Gila Rosen shows a patient how to administer medication. Pain Coordinator I Gila Rosen helps acutely-ill patients at Hadassah L:J Hospital get -ct) involved with their treatment. CC F- UJ I=1 LLI I- 90 he phone rings in a Jerusalem bedroom. The clock shows 2:10 a.m. Fortunately, the girls' room is at the far end of the hall and her husband sleeps heav- ily. "Hello? Yes, of course it's okay to call...He's had that reaction before, hasn't he? I remember, you telling me about it... No. No, it's nothing to worry about. That's how the medication works... Perhaps sit with him until he falls asleep. Yes, just to reassure him... Okay. See you Sunday." Almost 4 a.m. Again, the shrill of the tele- phone. This time it's more worrying. "Why don't you go to the emer- gency room. It's probably not serious, but let's be sure. Call me from the hospital if you need any- thing." Gila Rosen, R.N., is nurse/counselor to a spe- cial immuno-therapy trial at Hadassah- Hebrew University Medical Center in Jerusalem, now in_its fourth year. Cancer and lymphoma patients who have undergone bone marrow transplants run a high risk of relapse. Daily injections of Interleukin II could be the answer. "Interleukin II is a hard treatment, with uncomfortable side effects," says Ms. Rosen. "We see all the patients once a week, but we also make ourselves available to them 24 hours a day. Two calls in a single night is unusual — but as the injection is given in the evening, nighttime calls aren't a rarity." Born in Morocco in 1947, and trained at the Neuilly Hospital School of Nursing in Paris, Ms. Rosen has worked at Hadassah all her nursing life. "Hadassah has an international name," she says. "I knew of it long before I moved to Israel. "I joined the Interleukin II project because it could be very important," says Ms. Rosen. "But I also see it as very much within the mainstream of nursing: being close to the patient, helping to com- fort and to calm fears, and taking an increas- ingly responsible role on the medical team." When patients control the medication, they use less. Sunday is immuno- therapy day for Ms. Rosen. Monday, Tuesday, Thursday and Friday see her in the recovery room. "I've worked in the recovery room since 1971 — as long as I've worked at Hadassah," she says. "When I started here, it was the early years of open-heart surgery. I did a post-graduate course in intensive-care nursing, and have gone on to look after patients undergo- ing increasingly radical surgery — most recently, of course, organ trans- plantation." It was her recovery room work that led Ms. Rosen to put on a third nursing hat — the one she wears on Wednes- days, and which is demanding more and more of her time, energy and interest. "I have a title now," she smiles, "and it's unique, because so far I'm the only person with this job in all of Israel. I'm Hadassah's acute pain-service coordinator." Pain and its effect on recovery is a growing emphasis in health care worldwide. Many doctors now believe that sup- pressing pain speeds recovery, as well as improving patient well- being. Ms. Rosen now demon- strates to doctors and nurses the use of the intravenous PCAPs — setting a basal rate of small, renewable doses of pain killer, with a delay time and the maximum amount that can be given in an hour. They see the benefit — when patients control the pain killer, they use far less of it. Part of Ms. Rosen's service is visiting surgi- cal patients once they've returned to the wards. "Whenever I have time, I go and see how the patients are getting on," she says. "I saw a woman last week, following a major gynecological oper- ation. " 'I've had this kind of surgery before,' she said, `and I remember the agony I went through afterward. But this time, with the pump, I was sit- ting up, pain-free, the same day.' "And that , of course, is the kind of thing that makes the long hours, the broken nights, the intense pressure and the low pay all worthwhile." ❑