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					                      ONS in Motion
                            Central New Jersey
                                  Winter




    Message from the President
    Lizzie Martinez
    Fitting Yourself Into Your Own                                 Inside This Issue

    Schedule                                                       Message from the
                                                                   President
Happy New Year and Best Wishes. What are your
resolutions and are you sticking to them?                          News from National

As health care professionals specializing in oncology, you         President‟s Story for
are dedicated and committed to providing excellent care to         Fitting Self Into Own
                                                                   Schedule
your patients and loved ones. But many of you do not apply
that same dedication and commitment to your own well-              Staying Connected
being which is just as important, if not more so. We are
faced with a global nursing shortage that has been ongoing         CNJ ONS Election
for the past decade. Many nurses will be retiring within the
                                                                   Fundraising
next 10-15 years and there are not enough educators to
teach those who want to enter nursing. We cannot afford to         Health Policy
lose a nurse to burn out or illness. So this year, I want you to
focus on your own well-being whether it is to kick a bad           Save Your Breath
habit, adopt healthier lifestyle behaviors, make
                                                                   Evidenced Based
appointments, increase quality time with family and friends        Practice
or simply to find time for yourself! Your journey to well-being
is what you make it and I hope you will share your obstacles       Save the Dates
and triumphs so we can learn from each other as well as to
motivate and inspire each other.                                   Message from
                                                                   Immediate Past
Chapter Resolution: Fitting Yourself Into Your Own Schedule        President
                                                            Page 2

News from National

                                       Volunteers for Haiti Relief
National Elections                     Effort
Polls close February 15. You can       National Nurse United is
meet the candidates at                 recruiting nurses to volunteer
www.ons.org/Membership/Electi          to help the residents of Haiti
on/Candidates Please take the          and is looking for donations to
time to vote.                          sponsor a nurse to travel to
                                       Haiti. The American Red
35th ONS Congress                      Cross is supplying food, water
Registration is open. If you           and shelter. Marlene Navarro
register by April 8th, you will save   donated $150 on behalf of our
$100.00. Congress will be held in      chapter to the Red Cross. If
San Diego California from May          you would like to donate,
13 to May 16.                          please contact
                                       www.nationalnursesunited.org
                                       or www.americanredcross.org


Fitting Myself Into My Own Schedule
I have always been fighting the “battle of the bulge.” I have
memories of Weigh Day in middle and high school. There was
no HIPPA back then and the kids heard what you weighed. I
have been on just about every diet, lost weight but then
gained it back. But that is not all. I did not maintain a regular
schedule of important appointments such as for my
Mammograms and GYN. I allowed years to go by but luckily
everything was normal. Recently I have been diagnosed with
diabetes and I heard those words again from the doctor, “You
just need to lose weight.” It seems like simple advice but why
is it so hard? I also just learned that my daughter, Autumn
Rose, who has Juvenile Diabetes, probably has Celiac Disease
which means she needs to eat a gluten free diet. So the time
has come for “No More Excuses.” So what are my
resolutions? My goal is to lose weight by adopting healthier
lifestyle behaviors for both my family and myself. I bought the
WII Fit Plus so we can all incorporate exercise into our daily
routine while having fun. I will learn about a gluten free diet to
incorporate healthier choices of eating and to support my
daughter. I have also made it a point to schedule my
necessary appointments on a regular basis. It is time to start
investing in myself so that I may continue to do what I love
best: taking care of my loved ones and my patients. It is not
just about losing weight anymore. It is about regaining my
health as well as maintaining my family’s health.
By Lizzie Martinez
                                                                           Page 3

