Nurses start walking program, help patient log 110 miles after cancer treatment
Engaged and passionate nurses found a unique way to encourage their patients to get up and move – by walking marathons
Often with a cancer diagnosis, patients are advised that treatment may be more of a marathon than a sprint. No one took this counsel to heart more than Steve Pruisner.
During his three-week stay last fall on the adult stem cell transplant unit at University of Iowa Health Care’s university campus medical center, he literally walked a marathon. Four of them, actually. More than 110 miles, step by step.
Pruisner began treatment for lymphoma in January 2024 and eventually traveled to Iowa City from his home in Cedar Falls, to begin CAR T-cell therapy.
Of his lengthy stay, Pruisner remarked, “What else are you going to do? There are only so many episodes of ‘Gunsmoke’ and Caitlin Clark basketball games to watch!”
So, with the encouragement of his nurses, and an innovative program designed to get patients up and out of bed, Pruisner walked. And walked. And walked. His wife visited on weekends, but during the week, he had lots of time on his hands.
“I made the best of it,” Pruisner says.
The patient marathon program came directly from the nurses who work on the unit, says Shannon Hunger, MSN, BSN, RN, NE-BC, MBT-CN, a nurse manager in the stem cell transplant and cellular therapies unit. She and several other nurses had attended an oncology conference and heard from a keynote speaker who had implemented a similar program and had seen great success.
Some of the nurses on the unit were particularly intrigued by the program. With the encouragement of their leaders and other nurses who were excited to help, they pursued implementing a marathon walking program at UI Health Care.
Nurses at UI Health Care are encouraged to bring forth ideas based on their lived experience of hands-on patient care.
“It comes from within when people care passionately about what they’re doing,” Hunger says. “Here at UI Health Care, there is such mutual respect in the innovation, the ideas, the suggestions, or recommendations that come from nurses. There was no way to not do this program, because people were so engaged and cared so much about it.”
The stem cell transplant unit is one that is especially focused on learning and trying new things. Nursing school doesn’t generally cover stem cell transplants, so the learning is done on-the-job.
“We are trying to grow the next generation of stem cell transplant nurses,” Hunger says.
Responding to the needs of patients who in isolation
Patients on the adult stem cell unit often stay for up to a month and can’t leave the unit because they are in protective isolation. Due to the medications and treatments, patients can decondition (lose muscle tone) quickly if they don’t stay active.
“Walking has always been the number one mode of exercise for our patients because it’s safe, it’s relatively easy, and it can be done with a companion,” Hunger says.
Walking helps stave off more than losing muscle tone. It also helps prevent pneumonia, blood clots, and bed sores, and it helps promote good blood circulation and bowel movements, among other benefits.
But of course, walking 26.2 miles (184 laps) on an isolated hospital floor is no small feat. To make it as easy as possible, the care team created a map out of different routes and distances on the unit. Patients can easily see what it will take to complete a 5K, 10K, half-marathon, or a complete marathon. Patients are also given a log to track their progress over time.
For each milestone, patients receive a badge to display on their door. After finishing a half marathon, patients receive a special water cup. At the completion of a marathon, a custom t-shirt celebrates the milestone, along with nurses lining the halls and playing “We Are The Champions” as the finish line is crossed.
The door badges help spur competition, providing more motivation for some to keep moving.
For Pruisner, the badges did provide a little push to be sure he walked more than anyone else on the unit, but mostly the motivation came from within. For example, when he was told that he’d be released in just a few days’ time, his nurse asked him why he didn’t seem happier about the news.
“Well, I just committed to a fourth marathon,” recalls Pruisner. “And if I say I’m going to do something, I’m going to get it done.”
And he did. He walked 110.45 miles in 21 days.
Competition isn’t, however, the motivation for the nurses on the unit. For them, it’s all about bringing ideas to life that they know will help patients.
“With nursing at UI Health Care, it really does take all of us,” Hunger says. “It takes all eyes and all minds and all hearts and all experiences for us to collectively provide the very best care we can, and implementing this program is a really great example of this. When you have such a ‘nursing strong’ organization, like we do, and nurses are so well respected as they are here, there’s great power to reach our patients in positive ways.”
And that they do.
Just ask Pruisner, the four-time marathoner, about his experience with his nurses, and he will respond with enthusiasm.
“They’ll be in my heart forever,” he says.
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