Chapter 06 : Developing Nursing Care in the New Clark Clinic
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Description
In this chapter, Dr. Ecung talks about her shift to a new position as Nurse Manager of Station 55 (in 1987), which was moved to the newly constructed Clark Clinic. She talks about the physical organization of the new clinic space and how it functioned more effectively. She outlines changes that she helped make to nursing care between 1987 and 1993, including combining the roles of research nurses and clinical nurses into the Primary Attending Nurse designation. She talks about the challenges of effecting this change and the increase in patient satisfaction it created. She notes that she “had a list of nurses waiting to get into Station 55,” and she was extremely careful to bring in new nurses who fit with the culture of the group. She also recalls that other clinics were asking for information on how Station 55 had been so well reorganized.
Identifier
EcungWB_C06
Publication Date
9-21-2016
City
Houston, Texas
Interview Session
Wenonah Ecung, PhD, Oral History Interview, September 21, 2016
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the Institution; The Clinician; The Leader; MD Anderson Culture; Working Environment; Building/Transforming the Institution; Multi-disciplinary Approaches; Growth and/or Change; Discovery and Success
Transcript
Tacey Ann Rosolowski, PhD :
Well, tell me why you made the move from that position in 1987 to Nurse Manager Station 55.
Wenonah Ecung, PhD:
We were moving to a new concept at that time, and they were opening a new building. I don't know if so much we were moving to a new concept. We were opening a new building, a new ambulatory building. It was Clark Clinic. And like I said, the open environment that we had, which wasn't the bestwe were moving away from that to where we would be in reasonably enclosed environments, and so Station 55 was one of them. And a lot of what I had in [16], in Station 16, moved to Station 55. And at that point in time, they changed the title. But the role really didn't change. I went from Head Nurse to Nurse Manager. Right.
Tacey Ann Rosolowski, PhD :
Okay, so you were still with Developmental Therapeutics?
Wenonah Ecung, PhD:
But it wasn't called Developmental Therapeutics anymore. Each discipline was its own. So the umbrella was Station 55, whereas [ ] the umbrella was [previously] Developmental Therapeutics. The umbrella was Station 55, but it still had Sarcoma, it still had Head and Neck. It stillwe had Sarcoma, we had Head and Neck. We had five, so I'm blocking on the other three. We did not have leukemia. I lost leukemia at that time. It wentwell, we put solid tumors together and liquid tumors together, and leukemia was considered one of the liquid tumors. So they went together. So I did lose that discipline.
Tacey Ann Rosolowski, PhD :
Was thereI mean thathow was the situation in Station 55, reorganized? I mean, it was physically different, or?
Wenonah Ecung, PhD:
It was physically different. We had a true lobby for patients. The work was done, what I mean by "closed environment," so the lobby was separated from the work being done by the nurses and the physicians through walls and doors. It wasn't an environment you could just traverse through to get to another area. So you were contained, which was a lot better. If you were in the area, you belonged in the area. It was very difficult in 16 to evenI mean, you really had to get to know people. Charts were out in the open. In 55, it was a closed, contained environment.
Tacey Ann Rosolowski, PhD :
Were you involved at all in the design? Was there input solicited from people?
Wenonah Ecung, PhD:
There wasI remember there was input solicited, but were boots on the ground really involved in the design? No. And that, I have to say, Anderson did learn from. Because as we moved to the concept of one-stop shopping, true multidisciplinary care, they truly, at that point, administration, the architects came to boots on the ground, local actors, to find out what was the best way. So but for 55, no. We didn't have a whole lot of that.
Tacey Ann Rosolowski, PhD :
So tell me about the high points of this periodand I do realize we're kind of coming up on your time. Would you like to stop in five minutes, so I have time to pack up, and
Wenonah Ecung, PhD:
Yeah, if that's okay with you.
Tacey Ann Rosolowski, PhD :
Oh, yeah, absolutely.
Wenonah Ecung, PhD:
However long it takes you toyeah. Okay.
Tacey Ann Rosolowski, PhD :
Yeah. Yeah. I just didn't want towanted to make sure you
Wenonah Ecung, PhD:
I can't believe we've talked this long! (laughter) And we're only just a little ways further. It's, like, you are challenging me to remember things.
Tacey Ann Rosolowski, PhD :
And I have to say we're going a lot faster than normal. Usually it takes 90 minutes or so to get to MD Anderson.
Wenonah Ecung, PhD:
Really? Okay. Well, good. Good.
Tacey Ann Rosolowski, PhD :
Not that there's a race on. There isn't. So during this period, so you were Manager at Station 55 between '87 and '93. I mean, that's a good period of time. Six years. So what kind of happened? What did you see developing for care and working environment for nurses, and the partnership, nurses and doctors, during this period? Or, if I'm missing something, let me know.
