Navigating cancer with a professional’s help
At the moment you receive what feels like frightening medical news - something suspicious appearing on a routine scan or a concerning test result - wouldn’t it be a huge relief to know you have someone in your corner walking you through the next steps? That is the goal of the new Oncology Nurse Navigator Program at Cape Cod Healthcare.
“There is so much fear and uncertainty for patients," said Shelley West, the director of nursing for Oncology and Infusion Services at Cape Cod Hospital. “There's a big gap between someone finding a spot on your lung to getting your first visit with the oncologist and coming up with the treatment plan,” she said. “That's something that I think the average layperson doesn’t know how to deal with, so I'm very excited we are implementing the nurse navigator program.”
Nurse navigation programs are very common in oncology, said West, who has been in the Oncology Department for five years. She truly appreciated that the Cape Cod Healthcare administration saw the value in creating a position for a full-time nurse navigator in her department. “I really think our patients will be so much better off with a terrific advocate like Joan.”
West was referring to Joan Macallister, the first oncology nurse navigator for the brand new program. Macallister, who is originally from Cape Cod, was previously an oncology-certified nurse at Nantucket Cottage Hospital. “I actually worked at Cape Cod Hospital when I was 17 and then did a summer internship here while I was studying nursing at Northeastern, so it feels like I am coming home!” said Macallister. After graduating from Johns Hopkins University, she worked as a nurse at the Riverview School in Sandwich before she and her husband moved to Nantucket.
She sees her navigation role as being an anchor for patients who are moving through the process of diagnosis and treatment.
“We will try to limit the amount of time the patient has to go through the diagnostic process,” she said, “since getting them quickly into treatment can often provide for better outcomes.”
Working with doctors specializing in thoracic, gynecological and head and neck cancers, Macallister said her focus will be prioritizing patient care in conjunction with the primary care physician and multidisciplinary team.
“It can be overwhelming with the number of exams and appointments that are required,” she said. “People’s anxiety levels can get really high, so I want to help bring down that anxiety and let them know we're going to get them through this.’”
Macallister’s role will include helping to schedule the appropriate tests for each patient and coordinating information between their medical providers. “I can let the patient know why we are doing what we are doing, what we need to look for, and how one test looks for one thing and another test looks for something else.” She feels the other half of her job will be to understand and respond to the patient's perception of what is happening.
Macallister has already begun connecting with patients and has seen how her efforts can help. “Recently, I met with a patient who was coming in for chemotherapy, and his wife was very concerned,” said MacAllister. “She was worried because it had been impossible for a phlebotomist to get blood from him, and she didn’t see how he was going to be able to get the chemo.” MacAllister explained they have a solution for that. “ I told them we can have an implanted port for the chemotherapy, which made them so relieved before they got to the appointment.”
West said Macallister has done a “fantastic job already." When the position was envisioned, West knew the department needed someone not only with oncology knowledge and experience but also a good amount of resourcefulness.
“From a management perspective, we were looking for someone who is a self-starter because it's a very autonomous role,” she said. “It's a new program, so we needed someone who's not afraid to dive right in and find the answers for each patient.”
As she moves forward with her new role, Macallister is focused on creating the most efficient pathway for both the patient and the providers.
“My goal is to have a clear plan that is maximizing everyone's time,” she said. ”We don't want any barriers to care, so I’m going to be that support person who troubleshoots any obstacles.” She wants to make sure that everything along the way is as frustration free as humanly possible during what can be a pretty intense time.
Macallister’s philosophy of nursing is to look at each patient holistically.
“It's really looking at the whole picture and then advocating for the patient from where they are,” she said. She feels it is essential to put herself in the mindset of whatever is going on with them and then communicate her support. “I want to sort of virtually wrap my arms around them and say, ‘hey, I've got you.”
This position has been supported by funding from generous donations via our oncology education initiative, Alice's Classroom. In addition, proceeds from the upcoming Soirée on the Bay event, taking place on September 21, will provide continuing funding of the Oncology Nurse Navigator position. Soirée tickets and sponsorship details are available here.