                                                                            Leadership
Staying Connected                     Election                                 President
                                                                             Lizzie Martinez
Our chapter’s virtual            The 2010 election winners were:            President-Elect
community is a way for us to
                                 President-Elect: MaryLynn Breslin          MaryLynn Breslin
stay connected and up to date
on chapter events. I have        Treasurer:Maria Galgon                        Secretary
added a CEU corner to offer
                                 Nominating Chair:Kristen Perri             Mary Brandsema
membership opportunities to
obtain CEU’s since new           Congratulations and thanks to all
                                                                               Treasurer
regulations prevent us from      nominees.
having pharmaceutical                                                        Maria Galgon
sponsored CEU dinners.
Members are also able to print
                                                                           Nominating Chair
the ONS and Chapter
                                     Fundraising                              Kristen Peri
membership forms under Join
Our Chapter. The Save the          Fundraising Committee:                  Member at Large
Date Section allows members        Bernadette Kelly will be Chair           Debbie Moriarty
to plan ahead for chapter          and Marlene Navarro will co-
events and dinner meetings. A      chair this committee to ensure            Membership
complimentary therapy section      that there is a steady stream of
                                                                              Cathy Barry
was added with the                 income to support our
opportunity to also obtain         scholarships and community             Virtual Community
CEU’s.                             events.
                                                                             Lizzie Martinez
www.centralnj.vc.ons.org
                                   Chapter cookbooks-$10.00 each              Newsletter
The chapter‟s facebook page is
another way of staying             Oncology Bracelets are $15.00            Mary Brandsema
connected. Please join to          each or 2 for $25.00.                      Scrapbook
increase our membership to our
page at                            Anyone willing to help sell items,        Lizzie Martinez
www.facebook.com/group.php         please contact Lizzie Martinez.
                                                                                  PR
?gid=138758170201
                                   Well-Being Basket-$5 per ticket           Marcell Colmer
Your feedback is greatly
                                   from February to May. Winner to
appreciated.                                                            Fundraising Committee
                                   be announced in May for
                                   Oncology Nurses Month.                Bernadette Kelly Chair

                                   Broadway Tickets to Hair-$5 per      Marlene Navarro Co-Chair
                                   ticket at both February Dinners.
                                   A day to spend quality time with
                                   a friend for loved one.

                                   Please share your ideas for
                                   fundraising.
                                                                                    Page 4

         Health Care Policy

    If you are not a member of ONStat,
    please join. ONStat is ONS‟s
    grassroot organization that will notify
    you through email of important
    impending oncology legislation so
    that you are given the opportunity to
    have a say. You can join through our
    virtual community under health care
    policy. There is also a tool kit if you
    would like to learn more about how
    simple it is to become politically
    active.

Save Your Breath
Statistics from the American Lung Association report that “Tobacco use primarily begins in early
adolescence” (American Lung Association, 2006, ¶ 2), “in 2004, 11.7 percent of middle school students
smoked” (American Lung Association, 2006, ¶ 6), and “6.0 percent of all high school students and 2.9
percent of middle school students used smokeless tobacco” (American Lung Association, 2006, ¶ 8).
Furthermore, the American Lung Association posits that “Tobacco use is associated with alcohol and
illicit drug use and acts as a „gateway drug” (American Lung Association, 2006, ¶ 10).
The Central New Jersey Chapter of the Oncology Nursing Society applied for and received a $1000.00
educational project grant from the National ONS to facilitate our chapter‟s advocacy efforts to expand
public awareness efforts contributing to quality cancer care, to meet our strategic goal in promoting
healthy lifestyles and disease cancer risk reduction, more specifically by advocating for the cancer care
continuum through tobacco use prevention and ultimately lung cancer prevention.
The event took place at the Civic Center in Brick NJ, in collaboration with the Brick Municipal Alliance
Committee (B-MAC) on Alcoholism, Drug Abuse and Youth Services on November 13, 2009. The
participants of the event consisted of students grades 6th through 8th. There were total of 236 pre-
teens in attendance to this event. Participation was optional. 97 kids chose to participate. Six nurses
from the CNJ-ONS chapter and their children of school age, affected by the peer pressure and the
potential to start smoking, presented the Save Your Breath campaign.




                                                                                   The Dip Lip
Our Junior Volunteers
                                                                                Page 5



