By Loretta Gillespie
The Cullman Times
One of the most devastating statements a person can hear is, “You have cancer”. When this diagnosis is delivered, it often leaves people feeling as if they are dangling from a cliff. They often feel overwhelmed with paper work that looks insurmountable, while in the midst of dealing with the emotional and physical aspects of the disease.
For those who need help with the practical, business side of cancer, CRMC offers a helping hand — Nurse Navigators.
Nurse Navigators are a team of nurses and other clinical professionals who not only guide but ‘navigate’ a patient, or the family of a patient through a maze of information that may be intimidating to them. They also counsel, help with financial needs and provide spiritual and emotional support. They are here to help lead patients through red tape and answer any questions they might have.
“CRMC is proud to highlight our Nurse Navigation services which are part of our successful multidisciplinary cancer treatment program serving residents of Cullman and Surrounding counties. This program provides seamless services with the best patient outcomes in North Alabama,” said CRMC Marketing and Public Relations Manager, Lindsey Dossey.
This new team approach to cancer care is available at one place, CRMC FirstCARE Services and Nurse Navigation.
According to Nurse Navigator, LPN Kathy Tolbert, this vocation has been one of the most touching experiences of her life. “Sometimes people are at a loss when dealing with unfamiliar medical terminology. One patient had a diagnosis of prostate cancer and he didn’t know where to go next. It is our job to help him understand.”
Tolbert and the other Nurse Navigators accompany patients to doctor’s appointments so they understand what is being done, where it will be done, and why it is necessary. One consultation required the patient to travel out of town. Tolbert accompanied the patient and his wife to their appointment. “He told use later what a fun time if was,” she said. “Later, he brought me roses.”
“When a patient doesn’t know where to turn or what that diagnosis means, they need someone there who can explain to them in simple layman’s terms that they can easily understand,” Tolbert pointed out.
Patients are welcome to call or come by the Nurse Navigator’s office at CRMC. “We make ourselves easily accessible to patients,” stressed Tolbert, whose own husband succumbed to cancer. She can relate to her patients from both standpoints – as a medical professional, and as a family member who has seen what they face- first hand. “We give them comfort when they are scared to death,” she said softly.
Nurse Navigator and RN, Rhonda Neal, is also dedicated to her job. “We get referrals from everywhere,” she said. “Not only from doctor’s offices, but from other patients, churches, family members, or sometimes they just show up on our doorstep.”
“However, the majority of our patients are referred from their doctor’s office. They are in an emotional and physical crisis and they need support, some more than others. Often they don’t have this support at home – as in the case of a single parent. Sometimes they are in a blind panic. They want to know how much this is going to cost, how painful it will be, and most of all, how much time they have left,” said Neal. “We sort of take them by the hand and explain to them, ‘this is where we are, this is where we are going, and this is how we get there’.”
The Nurse Navigators are often guided by patients need. “We help them arrange their appointments, transportation to and from their treatments, and help with basic living expenses when necessary.”
Recently the Nurse Navigators had to do just that. They had three families in the Holly Pond area that needed help with food. Neal reached out to several area churches and teachers. The end result was overwhelmingly successful – they actually wound up helping six families. “We gathered enough to keep all six families in food for three months,” she said proudly. “When people around here see a need they really step up to the plate to help.”
Case Management and Nurse Navigation and Palliative Care Services, Division Director, Lori McGrath, DNP, CRNP, noted that those children who participated in the food drive now have a better awareness than they had before. “This has helped them to have a better understanding of the fact that some children don’t have enough to eat.”
Families are screened carefully according to guidelines similar to the screening process used by CRMC. “We also work closely with Bosom Buddies and the Scott Lockridge Foundation,” said Neal.
This assistance provides patients with a reliable ‘safety net’ in the whirlwind of paper work that comes with this illness. Just the sound of a confident, capable, knowledgeable voice is often enough to give patients reassurance that someone does care, and is there to help.
Sharon Riggs, a cancer patient who has benefitted from the Nurse Navigation program has nothing but praise for the team. Diagnosed last July, Riggs says that Rhonda Neal and the rest of the team never dropped the ball. “Any time I needed them, they were there. They became my support system,” said a grateful Riggs. “It was a sad and dark time for me, and I would have been lost without them. Not only did they meet my physical needs, but my emotional needs as well. They even found help to pay my light bill and rent, which took a lot of the stress off of me.”
