A nurse who is ‘custom-made’ for her job
The Oncology Nurse Navigator program at Cape Cod Healthcare is picking up speed, with the first navigator, Joan Macallister, settling into her job guiding patients through the process of testing and treatment for a variety of cancers.
The program stands out, according to Cape Cod Hospital General and Thoracic Surgeon Jeffery Spillane, MD, FACS, because it is being driven from the patient's standpoint, has the right nurse navigator in place and has philanthropic support from cancer survivors.
The 2022 Soirée on the Bay will benefit Cape Cod Healthcare Cancer Services and the Nurse Navigator Program, specifically. The cocktail reception and auction will be held Sept. 21 at the Pelham House Resort on Sea Street in Dennisport. The evening was organized by the Soirée on the Bay Committee.
“This is a very good program,” he said. “When looking at a cancer diagnosis, my decision process is very easy. I know what we should be doing next. But for a patient, it can be especially scary and confusing. It is Joan’s job to help them understand what is happening and to coordinate with us throughout.”
The time factor can feel very different if you are the one with the spot on your lung, said Dr. Spillane.
“People get an abnormal result from a chest X-ray or a scan, and the questions that loom over everybody are ‘is it cancer?’ and ‘how soon can I get it out?’ Joan can help them understand that we will take care of them and all the things - CT scan, pet scan, biopsy, oncology appointments - that need to happen next.”
Dr. Spillane explained that he likes to move quickly, but has to have an accurate and comprehensive diagnosis.
“ I usually tell my patients I understand they want to go fast, but I don't want to go down the wrong road at 90 miles an hour. You need a road map,” he said. Patients may not understand how important the standard work-up is for navigating cancer care, he said.
“We are looking for answers to questions like, ‘Is it cancer? What kind? What stage? Do we need oncology right away?’” he said, “Joan is able to walk them through all of it, answer their very natural questions and assure them we are taking all the right steps.”
A nurse navigator can ease some of the anxiety people may feel as they approach their cancer treatment, by helping them understand why the course of treatment, timeline and other aspects of care, Dr. Spillane said.
“In my opinion, Joan was custom-made for this job,” he said. “She has the knowledge and experience of an oncology nurse and the mission to put herself in the shoes of the patient. So, she has that perfect combination to be an effective and compassionate nurse navigator.”
A nurse navigator is valuable because in addition to the medical uncertainty surrounding a potential cancer diagnosis, patients can also face logistical challenges, which she can help them solve.
“People ask me all the time, ‘Who is in charge? Is there someone quarterbacking all of this?’ I would say that using the football analogy, Joan is like an offensive coordinator talking with the team and the patient. You are entering a world you don’t know, and she's your tour guide.”
Dr. Spillane meets regularly with a multi-disciplinary thoracic oncology team that includes several oncologists, radiologists, radiation oncologists, pulmonary medicine pathologists, a thoracic oncologist from Dana-Farber Cancer Institute, and occasionally social workers. The team reviews patient cases and advises on various aspects of care, even the basic things like getting to appointments and paying for treatment.
“There may be additional barriers to care for a patient: Lack of health insurance, inability to drive, that sort of thing,” he said. Having a nurse navigator join the patient conferences adds an important piece to the comprehensive approach to care, said Dr. Spillane.
