Tag Archive for: nurse

Insist on Better Lung Cancer Care | Tips for Essential Communication

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Insist on Better Lung Cancer Care | Tips for Essential Communication from Patient Empowerment Network on Vimeo.

How can you advocate for the best lung cancer care? Lung cancer specialist Dr. Isabel Preeshagul provides an overview of lung cancer healthcare team members, reviews how treatment goals are determined, and shares advice for communication with your care team.

Dr. Isabel Preeshagul is a thoracic medical oncologist at Memorial Sloan Kettering Cancer Center. Learn more about Dr. Preeshagul.

See More From INSIST! Lung Cancer

Related Resources:

Non-Small Cell Lung Cancer Essential Testing | What You Should Know

Non-Small Cell Lung Cancer Essential Testing | What You Should Know

 Personalized Lung Cancer Treatment | Key Factors to Consider

Personalized Lung Cancer Treatment | Key Factors to Consider

 Understanding Currently Available Non-Small Cell Lung Cancer Treatments

Understanding Currently Available Non-Small Cell Lung Cancer Treatments

Transcript:

Katherine Banwell:

I’d like to start with a question pertaining to our series title, Insist. Why is it essential for patients to collaborate with their providers on care treatment decisions?  

Dr. Isabel Preeshagul:

So, collaborating is so important, right? I always tell my patients this is not a dictatorship, right? This is a collaborative effort where I’m here to guide you, but you are the captain of the ship. 

You are the one that needs to make all of the decisions, and I’m here to make sure that the ship goes in a smooth direction, so making sure we have open lines of communication that the patients and their caregivers feel comfortable talking to me and my team and also vice versa and that we trust each other. It’s so important because we are going for a marathon, right? We’re not going for a sprint. This is a long-term relationship, whether we’re treating for cure or we’re treating you with palliative intent and it’s treatable but not curable. We’re going to be following with each other for a long time.  

Katherine Banwell:

A lung cancer healthcare team, of course, consists of a number of different providers. Would you tell us about the various members on a team? 

Dr. Isabel Preeshagul:

Sure. So, there is – there are the people that do the scheduling, that make sure that the CAT scan is scheduled, that the MRI is done, your chemo gets scheduled, all of that. The schedulers are super important and an integral part of our team.  

And then we also have our office coordinators that answers the phone calls and passes along the messages and assists with scheduling and sort of sets expectations and is the face of the practice. Then you have an office practice nurse or an oncology practice nurse who is the doctor’s right hand, making sure that the patients get proper chemotherapy teaches, making sure that they understand about possible side effects, risks versus benefits, making sure medications are up to date, assessing symptoms.  

They are sort of the front line when it comes to any patient call they’re triaging, and they’re escalating or deescalating. That would be the office practice nurse. And then you have an advanced care practitioner, an APP. You either have a nurse practitioner or a PA that’s working with you that’s sometimes seeing patients independently, sometimes putting chemotherapy orders, you know, really serving as almost as another doctor. 

If for some reason there is something that the doctor’s not available to do, the doctor needs in a pinch, or my patients that are almost at long-term follow-up that are doing great that are just kind of coasting, I will share with my NP and make sure that they know her just as well as they know me. And sometimes there’s a fellow, or there’s a resident or there’s a med student that’s part of the team as well because see one, do one, teach one. It’s really important to teach those that are coming after you and serve as mentors and really include them in part of the team and part of the decision-making. And then you have the doctor that just kind of oversees everything.  

Katherine Banwell:

Of course. How would you define treatment goals for people with lung cancer? 

Dr. Isabel Preeshagul:

So, the goal of treatment, I think, is really contingent upon someone’s stage, but it’s also contingent upon what’s important to the patient, right? So, we have patients that are stage I all the way to stage IIIC that we treat with intention to cure.  

And patients that have stage IV disease, it’s treatable but not curable. So, I am very transparent with that as long as I have the information to have that discussion. With that being said, there are some patients with stage III disease or stage I disease that don’t really want treatment and want to focus on quality of life. And that’s okay too. And in which case, you know, at some point, their cancer will likely progress. How quickly or when that will happen, we don’t know. Could they pass from something else? It’s possible. But you really need to talk about what’s important to the patient, because it’s not always cut and dry.   

Katherine Banwell:

As you mentioned, Dr. Preeshagul, there are several different support members on a team. What would you say to patients or even care partners who can sometimes feel like they’re bothering their healthcare team with their questions and comments? 

