Breast Cancer Service
Fox Chase Cancer Center (FCCC) is 1 of 41 National Cancer Institute (NCI)-designated Comprehensive Cancer Centers (ie, “centers of excellence” in the United States. FCCC was one of the first institutions to be awarded the elite NCI designation, which it received in 1974. In July 2012, FCCC joined the Temple Health System.
FCCC is known for its nursing excellence, and this 100-bed hospital in Philadelphia consistently wins top ratings for treating all types of adult cancers. Its website states that FCCC offers “the best technology and the best people,” and 2 of its scientists have won the Nobel Prize.
FCCC is fertile ground for cancer research, with basic scientists and staff physicians working together to move important laboratory discoveries to patient care. In fact, new treatments and technologies are often available at FCCC before filtering down as standard care in community oncology practices. At any given time, FCCC has about 170 ongoing clinical trials, and FCCC offers excellent postdoctoral research opportunities.
More recently, FCCC has incorporated nurse navigators into management of several types of adult cancers. The Oncology Nurse-APN/PA spoke with FCCC’s breast cancer nurse navigator Jessie Schol, RN, BSN, OCN, about her role and the changing landscape of treatment for breast cancer.
What are you excited about right now in the field of oncology?
Jessie Schol (JS): Oncology has become more patient focused, and now we have more-specific therapies targeted to tumor biology instead of a “carte blanche” approach to cancer treatment. The emphasis is now on customer ser-vice, aiming to be responsive to the patient’s needs. The role of nurse navigator is a key component of that approach.
What is the approach to treating people with cancer at Fox Chase Cancer Center?
JS: We now have a “service line” approach for each type of cancer, with all of the doctors, nurses, nurse navigators, and schedulers collaborating to treat specific cancers. That way, the patient sees the same practitioners at each visit and has a comfort level in having the same people treat her/him week in and week out. In addition to the comfort level for patients, there is also a comfort level for the whole team.
The new-patient office and the nurse navigator are the first points of contact in the service line. The nurse navigator schedules all appropriate appointments and refers the patient to appropriate services.
How is this different from the previous model?
JS: Under the old system, the new-patient schedulers had the patient fax her report to the new-patient office, which would then send those reports to breast cancer nurses, and then appointments would be scheduled. This could take a week.
For the past 2 years, we have had 2 full-time breast cancer nurse navigators who serve as a contact/liaison before patients walk through the doors for the first time. Under the new system, a patient with breast cancer can call the nurse navigator directly, and then I or the other breast cancer nurse navigator, Tracey Newhall, can make a recommendation based on our conversation with the patient. This moves the patient through the system more quickly and alleviates anxiety.
We now have 7 different nurse navigators at Fox Chase: 2 for breast cancer, 1 for gynecologic cancers, 1 for gastrointestinal cancers, 1 for thoracic cancers, 1 for head and neck cancers, and 1 in the infusion room.
How does a patient with breast cancer enter the system at Fox Chase?
JS: Patients come to the nurse navigator either through the new-patient office, a direct phone call to the phone number on our website, a friend’s referral, or a physician’s referral.
What inspired you to become an oncology nurse?
JS: During nursing school, I met a nurse recruiter from Fox Chase whose enthusiasm about the oncology program was inspiring. I worked in FCCC’s nurse extern program while in nursing school and found it was a wonderful environment with loving and caring nurses. I felt that I could make a difference in patients’ lives by being an oncology nurse. The faculty at Fox Chase were very supportive. I love the changes in the practice of oncology. The field has evolved so that now we offer more outpatient services that allow patients to live their lives.
What advice do you have for nurses just entering the field?
JS: First, seek a strong, compassionate mentor. If the current mentor is not a good fit for you, don’t be afraid to speak out and request a change. One of the best pieces of advice I ever got from my mentor was to set tangible goals: look for one small change you can make every day, for example, to help a patient with her nausea. This sustains you. Look to your patients to get your satisfaction.
What would you be doing if you were not an oncology nurse?
JS: Honestly, I can’t see myself doing anything else that could give me the spiritual, emotional, and professional satisfaction that I get from my job. It is a great fit, and I feel that it is my calling.