"I think of it like flipping switches, you have to learn to adapt quickly and effectively, but the variety is one of the reasons I enjoy my work with the NRU so much," says RN Jason Hu, pictured on 16A in 2021. (Photo: UHN)

Over the course of his four-day week, registered nurse (RN) Jason Hu has spent each day on a different inpatient unit at the Princess Margaret Cancer Centre. Describing the role that he and his unit colleagues play, Jason likens them to that of another essential service.

"I call us the firefighters," he says with a smile. "Wherever we are needed, that's where we go."

Jason is a member of the Nursing Resource Unit (NRU) at the Princess Margaret. Overseen by the Nursing Resource Team (NRT) out of Toronto General Hospital, the NRU are specialized oncology nurses who provide care to patients across all 10 inpatient units at the Princess Margaret.

The initiative was created to respond to unit nursing staffing requirements at UHN based on factors including patient acuity and replacement needs for such things as sick leave and vacation time.

"I think of it like flipping switches," says Jason, who has been working with the NRU for five years. "Today, I could be on a leukemia unit, tomorrow I could be on the palliative care unit, and the next day I could be on a transplant unit.

“You have to learn to adapt quickly and effectively, but the variety is one of the reasons I enjoy my work with the NRU so much."

It's a sentiment shared by RN Renata Birru, a recent nursing graduate who joined the NRU in the summer of 2021.

"Being able to float between 10 different units provides me with a unique learning experience that allows me to see a patient's entire care journey, helping build a holistic and therapeutic patient-nurse relationship," she says.

That flexibility, adaptability and experience collaborating with teams from across the Princess Margaret has made the NRU an invaluable resource during the COVID-19 pandemic, especially when a need to increase inpatient capacity due to the pandemic led to the opening of surge unit 16A.

"I feel like our shared experience has brought us closer together as a team," says Renata Birru, a recent grad who has been working with the NRU since 2021. (Photo: UHN)

For the first time, the close-knit team that rarely worked shifts alongside their NRU colleagues found themselves working together, almost exclusively staffing a surge unit that posed several unique challenges.

The surge unit was a newly outfitted one that had never been occupied by inpatients before. It was quickly repurposed from office space to accommodate its new and diverse patient population.

"The patient population of 16A was really unlike any other unit at PM," says Susan Clarke, Nurse Manager at the Princess Margaret. "We accepted oncology patients from all disease sites."

And it wasn't just the patient population that made 16A unique.

"Little things that we take for granted on other, established inpatient units weren't always available to start with on 16A," recalls Jason. "We had to be proactive in reaching out to our colleagues in other clinical roles to ensure patients received the same level of care and attention they would on any other unit."

Throughout the tumultuous time, the nurses remained eager to grow and learn, welcoming and taking on the clinically challenging situations they were presented with.

"Their commitment to ensuring staff and patient safety during this chaotic time was exemplary," says Susan. "The NRU made it all look easy, but that isn't to say it was easy. It definitely wasn't."

'Together Again: Connection, Reflection and Celebration'

Tuesday, April 5, was Oncology Nursing Day, a day to recognize these professionals on the front line of cancer diagnosis, treatment, care and research. This year's theme is "Together Again: Connection, Reflection and Celebration."

"The pandemic has impacted every aspect of care and process within the Cancer Program at UHN," says Anet Julius, Director of Professional Practice at PM. "Oncology nurses have been at the forefront of change, from shifting models of care, modifying workspaces, and ever-evolving IPAC processes.

"Throughout it all, they never lost sight of their role in supporting patient care."

Jason and Renata also acknowledge the challenges they and their colleagues have faced in the past couple of years. But, they too, see plenty to celebrate in their team and the opportunities the 16A experience afforded them personally and professionally.

"We had the opportunity to truly see how the whole hospital runs, how every role interacts and intersects to support each other," says Jason. "We learned a lot, but we also had the opportunity to share our knowledge."

"I feel like our shared experience has brought us closer together as a team," adds Renata. "We would not have been able to get through this without each other."

For Susan, one particular story stands out about 16A.

"Last fall, I remember repeatedly hearing from the patient flow team that patients who were in the process of being admitted to PM asked specifically to be admitted to 16A," she says. "They thought so highly of the nursing team there and knew they would be in safe and capable hands.

"That, for me, says it all."


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