Meeting the Needs of Patients
The Scripps Cancer Center—Stevens Division is located at Scripps Memorial Hospital in La Jolla, California, and is part of the San Diego County–wide Scripps Health cancer care network. The center is committed to working with cancer patients from diagnosis through treatment. As 1 of only 2 Integrated Network Cancer Programs in California (as designated by the American College of Surgeons), Scripps Health encompasses the oncology resources of 5 hospital campuses, a broad network of cancer care specialists and affiliated physicians, and the renowned Scripps research professionals.
In addition to providing a full continuum of cancer care for patients, the center offers cancer prevention and early detection services and access to educational and social support services.
The Oncology Nurse-APN/PA spoke with Janine Rodriguez, RN, and Paula Thomas, LCSW, about their work at Scripps Cancer Center—Stevens Division at Scripps Memorial Hospital, 1 of the 5 campuses in the Scripps network.
Can you describe the services you provide for cancer patients?
Janine Rodriguez (JR): I am the nurse navigator/clinical coordinator providing support for the patient through his or her treatments. I work with patients who have all types of cancer, and the majority of my work is with outpatients. Occasionally, I will see inpatients after a surgical procedure. Patients are referred to our support services by medical oncologists, surgeons, nurses on the oncology floor, or social workers, and we get self-referrals as well.
We call patients for a face-to-face interview after an initial diagnosis of cancer. For example, I might help them get a wig after their hair falls out from chemotherapy or direct a breast cancer patient to physical therapy if she develops lymphedema. I refer them to wellness classes, including yoga and meditation for de-stressing them, and nutritional support. In general, both Paula and I are patient advocates, and we are here to help meet their needs.
Paula Thomas (PT): I am an outpatient oncology social worker at the Stevens Cancer Center. I offer psychosocial support and screen the patients for emotional distress. I also help them deal with financial issues, insurance, and transportation, linking them to resources to solve these problems. I also offer emotional support and provide an outlet for them to discuss their fears and anxieties openly, which they usually don’t want to do with their families.
I also facilitate the Scripps Gyne-cological Cancer Support Group.
Tell me about that.
PT: The group includes anywhere from 13 to 16 women who meet twice a month. Most of them have ovarian cancer, but women with other gynecologic cancers are also invited to join the group. I have been facilitating this group for about a year and a half, and it is flourishing.
We deal with difficult issues, as most of these women are ovarian cancer patients at high risk of relapse and death. The group is incredible, helping women maintain resilience and providing compassion on this difficult journey. As you can imagine, the composition of the group changes with the loss of members.
Because the discussion about loss can be overwhelming, I generally don’t recommend support group participation at the time of initial diagnosis. I usually wait until after about 8 to 12 weeks following initial diagnosis to suggest participation, because at this time women typically need support.
JR: I am tangentially involved in helping to put on social events for the group. We are having a holiday tea next week, and it will be a lighthearted celebration.
What are your biggest challenges in this work?
PT: For me, I have to overcome and deal with my own fears associated with cancer death. I want to be careful not to transmit my fears to my patients. Even though I have worked in other settings where patients die, like hospice, I find working with cancer patients the most challenging in this regard—probably because so much is unknown for them.
JR: I don’t have the same fears. I was an ICU nurse and an ER nurse for many years. My biggest challenge relates to organizational structure. With 5 different hospitals serving different patient populations, I want to ensure that all patients have equal access to our support services. It can be frustrating, because we don’t always have access to all the patients we would like to help.
What are your biggest rewards?
JR: The patients and their families are so grateful for our help in allowing them to express themselves and in directing them to concrete resources for their problems. We might help a person living alone to get food, for example. The interaction with patients is my reward.
PT: I would echo that. Waxing philosophical, social work is dirty work. You work in all kinds of settings where the problems are not pretty. But the reward is that you are giving a lifeline to a patient. It is a wonderful feeling to help distraught persons feel better so they can face the journey ahead.
Not only do we provide services and connect patients with resources, but also, I will connect them with a therapist if they are having emotional problems.
JR/PT: The other Cancer Center personnel include our medical director, James Sinclair, MD; our administrative assistant, Eileen Gaudette; and an advanced nurse practitioner (APN) Cathleen Sugarman; as well as a full-time genetic counselor, Jaime Malone, MS, CGC. l