By Jessica Vanase, RN
What the heck is a nurse navigator?
I’ve probably heard this question dozens of times since returning to Backus Hospital’s Cancer Institute as an oncology nurse navigator. I like to compare it to being a travel guide. When’s the last time you took a road trip through uncharted terrain? Did it go smoothly or did you have to seek help, whether from an experienced guide, a map, or the Internet? Did you hit any detours? Get a flat tire? Get hopelessly lost? Wish you had planned things differently?
As any patient will tell you, the cancer experience — from diagnosis to treatment to recovery — is a journey. With our complicated health care system, it’s easy to get lost. That’s where a nurse navigator comes in. Whether it’s questions about your cancer type and treatment, how to talk to your doctors, where to get emotional or financial support, or how to deal with treatment side effects, I like to tell my patients that no question is too big or small — just ask. I will either have the answer or, more important (and more likely), know how to get it.
Each branch of Hartford HealthCare’s Cancer Institute — which includes campuses at Backus Hospital, Windham Hospital, the Hospital of Central Connecticut, Hartford Hospital and MidState Medical Center — has dedicated oncology nurse navigators to help cancer patients. My counterpart at Windham Hospital, Lori Surber (RN, BSN) has been an oncology nurse navigator for four years.
“I reach out to patients right from their moment of diagnosis,” she says. “Then I work with the health care team to get them from one step to the next. The best advice I can give to patients is to take one step at a time. Don’t look too far down the road.”
What’s the most rewarding part of being a nurse navigator?
“Making a difference in someone’s life every day,” she says. “Knowing you made the road a little easier for someone going through cancer is so rewarding,” Lori says.
I couldn’t agree more.
Here are 10 questions I have answered as a navigator:
Q: What does my pathology report really mean?
A: Your pathology report tells you specific details about the cancer cells that will help determine your course of treatment. For example, if the pathology report tells us that your breast cancer cells are ‘fueled’ by a certain hormone, such as estrogen, your oncologist may choose to treat you with a medication that stops the production of estrogen in your body. Of course, everyone’s pathology report is different.
Q: Why is my doctor talking about taking an anti-hormone pill for five years?
A: As mentioned above, some breast cancer cells grow in response to certain hormones. By blocking the production of that hormone, medications can help reduce the risk of recurrence. Many patients will take these medications for 5 years, but the exact length of time will be determined by your physician.
Q: Will I be totally sedated for my biopsy?
A: For breast biopsies, generally speaking—no. The radiologist will numb the area with medicine in a tiny needle before extracting the cells with a larger needle. You will be awake during the procedure and able to drive afterwards. If you are nervous about what to expect during the biopsy, you are always welcome to call your nurse navigator.
Q: Should I be “freaking out” if my doctor mentions chemo?
A: It’s hard not to freak out sometimes when facing cancer, but it doesn’t help. Your doctor will present the best plan for curing you of your cancer. Sometimes that includes chemo. My best advice is to take a deep breath and educate yourself on the recommended chemotherapy’s benefits and management of likely side effects. If you know what is expected, you can make adjustments and arrangements so your treatment is easier. Your oncology team and your nurse navigator are great sources of reliable, accurate information.
Q: How can I coordinate my chemo, radiation, and doctor’s appointments so I’m not driving back and forth all day?
A: Advocate for yourself, and explain what your traveling situation is to your medical oncologist and radiation therapy departments. The staff will do the best they can to accommodate requests. If you need additional back up, call me!
Q: How can I be considered for a clinical trial?
A: All of our patients with breast cancer are considered for clinical trials. Each case is presented at Cancer Conferences here at HHC Cancer Institute, and clinical trial eligibility is considered for every patient.
Q: Do you have any support groups for cancer patients?
A: Yes! Each site of HHC Cancer Institute offers breast cancer support groups. Here at Backus, our support group is the third Tuesday of every month, 4:30-5:30, in Conference Room 2 of the Backus Hospital Main Lobby. You can find a complete listing of other cancer support groups at hhchealth.org. If you’re not a support group type of person, we also have a social worker who can provide psychosocial counseling. And I’m here to listen if you need to talk!
Q: Am I allowed to have cats while on chemo?
A: Generally speaking, yes–but your doctor may ask you to make sure someone else cleans the litterbox if your white blood cells (which fight infection) drop during treatment. Your doctor may also want you to make sure your pet is fully vaccinated and is not prone to biting/scratching, since you could be at increased risk for infection.
Q: How can I reduce stress and anxiety during treatment?
A: Take advantage of your support systems at home, work, church, and wherever else you can. Let people help you during this time of your life. HHC Cancer Institute at Backus also offers free massage, reiki, or healing touch while you’re in treatment—ask your nurse navigator how to make appointments. Consider attending the breast cancer support group or Yoga for Cancer classes at Backus—you can call me at 860.425.3870 if you want more info. I can also direct you to our social worker if needed. And don’t forget to talk to your doctor about medication to help relieve anxiety if it’s overwhelming.
Q: My doctor hasn’t called me back with my results, what should I do?
A: Generally, it takes about 5-7 days for your results to come back and your doctor to review them. If you haven’t received a call back (or have an appointment scheduled to discuss results), after about a week, call your doctor’s office and ask when you might be getting a call back. If you need help getting an answer, call your nurse navigator.
Jessica Vanase is the Backus Breast Cancer Nurse Navigator. This advice should not replace the advice of your personal health care provider.
If you or a loved one are coping with cancer and need a little extra guidance and support, please contact your oncology nurse navigator. Working together, we can make your journey through cancer a smoother ride. I can be reached at Backus Hospital at 860-425-3870. For Lori Surber at Windham Hospital, call 860-456-6952. To connect with a Hartford HealthCare nurse navigator or learn more about our cancer treatments, call our Cancer Connect line at 855.255.6181 or click here.