                       Evidence Based Practice

 Ocean Medical Center in Brick New Jersey is an Organization that supports the philosophy of
empowering its nurses through shared governance teams. A group of oncology nurses
identified a problem with the triage and treatment of patients presenting with febrile neutropenia
to the emergency department. A Shared Governance team was born from this consisting of
Oncology Clinical Nurse Specialist Michele E Gaguski, RN, MSN,AOCN, CHPN, APN-C ,Mary
Brandsema, RN, BSN, OCN, Elizabeth Mary Martinez, RN, BSN, OCN, Lani B Gernalin, RN,
BSN, OCN, Tara L Davis, RN, OCN, and Diana Chu, PharmD.
 The team identified delays in the time it took for patients to receive their initial dose of antibiotic
treatment. The team was aware that the organization already had an existent febrile
neutropenia protocol but even with this protocol in place, it was apparent that there was a
general lack of awareness in the proper assessment and management of febrile neutropenia
(FN) patients.
In response, the team developed a Neutropenic Fever Standing Order Form. The team utilized
the ONS PEP resource on infection prevention and the most current edition of the National
Comprehensive Cancer Network (NCCN) guidelines to develop a standardized order set to
expedite the treatment of patients presenting with this oncologic emergency. The purpose of
the form is to allow for quick retrieval of evidenced based practice interventions that will
enhance the quality of care delivered by listing life saving interventions that need to be initiated
as promptly as possible.
The FN protocol form allows physicians or nurses receiving physician phone orders to simply
check off what is being ordered. It is a direct translation of the protocol that already existed
within the hospital system. Recommendations include prompt initiation of empiric intravenous
broad-spectrum antibiotic therapy soon after time of presentation. The organizations‟ existing
policy calls for the implementation of the antibiotics if the patient presents with a fever of 100.4
or greater or with an ANC of less that 1000 per mm3.
 The diagnostic work up is looking for evidence as to why the fever has occurred. Work up
includes; blood work, particularly a complete blood count, two sets of blood cultures, one set
being drawn from a central line if present, a metabolic panel, a urine culture and sensitivity,
urine analysis, stool for culture and Clostridium difficile if presence of diarrhea, culture of any
suspicious sites of infection such as wounds or surgical sites, and a chest x-ray if not previously
done or clinically indicated. Nursing considerations are listed on the check list to serve as a
guide for the nurse to place the patient on neutropenic precautions by isolating them from the
general public, refrain from rectal temperatures or suppositories, strict hand washing, to obtain
allergy history prior to initiation of antibiotics, and avoid exposure to fresh or dried flowers or
plants. The patient should have a mask on when traveling outside the protected area. These
guidelines are intended to serve as a framework for interventions that need to be carried out for
patients that present with FN.
The antibiotic that is recommended by the National Comprehensive Cancer Network is
Imipenem if there is no significant penicillin allergy present. If penicillin allergy is present, it is
recommended that the physician choose the triple therapy consisting of Vancomycin,
Amikacin, and Aztreonam. The form indicates varied doses of the antibiotics based on the
patients creatinine clearance.
 The Febrile Neutropenic Standing Order Form lists indications for use of G-CSF. Some
indications include prognostic factors associated with poor clinical outcomes such as an
expectation of prolonged neutropenia of greater than ten days, age of greater than 65,
uncontrolled primary disease, pneumonia, hypotension or invasive fungal infection. The
standing order form also provides the nurse with the calculation formula to determine the
patient's ANC so the nurse and physician can determine the severity of neutropenia.
The team has truly strived to make a difference in the outcomes of the patient presenting with
FN. We have currently rolled out education to the emergency room department and the staff
on the inpatient oncology unit regarding awareness of the protocol and utilization of the form.
This form had also been distributed to the oncology physicians‟ offices for utilization from the
office that may be faxed to the emergency department.
The team is proud to announce that they are the recipients of the Excellence in Oncology
Nursing-Sensitive Outcomes Award. The award was presented to the team at the
Neutropenia SIG session at the 2009 ONS National Congress in San Antonio. We are still
monitoring the use of the form and plan on the evaluation of this initiative to determine how it
has impacted the outcomes of patients presenting with FN.


                                                                     ONS Excellence Awards




The CNJ-ONS newsletter is intended for a sharing of information. The Board is
inviting all members to utilize this tool and encourages any chapter member to
use this newsletter as an opportunity to share EBP amongst colleagues. Please
submit any EBP activities to miabrand812@comcast.net so you can share your
knowledge with your chapter!
                                                       Page 6

                               Save the Dates
Please help the Board to make these events a success by
               donating some of your time


•     March 20-Garage Fundraising event
•     April-World Youth Day
•     May-Relay for Life
•     May 13-16- ONS 35th Congress in San Diego
•     June 5th & 6th-Relay for Life
•     July 17th-Choose Your Cover
•     October-Making Strides
•     November-Save Your Breath
•     November 12-14- IOL in Orlando

•     As a thank you for volunteering, membership will receive a $5
      gift card or a CNJ ONS handmade bracelet for one event.




