The Massachusetts General Hospital Cancer Center is an integral part of one of the most distinguished academic medical centers in the United States: Massachusetts General Hospital, Boston. The institution offers personalized innovative treatments to adults and children with cancer through >37 programs within 29 multidisciplinary disease centers plus a vast array of support and educational services in New England and the southeastern United States. It also has one of the largest hospital-based research programs in the country. Its physician investigators conduct nearly 400 clinical trials annually, and its nurses were the first in Massachusetts to achieve Magnet status from the American Nurses Credentialing Center in recognition of the excellent care they provide to patients.
In this issue of The Oncology Nurse-APN/PA (TON), we feature an interview with Kathryn E. Post, PhD, RN, ANP-BC, Clinical Oncology Nurse Practitioner, Breast Oncology Group, and Postdoctoral Research Fellow, Cancer Outcomes Research Program at the Massachusetts General Hospital Cancer Center. Dr Post discusses her roles and responsibilities, the life events that influenced her decision to pursue a career in oncology nursing, and some of the ongoing challenges—as well as the rewards—of her profession.
TON: What is your role at the Massachusetts General Hospital Cancer Center?
Dr Post: I actually have 2 roles. My first role is as a Clinical Oncology Nurse Practitioner in the Breast Oncology Group, where I have been on the medical oncology side of things since 2007. I work closely with patients with breast cancer from the time of diagnosis, through survivorship, and sadly, sometimes until the end of life.
My second role is as a Postdoctoral Research Fellow. I work at the Cancer Outcomes Research Program (CORe) with Jennifer S. Temel, MD, Clinical Director, Thoracic Oncology, and Director, CORe, and Joseph Greer, PhD, Clinical Director, Psychology, and Associate Director, CORe. This is a new role that I took on after obtaining my doctorate degree.
My postdoctoral research involves helping to manage 2 R01-level funded studies, both of which involve patients with advanced lung cancer. The first study is comparing early integrated palliative care versus a stepped model in which patients’ health-related quality of life is monitored and they are “stepped up” to monthly visits with a palliative care clinician if their quality of life worsens beyond a certain point. Research suggests that patient-reported and end-of-life care outcomes are improved when palliative care is integrated early in the course of disease.
The second study involves patients with advanced lung cancer who are experiencing dyspnea. We are evaluating whether nurse-led interventions using mindfulness strategies and breathing exercises can improve dyspnea, reduce overall stress, and improve patients’ quality of life.
TON: How did your career path lead to becoming an oncology nurse practitioner?
Dr Post: I was diagnosed with thyroid cancer at 22 years of age and coincidentally began a job as a clinical research coordinator here in the Breast Oncology Department. The experience of being diagnosed with cancer changed the way I viewed oncology care and it was a turning point for me. What really inspired me to embark on a career in nursing was working closely with our amazing nurse practitioners and seeing how they made a positive, lasting impact on the lives of their patients every day. I knew then that I would pursue a career in oncology nursing and dedicate my life’s work to achieving the same goals.
I entered a Direct Entry Program at Boston College’s Connell School of Nursing, Chestnut Hill, MA, and in 2007, graduated with my master’s degree in nursing; I began working at Massachusetts General Hospital Cancer Center as an oncology nurse practitioner right after that. I have always had a passion for research and thought I would pursue a doctoral education in nursing, so after practicing as a nurse practitioner for approximately 8 years, I felt that it was the right time. I had also started to engage in my own research in breast cancer survivorship and knew that a doctoral education would enable me to more effectively conduct research.
TON: What are some of the challenges and rewards of your role as a clinical nurse oncologist?
Dr Post: The hardest challenge is losing patients who I have cared for over many years. It does not happen very often, but when it does, it does not get easier with time. I also feel challenged on days when I feel that I could have done better. I always want to get it 100% correct 100% of the time.
My biggest reward is meeting all of the wonderful patients and their families. I am always surprised at their gratitude regarding the care I give them, even when they are going through such difficult experiences themselves. This is what keeps me coming back to my work. Being an oncology nurse has profoundly changed me as a person for the better.
TON: What are some of the challenges and rewards of your role as a postdoctoral researcher?
Dr Post: The biggest challenge I face is that I am a novice researcher and the learning curve is steep. Unlike my role as a clinician, where I am experienced and feel quite comfortable, in my role as a researcher, I have much to learn and am back at the starting line. However, I do have some great mentors and I am up for the challenge.
My biggest reward is that I finally accomplished my goal and I am a doctorally prepared nurse. The CORe group is very welcoming and intellectually stimulating. I love being part of a group that is committed to improving outcomes for patients with cancer and their families.
TON: What are you excited about in the field of oncology right now?
Dr Post: I am thrilled at the pace of discovery of the new therapies that have been introduced for cancer treatment, including targeted therapies and immunotherapies. We are now achieving durable responses in cancers that used to be considered difficult to treat. For example, patients with lung cancer with targetable mutations are having extended responses. The therapeutic landscape is changing. We used to treat patients with one-size-fits-all chemotherapy, followed by the next line of chemotherapy, and so on, and the outlook was dismal in many cases. It is invigorating to be involved in cancer care in this evolving therapeutic landscape. Oncology providers can experience burnout so it is helpful to have these positive outcomes, which provide some optimism and hope in what can be a stressful occupation.
TON: How do you prevent burnout?
Dr Post: I find the monthly Schwartz rounds at our institution to be very helpful. We meet and discuss emotionally challenging and difficult cases. However, on a daily basis, my nurse and physician colleagues are my greatest source of support. We talk to each other and debrief about our days and that is very helpful. The work we are doing is invigorating but can also be challenging.
TON: What would you do if you won the lottery? Would you still be an oncology nurse practitioner?
Dr Post: I have 2 small children and my doctoral studies and my work have definitely been challenging in terms of the work/life balance. If I won the lottery, I would take an extended family vacation, and once we were all refreshed, I would come back and continue what I am doing.