Wenonah Ecung, PhD:
No, I think what we began to seewell, a couple of things were happening for those of us that were in 55 at that time. One, you asked me early on about the Research Nurses in Developmental Therapeutics. That had become very apparent to me, that there was this handoff between the Clinic Nurse and the Research Nurse. And I became interested in learning whatwell, I started to feel we were sending a message to patients, and maybe not such a positive message. If you worked with a clinic nurse, the message was you were kind of doing well. You're on phase III. But if I have a research nurse coming in to see me, I'm not doing too well, and they're coming in to talk to me about phase I or phase II [therapy]. But nonetheless, they're both nurses. Educational backgrounds were similar. Why can't we combine those roles? And I was fortunate enough to work with Robert Benjamin, who was chair of Sarcoma at the time. He agreed to let us try combining those two roles. So we were the first to come up withand I remember presenting this to different division heads at that point in time. But we came up with the concept of the "total nurse," PAN in Greek.
Tacey Ann Rosolowski, PhD :
I'm sorry, what was that phrase?
Wenonah Ecung, PhD:
PAN, which means "total" in Greek. And it became an acronym for us, meaning, Primary Attending Nurse, just like we had primary attending physicians. The only difference was, the Research Nurses and the Clinic Nurses had to agree to perform each other's role, the total role, with the patient, whereas before maybe the Clinic Nurse placed the patient in the room, took the vitals, did a history, and then would hand it off to the Research Nurse to do consent forms, signing for the protocol, discussion of the protocol. I combined the two to where if you were previously the Research Nurse, you did it all. If you were the Clinic Nurse, you did it all. And patients signified that they were a lot more satisfied. There was not this handoff anymore. Now, it meant lots of education. The Clinic Nurses had to learn what the Research Nurses knew, less difficulty for the Research Nurse because she had that minimal nursing background of being able to take vitals and a history. But you had to change the attitude there. There was also the attitude as Research Nurse, I'm at a higher level, I'm better than the Clinic Nurse. So we had to change some attitudes there. And we had to changewe had to have a group that was willing to learn what they didn't know. But that went quite well. I was fortunate enough, like I said, to work with Robert Benjamin, who was open to that type of idea. So that was one of the things that was different for us. The other thing was, I truly would have a list of nurses wanting to get into 55. So we could have an opening. My nurses understood, I had the final say-so in terms of who came in. But they had a huge voice in who was to come in. So not only were we looking then, at that time, for your ability, skill-wise, your clinical skills, but we were looking for your fit with the group. And then ultimately, if they said this is the person, Tacey is the person, then I was looking at your fit with me. I was already convinced that clinically you were competent enough to come in. We had other clinics beginning to ask us how we were doing things, and beginning to mimic the way we were doing things, like the panel of interviews.
Tacey Ann Rosolowski, PhD :
That sounds like a good place to stop.
Wenonah Ecung, PhD:
Okay. Very good.
Tacey Ann Rosolowski, PhD :
Well, we will continue with this when we resume our conversation.
Wenonah Ecung, PhD:
Okay. All right. Well, I hope I'mI don't know. I don't know what I hope.
Tacey Ann Rosolowski, PhD :
Yeahwell, this is great!
Wenonah Ecung, PhD:
I'm not just taking you in circles, or it's
Tacey Ann Rosolowski, PhD :
No, not at all.
Wenonah Ecung, PhD:
It's what you expected, or something.
Tacey Ann Rosolowski, PhD :
Yeah. No
Wenonah Ecung, PhD:
Okay.
Tacey Ann Rosolowski, PhD :
This is fine. It's great, thank you. It's very interesting.
Wenonah Ecung, PhD:
Okay.
Tacey Ann Rosolowski, PhD :
No, it's always nice to go into a new corner of the institution that you haven't seen before. And I was really excited when I began reading your background. I thought, wow, this is an individual who really did have a hand in working very closely with these multidisciplinary teams. Because obviously, every person I interview talks about that as a theme at MD Anderson.
Wenonah Ecung, PhD:
Mm-hmm.
Tacey Ann Rosolowski, PhD :
You know, so
Wenonah Ecung, PhD:
But we got to live it before and during.
Tacey Ann Rosolowski, PhD :
And during. Yeah. So no, I'm very grateful for your view on this.
Wenonah Ecung, PhD:
Yeah. Well, my pleasure.
Tacey Ann Rosolowski, PhD :
Yeah. And I will look forward to our next conversation.
Wenonah Ecung, PhD:
Okay. All right. And you know how to get here.
Tacey Ann Rosolowski, PhD :
I do now, yes.
Wenonah Ecung, PhD:
All right.
Tacey Ann Rosolowski, PhD :
And I am, just for the record, turning off the recorder at about 12:52.
Recommended Citation
Ecung, Wenonah B. PhD and Rosolowski, Tacey A. PhD, "Chapter 06 : Developing Nursing Care in the New Clark Clinic" (2016). Interview Chapters. 694.
https://openworks.mdanderson.org/mchv_interviewchapters/694
Conditions Governing Access
Open
