From left: Jennifer Pouliot, MSN, RN, OCN; Frances Cartwright, PhD, RN-BC, AOCN, FAAN; Rita Jakubowski, DNP; and Jane Weisser, NP, AOM, P-BC
When the Mount Sinai Tisch Cancer Center (TCC) received its Comprehensive Cancer Center designation from the National Cancer Institute, it completed a comprehensive, 10-year review process that placed TCC among the top one percent of cancer centers nationwide. These centers dedicate significant resources to develop research programs, faculty, and facilities that promote better and innovative approaches to cancer prevention, diagnosis, and treatment.
At Mount Sinai, nursing plays a significant role.
“After a decade of growth in research, clinical trials, and community outreach, Mount Sinai became eligible to apply for Comprehensive Cancer Center designation in 2024,” says Frances Cartwright, PhD, RN-BC, AOCN, FAAN, Vice President of Nursing, Mount Sinai Health System Oncology Services, the Center for Nursing Research and Innovation, and Associate Professor of Medicine, Icahn School of Medicine at Mount Sinai. “Nursing has been an integral part of that rigor—developing practice standards for clinical trials, delivering high-quality care, standardizing practices and education to enhance safety, innovating to offer seamless care to patients throughout their care experience, and it goes on.”
For example, in the case of multiple myeloma research, clinical trials, and survivorship, Mount Sinai’s nursing leadership extends globally.
In 2017, Mount Sinai administered the first chimeric antigen receptor (CAR) T-cell therapy in myeloma, a groundbreaking cellular therapy that uses the patient’s own immune system to fight cancer.
“We treated the first human ever to receive this therapy,” says Donna Catamero, NP, DNP-c, OCN, CCRC, Associate Director of Myeloma Research, The Mount Sinai Hospital. “These patients had a three-year survival rate, and today we’re talking about how we define ‘cure.’ This dramatic progress is directly due to the clinical trials we conducted at Mount Sinai, and the care and treatment approaches our nurses developed are now literally the standard of care worldwide.”
“The role of nursing is crucial,” Dr. Catamero says. “We’re very closely linked to the patients throughout, overseeing their care, collecting and evaluating blood samples, managing adverse events. In so many ways, nursing serves as the backbone of these clinical trials.”
While the protocols for clinical trials vary significantly from one to another, Mount Sinai has established its own set of required quality and safety-driven standards to be met by every trial within the Health System.
“Mount Sinai sets the bar high,” says Ruth Knecht, MSN, RN, Nurse Clinician, The Mount Sinai Hospital. “It boils down to numerous multidisciplinary teams determining: Can we do this in a manner that is safe, maintain the integrity of the study, include all the resources we’ll we need—staffing, education, equipment—and adhere to Mount Sinai’s exacting standards.”
“Standardized workflows are vital,” Ms. Knecht says. “They ensure the consistency, predictability, reliability, and ultimately safety, of our clinical trials. For example, we’ve developed a standard study procedure checklist that must be followed for every study patient, every day. The nurses know exactly what they have to do at every encounter.”
Donna Catamero, NP, DNP-c, OCN, CCRC, left, and Ruth Knecht, MSN, RN
A complementary set of robust Health System-wide policies now applies to each entity throughout the Health System, including those that have the potential to administer aspects of clinical trials in the future.
Jennifer Pouliot, MSN, RN, OCN, Senior Director, Oncology Quality and Safety, Mount Sinai Health System, helped make this complex task a reality. She and her colleagues had a poster about their work accepted for the Oncology Nursing Society’s Annual Congress.
“We worked with an interdisciplinary team from across Mount Sinai to ensure we had crystal clear clinical trial guidelines,” Ms. Pouliot says. “Likewise, if and when we conduct clinical research at any Health System entity, the necessary policies would already be in place and applicable: how Pharmacy prepares the drug being investigated, how we measure nurses’ competency for research trials, etc. It was our job to ensure everyone involved was on the same page and supported at every step.”
The impact of nursing extends beyond completion of a clinical trial. For example, cancer patients who undergo a bone marrow transplant (BMT) also receive chemotherapy and immunosuppressive therapy. While potentially lifesaving, these treatments can put patients at risk for other health problems post-transplant.
The nurse-led BMT Survivorship Clinic at Mount Sinai offers these patients ongoing health care that is specific to their initial diagnosis—looking for early signs of graft-versus-host disease, secondary cancer, bone thinning, cardiac issues, thyroid function, and others—to enable cancer survivors to live a healthy life.
“In addition to their routine doctor visits, the BMT clinic nurses see patients at key milestones: 3, 6, and 12 months and then annually,” says Rita Jakubowski, DNP, Clinical Program Director and Founder, BMT Survivorship Clinic, The Mount Sinai Hospital. “This creates a critical bridge between the transplant and primary care doctors and offers patients significant peace of mind. We’re educating survivors about this next phase in their journey and ensuring that everyone involved in their care—including the patient—keenly understands what tests are being done, when, and why, and what we need to be especially vigilant about to avoid complications as each BMT patient progresses.”
Dr. Jakubowski’s work has gained widespread attention, and she was invited to present at the national Advanced Practice Providers Oncology Summit, an annual conference designed to highlight the latest evidence-based strategies to optimize care and outcomes for patients with cancer.
In the case of breast cancer patients, medical oncologists provide care for many years, through completion of their antiestrogen treatment. At this four-year mark, patients enter a new phase of their cancer journey and are referred to the Breast Cancer Survivorship Clinic.
“Our clinic nurses are in the middle lane of wellness and ensuring full-circle service,” says Jane Weisser, NP, AOM, P-BC, Clinical Program Manager, Breast Cancer Survivorship Clinic, Dubin Breast Center. “We operate a robust clinical program that specializes in the breast cancer survivor’s specific needs,” Ms. Weisser says, “including offering survivors a consistent and specialized clinician as their health care lead.”
Ms. Weisser also co-chaired a systemwide survivorship committee that is a cross section of various specialties: medical oncology, surgery, social work, psychiatry, chaplaincy, nutrition, therapeutic massage, and other providers involved in oncology. Her work is spreading throughout the Health System as a high-risk clinic and breast cancer survivorship care will soon be offered at a second site.
The Comprehensive Cancer Center designation of the Mount Sinai Tisch Cancer Center affirms a relentless dedication by so many—individuals and teams within multiple specialties and sites—to provide high-quality, safe, and innovative cancer care and treatment. And in the end, all of their time, care, attention to detail, and advocacy come together in every moment a patient receives care—always with a Mount Sinai nurse at their side.