Riggs recalls that the first week after her diagnosis was a blur of office visits and tests, then in just over ten days, she was faced with surgery. Her wound failed to heal properly, so nutrition was vitally important. The team made sure that Riggs had plenty of Ensure for the necessary protein she required. “They would even take it out to my car for me,” Riggs said.
“Rhonda knew how bad my fear was, and she would console me frequently,” said Riggs. “I think those ladies were put here on this earth to do what they are doing. They have become lifelong friends.”
The Nurse Navigation team also secured gas cards for Riggs so that she could get to her office visits and radiation treatments.
The Nurse Navigation team, under the guidance of McGrath, has made a huge impact on the well-being of cancer patients in this area.
“There are two things I look at when I think of this team,” said McGrath. “They help patients deal with the practical burdens of this illness just as the doctors help them deal with chemo and radiation treatments. But people in this situation also need emotional, spiritual and financial support. As we build these relationships we also build a lot of trust. We focus on cancer, but the second thing, which really makes me proud, is that we look at the whole person, and their family, not just the symptoms,” she said with sincerity. “We look at the practical burdens of care during the illness. If you can’t sleep or don’t have food, this all has to be addressed before a person can concentrate on healing.”
When you hear these ladies talk about the rewards of what they do it’s as if you can hear the theme song from Mission Impossible in the background. They are quick to point out that they have the full backing of the CRMC Foundation, that part of their support system includes Bosom Buddies, the Medical Alliance, and the Good Samaritan Clinic.
“We didn’t invent the wheel,” said McGrath. “The power of the Nurse Navigators is what we do in concert with other agencies like the United Way and the Commission on Aging or the Quality Health Clinic.”
Cullman Regional Medical Center’s Nurse Navigation program provides expert cancer care through this multidisciplinary team approach which educates and supports the patient and family during their battle with cancer and improves patient outcomes through education and monitoring.
“God led me to Nurse Navigation, plain and simple,” says CRMC Nurse Navigation Case Manager and Discharge Planning Assistant, Jessica Nicholson. “One day, I went to the internal job board and saw a posting for FirstCARE. It was a dayshift M-F position and an answer to many prayers. However, I had no idea what FirstCARE was or any idea of what they did.”
“As it turns out, they were taking care of cancer patients in need. My own grandmother passed away from complications of breast cancer in 2005,” Nicholson continued. “What better way to serve her memory than to help people going through obstacles she herself may have faced?”
Nicholson loves her job. It is rewarding to her to be of assistance to patients who might become overwhelmed when given a diagnosis of cancer. “A simple phone call is all it takes to brighten a patient’s day. Sometimes that phone call is just to say, "How are you and what can I do for you?” Other times it is a phone call to our donors to ask for help with a cancer patient’s medical bill or living expenses.”
“I am so blessed to be a part of this,” said Nicholson softly. “When patients come to our office we are allowed to share in their triumphs and sorrows. We have laughed, cried and mourned with many. It is truly an honor and a blessing to be a part of the Nurse Navigation department. Our staff and patients are among the best people I know.”
McGrath and her team of Nurse Navigators use their nursing skills to look at the patient as an individual and spend a lot of time talking to them, as well as to the various agencies. Some patients might be in need of clothing, food, or various other things. “Sometimes we start calling these agencies and miracles happen,” smiled McGrath. “So many times I walk into my office and one of them will say, ‘You won’t believe this, but…’ and they will proceed to tell me how things fell into place for one of our patients.”
“I hope when we go home each day, we can look back and see that we have made a difference,” said McGrath with conviction. “
What services does the Nurse Navigator provide?
· Serves as the patient and family’s direct resource.
· Acts as care coordinator, educator and initiates team referrals when needed.
· Helps patients understand their diagnosis and treatment options.
· Explains medical terminology to patient and family.
· Explains diagnostic tests, procedures and surgical procedures. Assists the caregiver with patient preparation for procedures.
· Watches closely for any problems that may arise over the course of treatment and recovery.
· Serves as a liaison with physician’s office to ensure accurate patient communication and timely appointments.
· Seeks ways to ease the burden of care for patients and families.