The role of the nurse navigator in helping patients through the trajectory of their journey from diagnosis to treatment to survivorship has evolved, and in many settings, the nurse navigator [ Read More ]
June 2015 VOL 6 NO 3
A Coincidence Turns into a Career
Penny Daugherty, RN, MS, OCN
I became a nurse almost by coincidence, even as I realize it was meant to be.
I was at home with my third child who, at age 6 months, was nursing voraciously (he did everything voraciously) when a good friend called me. She was in the midst of a divorce and was looking for a way to support herself and her 2 children going forward. She told me she was applying to nursing school and suggested that I join her that day in applying.
I had enjoyed a lovely career as a Master’s prepared clinical psychologist before having my third child; having received a wonderful education at the University of Washington, I had every intention of being a stay-at-home mom, not to mention my aversion to blood-splattered scenarios. Needless to say, I was not very motivated to embark on a new and strenuous education.
But friendship prevailed. I did go to Edison College with my friend, and, strangely enough, ended up enrolling in nursing school. On the way home, I rationalized that I could always be a school nurse (having worked with mentally handicapped children in my first career), thus combining my background in psychology with nursing—no problem.
From the first day in school, I was enthralled—anatomy, physiology, microbiology, and, most especially, pathophysiology were like gates to a whole new world, and studying became an obsession. My husband just handed over his precious drafting table, so all my books and papers were always available to me as he watched me engulf myself in my studies.
As an aside, I was blessed with what I consider some of the finest instructors in nursing education, so their contribution was an enormous motivating factor. When I started my pediatric clinical rotation, the instructor bluntly informed me, after seeing me with 3 very ill children, that this was not for me, that I could never be therapeutic with children, and that I needed to redirect my focus. She was right. I was a tearful, emotional wreck when exposed to the manifestation of physical illness in children.
Surgery was next, and after obsessing all night about what I would do with blood-splattered operations, I somehow ended up shoveling my way to the front of the surgical field (I who was previously so squeamish). All my knowledge of anatomy, physiology, and pathophysiology just leapt into life, and my love of surgery was born that first day, despite the scolding I got from the circulating nurse about being too close to that field. If anything, that just ignited the fizz of the drama of surgery.
I did my oncology rotation in a head and neck unit at Fort Myers Community Hospital (remember me, squeamish about blood and body fluids?), and between the incredible head nurse, Madeline Norsworthy, and all the incredibly welcoming staff nurses (and the feisty and very needy patients), I knew that this was where I belonged. Surgical oncology became a part of my life in that moment, and has since been my soul’s home as a nurse.
After graduation, I went to the same head nurse and pleaded my case, and miraculously, she hired me—a new graduate. My orientation was intense, filled with tough love, and entirely ingrained in me the desire to be the best oncology nurse I could be. Keep in mind that this was the late 1970s, when extensive surgeries were being done, and every patient was a challenge to the primary nurse, from the endless tracheostomy care to the disfiguration, to the already unique personalities and needs of the patients with head and neck cancer. I loved every minute of it: at that period in oncology nursing, we, the primary nurses, did everything, from wound care to intravenous administration and tracheostomy care, and sometimes (yes, it happens) reinsertion.
When my husband and I opted to move from Florida to Atlanta, at first I had trouble adapting to this huge, sprawling city, and through a series of coincidences (there’s that word again), I met Alice Kerber who offered me a position as a Community Clinical Oncology Program (CCOP) research nurse at Southern Regional Medical Center. They had just hired a new clinical nurse specialist, Marty Polovich, and she and I shared what we euphemistically referred to as our “office” for many years. Alice (as our manager), Marty, and I were teammates, in an effort to make our oncology program shine—and shine it did.
We had the highest CCOP clinical trial accrual in the city, and we brought state-of-the-art treatment to many underserved patients in our service area. I developed a new love for research as I familiarized myself with diseases I had never heard of, and guided patients through their care and treatment. Alice, Marty, and I are still close friends, and those of us who have been oncology nurses for many years know what this very unique and special bond means.
I heard a talk at an Oncology Nursing Society (ONS) Metro Atlanta Chapter meeting about ovarian cancer, and a little fire sparked in me that this might well be something I could embrace. Just a few short years later (another coincidence?), I was offered the position of Research Director of one of the biggest gynecology oncology practices in the country, and I “threw” myself into that opportunity, where I happily flourished (blessed by a super research team and amazing doctors) for 10 years.
