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Bringing comfort to cancer

For its new center, Providence had the help of nurses who have been patients
by: L.E. BASKOW, Nurses Lindi Goins (left) and Lee Martin check in on patient Michael Heinrich, who’s noticed the difference between Providence’s old cancer facility and the new one that opened in February — with design help from Goins and Martin.

From the beginning, Lee Martin and her staff of nurses were going to have a say in the creation of the new cancer center at the Portland Providence Medical Center. The state of the art facility, which opened in February, would distinguish itself in a number of ways: some of the top cancer specialists in the world, a growing patient population that would make the center the largest provider in the region and a $204 million budget, enough to provide unprecedented amenities. Precisely what those offerings would be was a question hospital administrators put to, among others, Martin and her 31 years of experience in nursing. Then her experience changed. In late 2002, not long after planning for the new center got under way, Martin’s friend and co-worker Lindi Goins, a veteran oncology nurse at Providence, got sick. The then 42-year-old mother of two was having stomach problems, something Goins attributed to stress. She was wrong. “In October of 2002, I was diagnosed, quite unexpectedly, with colorectal cancer,” Goins says. “I was in my early 40s, no history at all. It was really a shock to everyone.” Seven days later, Goins had surgery, but well before her six-month course of radiation and chemotherapy had ended, she decided to do what she does best. She went back to work. “If I wasn’t really sick and I wasn’t a patient, I would be a nurse,” she remembers telling herself. “I’m an oncology nurse, by God, I’ve seen people a lot sicker than I am.” Difficult as it was, returning to the job was tonic for Goins, and in time, she recovered and began working and living cancer-free. Then Martin’s experience broadened again: In July 2004, she was diagnosed with cancer. It’s a long way from 5K The Providence Cancer Center is a jewel, designed to be the most technologically advanced cancer facility on the West Coast. Led by Walter Urba, a decorated researcher and expert on immunology, its staff of renowned doctors and researchers recently added Craig Nichols, who helped keep testicular cancer from interrupting the career of seven-time Tour de France winner Lance Armstrong. The panoply of advanced technologies available at the center includes the Northwest’s first Gamma Knife Perfexion, a cutting-edge radiosurgery tool that can target cancerous tissues with pinpoint accuracy. But the center also was conceived with a holistic approach to patient care that incorporates a learning center, alternative medicine, improved access to caregivers, and amenities for the families and other visitors who provide a crucial support system for patients. Walls painted in soft hues and accented with pale woods are hung with paintings by local artists. Reception areas are lit by fixtures that wouldn’t be out of place in upscale downtown restaurants. Hallways end with picture windows that frame tall firs and broad views. “The opportunity to create an experience for patients was important,” says Dave Underriner, Providence’s chief executive for the Portland area. “This is really a collective design from a spectrum of folks and perspectives. All the way from what kind of colors are you going to use to being a green building. I remember nurses spending time going through mock-ups of rooms. That’s where Lee and Lindi came in.” Martin and Goins, who began their long tenures at Providence within months of each other, were providing plenty of input before each was diagnosed with cancer. “I was already sitting on a lot of the committees,” Martin says. “We sat down with patients, with nurses, with staff. We developed our guiding principles. Nurses needed to be closer to patients. For every seven rooms, you have a nutrition room. You have your medicine. You have your supplies. You’re not running around looking for what you need. “We went around the country. We brought back bits and pieces from best practices. We want patients and families to be comfortable. Patients don’t need reminders that they’re sick. These rooms are beautiful. They look like a bedroom.” Michael Heinrich rests in a seventh-floor room following a round of chemotherapy as aggressive as the melanoma he’s battling. He began the treatment at the old cancer center, which staffers refer to as 5K. “It was so white in there I woke up one time and thought I was in the morgue,” Heinrich says. “Here I feel like I’m at home.” The 42-year-old says the rooms, with their spacious bathrooms and pullout beds for visitors, have been a comfort for family members, including his two preteen children and his mother. “The beds are more comfortable, the bathrooms are a lot better. My mom likes it.” The ambience in the hallway outside is worlds away from the old image of a hospital: sterile white walls and tiled floors, information blaring over loudspeakers, staffers racing up and down hallways. Gone is the bustling central nursing station, replaced by small work stations connected to individual rooms. In place of cold, hard surfaces are carpeting and walls bathed with soft light from designer sconces. Experience acts as guide There also are features at the center that