The Baylor Scott & White Charles A. Sammons Cancer Center, Dallas, TX, is an integral part of Baylor University Medical Center, a nationally recognized, faith-based, not-for-profit hospital that serves more than 300,000 patients each year. The principal goals of the center are to provide patients with personalized, high-quality care and to conduct educational and research programs that advance knowledge in the field of oncology.
The Oncology Nurse-APN/PA (TON) recently interviewed Stacey L. Webb, MPA-HCA, BSN, RN, ONN-CG, Patient Navigation Program Manager, Charles A. Sammons Cancer Center. In this article, Mrs Webb discusses her day-to-day responsibilities, the essential role that nurse navigators play in assisting patients throughout their cancer journey, the ongoing challenges and barriers to care that still need to be addressed moving forward, and some strategies for achieving a healthy life/work balance.
Mrs Webb: My current role is Manager of the Baylor Scott & White Charles A. Sammons Cancer Center Patient Navigation Program. I wear many hats throughout the course of the day, and often find myself shifting gears and reprioritizing to accommodate the many needs of my patients and their families, as well as the needs of my fellow navigation colleagues.
Some of my responsibilities include overseeing day-to-day operations, monitoring performance and metrics, and creating and maintaining budgets. I also collaborate with key stakeholders to identify new opportunities for navigators to help patients along their journey. Because Baylor is a Commission on Cancer–accredited facility, I am also responsible for ensuring that our program meets certain accreditation components, including patient navigation, community outreach and education, and survivorship.
In addition, I navigate patients who are newly diagnosed with cancer, so I am able to actively work in the trenches along with my colleagues, which is very rewarding. I must say, it is truly a privilege to serve others on a daily basis, and assist them on their cancer journey.
Mrs Webb: The pandemic resulted in many patients delaying vital cancer screenings because they were apprehensive about visiting a physician’s office or other healthcare facility. Our nurse navigators worked hard to increase and improve our messaging to patients, so that they knew it was safe to come back to receive the care they needed. It is important for patients to understand why it is critical to stay up to date with their screenings and treatments. We continually educate them on the safety protocols we have in place and assure them that we are adhering to the Centers for Disease Control and Prevention guidelines to help alleviate any fears they may have.
We also stress to patients the importance of becoming actively involved in their own care so they can make informed decisions. Typically, they are overwhelmed and frightened when they receive a cancer diagnosis. We help patients prepare for their cancer journey by educating them about their diagnosis, informing them of next steps, and discussing the potential treatment options they may receive for informed decision-making. We continually assess patients and families for barriers to care and assist them with access to the tools and resources they need to move forward successfully.
Whenever possible, we like to involve the whole family unit, not just the patients. Unfortunately, in the early days of the pandemic, family members were often restricted from accompanying patients to their appointments. This was, of course, very stressful because they were accustomed to having that emotional support. We identified ways for patients and their families to remain connected during appointments and treatments. This involved increased messaging to alleviate fear and anxiety, giving the patient options through technology and “hands-on” assistance with using devices, as well as the potential offering of provider telehealth consults for follow-up appointments.
Mrs Webb: We have a plethora of onsite services conveniently under one roof for patients and their families. These include supportive and palliative care programs; physical, occupational, and speech therapy; genetic counseling; exercise programs; lymphedema services; and chaplain services, to name a few.
In addition, we offer art therapy to patients and their families through our Arts in Medicine program. Led by trained art therapists, this program allows individuals the opportunity to express themselves through various mediums, including paint, colored pencils, and clay. We feature their work in a rotating gallery, and people can bid on these pieces if they wish to purchase them. The funds from these sales go back to our art program to help pay for supplies and to support our therapists.
We also have musicians on staff who play for a few hours a day in the mezzanine outside of our café. These individuals will also play for patients at the bedside, which has been very beneficial for helping to alleviate fear, anxiety, and even pain.
Patients are also able to take advantage of various nutritional support services; these include live cooking demonstrations by a chef who promotes healthy eating. These classes are recorded so patients can watch them later if they so choose.
Mrs Webb: I think there are several ongoing unmet needs among patients with cancer, such as access to public transportation for those on a fixed income. Currently, we are seeing financial constraints growing with rising gas and food prices. Since we are such a large cancer center, a lot of patients come to us from far away. The good news is that we work in conjunction with the American Cancer Society to temporarily house patients and their caregivers at Hope Lodge, where they can stay free of charge. Patients do need to obtain a referral ahead of time, but it is a wonderful service, especially for those with limited financial resources.
I also believe there should be more discussion around advance care planning and goals of care. Understandably, this is sort of the “elephant in the room” that nobody wants to talk about, but it is so important. After I have met with patients a few times, and have developed a relationship with them, I gently approach this topic, so they understand how advance care planning can help them stay in the driver’s seat and remain in control of their cancer journey. It also enhances informed decision-making and relieves the burden on the spouse and other family members to make these important decisions. I encourage patients and their families to have these discussions early, so when there is a health crisis, everyone is on the same page. Having a formal plan in place prevents anxiety among family members and allows patients to remain in control of their own healthcare wishes. I try to plant the seeds early, so that hopefully this will be something they consider.
Overcoming barriers to clinical trial participation also remains a high priority. If we are truly going to advance cancer research and develop more effective therapies, it is vital that we increase awareness of, and participation in, these trials. Unfortunately, many patients do not know where to find up-to-date information on trials and often become overwhelmed when trying to decipher criteria to determine whether they are eligible to participate.
Nurse navigators can play an important role in educating patients with cancer about clinical trials and walking them through the process.
Furthermore, it is important to recognize the healthcare disparities that exist when it comes to clinical trials. Studies show that less than 10% of all patients with cancer enrolled in trials are minorities. Therefore, it is not only important to increase overall participation, but we need to increase the diversity of that participation through better outreach and education.
Mrs Webb: Over the past few years, nurses have had to cope with a lot of unique challenges, and we have seen a great deal of stress and burnout. So, it is important to get adequate amounts of sleep and exercise, while following a healthy diet. I also think practicing mindfulness can be very helpful, and there are a variety apps that people can download and use for free.
Baylor does a great job of providing a variety of emotional support programs and spiritual development programs for its employees, as well as traditional employee assistance programs, which are very beneficial. I think it is important for healthcare professionals to take advantage of these services, especially considering everything they have been through during the pandemic.
I am very fortunate to be part of an amazing team, and as a leader, I try to create a supportive environment for my colleagues. This includes active listening, frequently checking in with them and giving them the opportunity to express their feelings, so they know that they are being heard. If they are having a tough day, I encourage them to take a break and go for a walk around our campus, especially on beautiful, sunny days.
We all have demands that extend beyond our responsibilities at work, whether that is caring for children, a sick spouse, or elderly parents. It can be very challenging to keep a healthy work/life balance, so I try to remain flexible with my team members whenever possible to help them achieve this balance.
The field of navigation has evolved tremendously over the past several years, and fortunately, we now have many more resources available to help us. For example, we have the Academy of Oncology Nurse & Patient Navigators (AONN+), which offers a variety of vital services, including training and certification. The AONN+ conferences also provide a wonderful opportunity for navigators to connect with their peers, share best practices, and get the support they need to perform their jobs.
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