CIOS

1. Greenville Health System
Center for Integrative
Oncology and
Survivorship Internship
Kendall Phelps-Polirer
Health Science Intern
August – December 2016
Clemson University
900 W. Faris Road
Greenville, SC 29605

2. Student Internship
Introduction
As a Health Science major at Clemson University, I am required
to complete a 180 hour internship in a healthcare field of
choice. With a strong interest in the field of oncology, I had the
privilege of being a student intern at the Greenville Health
System Center for Integrative Oncology & Survivorship (CIOS)
in the fall semester of my senior year.
I was responsible for various clinical and administrative duties,
and experienced firsthand how CIOS provides holistic, patient-
centered care.
This PowerPoint will serve as a guide to display my
experiences interning at CIOS. A description of the site and
department I worked in, my roles and responsibilities, and
descriptions of the projects I completed as a student intern will
be presented.

3. Greenville Health System
• Greenville Health System (GHS) is a
nonprofit, patient-centered, teaching and
research institution.
• With 500 employees located among 10
sites of service, GHS is committed to
providing patients with comprehensive
health care.
• With the Center for Integrative Oncology &
Survivorship (CIOS) opening its doors in
2012, GHS has become the most
comprehensive cancer program between
Duke and Emory with a staff of 60
oncologists

4. Mission, Vision & Values
• “Our vision at Greenville Health
System is simple...to transform
health care for the benefit of
the people and communities
we serve.”
• Mission: Heal
compassionately. Teach
innovatively. Improve
constantly.
• Vision: Transform health care
for the benefit of the people
and communities we serve.
• Values: Together we serve with
integrity, respect, trust and

5. Center for Integrative
Oncology and Survivorship
• As a student intern this fall semester at the Greenville
Hospital Center for Integrative Oncology & Survivorship
(CIOS), I have experienced the delivery of “patient-
centered care” firsthand.
• The program has been described as the first of its kind
by many of its staff. Located on the first floor of the
Cancer Institute, the center houses the multidisciplinary
team of health care providers dedicated
to caring for all aspects of
the patient.
Center for
Integrative
Oncology
and
Survivorship
Oncology
Rehab
Cancer
Genetics
Smoking
Cessation
Lung Low
Dose CT
Screening
Social Work
Lifetime
Clinic
Lymphedema
Physical
Therapy
Integrative
Therapies
Nutrition
Sexual
Health
Clinical Trials
• The center provides
patients with different
complementary
therapies that
addresses any
physical, emotional,
and social needs.

6. What is Integrative Medicine?
“ Medicine that integrates the therapies of alternative medicine
with those practiced by mainstream medical practitioners”
The goal is to treat the mind, body, and spirit, all at the same time. Below are
some of the forms of integrative medicine offered at CIOS:
• Integrative Classes
• Yoga
• Acupuncture
• Music Therapy
• Massage Therapy
• Nutrition Counseling
• Individual Counseling
• Writing Classes
• Integrative Education
Classes for staff
Merriam-Webster

7. A Typical Day
• I start every Tuesday and Thursday morning meeting with my
preceptor, Maggie Thomas, in our office to get my schedule for the
day. I split my time at CIOS between administrative and clinical
observations. Maggie provides me with any materials I need to
complete my administrative duties and organizes the times I can meet
with different health care professionals to interview and shadow. After
I spend time observing in the clinic or conducting an interview, I report
back to the office for my next duty. I end the day checking in with
Maggie to ensure all tasks were completed and to learn of any
important notifications before my next shift.

8. Roles &
Responsibilities

9. Shadowing
• As part of my internship activities,
I spend time shadowing the
multidisciplinary team of health
care providers to see how the
dedicated staff works together as
a team to address the person as
a whole.
• I have been able to observe
Integrative Oncology and
Survivorship (IOS) visits, Moving
On visits, Lung Cancer Screening
visits, Smoking Cessation
Program visits, the Lifetime Clinic,
Physical Therapy for
lymphedema, and Music Therapy
classes.

11. IOS Visit
 I shadowed Nurse Practitioner LeAnn
Perkins and Nurse Practitioner Gina during
their IOS visits to present patients with a
Survivorship Care Plan (SCP).
 An SCP is a comprehensive plan for care
that gets reviewed with the patient and
becomes a permanent part of their medical
record.
 The accrediting institution, the Commission
on Cancer (CoC), requires that 25% of
eligible patients receive an SCP to maintain
compliance, so informing patients and other
healthcare providers of the importance of
this visit is crucial to maintaining CIOS
accreditation.

12. Moving On Exercise Program
 Moving On is a free 12-week Oncology
Rehabilitation Program that focuses on
increasing physical fitness
 The program is held in the Life Center Gym
so that patients are taught how to use the
equipment in a real gym atmosphere.
 I was able to shadow Nurse Practitioner
Doug McCormick and see the process of
evaluating and referring a patient to the
program
 I also interviewed Nursing Program
Coordinator, Noreen D ,on her role
supervising the program and working to find
what motivates each patient.

13. Lung Cancer Screening &
Smoking Cessation Program
• I shadowed Nurse Practitioner LeAnn Perkins during a Lung Cancer Screening
visit in which the patient is referred for a free, low-dose CT scan for patients that
meet the criteria. The radiology reports from these scans often detect unknown
cancers in other organs that are included in the radius of the CT, and this early
detection means more treatment options are available.
• The QuitSmart Smoking Cessation Program provides patients with the necessary
tools to stop smoking. I shadowed both Nurse Navigator Stephanie Hoops and
Nurse Practitioner LeAnn Perkins during their visit with a patient. The program
allows the healthcare providers time to ensure all the patients needs are met and
discuss how to overcome hardships one may have during this time. The visits are
very informative and comprehensive, with the whole person being taken into
account and not just the acute issue.