came directly from the experience Martin and Goins shared as cancer patients. “Here were these two nurse leaders who firsthand could give us the emotional experience about what they believed,” says Lisa Vance, chief executive at Providence Portland. “It gave more credibility and more conscience to what we were trying to do. They were really influential in telling their story.” “We knew family space was important,” Martin says. “After I got sick, we really understood. We needed a zone for families away from direct care.” What resulted was the Family Room, essentially a comfortable one-bedroom apartment with a kitchen, shower, living room and laundry room. “We were not going to open this without a washer and dryer,” Martin says. One corner of the living room is brightened by a small pink chest that doubles as a bench. On it are painted seashells and leaves in a childlike hand. The item was donated by the family of a young mother who died of cancer. The other amenity that emerged was the seventh-floor Meditation Room, a small space at the west end of the building with a wall of glass windows offering breathtaking views toward downtown. “You have a family member standing outside a room, crying; it happens routinely,” Martin says. “You bring them in here, it gives them a little time to come to grips with their thoughts.” The same goes for nurses. “The work we do is really hard,” she says. “There are break rooms, but where is that space where they can have a few minutes to pull themselves together?” One floor below is a suite of rooms and cubicles where outpatients receive chemotherapy treatments. Sunlight streams through large windows and each of several curtained compartments is outfitted with a reclining chair and a television monitor. No such luxury was available to Martin in 5K. “I am not exaggerating: The chairs were lined up in a room. I didn’t mind being open about my cancer, but there was no privacy in there at all,” she says. “When we designed this one, we pushed to the limit.” At one end of the unit is a door that opens onto a terrace garden. Here, patients can receive treatment in the open air, surrounded by lush beds of vegetation dotted with smooth stones bearing inscriptions that read “love,” “faith,” “courage” and “God rocks.” Staying on the job helped Goins, who lives in Gresham, says her time as a nurse did not prepare her for the firsthand experience of cancer. To understand the effects of a chemotherapy treatment, she says, one must first imagine a severe flu with fever, aches and weakness, perhaps accompanied by nausea and diarrhea. “Take that and magnify it by a hundred,” she says. Still, going back to work — she says the whirring of the portable pump that sent cancer-killing chemicals into her body was sometimes audible to co-workers and patients — was both an inspiration to others and the medicine she needed. “She got a lot of strength out of being at work with her peers,” Martin says. “Not only could you forget, you could get strong again.” Debbie Scoles, a registered nurse who works with both women, says being a patient made Goins a better caregiver. “She was always a good advocate for patients. It made her even better. You watched her become this resource,” she says. When Martin was diagnosed with colorectal cancer, she followed her friend’s example. “I just refused to give in,” she says. “I worked through my whole treatment, but there were times when I went from my office to the hospital. I reached a point where I could hardly move.” One morning, Martin heard the doorbell at her Tigard home. “I went to answer the door,” she says. “It was somebody standing there who was assigned to drive me to work: Lindi. She was the emotional support because she’d been there. ” New space ‘feels hopeful’ Goins dislikes the term “cancer survivor,” which denotes a closure the fearsome disease doesn’t recognize. Cancer, she says, “is never behind you.” But she and Martin now are uniquely qualified as care providers. “Even when we were sick, we were still thinking a lot of times from the nurses’ perspective,” Martin says. “I can talk to patients about hope in a different way. We both had a 67 percent chance of survival; we’re still here. I said one day to Lindi, ‘Everything happens for a reason.’ ” Goins says she’s never questioned why fate brought cancer to her door. “People say, ‘Why me?’ I say, ‘Why not me?’ ” she says. “Our patients are at their most vulnerable, and they allow us into their lives. Because of that, I come back every single day.” “It’s such a traumatic thing when you’re diagnosed with cancer,” Martin says. “You lose all control. You have no idea what’s going to happen to you, if you’ll survive. The new center, she says, “feels hopeful.” Vance, the chief executive, recalls a conversation she had with a woman who attended the party Providence threw to celebrate the opening of the center in February. The woman had survived cancer in her early 20s only to have a recurrence in her mid-30s. She did not think she could mount a second grueling fight against the disease. Then she inspected the new facility. “She came up to me and said, ‘After touring your building and realizing that you listened to families and patients and staff, I’ve decided I will be treated.’ ” “We realize we have created a model,” Vance says. “It’s not just the high tech. It’s the high touch. This email address is being protected from spambots. You need JavaScript enabled to view it.