Cancer care can be provided by many types of institutions, from large comprehensive cancer centers to small rural hospitals. In this issue of The Oncology Nurse-APN/PA (TON), we are focusing on a rural cancer center in Appalachia—the Adena Cancer Center, Chillicothe, OH, which is part of the Adena Health System. Adena has a main campus, where the cancer center is situated at Adena Regional Medical Center, as well as 2 additional critical access hospitals in Greenfield and Waverly. Together, they serve the health needs of 9 counties in south central and southern Ohio.
Adena Cancer Center has 4 beds and 12 chairs for infusions and serves approximately 16,000 patients per year. Services provided include chemotherapy, radiation, and certain types of surgery. We spoke with Jina Fields, RN, BSN, Nurse Navigator, about her roles and responsibilities at the Adena Cancer Center, some of the challenges and rewards she faces in her day-to-day duties, and which advances in the treatment of cancer she believes hold the most promise for improving patient outcomes.
TON: Tell us about your position at Adena Cancer Center. What are your main responsibilities?
Ms Fields: I am a nurse navigator for patients with gastrointestinal cancer, and I also collaborate with another nurse navigator at our center who works with patients who have been diagnosed with head and neck cancers. We handle every new consultation for patients with these malignancies, as well as consultations for patients with lymphomas and myeloma.
We see patients in the medical oncology clinic and follow them through surgery (depending on the type of surgery), radiation, and chemotherapy. We are there to help them every step of the way on their cancer journey and to address any problems and concerns they may have.
We help patients set up appointments with physicians and assist with referrals and second opinions. We act as a patient advocate because many of the individuals at our center have limited resources or do not have family members to help them. We also assist in arranging procedures at our facility and surrounding facilities.
I act as the leader of our patient team by coordinating care and services from day 1 through survivorship or hospice. Adena Cancer Center may not be the largest care provider in the area, but our team offers a variety of services, including social workers and an on-site dietitian, as well as help with insurance, billing, and transportation, which allows patients and their families to stay close to home for treatment and other services.
TON: How did your career path lead to becoming an oncology nurse practitioner?
Ms Fields: Basically, I worked my way up the ladder, from Certified Nursing Assistant to Licensed Practical Nurse to Registered Nurse. I worked on the medical/surgical unit; at that time, my goal was to be an emergency department nurse. I did that for approximately 2 years and found that it was not for me. I became a nurse to help people, and I have found that working here at the cancer center is a very good fit. I plan on becoming certified in navigation within the next year.
TON: What are some of the challenges and rewards of your job?
Ms Fields: My first day was April 1, 2019, so I am new at this job. As a result, I am learning all the time. I am focused on finding the best way to help our patients. It seems that the most important thing is to listen to my patients and be there to support them and their family members. Most of the time, people just want to feel like someone is listening to them.
I find it extremely rewarding to be able to help patients cope with their fears and anxieties and to be the face of hope for them. Many cancers are curable, and some act like chronic illnesses. Not all patients are terminal. I like to cheer patients on and encourage them throughout their treatment. At our cancer center, patients ring a bell when they complete radiation or chemotherapy. When they ring that bell, it is a special time for me as well.
TON: What are you currently excited about in the field of oncology?
Ms Fields: I have experience working in our genetics clinic, and I find the recent discoveries in targeted therapy to be very exciting. In addition, the work being done with immunotherapies is very intriguing. These newer drugs have fewer side effects than chemotherapy and are helping our patients live longer and experience better quality of life. Genetic discoveries also allow us to pinpoint patient selection and give the right treatment to the right patient. I think these are the most significant advances in the field of oncology.
TON: What would you do if you won the lottery? Would you stay at your job?
Ms Fields: Well, it would depend on how much money I won. If I won a large sum, I would like to do more for my patients. For starters, I would buy a positron emission tomography scan machine, and I would build a larger cancer center so we could help even more patients and families in this region.