Hematology In the Department of Medicine

VAPAHCS Services Provided

Comprehensive care is provided through the Hematology Clinic where patients are seen by either a Stanford resident or fellow as well as an attending physician. Continuity of care is provided through the attending physicians and clinical nurse specialist. Much of the prescribed treatment is provided in the Ambulatory Infusion Center where infusional therapy (including chemotherapy) is administered and blood products are transfused. The Infusion Center is open daily throughout the week, staffed by chemotherapy-certified registered nurses. Hospitalized patients are admitted to the medical unit, where the Hematology Fellow, Hematology attending, and clinical nurse specialist coordinate their care with the housestaff and medical attending.

Mary Thomas

Mary Thomas, RN, MS
Clinical Nurse Specialist

The Hematology Clinical Nurse Specialist, Mary Thomas RN, MS, serves as a major continuity link between the inpatient and outpatient services, home care, and satellite clinics. She is available by phone to patients and families to answer questions, evaluate problems, and assist patients in obtaining any necessary medical care. Patient and family education are important components of her role, as is supportive counseling. She gives a course to teach patients receiving chemotherapy about the drugs which will be administered to them and the implications of this treatment for their illnesses. She also serves to coordinate care between the various satellite clinics and the Palo Alto division. Her research interests include studying the impact of specific types of illness on the individuals' quality of life. She has two independent studies exploring quality of life in individuals with multiple myeloma and with myelodysplastic syndromes, and has developed a quality of life section for two clinical trials in the MDS patient population.

Individual Counseling is available through behavioral medicine. A clinical psychologist has recently joined the Hematology service and is available during clinic for individual counseling. Holly Cacciapaglia PhD provides support to patients in quality of life and adjustment issues in cancer. A social worker, Karen Chwick, is also part of the Hematology service and provides valuable assistance to patients as necessary.

Veterans Affairs Statue

Patients who are eligible for bone marrow transplant are provided this service, usually at the VA in Seattle. Post-transplant care is provided at Palo Alto as soon as the patient's physical condition permits the patient to return. Patients in the terminal stages of illness may be eligible for hospice care. The VAPAHCS has one of the only in-patient hospice programs in the San Francisco Bay Area. This program provides compassionate care to those for whom death at home is not desired, for those who need a respite before returning home, or who have a need for a more intensive treatment, such as for uncontrolled pain. Hospice care can also be provided in the home setting, using community hospice agencies. Counseling is provided to both patient and family, as well as bereavement counseling.

In addition to the educational forums provided at Stanford, there are several educational formats used at the VA. A weekly conference is held after clinic to discuss the new patients seen in clinic, modify and coordinate plans of care as needed. Formal presentations are made at Tumor Board on a regular basis that provide a vehicle to disseminate information on hematologic malignancies. Informal in-services are provided to the medical house staff and nursing staff as needed.

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