The Family Pharmacist
Written by Rebecca Budde • Photography by Jason Johnson
At the tender age of 12, Rob Nelson served sodas from a soda fountain in Pawnee, rang up customer orders and counted back their change. He learned early on the gratification of good customer service.
“It was like the Walmart of Pawnee,” Nelson says of his father’s business, Nelson’s Drug Store. “We had office supplies, toys, cards, jewelry...” The large soda fountain, the highlight of the store, had been a fixture in the Pawnee community since 1937. Nelson worked behind that counter for many years starting with sodas and, years later, filling prescriptions and providing customers with the medications they needed. For many residents of Pawnee, visiting Nelson’s Drug Store wasn’t just about the soda fountain or picking up their prescriptions. It was a place to meet and socialize, one of the few in a town of less than 3,000. In 1998, after running the store for 28 years, Rob’s father, Bob Nelson passed away from pancreatic cancer. This loss motivated Rob to pursue oncology pharmacy.
The family business was ingrained in the Nelson boys. Bob’s older brother Bill Nelson, a recently retired pharmacist (at the age of 92), owned a pharmacy in Princeton, which closed last year after 63 years of business. Following in his father and uncle’s paths, Rob graduated from Raabe College of Pharmacy at Ohio Northern University in 1989, where he also met his wife of 24 years. Now Rob’s son, Seth, is in his fourth year of study at St. Louis College of Pharmacy.
Though he no longer works at the drug store, Rob Nelson continues to exemplify the principles he learned there by offering quality customer service to the patients at Simmons Cancer Institute at SIU (SCI). “When I chose pharmacy, I just basically looked at it as an initial degree,” Nelson says. “I never really pictured myself as a pharmacist. I just thought I’d complete the course of study and then see what I wanted to do next.” Nelson’s first job as a pharmacist at St. John’s Hospital in Springfield convinced him that pharmacy was where he was meant to be. “I liked having a positive impact on patients. I just felt it was really what I wanted to do.”
While working at St. John’s, Nelson also filled in part-time at the store in Pawnee. “It was nice to be in an atmosphere different from the hospital,” Nelson says. He helped his father with all aspects of running the drugstore, including dealing with the insurance questions and claims. “Dad would leave a little pile of insurance papers, and I’d come in and take care of it,” Nelson says. “Dealing with the insurance side is one of the more complex issues with pharmacy.”
When SCI opened three years ago, Nelson was impressed. “I said that if they ever need a pharmacist, I want that job,” said Nelson, whose 19 years of work at St. John’s was heavily focused on oncology. He worked with all the oncologists, including those in the SIU children’s oncology group. In the spring of 2012, an ad for the job he prized showed up in the newspaper; Nelson applied and was hired. “Having a pharmacist in an ambulatory infusion center like SCI is a new, emerging idea,” Nelson says. Currently, SCI is the only outpatient chemotherapy infusion center in the area not affiliated with a hospital that has a full-time pharmacist on staff. The expertise of a pharmacist in a setting like SCI offers many advantages to the patients, physicians and other providers. “Everyone is working in their own area, but I’m able to work with everyone. I feel like I’m in a prime position to help change things,” Nelson says.
“Having a pharmacist on board adds a lot of safety into the process of administering chemotherapy in the outpatient setting,” says Dr. Aziz Khan, chief of the division of hematology/oncology and chief medical officer for SCI. “Rob has developed robust system checks where the protocol is completed the same way for every single dose.” SCI is also fortunate to have pharmacy technician Peggy Martin, who is a great asset to the team. “I try to do anything I can to assist our clinical staff in providing the best care possible to our patients,” Nelson says. “I enjoy working with such an extraordinarily talented and caring group of people. Without each person’s contributions, we would not be able to provide the level of care that we all strive for. There’s just something special about people who wind up working in oncology.”
Whether it’s making sure that medications are available in a timely fashion or revising chemotherapy regimen order templates to make the ordering process safer and more efficient, it’s all part of providing great customer service. A large component of the clinical support that Nelson adds to SCI is making sure that everyone follows the National Comprehensive Cancer Network guidelines. All SCI’s infusion nurses are chemotherapy certified.
In addition, Nelson has developed a program to train and validate the process for preparing sterile products, both hazardous and non-hazardous. Standardizing chemotherapy production — beginning with the medications that patients receive prior to chemotherapy through the end of their treatment — often results in fewer side effects and fewer delays in treatment. “We like to get people in and out of here as efficiently and safely as possible so they can go about their lives,” Nelson says.
Nelson says that his position at SCI has been evolving from more of a “nuts-and-bolts” type role to a more clinical role. He has gotten to know several patients, especially those who are having pain control issues or want to work on a certain side effect of chemotherapy. “I would like to see this area of my job grow into more involvement with patients so I can assist and enhance patient outcomes and overall experience,” Nelson says.
Nelson’s knowledge prompted him to offer a monthly lecture on chemotherapy side effects for the resident physicians, and he has conducted in-services for the nurses. Embracing the educational component of his job, Nelson is also a preceptor for a five-week experiential oncology elective rotation with multiple pharmacy students each year from SIU Edwardsville College of Pharmacy.
As a licensed pharmacist, Nelson qualifies as investigational drug coordinator for clinical trials, allowing SCI to offer an expanded array of clinical research opportunities to patients. “Many times, the best treatment for a certain cancer will be something that’s in a clinical trial,” Nelson says. As the investigational drug coordinator, he is in charge of managing the drugs used in the studies.
Nelson’s team-oriented attitude, dedicated work ethic and positive outlook help keep the atmosphere of SCI upbeat. “We have a lot of people graduate from the infusion center,” Nelson says. “Even the ones who don’t have a good prognosis are usually upbeat about doing something to fight their disease, and we’re helping them fight it. We’re all on the journey together. Besides working at the family drug store, this is the best I’ve felt about the level of customer service I’m able to provide.”