    Oncology Nursing Society
    Central New Jersey
    Chapter
    P.O. Box 578
    Point Pleasant, NJ 08742
                                                                            Page 7
                     2009 CNJ ONS Summary of Events
                             Marlene Navarro
                         Immediate Past President

•   Greetings to all chapter members! I hope everyone had a joyful holiday. It truly was
    a great honor to serve as your president this year. My tenure has been among the
    most personally and professionally challenging and rewarding experiences of my
    life. I feel extremely fortunate to work with diverse, talented, and dedicated
    members who shared in every way achieved the mission, vision, values and
    strategic goals of the ONS locally and internationally.
•   I would like to thank all the members and the Board for your continued commitment
    and dedication.
•   With our great teamwork, I‟m very pleased of all that we have accomplished
    together in 2009.
•   In February, our voices were heard as we participated in the ONS National election.
    We supported the Family Prevention and Tobacco Control Act by sending Tobacco
    Control Advocacy Postcard to the ONS National. We supported the Assuring and
    Improving Cancer Treatment Education and Cancer Symptom Management Act of
    2008.
•   We endorsed the World Cancer Day in February 4, 2009, to protect the children of
    the world from second-hand smoke. This is in support with the UICC Campaign “I
    love my smoke-free childhood”.
•   On February 19, 2009, in partnership with the New Jersey Student Nurses
    Association (NJSNA), we presented a panel discussion about oncology nursing.
    A special recognition to the participants, Elizabeth Martinez, Mary Brandsema,
    Debbie Goldman, Debbie Moriarty, Liz Brown and Cathy Barry. I presented a topic
    on “The Joy of Oncology Nursing” to a focus group of students. This was held at
    Trump Taj Majal in Atlantic city. These presentations were well-received by the
    participants.
•   In March 25, 2009, we celebrated “Certified Nurses Day”, a letter of recognition
    from the Board were given to Certified Nurses, and applause was acknowledged
    from all the members to symbolize the pride and joy of being a certified nurse. This
    was followed by group pictorials.
•   On April 25, 2009, we partnered with Brick Municipal Alliance Council (BMAC),
    Global Youth Day, “Brick Circles the Globe”. Our team includes a dietician
    Samantha OBrien who brought healthy snacks for the youth & parents along with a
    storyboard detailing literatures on healthy nutrition. We stressed the importance of
    diet and exercise to promote health and prevent cancer.
•   On April 29, 2009, we awarded a full ONS Congress Scholarship to Lina Dy, ($420)
    and partial scholarships to Mary Brandsema, Elizabeth Martinez and Debbie
    Goldman ($425 total for the 3).
                                                                         Page 8



•   On April 30, 2009, we partnered with the American Cancer Society, Relay for Life.
    We were able to donate a total of $683 thru series of fundraising events with the
    generous support of our members by bringing their own items and gift baskets . A
    special recognition to Liz Brown for the 2 beautiful gift baskets she donated.
•   On May 5, 2009, we celebrated Oncology Nursing Month. As a tribute to oncology
    nurses, we raffled a membership to ONS. Each member was recognized for being
    special and was given the chance to express why they love oncology nursing.
•   In May, 2009, I represented our chapter in facilitating the international partnerships
    with some organizations to promote the mission, vision of the ONS. We partnered
    with the President of the Philippine Oncology Nurses Association (PONA), MA.
    Encarnacion Dychangco, RN, Past President of PONA, Helen Ayapana, RN, Acting
    Dean, Aquinas University, College of Nursing, Mr. Vicente Peralta,RN, and with the
    San Isidro East Elementary School, Parent-Teachers Association (PTA). Our
    chapter donated $100 to a vulnerable community, the San Isidro East Elementary
    School, in which 60% of the pupils belong to a category of malnutrition. The money
    was used to pay the 3 month electric bills that the school was unable to pay. The
    PTA will educate the youths on healthy lifestyles; like eating healthy, no smoking,
    and sunsafety measures. We offered international ONS memberships and we gave
    our Oncology Nursing Drug Handbook and Cancer Chemotherapy/Biotherapy
    Guidelines and some oncology journals to the PONA.
•   On July 15, 2009, we offered 3 BSN and 3 MSN scholarships for $250 each to
    further their education. Congratulations to our BSN recipients, Diane Doherty, Gail
    Harren and Maria Galgon and to the MSN recipients Mary Brandsema, Elizabeth
    Martinez, and Lori Bognar.
•   On July 17, 2009, we sent 2 representatives for the Mentorship Weekend. This
    scholarship was offered to the general membership. The only applicant and the
    recipient was Lani Gernalin. This is a great opportunity for each member to consider
    to be more actively involve as a leader locally or nationally. Just remember, each
    one of us has the potential to be a leader.
•   On July 21, 2009, in partnership with the Ocean County Cancer Coalition, our
    chapter was represented during the “Proclamation of July 25, 2009 as Choose Your
    Cover Day”, skin cancer awareness event, during the Brick Township Hall Meeting
    at the Courtroom in Brick Municipal Building. I attended with Debbie Levinson
    (Coordinator of OCCC). I had the opportunity to thank Mayor Acropolis and the
    Brick Township Council for the honorable Proclamation of July 25, 2009 as Choose
    Your Cover Day and speak to the public that we will provide education regarding
    the dangers of skin cancer, preventive measures, sun safety, and the importance of
    early detection .
                                                                          Page 9




