Rosemary Ford: Establishing the Standard for Bone Marrow Transplant Nursing

ALLIE CASEY
Thursday, February 02, 2017
Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
Rosemary Ford, BSN, RN

Rosemary Ford, BSN, RN

During her 40-year career in nursing, Rosemary Ford, BSN, RN, has held a number of positions, yet perhaps none more notable than her work at the Fred Hutchinson Cancer Research Center during the early years of its Bone Marrow Transplant program led by Nobel Prize winner Donnall Thomas, MD.

Ford retired in 2015, and recently, the Seattle Cancer Care Alliance (SCCA), which includes Fred Hutch, announced a scholarship in her name. The Rosemary Ford Future of Oncology Nursing Scholarship honors Ford’s legacy in serving SCCA nurses and oncology nursing students training at universities and colleges in Seattle and the Puget Sound region.

Oncology Nursing News spoke with Ford about the some of her career highlights, and especially how thriving in a culture that respects and elevates the work of nurses has made such a difference for her professionally, but most important, in setting the standard for patient-centered care.

How did you get started in nursing?
I had a clerical job which happened to be in a labor union that represented county nurses and other county employees. The public health service sectors that we represented included these amazing, engaged women who were passionate about their juvenile diabetes classes and helping the elderly to remain in their homes. When I was about 22, I decided to take the prerequisites for nursing, and after I graduated in 1976, I moved to Seattle and took a job at Harborview Medical Center where I worked in the burn unit for about 2 and a half years.

A colleague’s sister who worked at Fred Hutchinson Cancer Research Center told me that they did bone marrow transplants for leukemia and needed ICU nurses. I thought, “What? What on earth is that?” After I left work 1 day, I walked the 10 blocks over to the center, applied, and was hired in early December of that year.

What was it like working at Fred Hutchinson?
My first morning of orientation, I was in the room with a patient, her husband, and the nurse mentoring me, who urged the patient's husband to make sure that he asked any questions when the doctors come on rounds. When the doctors entered the room, the first thing the attending physician did was to greet the patient’s spouse because the patient was too ill to participate. He made sure his questions were answered, then the physician turned to my preceptor and said, "How is the patient tonight? Do you need any more orders? What do you think is happening in this room since we last talked?"

I just stood there with my mouth open. This exchange exemplified the philosophy at Hutch to include nurses as full members of the team and value their unique perspective and role. The respect for nurses there was just amazing.

What was it like working with Dr. Thomas?
Back in the early 70s, there were articles in the New England Journal of Medicine saying that the best thing to do for leukemia patients was to keep them comfortable and let them die quickly. Dr. Thomas, however, favored very intense treatment, and he cured people.

Our unit’s work under Dr. Thomas got the attention of the National Cancer Institute (NCI), which resulted in more NCI grant funding to the Fred Hutchinson program; in 1990, Dr. Thomas was awarded the Nobel Prize for his accomplishments. When he learned the news, the first thing he did was come to the nurse's station in the patient unit and said that he couldn't have done it without us. In media interviews, he described nurses as his “secret weapon,”—such an amazing acknowledgment from someone who had just gotten the Nobel Prize for medicine.

That respect for nurses was something he expected from everybody in medicine. Everybody had a perspective on what was best for the patient. He would not only listen; he expected everybody on the care team to participate. If somebody was quiet, he would ask them directly, "You've been following this patient. What do you have to add?"

What was the best thing about working at Fred Hutchinson? Was it that respect that Dr. Thomas instilled?
He set the stage. There was an incredible camaraderie among the nurses in the bone marrow transplant department, and it was very patient-focused. We had a high death rate in the early years. All the nurses on every shift supported each other: "Whose patient is not doing well? Which nurse needs more support?" This mindset would have been an uphill battle to maintain without the leadership and philosophy of Don Thomas.

What I liked about the burn unit [at Harborview] was getting to know the patients, taking care of them over weeks and months, and feeling like I was making a difference not just during that shift but over time. Certainly, bone marrow transplants are similar; in those days, patients were discharged before day 50 and were in the hospital at least 12 days before that. This meant a full 2 months of getting to know the patients and their families and helping to integrate this pretty horrendous therapy into their lives while trying to make every day as good as possible for them.

Can you provide another example of this team spirit and collaborative approach?
In 1993, I volunteered to take over the job of nurse manager at the outpatient department. We had 1 small group comprised of intake (pretransplant) nurses when the patients came in. Everybody went to the hospital and when they came out there was a whole different group of nurses who took care of the posttransplant patients. I knew from the inpatients that they were very bonded to their original nurses and were astounded they weren't going to be seeing those nurses when they were discharged.

One of the ideas that had been batted around was to group the patients under teams of physicians, nurses, social workers, and nutritionists who would be them from initial arrival all the way through until they were discharged. That was the way we structured it in 1993, and it's the same structure we're using now. Each team treats between 15 and 20 patients, and this model of having the same team with a patient throughout their treatment really works.

What would you consider your greatest accomplishment as a nurse?
Providing hope. Some of these patients had very slim chances of making it, but especially in those early days, a lot of them wanted to go out fighting. They said if their therapy or their case can contribute to the base of knowledge for transplant for the future, they wanted to participate. Certainly there was some self-selection before the patient came to our unit. Not everybody wants to do research or be a guinea pig. Usually those decisions were made before the patient actually came to our unit. Sometimes when they got there and they figured out what it was about, they would leave, but that was extremely rare.

What does this scholarship established in your honor mean to you?
It is an amazing honor, just incredible. I'm humbled that they did this, and I certainly didn't do anything by myself. I had my fellow nurses and the rest of the staff.

What advice would you give to nurses who are starting out?
Make sure you're working in a specialty of nursing that really calls to you. There are so many options in nursing. If something's not a good fit, figure out what your priorities are, where your passion lies, and follow that. My younger sister is a neural ICU manager in California, and she talks about her staff the way I do about mine. Those nurses are collegial and passionate about what they do. Not every nurse is meant to be an ICU nurse or an oncology nurse, but there are so many options in nursing. Find something you enjoy.
For more information about The Rosemary Ford Future of Oncology Nursing scholarship, provided with the generous support of the glassware company glassybaby, click here.

Talk about this article with nurses and others in the oncology community in the General Discussions Oncology Nursing News discussion group.
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