New Director of Nursing at Norris Cotton Cancer Center

A short discussion with Dorothy Dulko, PhD, APRN, reveals a central theme for her plans for the future of nursing at Norris Cotton Cancer Center: education.

Focus article photo

Dorothy Dulko, PhD, APRN, stresses education for oncology nursing staff.

The new Director of Ambulatory Cancer Nursing and Advanced Practice, Dulko is responsible for the advanced practice nurses in hematology/oncology, and for nursing practice in the infusion suite, clinics, research, and radiation oncology. Again and again, Dulko stresses that in a field as complex as oncology, at a time of rapid innovation, continuing education and professional development are critical to delivering quality cancer care.

Much of Dulko's life attests to the high priority she places upon education. She began her career in emergency services and community hospital management in 1986 in New York City. She then attended SUNY Stony Brook, where she obtained her Master's degree and Nurse Practitioner Certification in Women's Health. Soon after, her focus began to change. "During routine screening, a large number of my primary care patients were being diagnosed with early-stage cancers. They were going on to receive cancer treatment and I felt that I wanted to take that journey with them."

Dulko fused her interests in oncology and women's health when she began a ten-year career as a nurse practitioner in gynecologic oncology at the Memorial Sloan-Kettering Cancer Center in 1997. She earned a PhD in 2007 from the University of Utah, and then moved to a position as medical director at the Institute of Medical Education and Research, overseeing the development of accredited continuing education programs for oncology professionals.

Dulko acknowledges that oncology can be a challenging yet rewarding nursing career. Oncology nurses help to manage and deliver highly specialized care in a field where research and innovation mean constant change. As an example, Dulko points to the transition over the past few years of many inpatient cancer treatments to outpatient programs. This is a good thing, because patients largely have a better quality of life when they can stay at home with their families. But it also means new challenges for oncology nursing. "Outpatient oncology nurses are now central to interdisciplinary cancer care, especially in helping patients to navigate through the cancer care system, and to manage the symptoms resulting from treatment," Dulko says. "So we must continually foster professional development and implement educational initiatives for oncology nursing staff."

In order to stay current, oncology nurses must collaborate with physicians, staff, and each other more than ever. Dulko hopes to promote the increasing use of communication technologies to do so. For example, the Oncology Nursing Society offers many tools for members to communicate with one another, and Dulko hopes to expand upon this support system to offer Cancer Center nurses easier access to resources such as oncology certification reviews and evidence-based literature. Dulko has used such tools extensively in her own professional development. For her PhD she was part of a "virtual classroom" of oncology nurses from across the country. "I know that even in rural areas such as ours, nurses can connect with other nurses virtually to share experiences, educational endeavors, and professional development activities," she says.

In the more immediate future, Dulko will work with the advanced practice nurses (APNs) who established Norris Cotton Cancer Center's Cancer Survivor Program to further develop this initiative. Her first priority is the use of "transitional care plans." These APN-generated summaries are a comprehensive record of all the treatments a cancer survivor has received, along with a specific plan for ongoing care and screening for the future. Transitional care summaries are designed to help primary care physicians manage the care of cancer survivors, ensuring close monitoring and continuity of care after patients have finished cancer treatment.

With both immediate and long-term goals to work towards, Dulko has a full schedule. She doesn't just want to be the person behind the desk directing care from afar, though, so she also plans to provide care at Norris Cotton Cancer Center for part of her time, seeing patients on a weekly basis. "I love patients and patient care," she says. "I think that at the core of every physician and nurse is the desire to make each cancer patient's experience a better one. I don't think that ever leaves you, whether you become a director or you stay at the bedside."

October 15, 2009