A single bed-side tray table at Grande Ronde Hospital used to be the gateway to the Oncology Department. Today, thanks in part to a few now-retired staff members, there is nearly an entire wing devoted to getting patients the care they need for their cancer diagnosis. 

“I wish we would’ve started (the oncology department) sooner,” said Jan Koegler, who retired as a staff nurse from GRH eight years ago. “I knew it was important to have an oncology identity.” 

Koegler, 69, was instrumental in origins of the oncology department. Prior to 2006, GRH was only able to administer single-drug chemotherapy medication. It was typical that staff at medical offices could administer the drug to patients, but it was for ‘little treatments.’

Koegler explained that for patients who needed multiple drugs to attack the cancer, they had to travel to Portland, Walla Walla, Pendleton or Boise. The older population tended to be those typically diagnosed with cancer, she said, and traveling several hours every day for a treatment was an undue burden. 

When April Brock, RN; currently the nurse manager for GRH’s Emergency Department, became the surgical services nurse manager in 2006, at one of the first staff meetings she asked “what’s your magic wand request?” Koegler recounts. 

“If you can have anything for the hospital, what would it be?” Brock remembers asking. “What’s impossible, but your dream?”

An oncology department, said Koegler without hesitation. 

After that initial pitch, Brock took the idea to Doug Romer, who was the executive director of patient care services at the time. Romer retired from GRH in 2018. 

“He was really excited,” Brock said. “We (immediately) had top leadership who were all in (for the project).”

Romer then went to find someone to partner with to get the department running. Once they established the connection out of a Pendleton hospital, which already had a successfully running oncology department, things fell into place.

“Within two years, we had (Dr. Robert Quackenbush) coming,” Brock said.

It wasn’t glamorous, but the services were available.

“April and Jan were visionaries,” said Lorna Oman, 66, who retired as a patient advocate for the oncology department at GRH. It was Omann’s food tray “desk” that admitted the patients at the beginning of Brock and Koegler’s implementation project. 

Pull Quote

“I worked out of the hallway. It was fine. My desk was a tray and I stayed on my feet all day. I didn’t mind it though. I loved the patients. They taught me courage. They taught me grace.” 

 — Lorna Oman, former patient advocate for GRH oncology department

“I worked out of the hallway,” Omann said. “It was fine. My desk was a tray and I stayed on my feet all day. I didn’t mind it though. I loved the patients. They taught me courage. They taught me grace.” 

Koegler said she knew this ask was not going to be a money maker for the hospital. The elderly patients were the vast majority of who they had been seeing. 

“I knew it was likely going to lose money,” Koegler said. “Medicare was going to be the primary payer.”

There was a need for it at the hospital, though. Previous to the pitch, the hospital staff saw about 10 cancer patients a month.

Quackenbush, who was out of Walla Walla, joined the team at GRH. He had already been traveling in the Eastern Oregon region to area hospitals. He started coming to GRH once a week, Koegler said. 

On his first day, he saw four patients. Two weeks later they had 16 patients.

“We didn’t know if that was a fluke,” Brock said. “We were scrambling. The next visit we had more than 30 patients.” 

Koegler said that was the maximum he felt comfortable seeing. Quackenbush then brought on Dr. Maynard Bronstein, who was also out of Walla Walla at the time, to help with the workload.

“It continued to grow,” Koegler said. Eventually, the hospital asked whether either of the doctors would be willing to take on more days. Bronstein said yes and began working at GRH three times a week.

“Jan had a vision of the community need, but I didn’t (see it),” Brock said. 

She called it their Field of Dreams.

“If you build it, they will come,” Brock said. “That’s what it felt like.”

Brock was surprised at the massive need for the department. She said these were tired, vulnerable patients who didn’t have to drive to get their medicine anymore.

For Omann, it was always more than a job. 

“Sometimes you were just an ear for them,” she said. “I always tried to be available for that.” 

She admitted she always got attached to the patients. 

“I loved the job, but it was the patients that was where it was at,” she said. “It was the hardest part. You poured your heart into them.” 

Brock said it was eye opening to work with these patients specifically.

“The special thing about oncology is they have a great perspective on what’s important in life,” Brock said. “These patients are at their most vulnerable and you’re able to be there through their journey. You develop a relationship that’s extra special.”          

Brock said there was a handful of people who made the beginning of the oncology department work. Koegler and Omann were instrumental in it. 

“Lorna was able to connect with people in a different way,” Brock said. “And Jan had the right idea at the right time and was willing to ask for it.” 

There are few people in Union County that cancer hasn’t affected, Brock said.        

Seventeen years later, the oncology department has its own space. It took over what was the physical therapy wing of the hospital. Patients are now able to have a view of the Grande Ronde valley as they get their infusions, Koegler said. 

Brock added GRH is now able to help the hospitals in Baker City and Wallowa with their oncology patients — like Pendleton and Walla Walla did for GRH.