14. Lifetime Clinic
I was able to observe Nurse Practitioner LeAnn
Perkins during a few Lifetime Clinic visits with
patients that had been in remission for several
years but had ongoing survivorship needs. Nurse
Practitioner LeAnn Perkins provided information
on all of the services provided by CIOS that could
be of benefit to the patients. This new model of
long-term follow-up care for cancer survivors
ensures that all post-treatment issues are
addressed during the hour long visit, and the
patient can be followed up by the Lifetime Clinic
for the rest of their lives

15. Supportive Therapy Classes
I shadowed Physical Therapist Kathie Beldon during
a Lymphedema Management Program visit. I
observed how she manually drained the lymph
nodes in a breast cancer patient’s arm to decrease
swelling and relieve pain.
I attended the Music Therapy Classes on Tuesdays at
2:00pm with Music Therapist Meredith Bowden. Meredith
used music, instruments, and lyrics to teach the group ways
to build self esteem and confidence, improve memory and
cognition, and utilize relaxation techniques. The class
included open discussion that addressed issues some of the
women faced and created a close-knit support network
amongst the group.

16. Tumor Board Meetings and
MDC Observation
• I was given the opportunity to attend the Multidisciplinary Breast
Center (MDC) Tumor Board Meetings on Thursday mornings
that focused on the diagnosis and treatment of breast cancer.
• The MDC allows for collaboration between the medical, surgical,
and radiation oncologists and other specialties including
radiology, pathology, fertility specialist, genetic counselors, and
access to clinical trials and research.
• The patient’s images, pathology report, and medical history are
all reviewed as the healthcare team decides possible treatment
options and formulates an individualized treatment plan specific
to each patient. Following the Tumor Board Meeting, I was able
to observe each physician’s consultation with the patients
discussed.
• This advanced breast cancer care helps to eliminate the delays
many cancer patients experience in the course of diagnosis to
treatment. Many of the patients I observed were scared and
uninformed about the details of their cancer diagnosis, and the
oncologists spent as much time as each patient needed in order
to understand their treatment plans. The time the doctors spent
with their patients allowed for trust to be established, which is
important for ensuring a patient will agree with and adhere to
the treatment plan.

17. Administrative Duties
 Contacting patients
with scheduled
therapeutic events
and appointment
reminder phone calls
 keeping the
pamphlets, patient
resource binders,
boards, and flyers
around the floor
current and relevant
 Entering patient data from CIOS
programs:
 Input of the Low Dose CT Lung Cancer
Screening Program data into REDcaps and
Microsoft Access
 Input of Body Composition Data into
REDcaps
 Input of Lymphedema Measurement data
into LVP60 Program

18. Internship Projects

19. Informational Interviews
• I interviewed the
different health care
providers such as
nurse practitioners,
project and
research
associates, nurse
navigators, music
therapists, social
workers, and
nutritional therapists
to gain an insight of
their career and the
part they play within
the CIOS team.

20. Patient Resource Documents
Scholarship
Information for
Childhood Cancer
Survivors
Internet Based
Patient
Resources
I collaborated with my preceptor, Maggie
Thomas, to put together
a comprehensive Internet Resource Guide to
help patients find online support groups and in-
depth information about their cancer.
I worked on creating a document with
current information on available scholarships
for social worker Kerri Susko to provide to
her patients

21. Patient Resource Documents
QuitSmart
“QuitKit”Checklist
Mindfulness
PowerPoint
I worked to develop a PowerPoint on
Mindfulness. The presentation covered an
explanation of the practice, benefits, and ways to
implement mindfulness into survivorship. This
presentation will be incorporated into a Nurse
Navigators overview of CIOS and Mindfulness to
a local cancer support group
A checklist for items to be included
in the “Quit Kit" for smoking
cessation patients

22. Woman to Woman
• Woman to Woman is a new support network program at GHS
that pairs women in treatment for gynecological cancer with
trained volunteer survivors to provide one-on-one advice and
support
• I was very excited for the opportunity to assist with the
coordination of this program and worked alongside social worker
Candace Sprouse.
• My role was to identify patients in the EPIC electronic medical
record system with gynecologic cancers, then call to inform them
of the new program and ask if they would be interested in joining.
• We held the first comprehensive volunteer training meeting to
teach the mentors what they can do to provide the best support
to the newly diagnosed patients. This was an 8 hour session in
which the women were taken on a tour of the hospital, educated
by guest speakers, and role played different mentoring
situations.

23. Internship Reflection
From participating in program offerings, I have seen firsthand how CIOS
provides holistic, patient-centered care that focuses on the entire well being of
the patient. I have learned that cancer does not just impact the place where the
tumor originated, but rather invades and affects a person and their family both
psychologically and emotionally. Completing this internship at Greenville Health
System Center for Integrative Oncology & Survivorship has allowed me to reach
many personal goals and has provided me with unique, lifelong skills that I can
bring with me to succeed in my journey through medical school.
 I can confidently communicate my decision for pursuing a career in the field
of oncology
 I can define how the Center for Integrative Oncology & Survivorship
provides a holistic approach to the treatment of cancer.
 I am able to articulate at least three core values and skills necessary to
become an effective and patient-centered health care professional
 I have implemented a program that will help CIOS continue to provide the
most effective and patient-centered care.