Breast Imaging Nurse Navigation at UCSF Health: Improving the Patient Experience

TON - October 2023 Vol 16, No 5
UCSF Health in San Francisco.UCSF Health in San Francisco.
Photo credit: Matt Beardsley/for UCSF.

UCSF Health is recognized worldwide for its high-quality, comprehensive patient care, informed by pioneering research and advanced technologies. It includes 3 UCSF Medical Centers, 2 UCSF Benioff Children’s Hospitals, the UCSF faculty practice group, Langley Porter Psychiatric Hospital and Clinics, UCSF Benioff Children’s Physicians foundation, and joint ventures with John Muir Health and Hospice by the Bay.

The health system also includes affiliations with top-tier hospitals and physician groups throughout the region, allowing patients to receive specialty care close to home.

UCSF Health’s world-renowned breast imaging program spans 30 years and offers a full spectrum of imaging techniques for detecting and diagnosing breast cancer and related cancers, using the latest state-of-the-art equipment. Services range from digital mammograms to breast magnetic resonance imaging (MRI) scans and ultrasounds to image-guided procedures, such as obtaining tissue samples, removing fluid, and locating areas of concern before a surgical biopsy. The staff are committed to delivering innovative and compassionate care that is tailored to each patient’s needs.

The Oncology Nurse-APN/PA (TON) recently interviewed Sueann Mark, MS, PhD, RN, AOCNS, Breast Imaging Nurse Navigator, UCSF Health, and Assistant Clinical Professor, UCSF School of Nursing, who discussed what inspired her to choose a career in nursing, her roles and responsibilities at the center, the most rewarding and challenging aspects of her job, her work as a breast cancer advocate, and how she maintains a healthy life/work balance.

TON: What inspired you to pursue a career in nursing and where did you receive your training?

Dr Mark: Nursing is my second career and my inspiration to change fields was distinctly personal. I was a sex educator working with women and couples when I was diagnosed with breast cancer at the age of 34. As a result, I changed my professional focus and started specializing in the unique sexual health needs of people with breast cancer. It didn’t take long for me to realize that my calling was much broader than sex education for this population.

I recalled how during my own treatment, the 2 providers that I relied on the most were an oncology clinical nurse specialist and an oncology nurse practitioner. These individuals showed me the invaluable impact that advanced practice nurses can have on the lives of their patients, and both have remained cherished mentors to this day. They are at the heart of the inspiration for the clinical nurse specialist that I am today.

After completing treatment, I volunteered as a breast cancer patient advocate and had the opportunity to add the patient perspective to breast cancer research. The training I received as an advocate further sparked my interest in joining the field of nursing.

Approximately 5 years after I finished treatment, I took the plunge and enrolled in the Master’s Entry Program in Nursing at UCSF School of Nursing. The program provided me with accelerated RN training over the course of 1 year, followed by 2 years to complete a Master of Science degree with a specialty in oncology. I am now a proud faculty member at UCSF School of Nursing and hope that I can inspire my students to pursue careers in oncology after graduation.

TON: Can you tell us about your responsibilities as a breast imaging nurse navigator?

Dr Mark: My work allows me to guide patients through the breast imaging process from the point at which there is a finding on a screening mammogram all the way through to a diagnosis of breast cancer. I serve as a main point of contact for patients and provide them with education about their breast health, imaging, and biopsy procedures. I advise patients of the results of their biopsies, and if they do have breast cancer, I prepare them for their first appointment with the breast surgeon.

As a nurse navigator, I also provide risk assessments for patients who are at an elevated risk for developing breast cancer. This role involves educating patients about modifiable risk factors, such as exercise, diet, and alcohol use, as well as providing them with referrals for genetic testing and MRI screening, when appropriate.

TON: What are the most rewarding and challenging aspects of your job?

Dr Mark: The prospect of having breast cancer can cause significant distress. I know this on a personal level and can recall how important it was for me to have at least one advocate on my side during the process. My role as a nurse navigator allows me to advocate for and support patients and this is one of the most rewarding aspects of my job. I feel strongly that my patients should be active participants in their healthcare and arming them with the information they need to fully understand what is happening each step of the way is incredibly rewarding.

Most of the challenges related to my job are logistical in nature. My role is to help patients overcome barriers to care, and coordinating that care among different providers, departments, and health systems can present challenges. Fortunately, I have built good relationships along the way to help this aspect of my work go smoothly.

TON: Can you tell us about your breast cancer advocacy work?

Dr Mark: I began volunteering as a breast cancer patient advocate after I finished my own cancer treatment. I became involved in federal lobbying efforts sponsored by the National Breast Cancer Coalition and provided support and raised awareness of breast cancer in young adults through the Young Survival Coalition. The advocacy work that I am most proud of and engaged with is my role as a research advocate. I serve on grant review panels for the Department of Defense Breast Cancer Research Program. In this role, I work closely with scientist reviewers and provide a patient’s perspective on the potential impact of the studies being reviewed.

TON: What strategies do you find helpful for maintaining a healthy life/work balance?

Dr Mark: The work of a nurse navigator can be emotionally taxing, so I take work/life balance and self-care very seriously. I get regular exercise by commuting to work by bicycle. My daily rides are an excellent buffer for the start and end of each day. I also believe strongly in the healing aspects inherent in nature. The Japanese tradition of “forest bathing” is one of my favorite ways to access this. I take daily walks in Golden Gate Park with my dog and find that when I focus in on the sights, sounds, and smells of nature, the noise of daily life fades into the background.

I also rely heavily on my fellow nurse navigators for support. Having a team that I can count on to help when work has drained me emotionally is invaluable. It helps to know that there is always someone in my corner when things get rough.

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