Redefining the Bell—How We Can Recognize Milestones

Ringing the bell on a patient’s final day of cancer treatment is a long-standing rite of passage in oncology. Although it’s meant to be a time of happiness and celebration, it can also stir up a variety of other emotions in patients, particularly those on indefinite treatment or whose cancers have persisted through many treatment cycles. The ONS Bridge session, Re-Defining The Bell: Recognizing Milestones, occurring live on Thursday, September 14, 2023, at 10:15 am ET, will provide nurses in direct patient care with a deep dive into how to celebrate and support patients along their entire cancer trajectory.  

I spoke with the session’s speakers, Lindsey Zinck, MSN, RN, OCN^®, NEA-BC, and Melanie Zisa, RN, BSN, OCN^®, to give you an exclusive sneak peek on what to expect and insight on ways that their own clinic has redefined the bell and recognizes milestones at every step of a patient’s journey.  

 
What made you start thinking about how ringing the bell might spark exclusionary feelings?  

Zisa: Honestly, the patients’ own feedback started my thinking about the pros and cons of the bell ringing at the end of treatment. During my time as a treatment nurse in the infusion suite, many patients would say things to me like, “I’ll never get to ring the bell” or “Even though I can ring the bell, I feel bad for the patients sitting around the suite who won’t get to ring.” We were being discriminatory without that intention. Many physicians at our cancer center have always had mixed feelings about the bell ringing. As my experience in oncology grew, it was easier to see why they had these mixed emotions. I knew something had to change to help capture hope for more of our patients and staff population.  

Have you seen changes in your practice since implementing new ways to celebrate patients?  

Zisa: Yes, our wall mural is such a success! We decorated the pathway that patients walk through to get to the infusion chair with a beautiful wall mural titled HOPE. We have another wall mural with the bell further down the hall, but the HOPE mural brings so much additional light and happiness. My office sits adjacent to the HOPE mural, and I constantly hear patients commenting how wonderful it is. Just yesterday one lady said to our triage nurse, “I just love this; it makes me smile every time I walk by.” That was our goal.  

What is the most important message that you’re hoping attendees will take from your session? 
 
Zinck: I hope attendees can find creative ways to celebrate all patients. Although the bell was a wonderful idea, we unintentionally left out an entire population of patients with cancer. The sad truth is that many patients will lose the battle with cancer, have recurrences or metastases, or develop a new cancer. People are also living on maintenance therapy with dormant cancer for many years longer than they did decades ago. So, how can we celebrate patients who are on a difficult journey every step of the way? Our new HOPE idea also allows us to include our non-oncology population who are on a very real disease journey.  

What are the most common responses you get from patients who ring the bell to celebrate something other than a recovery or remission?  

Zisa: Our very first patient who rang the bell post grand opening was crying happy tears because she was able to partake in this ceremony. She is not in remission or recovery but a long-term patient who is "stable" and will need treatment for the rest of her life. She was so thankful that we have made this possible to include all patient populations. Due to the new image, mural, and bell location, I am excited to see what other responses and feedback we will have in store for patients to come! 

Tune in to this thought-provoking session during ONS Bridge, and learn more about ways that oncology nurses can create a care plan that supports the individual needs and journeys of their patients with these additional topics: 

• Caring for Patients With Physical Disabilities: Discuss cancer detection, diagnosis, and treatment for adults with disabilities and nursing strategies to ensure that patients with disabilities receive the care that they need.   

• The Impact of Implicit Bias on the Care of People With Cancer: Mindfully reflect on current practices and gain tangible ideas on how to improve patient care with consideration of implicit biases. 

• Transgender Persons With Cancer: What Can We Do Better? Get cover tools and information to confidently provide culturally sensitive nursing care to transgender people throughout the cancer care continuum.  

• Conversations Surrounding Fertility Preservation—How to Best Serve and Support Our Patients: Learn about conducting conversations around fertility preservation, legal and financial effects, the process of fertility preservation, and resources for patients. 

ONS Bridge brings you 20 dynamic sessions, created specifically for nurses in direct patient care to improve strategies and processes so that you can give your patients the optimal care that they need and deserve. View the full schedule.  

Register today to gain access to cutting-edge clinical content, available at your convenience. We hope to see you in September.  

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