My Specialty

Hematology/Oncology, Devon Ballentine, UCLA Santa Monica

Using new therapies and clinical collaboration to help patients fight cancer

Devon Ballentine, RN, BSN
Clinical Nurse II, Charge Nurse
AMN Hematology/Oncology Unit
UCLA Santa Monica Medical Center

Please share with us a little about your career.

I joined UCLA Health as a new grad. I’ve been with this great organization since 2019. I started out on the floor, then served as resource nurse, and am now a charge nurse.

Management offered me the opportunity to train as charge about a year and a half into my time here, but I quickly turned it down. I felt I needed to work on my confidence and build a stronger nursing foundation.

They asked me again a month ago, and I finally said yes. It’s been exciting, and I’m pleased with what I’ve accomplished so far.

How do you feel about being elevated to charge?

The idea was daunting at first. In my mind, I perceived the charge nurse as the one who knows everything, but I began to realize that the charge RN isn’t perfect or all-knowing — they just know how to find the answers, and they take responsibility for doing so.

We’re transitioning from hematology/oncology to hematology/oncology stepdown, so we’ll begin taking patients with higher acuity. It’ll be an exciting challenge.

What was it like starting as a new grad?

In nursing school, I always thought I was going to be an ED nurse, since I enjoy a fast-paced environment. I tend to lose energy if it’s slow, and a faster pace keeps me ready to always complete the next task.

However, when I was hired, AMN (A-Level Merle Norman Pavilion) was a med-surg/telemetry floor, and I was fine with that. When the pandemic hit, we pivoted and became a COVID-19 floor for a few months. When that period was over, we then transitioned into a hematology/ oncology unit, with our own service providers and attendings. AMN is the newest unit at UCLA Santa Monica, so we’ve been taking on all sorts of things.

Our work is always interesting. We now offer CAR T (chimeric antigen receptor T-cell) therapy for patients with certain types of lymphomas and leukemias. This is a new therapy that uses patients’ own T-cells, which are collected, reprogrammed and later infused into the patient to selectively target their cancer cells.

RN Career Events

What fascinates you about oncology?

I enjoy working with the patient population. Hematology/oncology patients on our floor range in age from late 20s to 40s. Since they’re younger, they often have more energy and willpower to battle their disease. These are patients who, even on a bad day, push themselves to ambulate the hallway for exercise. They’re knowledgeable about their disease process and about potential chemotherapy and/or immunotherapy treatments related to their cancer.

It inspires me when I see patients willing to do anything to fight their disease, and it makes it easier to build an effective nurse-patient connection. I also love educating patients and their families, and communicating and collaborating with the doctors and specialists.

What are the best aspects of the collaborative nature of cancer care?

Hematology/oncology is truly a collaboration between all of the different specialties. The initial cancer can progress quickly, and there can be metastasis everywhere, requiring cooperation between multiple services and teams. There are many cooks in the kitchen, so to speak, so everyone has to work together seamlessly.

It’s also a good challenge to think about all of the different processes in the body and how they work with and against each other. I always try to be proactive, identify important issues, stay organized and be ahead of the curve.

How have patients responded to the added stressor of COVID-19 on top of a cancer diagnosis?

Even without COVID-19 in the picture, patients were already enduring a lot.

The visitor limitations were hard to enforce, and the effects on patients were difficult to witness. We want our patients to see friends and family as often as possible, since socialization and support can do a great deal for the healing process, but we also can’t risk COVID-19 being spread to our immunocompromised patients. We had to find the right balance.

Nursing Education

Many of our patients come from skilled nursing facilities, and no one could see them there during the pandemic either. UCLA was sometimes their last chance to see their loved ones, if the visitor situation allowed for that to happen.

What is it like to witness patients at the end of life?

It’s very tough to see. I once cared for a cancer patient with metastatic disease. We had this patient for an extended period, and he was on an intensive pain regimen.

During one particular admission, his condition continued to decline. I remember holding his hand while helping him with breathing exercises — he always felt like he was falling after pushing a large dose of intravenous Dilaudid. Despite the horrible situation, I had a feeling of deep fulfillment that I could get him over that hump of excruciating pain. I’m getting goosebumps right now as I think about it.

The last time I provided care for him was the day before he was discharged. In the final 10 minutes of my shift. I knew it was going to be the last time I’d be seeing him. I told him what an honor it was to provide him with nursing care, said my goodbyes and left the room.

I quickly walked to the med room and broke down. That was the first and last time I cried. It was my first true connection with a patient in such a situation. One of my coworkers gave me a hug to support me, and I moved on.

We later received a letter from the patient’s wife about how he was calm and at peace when he died. It was so meaningful to hear that he was with his loved ones at home.

Are there any important changes you’ve noted in the nature of cancer care?

In the early days of oncology, if you had cancer, you often had the choice of one chemo agent. Now, there’s immunotherapy, CAR T therapy, and autologous and allogeneic transplants. The options have increased, and the outcomes have improved greatly for many cancers.

You’re also on the skin committee. Tell us a little about that.

The wound care team deals with all of the wound care consults, and they lead the skin committee. There are also a few nurses from each floor in the group. We round on patients on the first Thursday of every month and check all of their bony prominences. We have the opportunity to educate nurses on the floor about how to provide optimal skin care and prevent skin breakdown. It’s very gratifying.

Do you have any future career plans or aspirations that you’d like to share?

Right now, I’m happy on my floor, and I plan on continuing to expand my oncology nursing knowledge here at UCLA. I really enjoy being a bedside oncology nurse. I love being on the front line, at the bedside, and I don’t currently plan to go anywhere.


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