On July 28, 2009, I submitted the ONS international membership for our 3 recipients,
1 active membership and 2 tiered membership. Active membership was given to the
President of the Philippine Oncology Nursing Society, Ma. Encarnacion Dychangco
and tiered membership was given to The Past President of the Philippine Oncology
Nursing Society Helen Ayapana. Helen Ayapana, is nurse supervisor at the Cancer
Institute of the Philippine General Hospital. This hospital is the country‟s sole medical
establishment that serve as the referral center for the care and prevention of cancer
especially for the underserved Filipinos.
We offered another international tiered membership to Vicente Peralta, Acting Dean
College of Nursing in Aquinas University, Legaspi city, Philippines. This will provide
an opportunity for student nurses to know more about oncology nursing and be
encouraged to choose oncology nursing as their career and to incorporate cancer
prevention awareness initiatives during student‟s clinical rotations. This university has
been massively destroyed by a strong typhoon in 2006, in which the building is still
under re-construction process. The University lost all the educational books and
journals from the library. They were approved as international ONS members.
They were very receptive and thankful for our chapter‟s initiative.
In July, 2009, we donated $500 to the ONS foundation.
We published our summer newsletter and e-mailed to memberships. Copies were
distributed during the dinner meetings and were posted in our virtual community. Our
virtual community has been a great means of communication, a discussion board
was posted for all members to share ideas and opinions.
On October 18, 2009, we participated in “Making Strides Against Breast Cancer” in
Point Pleasant Beach, we donated $145 (proceeds from our dinner meeting tricky
tray).
On November 10, 2009, our chapter was approved for a grant that was applied by
Elizabeth Martinez for a special funding for “Fitting Yourself Into Your Own Schedule”
that will be completed next year.
On November 13, 2009 our chapter sponsored the “Save Your Breath Event”, chaired
by Mary Brandsema with the support of ONS chapter grant in an amount of $1000, in
partnership with BMAC at the Brick Civic Center. We provided education to the youth
to say “no to smoking”, not to start smoking as a cancer prevention strategy.
In December, 2009, our chapter donated $100 (donation from a member) to the San
Isidro East Elementary School to support their educational event in promoting healthy
lifestyle during their Christmas party. A box of journals (Oncology Nursing Drug
Handbook, Chemotherapy/Biotherapy Guidelines, oncology journals) was sent to the
President and Past President of the Philippine Oncology Nursing Association and to
the Acting Dean of Aquinas University College of Nursing, Philippines.
                                                                    Page 10




 Our chapter elected new officers for President elect –MaryLynn Breslin, Treasurer-
   Maria Galgon, and the Nominating Chair- Kristen Perri. Congratulations to the
   elected officers and thank you to all nominees who participated in this election.
  Thank you and I wish you all continued growth and joy in your personal as well as
             professional lives and more success with our organization.
I welcome the new Board for 2010, together, we will make a difference in the lives of
                        patients with cancer and their families.
                      Marlene Navarro, MSN, AOCNP, ANP, BC

				
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