of us. Way to go Gail.

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  48. November topic Substance Abuse and Cancer related pain. Very interesting.

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    1. Oh yes, this was a good article too. It really helped me understand how we can help our patients with their pain and protect them from abusive tendencies at the same time. so many of the articles were so thought provoking.

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  49. I appreciated all the articles but the one that was most interesting was the one on genetic testing. It was a topic that i wasn't familiar with and was glad to read more about it.

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  50. Well I truly thought you chose some strong topics for this year Melissa! Thank you for feeding our minds with new perspectives and insights! I can say that each topic you chose I was able to apply to my direct nursing care. When some coworkers or other colleagues I work with that are quick to assume someone is a “drug seeker”, your article posted about Successful Pain Management for Recovering Addicts, truly impacted my perspective on my patient who are in pain and appear to be a “drug-seeker” but in reality may just truly have severe uncontrolled pain. I also am more intentional with the effects of hospital noise on patient’s healing capacity and how we as healthcare providers can become “immune” to hospital noise. We have tried to be more intentional about this issue on our unit to enhance patient care. Most recently, I really enjoyed the post about bone metastases pain and treatment plans. I know that the majority of the patients I care for on 3rd floor have bone metastases and this article helped me to gain perspective to better care for my patients.
    For next year, I am excited to see what more you have to share! I suppose if I had to chose a topic, I would love to see an article about something the along the lines of Holistic Nursing care. I don’t have a specific idea in mind, and I know that is a broad topic. I just feel that holistic care is the core of our hospital, and I would love to see articles to help empower some of our nurses to center their care in seeing our patient’s as a whole.
    Another strong topic that I think we are struggling with as a hospital is our changes in communication and workflow in our transition to the new tower. I would be curious to see if there are articles to better enhance communication in a decentralized environment or enhanced interdisciplinary communication, seeing as that we will not be in located in the same parts of the building as before. Just throwing it out there! I know that these are broad topics, but they have been the prominent topic of discussion at several meetings I have attended in the last couple months.
    Thanks again for such a wonderful year Melissa!

    -Samantha Brandt

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  51. I enjoyed the last article. It has helped me understand the benefits of medical marijuana and who would benefit from this. Next year is like to see more articles on oral/iv chemotherapies and benefits of vitamin c infusions.

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  52. Hi Everyone,
    Melissa, thank you for all the time and effort you put into Journalphoria for us! This was my first year doing this and I would recommend it highly, I learned a lot in a fun way.
    My favorite article was the "I'm No Angel", because it really made me consider another point of view, and re-evaluate my own beliefs on the subject. I would like to see an article on working with patients that are recommended hospice, and how to help them cope with that step.

    Thank you!!!!
    Christi A, IR x1517

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    1. Christi, I agree that the "I'm no Angel" article was a great different perspective that nurses often don't consider. It was a great article that provoked a positive or negative response based on each individuals opinion. Your suggestion on hospice and how to help cope is a great suggestion. End of life issues can be difficult when your not sure how to provide the information.

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  53. Thanks again for another wonderful year of journalphoria! I think the article about nurses as angels was my favorite. I'd like to see an article in the future about different types of new medical therapies that are being used to treat cancer as it is always evolving and being a specialized hospital we should all be informed on the latest treatments that are available!

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  54. My favorite article was this one on Medical Cannabis. It will help me in the future to explain and teach patients about regulations surrounding the use of marijuiana when it comes to a possible alternative treatment for them. We are having more patient's asking about it. I would like to see articles addressing alternative treatments and the science behind them. All the articles this year gave you something to think about but also I learned something from each of them. Thanks Melissa for all the work you put forth to journalphoria.

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    1. I agree it is interesting to be continually aware of the current status of this treatment

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  55. I enjoyed the February article about the Hospital noise. I like the discussion we had on ideas how to create more quiet and peaceful environment in our own work area/unit. Enjoyed reading how to minimize noisy environments for our patients who need their rest and sleep. We really should educate our staff on the noise reduction measures to create the quiet zone.

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    1. I agree, this article was a great reminder to all. It really brought some great ideas to light to help reduce noise for our patients.

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  56. Melissa - thank you for another wonderful year and for bringing such a great range of ideas to discuss and learn about! I really enjoyed all of the articles, but the one that was my favorite was looking at nurses as "angels" because I feel it created a lot of great conversations because people felt so passionate about it. I like the medical marijuana article, and feel it can truly be a miracle drug for many patients. However, I have read that in patients that are severely immunocomprimised smoking it can be dangerous due to increased risk of getting aspergillis and I was surprised this wasn't mentioned in this article. I need to look into this further to be sure I'm up to date.

    With our changing healthcare, I think an article on the Affordable Care Act and it's impact on nursing would be very relevant and help us in conversations with our patients (although, it might not be very exciting!). Thanks again!

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  57. Melissa, I thought that all of the articles were very well selected and meaningful. Each one had thought- provoking questions and very interesting responses from everyone. Continue the great work that you do- it is very appreciated!

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  58. Melissa, This month’s article and the article on hospital noise were my favorite. The additional information on the use of medical marijuana was very educational. I know we prescribe marinol as an appetite stimulator and that is can help with nausea and sleep but there are so many more uses. The article on hospital noise was an eye opener because I think we get so caught up in our day to day work that we forget and need reminders that we need to provide a quiet nurturing setting that benefits the patients. You always do a great job of picking articles that are relevant to our patient’s needs. I appreciate your effort in giving us such great topics from month to month.

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  59. Melissa, I really enjoyed this year's articles they were all very informative. I found this last article on Medical Cannabis very interesting since many patients are interested in getting more information on medical marijuana. Thank you so much for all your work towards journalphoria and I look foward to reading next year's articles.

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  60. I am not sure I could pick a favorite. I really enjoyed the medical marijuana article, the article on the angels, and the hospital noise article. All were excellent choices and created some great blog discussions. Thank you for all you do.

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  61. Thank you Melissa for a great year of Journal Club. All of the topics/articles were excellent. I would say the one I learned the most from was on Genetic testing. I had very little knowledge of this prior, and felt with our new genetic testing center, that this was very timely.

    Suggestion for an article for next year would be "Life after cancer...now what?" For many patient's, after treatment perhaps they lost their job, spouse, etc., and it is hard for them to cope with all of the changes. I encounter many patients who are going through this and find themselves in a tough spot.

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    1. Melissa, thank you for all of the articles. They were all very interesting and informative. Great choices Brenda, I agree Genetic testing would be interesting topic. I found this last article on cannabis was very interesting and learned a lot about it.

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  62. Thank you Melissa for Journal Club. This is the first year I participated and I really enjoyed it! I learned new information and it was good to read about things that were outside my area of expertise. The article that was the most helpful to me was the one about genetic & genomic testing. I think my favorite article was this last one about cannabis. I checked out the Harborside dispensary and that was really eye opening! I read several of the postings/articles that were on their site and my view was broadened. I'd love to see some articles next year on health care insurance/coverage, an article on personalized medicine, something on holistic nursing, and an article on self-care. Thank you!

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  63. I enjoyed participating in all of the topics. I especially liked the journal artical on genetic testing. Thanks for all you do for providing this education.

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  64. My favorite journal club article was about genetics vs genomics. This topic has always fascinated me and with the evolving prospects for chemo, immuno and radiation therapies there will be lots more to come.
    Future topic suggestions include more of the evolution of genomics and survivorship.
    Melissa, thank you for continuing to coordinate, facilitate and maintaining effort for the Journalphoria Club. Once again it was an informative year for us all.

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