Jacqueline Savill
Jacqueline Savill, a registered nurse at the Princess Margaret Cancer Centre, checks in with her patients through the virtual clinic in between her in-person clinic activities. (Photo: UHN)

Cancer patients with COVID-19 are getting a virtual helping hand from specialized oncology nurses to access the care they need exactly when they need it.

Princess Margaret Cancer Centre has launched its first Nurse-Led Virtual Care Clinic geared towards assessing and managing symptoms of cancer patients who have tested positive for COVID-19.

The clinic incorporates all the principles of specialized oncology nursing: therapeutic expertise, sound clinical judgement, coordination and continuity of care, compassion – and ties it with proactive monitoring of COVID-19, all through the phone.

Once a patient tests positive for the novel coronavirus, their oncologist can refer them to the Nurse-Led Virtual Clinic where they'll receive a call from a nurse within one business day. The nurse assesses them using an algorithm and develops a tailored management plan for each patient that includes regular check-in calls, sometimes occurring daily.

If any red flags or symptoms appear that requires additional care, it can be raised immediately to their physician or the appropriate urgent care centre. The nurses also help guide patients through the recovery, including the process for officially being declared COVID-19 free, which requires two negative swabs within a 48-hour window.

"We've wrapped our services around what makes most sense for the patients," says Michelle Mackay, Nurse Manager, Solid Tumor Oncology Ambulatory, Urgent Care, and the COVID 19 Assessment Clinics. "This way we can proactively identify symptoms and escalate them in a streamlined way.

"We always want patients to receive the best possible care. During the pandemic, the clinic is an extension of virtual care that ensures our patients feel safe and supported by the care team."

A component of that support is easing the fear and psychological impact of COVID-19 that comes along with being immunocompromised.

Nurses such as Jacqueline Savill, registered nurse at the Princess Margaret, experience the anxiety this creates first-hand.

"I feel for our patients right now," she says. "They're already sick, and now face the added uncertainty of COVID-19, which means being more vulnerable and the risk of their cancer treatment being delayed.

"We provide as much comfort as we can, but it's hard when even we don't know what the future holds."

nurses in hallway
The nursing team that powers the clinic, (L to R): Judianna Law, Emma Hagopain, Rebecca McKinney, Kelly Kwok, Tania Rodrigues, Carmen Jones, Recalin Albutar, Karuna Seghal and Pat Cotman. (Photo: UHN)

Like many, Jacqueline's work has shifted significantly since the start of the pandemic. Her typical nursing rotations in the Breast, Melanoma, and Gynecology Oncology Ambulatory Clinics have incorporated one more unit: the Princess Margaret COVID assessment clinic. There, a group of dedicated staff assess patients for COVID-19 and ensure they can access their cancer treatment in a safe way.

The increase in virtual visits also means she's not seeing a lot of her patients in person.

"We don't have the same connection we used to, so we ask [ourselves], how can we provide excellent care to our patients without seeing them?," Jacqueline says.

The Nurse-Led Virtual Care Clinic bridges the gap between virtual care, symptom management and psychological support for COVID-19 cancer patients.

 "It's exciting," says Jacqueline. "I'm thrilled to offer our patients the support they need to prevent them from getting too sick – either with cancer or with COVID.

"I look forward to being there for them when they need us most."

A nod to the future of cancer care

Virtual care has accelerated rapidly across UHN during COVID-19. At the Princess Margaret, it's the start of a new era post-pandemic: incorporating existing remote tools with new technology to elevate specialized oncology nurses to the helm of proactive and compassionate care.  

The clinic empowers nurses to order swabs under a medical directive, monitor symptoms with standardized assessment tools, and align patients with the most appropriate healthcare resources in consultation with their physician.

"It brings the care we provide into the future," says Lesley Moody, Clinical Director, Solid Tumor and Ambulatory Clinics at the Princess Margaret. "Empowering our nurses to work at their full scope of expertise and integrating them in our Virtual Care Management System adds significant value for our patients and their care."

The clinic was brought to life by an interprofessional team including Smart Cancer Care – who has led the charge in the switch to virtual care at the Princess Margaret – Nurse Managers, Clinical Directors, Medical Site Leads, Nurse Educators, Professional Practice and more.

"It's amazing how fast this has come together," says Jacqueline. "Above all, it's really great for our patients." 

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