On the day late last month that they graduated from the Flynn Pediatric Oncology Nursing Fellowship at Hasbro Children’s Hospital, a Brown University Health system, Bella Gomes and McKaylee Swatt were one step closer to careers in nursing, a field that has experienced a steep decline in practitioners in recent years.
They also were realizing ambitions that took root in childhood, when both experienced deeply personal events that shaped their own lives.
“Growing up, I knew I wanted to be in pediatric oncology,” Swatt, a rising senior at the University of Rhode Island, told Ocean State Stories. “One of my good friends growing up had leukemia. So, going with her for treatment at Boston’s Dana-Farber Cancer Institute, I realized I wanted to be a nurse and I wanted to go into pediatric oncology.”
“Like a lot of us, my family has been affected by cancer, but also I have a blood disorder myself,” said Gomes, a rising senior at Sacred Heart University in Fairfield, Conn. “So I’ve grown up knowing a lot about hematology, and I have always had an interest in learning more about it and helping others with what they go through in hematology and oncology.”
When they learned about the Flynn Fellowship, Gomes and Swatt quickly applied and were accepted.
“The Flynn Fellowship stood out to me just because of the great work that Mr. Flynn does with all the fellows and gives these nursing students opportunities to do,” Swatt said.
“It was the most incredible opportunity,” Gomes said. “What Mr. Flynn and his foundation do with the entire program is incredible and the amount of things that I’ve learned is incredible.”
A retired financial executive now, Flynn and his wife, Susan, residents of Connecticut, “were living an idyllic life with their family [when] in 2010, Susan was diagnosed with Stage 4 Ovarian Cancer and everything changed,” according to the Flynn Foundation website.
Susan began chemotherapy treatment but by 2013 her disease and medical interventions were taking a toll. The Flynns met Dr. Donna Colletti, Palliative Care Director at Greenwich Hospital, a member of Yale New Haven Health, and Colletti arranged for Susan to return home, where a hospice-trained nurse provided end-of-life care. Susan “passed away peacefully at home in the company of her loving family on May 8, 2013, at the age of 61,” the website states.
“After Susan passed away, Fred was inspired to support the work of Dr. Coletti and her Palliative Care team at Greenwich Hospital that made such a difference in the last month of Susan’s life,” the foundation writes. “His passion and personal advocacy enabled him to raise over $140,000 for the benefit of the Palliative Care department at Greenwich Hospital. But that was not enough. He wanted to influence real change in the treatment of cancer patients, as well as in the skills of the nurses who support them. The Flynn Foundation was born.”
In an interview with Ocean State Stories, Flynn described its growth:
“I happened to be aware of the rising incidence of cancer and the aging of the nursing workforce and the fact that students like Bella and McKaylee didn’t currently get much, if any, exposure to oncology nursing in their undergraduate training. And so I created a pilot program in 2014. There were five hospitals and 11 students.
“Originally, it was intended to be a two-person pilot program at Greenwich Hospital, and I decided if I was going to do it there, there were too many other good hospitals in the New England area that I should try to include. And it’s really grown by leaps and bounds. Hasbro is my fifth pediatric hospital.” Others include the world-class Boston Children’s and Children’s Hospital of Philadelphia.
Several adult hospitals offer fellowships, among them Mass General Brigham and Penn Medicine. Besides Sacred Heart and URI, university partners include the University of Michigan, Villanova, the University of Pittsburgh and New York-Presbyterian.
“They’re all top hospitals and I relocated a year ago from Stanford, Connecticut to Westerly, where I’ve had a home for a long time and it occurred to me that since this has kind of turned into my calling, I could do this full-time. Now with this affiliation with Brown University Health, there’s an umbrella organization where, in time, we hope to include Rhode Island Hospital as well. But regarding Hasbro, my partner, Anne Earle, is very involved with me in this program.”
Nurse Jennifer Mello and colleague Alison Kelley were instrumental in establishing the Hasbro Children’s fellowship.
“Fred brought this to us last year, probably around this time, looking to implement this program here at Hasbro,” Mello said. “I reached out to our leadership who then reached out to Allison and we ended up being the co-coordinators of the program here. We were so excited to take this on because we share this passion for pediatric hematology.
“I love to have nursing students come in who share that same passion and being able to share our knowledge of not just the clinical aspects of caring for the patients, but also that emotional support that also goes hand in hand with it. So we were ecstatic to hear of this program.
“After reviewing the applications, it wasn’t an easy choice. Everyone who applied were such great candidates but Bella and McKaylee really stood out to us. And it was just amazing to see them really shine and just grow in the roles throughout the eight weeks that they were here, really being hands-on, just being sponges and absorbing everything from our nursing teams — but also the patients and their families.”
The young women worked with preceptors – practicing nurses with decades of experience collectively.
“Our preceptors especially showed us that it’s okay to get vulnerable with patients,” McKaylee said. “That was very beneficial to see because it’s important to develop rapport, like a relationship with these patients. That was important.”
Said Gomes: “This program offered a different perspective to nursing than nursing school does. I could sit in a lab and really practice my clinical skills over and over again, but the experience of walking into a pediatric oncology patient’s room day after day and connecting with them and building a relationship with them and growing emotionally was really the biggest part of my eight weeks because it really takes that hands-on, really immersed-in-the-hospital experience to grow emotionally into the nurse you’re looking to become.”