During that period, I was incredibly privileged to participate in the ONS Core Competencies for Clinical Trial Nurses. During that time, Mary Gullatte asked me to be a contributing author in the third edition of her book, Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook. I blithely agreed, and then realized I had absolutely no experience writing. Mary patiently edited my piece numerous times, giving me the encouragement to feel that I could actually be a credible author.
At the ONS Congress in 2009, Barb Sigler (the then ONS Director of Publications) asked me if I would consider writing a “little book” to be titled Case Studies in Navigation. Coincidently, I had just finished my piece in Mary’s book, so I was brash enough to agree. John Zaphyr, Lisa George, and the entire ONS publishing team were to be our shining beacons of support with this book going forward when Barb retired.
Historically, our gynecology/oncology practice was sold in 2010. I had become intrigued by the new navigation initiative, and our GASCO (Georgia Society of Clinical Oncology) team, under the inspired guidance of Matthew P. Mumber, MD, of the Harbin Clinic in Rome, GA, had created the Cancer Patient Navigators of Georgia. I was so excited to be one of the founding members—having no idea what I was about to do with my life and career—but loving every moment of that highly inspired beginning. The concept of navigation seemed to be such an incorporation of every experience I had had up to that point in my life.
I applied to be the gynecology/oncology nurse navigator as Northside Hospital began their affiliation as a Cancer Institute through the National Cancer Institute Community Cancer Centers Program (recently renamed as the National Cancer Institute Community Oncology Research Program), and when Patti Owen, Director of Oncology, told me I was hired, I could hardly sit in my chair across from her desk. I remember telling her that I was considering stepping over her desk and hugging her. Gracious, lovely lady that she is, she simply smiled.
The Northside Hospital Cancer Institute Navigation Program has flourished and burgeoned into one of the largest navigation programs in the country, and I can truly say I love every moment of my job.
As for the little book I told Barb Sigler I would write? ONS had decided that much more was needed, and I asked our navigation coordinator, Kathleen Gamblin, to be a coeditor; then Karyl Blaseg, from the Billings Clinic in Montana, joined us as the third and lead editor of the first ONS published book on comprehensive nurse navigation, titled Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum.
This year, ONS has approved the companion book, Case Studies on Nurse Navigation, which we hope to publish in 2016. Our editors for this new book will be Kathleen Gamblin from Northside Hospital in Atlanta, GA, Margaret (Peg) Rummel from the University of Pennsylvania, and me.
When I was selected to present at the prestigious and incredibly well-attended Academy of Oncology Nurse & Patient Navigators (AONN+) conference last year, I looked out at all my fellow navigators with an overwhelming feeling of kinship and admiration for each individual who embraces this new specialty within our specialty. I am ever grateful that Lillie Shockney and Sharon Gentry had the confidence in me to let me speak at the elegant AONN+ conference.
My patients are all beautiful, heroic women who are given devastating and horrifying diagnoses that shatter their lives, and my job is to guide them through this incredibly treacherous set of diseases, so their lives and their families’ lives are filled with the highest possible quality of life. I am blessed to work with my patients through the entire continuum of their care.
As I look back on my journey, I can clearly say that there are, indeed, no coincidences, and every single experience I have had as a nurse has gently (and sometimes not so gently) guided me to this moment—the very best job I could ask for, and to bring my personal compendium of experience to be that guide for my precious patients.
In the interest of full disclosure, I can truly say that I have been blessed with a husband who has created an ever safe haven for me to come home to, and his outrageous sense of humor has sustained me in situations too numerous to mention. From the day he let me have his very precious drafting table, I knew he “got it,” and we would be a great team.
Cancer Support Services Outside of Clinical Settings: An Evaluation of LIVESTRONG Foundation’s Cancer Navigation Program
Katherine Treiman, PhD, MPH1; Carla Bann, PhD1; Linda Squiers, PhD1; Bree Hemingway, MPH2; Sarah R. Arvey, PhD2; Emily Eargle, MSSW2; Ruth Rechis, PhD2 1RTI International, Research Triangle Park, NC; 2LIVESTRONG [ Read More ]