Episode 47 of The College Handoff, titled “Being a Bone Marrow Transplant Nurse,” features Carlie Gluch, a bone marrow transplant and hematology nurse at Huntsman Cancer Institute. The episode also features Tamara Ecker and Kirsten Schawartz, the president and secretary of the Wasatch Front Chapter of the American Association of Critical Care Nurses.
Though the world of hematology and bone marrow transplants is second nature to Carlie Gluch, she acknowledges that the majority of the population doesn’t understand what bone marrow transplants are used to treat. She explains, “bone marrow transplants are primarily used to treat hematological cancer disorders, meaning leukemias, lymphomas and multiple myelomas. We also use bone marrow transplants to treat what we call benign hematological disorders, meaning the blood disorders that are not associated with cancer, such as aplastic anemias and amyloidosis being two of the primary ones. And then on occasion, we do use bone marrow transplants to treat solid organ tumors as well.”
Carlie also explained how bone marrow transplants work. “In essence, what we do during a bone marrow transplant is that we decide that the immune system itself has not been effective at preventing cancer from occurring (or at functioning in the correct way in the case of a benign human biological disorder),” she says. “So essentially what we do is give incredibly high doses of chemotherapy to the patient initially, which kills off all of their stem cells and their stem cell lineage, because chemotherapy kills all rapidly dividing cells… And then we find a donor that is either matched to you, or on occasion people donate to themselves if it’s the correct type of cancer and the type of cancer will allow for that. And we take your cells or someone else’s cells and harvest them through a process that’s very similar to platelet donation. And then we actually put them in a little IV bag and give them back to the patient.”
While there is always variety in the day in the life of a bone marrow transplant nurse, the day follows a structured set of patterns and routines. “Most of the time for a bone marrow transplant nurse, the day will start out with a very intensive report. Despite the fact that we only have three patients, report normally takes us that full hour that we’re allotted… We go ahead and review all their labs, all their meds, and make sure that everything looks good,” Carlie describes. “At 9 a.m. we do med paths. We tend to do a ton of IV stuff, a ton of blood, a ton of platelets… We do a lot of antibiotics. And really we just educate a ton. So it’s a very neat unit because it’s much more specialized, I think, than some other units are, so you get really a whole vast array of things coming at you. You’re constantly learning. You’re constantly in talks with the doctors. You develop a really good working relationship with your coworkers and also with the providers on the unit. It’s a really, really fun and intense place to work.”
Working in an in-patient oncology unit requires several skills and characteristics in order to be successful. For Carlie, she cites compassion as one of the most important components to working at the Huntsman Cancer Institute. “You never know when they’re going to just need a listening ear to be there. A lot of what we do as initial diagnosis work with our patients, and that’s probably the part that I love the most: being able to be a friend to them in a time of need, or comfort to my patients in a time of need, or being able to just tell my patients that it’s okay if they want to cry. It’s okay if they want to be upset that they have been diagnosed with cancer, that we’re there for them and that we do this a lot, and that they’re in good hands. Because sometimes it’s the first time that the patient has heard that being newly diagnosed. There’s kind of a rush of information that comes to people when you’re newly diagnosed with cancer. And I really, really enjoy being able to kind of take time out of my day to help people feel more comfortable with the life changing event that’s just happened to them.
In a unit that is all about healing intense internal diseases and disorders, having the spirit of the Healer’s art is essential. “I think that the Healer’s art is more omnipresent than we realize. And I think that you can not really understand the impact that you have on someone until long after you’ve taken care of them,” Carlie testifies. “There have been multiple times when patients have come back and tried to thank me and my coworkers and we really vaguely remember them, but we had no idea that, you know, the five seconds that we took to grab them an extra blanket or to get them that extra pudding, or to just sit with them and say, I’m sorry, I know that this is really hard and then this really, really sucks for you right now, made an enormous impact in their lives. And I think that the Healer’s art is so much more subtle than we think it is. It’s very rarely in the big, grand gestures and very frequently in the small things that we do as nurses to help our patients.”
In the second half of the podcast episode, Tamara Ecker and Kirsten Schwartz discuss the importance of the American Association of Critical Care Nurses and the resources it can provide to students. “The national organization was started fifty-one years ago to support, celebrate, honor, help train, and educate critical care nurses who take care of the sickest of the sick,” Tamara explains.
The local Wasatch Front Chapter started mid-pandemic in April 2020. The motivation behind creating the local chapter was the desire to create a sense of community among critical care nurses. Tamara says, “we were really finding that locally we didn’t have that place that we could come together… [Critical care nurses] really didn’t have any companionship or community beyond your hospital or beyond your unit. And there’s so much expertise that goes on in the Wasatch Front, that part of what we wanted to do is celebrate that and help these nurses recognize that what they’re doing is so important and so impactful and powerful.”
One of the primary resources the AACN can provide for BYU nursing students is the opportunity to network. “One of the biggest things that helps you when you’re getting your foot in the door, especially in critical care, is who you know,” Kristen admits. “And particularly with the Wasatch Front chapter, we are located in several different hospitals throughout the Wasatch front area. And so finding people that you can talk to–that you can talk about who the managers are, how would be the best way for me to get into this unit I want to work in after I graduate–that’s really one of the best opportunities. I wish I had networked more when I was first graduating from BYU, and being a part of local organizations and local chapters, like the American Association of Critical Care Nurses, is a really good opportunity to network, so that you can get your foot in the door after you graduate.”
Additionally, the AACN has immense educational resources. “One of the huge things about the American Association of Critical Care Nurses is the amount of education that they can give. If you’re not a member of the association, there are things that you can access on their website,” Tamara reveals. “If you are a student and decide to join the organization, it’s a lot less money. And if you have any aspirations at all at being a critical care nurse, or if you are thinking of acute care on a med surg floor, there’s so much education there that would support your learning and support your practice.”
Students who are interested in joining the Wasatch Front Chapter of the AACN can contact faculty members Matt Anderson (who is President Elect of the chapter) and Jeannette Drake, who are both on the board for the chapter. Students can also go to https://wfcaacn.com/ to learn more.
If you want to listen to Episode 47 of The College Handoff that features the full interviews and more insights into bone marrow transplants, hematology, and the AACN, go to https://www.podbean.com/site/EpisodeDownload/PB11435ADSSKS2 or anywhere you listen to podcasts.