Helping the Most Vulnerable Patients During a Pandemic

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Dealing with COVID has been difficult for everyone. However, patients who have cancer face a more complex battle.

Gabriella Magarelli MSN, ACNP-BC, AOCNP, is the Director of Nursing, RCCA at Hackensack Meridian Health John Theurer Cancer Center at Hackensack University Medical Center in New Jersey and a Lymphoma Research Advanced Practice Nurse. Magarelli has been with the cancer center since 2004. She was a staff nurse from 2004-2010, then joined the Lymphoma Team, where she currently works.

“At the John Theurer Cancer Center, our patients are always our top priority,” says Magarelli. “During the pandemic, we remained involved in their care even when diagnosed with COVID.”

While oncology dedicated treatment needs to pause to treat COVID, Magarelli and her team are still active members of the care team, working closely with the primary medicine and infectious disease teams to safely and swiftly return the patient to their cancer treatment. 

If a cancer patient was diagnosed with COVID, their immune system must not be further compromised through cancer treatment.

Gabriella Magarelli MSN, ACNP-BC, AOCNP

Gabriella Magarelli MSN, ACNP-BC, AOCNP

Factors to Consider for Cancer Patients with COVID

Magarelli notes that “there are lots of factors to consider. COVID symptoms, disease status, and types of therapy needed are often considered before continuing or holding cancer-directed therapy.” However, every patient is different, and every situation calls for further treatment, withheld or not. In some patients, pausing chemotherapies or other treatments that cause severe immune system suppression is not an option. 

To safely continue care to patients in the inpatient and outpatient setting who also tested positive for COVID, Magarelli and her team protected the immunocompromised in many ways. Including screening patients before visits to assess for signs and symptoms, limiting visitors, and creating dedicated elevators and pathways for COVID-positive patients to travel in. In some cases, the team would use telemedicine check-ups instead of in-person visits.

Cancer patients are encouraged to get COVID vaccinated and boosted. Magarelli and her team are constantly educating their cancer patients to avoid large crowds, wear a mask in public, and alert the team immediately with any signs or symptoms of infections.

Any type of infection on top of a patient already who has cancer is difficult. However, Magarelli and her team faced new, more complex challenges when COVID began infecting her patients.

“COVID and cancer is a complicated combination and is ever evolving as we learn more about COVID and have new therapies to treat it,” she shares. “While general guidelines are in place, the multidisciplinary team looks at each patient’s care independently to determine whether to proceed with or hold cancer-directed therapy.”

There is More to Cancer Care Than Just Physical Treatment

Magarelli and her team emphasize communication with the patient, as having cancer and COVID can be a terrifying experience. Patients have strong relationships with their oncology team and lean on them for advice and support throughout the process.

The care team needs to remain actively involved with their patient, as open communication is, in Magarelli’s opinion, the best thing she can do for them throughout treatment.

Overcoming COVID while suffering from cancer is a difficult obstacle for the patient. Still, these new challenges have also taken a toll on the John Theurer Cancer Center oncology team.

“While I have experienced lots of healthcare challenges in my 17 years as an oncology nurse, nothing has compared to this,” she admits, “At the beginning of the pandemic, I remember feeling helpless, which goes against the very essence of what people go into nursing to do: ‘help people.’”

Pandemic Builds Strong Unity

However, in these trying times, Magarelli has felt a strong unity among healthcare workers.

They have all worked tirelessly to care for their patients, develop standard operating procedures and workflows, and develop testing and vaccines to combat the virus. “As the pandemic evolved and we learned more about COVID, it reignited my passion for medicine and research,” she adds.

From the moment she became a nurse in 2004 and started her career in oncology, Magarelli has always been proud to call herself a nurse. More now than ever, nurses and healthcare professionals acknowledge the selflessness, compassion, and hardworking nature of their colleagues. With COVID-19, the world’s eyes have also been open to this determination.

Thanks to Magarelli and her oncology team at the John Theurer Cancer Center, cancer patients diagnosed with COVID can continue their treatment with undivided support and attention.

“I could not be more proud of this profession and how everyone pulled together during the pandemic. As a result, 2020 was labeled the year of the nurse, and it could not have been more fitting.”

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