Said Mello: “It’s bittersweet that they have finished the program and they’ve graduated from us, but we are looking forward to what the future holds for them and for this program.”
“The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for health care grows,” according to a 2024 Fact Sheet from the American Association of Colleges of Nursing (AACN). “Compounding the problem is the fact that nursing schools across the country are struggling to expand capacity to meet the rising demand for care.”
Using data from other sources, the AACN highlighted other disturbing trends:
• “In April 2022, Dr. David Auerbach and colleagues published a nursing workforce analysis in Health Affairs, which found that total supply of RNs decreased by more than 100,000 from 2020 to 2021 – the largest drop than ever observed over the past four decades. A significant number of nurses who left the workforce were under the age of 35, and most were employed in hospitals.” The COVID pandemic, which affected healthcare practitioners in a multitude of fields, was a major factor.
• “In March 2023, the International Council of Nurses (ICN) released a report calling for the worldwide shortage of nurses to be treated as a global health emergency. The report, titled ‘Recover to Rebuild: Investing in the Nursing Workforce for Health System Effectiveness,’ details the impact that the pandemic had on the world’s nursing workforce, nurse burnout, and access to care. The authors call for protecting and investing in nurses as key to health system recovery.”
• “Published October 4, 2023, by the Journal of the American Medical Association, Dr. Melissa Suran published an article titled ‘Overworked and Understaffed, More Than 1 in 4 US Nurses Say They Plan to Leave the Profession.’ The author looks at the latest data on nurses’ intent to leave their positions and how burnout and understaffing are impacting the workforce.”
According to the Rhode Island Department of Labor and Training, during the first quarter of this year, there was a shortage of 1,284 registered nurses in the state.
Dr. Betty Rambur, Professor of Nursing and the Routhier Endowed Chair for Practice at the University of Rhode Island College of Nursing, knows these statistics well.
Everywhere I go around the country, it’s a catastrophe,” she told Ocean State Stories. “It’s the worst I have ever seen .”
Rambur said that hospital billing practices do not recognize nurses’ contributions to safe and effective care.
“The heart of the problem is the way we reimburse in the United States because physician care, medical procedures, hospitalization and all that is a revenue generator and nursing in the current model is a labor cost,” she said. “So there’s an inherent incentive to keep volume [of patient admissions, invasive, intensity procedures, etc.] as high as possible and the staffing levels as low as possible. That’s the economic incentive. And so you find that more and more people are just not willing to do it. They don’t stay in the profession.
“This has always been true to some degree. But it’s become an issue of self-cannibalizing. The less experienced nurses you have around to mentor and get you started, the more unsettled and unhappy novices become. And nurses feel, for the most part, a very strong moral obligation to patients. And so they want to work in conditions in which they feel they can contribute safely and effectively.”
Rambur sees the way forward as quantifying “the actual contribution of nursing so that when administrators are looking at their ledger, they’re not looking at nursing as a cost, but as a value… Secondly, there’s a huge shortage of nursing faculty. And think about the $20 billion/year the nation puts into medical education because we want to make sure there are preceptors and learning experiences for physicians. That may be okay, but it’s just been expected that somehow or other there will be enough expert nurses to educate nursing students. That model is no longer viable. So focused attention on preparing nurse faculty is very important. I do think AI will have some contributions, although as of yet, it’s unclear exactly where that’s going to land. And we need to get rid of the anti-competitive barriers that prevent nurses from entering the market and creating new innovative strategies for people.”
The fellowship also requires completion of a research project, which Gomes and Sweet presented on graduation day. For hers, Swatt chose neutropenic dietary restrictions.
“When these patients are immunosuppressed from chemotherapy, they enter this stage of neutropenia, which is when really their body just can’t attack infections that may be simple to us that have immunity and the blood cells to attack something so simple,” she said. “During this time, they enter this restrictive phase on their diet where they can’t eat raw meats, undercooked food, non-pasteurized food items, stuff like that.
“In my research, I found that might not be the go-to protocol anymore — that (practitioners) are leaning toward a less restrictive manner. I thought this was important because I saw many patients in the clinic (who) were placed under these neutropenic dietary restrictions. As a foodie myself, I found that if we could give them one easier thing, especially at mealtimes, that just alleviates a little bit of stress.”
Said Gomes: “My project touched on reducing anxiety in pediatric oncology patients, specifically surrounding their treatment process. I wanted to do this project after I’d seen a child who was so playful and running around in the playroom became so distressed around the time” of treatment.
“It made me want to look into things that we could change that weren’t pharmacological — that didn’t have to do with just giving them any medicine to calm them down. So I touched on building rapport with the patients and using the primary nurse system that is utilized in clinic. So that the patient sees one nurse every time that they go into clinic and increasing patient communication and making sure the patient knows everything about their disease process so there’s no miscommunications and spots left for any anxiety in that aspect.
“I touched on using the ‘gate control theory’ of the brain, which entails using distraction to decrease the number of pain sensations that go to the brain. It was an amazing experience to be able to learn more about that.”
Copyright © 2025 Salve Regina University. Originally published by OceanStateStories.org.