Dr. Isabel Preeshagul:

So, we do get that concern a lot. And I always say, “I’m here for you 24/7. And, if it’s not me, it’s someone that’s just as qualified to answer your questions no matter what.” 

“And I would rather get a phone call at 3:00 a.m. than get a phone call at 9:00 a.m., and you need to go to the hospital right now or God forbid something happened. I get a phone call from someone in the ICU that you went overnight and terrible things happened. So, I want the phone calls to come through to keep you out of the hospital and keep you from going south. So, call me.” And I never try to – I don’t try to outline contingency plans or criteria of what would warrant a call, because then you end up getting in trouble.  

I always just tell my patient, “Think about how you’re feeling now in front of me. If you’re feeling any different than how you feel at this very moment, call me.”  

Empowering CLL Patients for Treatment and Survivorship

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Empowering CLL Patients for Treatment and Survivorship from Patient Empowerment Network on Vimeo.

How can chronic lymphocytic leukemia (CLL) experts help empower patients? Expert Dr. Danielle Brander explains ways that she helps her patients prepare for treatment and survivorship.

Dr. Danielle Brander is an Assistant Professor in the Division of Hematologic Malignancies & Cellular Therapy at Duke University Medical Center. Learn more about Dr. Danielle Brander.

Download Resource Guide   |  Descargar Guía en Español

See More from START HERE CLL

Related Programs:

BTK Inhibitor Treatment Side Effects: What CLL Patients Should Know

 Can CLL Patients Take a Break From BTK Inhibitors?

 Can Lifestyle or Supplements Impact CLL Treatment Response?

Can Lifestyle or Supplements Impact CLL Treatment Response?

Transcript:

Lisa Hatfield:

“As a CLL expert, how do you help empower your patients so they can get the most out of their CLL treatment and survivorship? How do you work with them as a team to make sure, I guess they’re having the best outcome they can?”

Dr. Danielle Brander:

Absolutely. So it starts at the start. I guess so for conversations, meaning for those that don’t need treatment right away building the relationship, understanding how I can help patients and their caregivers help, for example, they like to learn how much they want to know, what resources can I connect them with. And then I think it’s important for them to have other team members that they can go to and talk to and hear it from, because sometimes the same information we can just share in different ways or approach differently. The nurse on our team or our pharmacist or I work with a wonderful group of nurse practitioners and physician assistants as well. And so from the beginning, I want patients to feel free to ask the questions that come to mind.

It’s amazing, of course, during the course of the visit when you’re going over your labs and that, that sometimes it’s easy to forget the questions you came in with. So, of course, anytime you can write them down before coming in, write them down and then maybe prioritize because all of us…I think it’s hard to remember everything. So prioritizing the questions we want to make sure we get to and go over as well as know that these same questions are going to mean different things to you the longer you’re living with your CLL. And so it’s okay to ask the same questions. Again, there’s never a question that any of us mind going over several times. And then just know how the team can help you. You know, are you coming? How much information do you want?

How much input do you want us to put? And what is your importance and priority? At the end of the day, I want all patients to know no one knows what it is, like living with it. No one knows what’s most important as much as you and your family or your caregiver team does. And I learn just as much from patients and the way they share their experiences. There’s a lot we can look at a group of patients with CLL and say how different each patient’s experiences, who needs treatment or not, who has side effects or not. But no one’s going to know as much as as you do living with it. And it’s our hope to help you wherever you are in your journey or whatever ways that we can help you.

Lisa Hatfield:

Well, and I appreciate your comment that we can ask the same questions over and over if we need to. I know my oncologist when I first met with him, I felt guilty taking in more than two questions, but right before he moved, I took in a long, I rolled up a piece of paper, a long scroll, and I said, I have some questions for you, but I knew they were all repeat questions. But it does give us a little bit of peace of mind just hearing it again from somebody, especially in those initial phases of treatment, just hearing it, even if you have to hear it again and again. So thank you for mentioning that. It makes us feel a little more confident in taking those concerns to our providers, even if they’re repeated concerns. 

Lisa Hatfield:

Dr. Brander, it’s these conversations that help patients truly empower themselves along their treatment journey. And on behalf of patients like myself and those watching, thank you very much for joining us.

Dr. Danielle Brander:

Thank you for having me.

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Acute Myeloid Leukemia Care | Who Are the Essential Team Members?

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Acute Myeloid Leukemia Care | Who Are the Essential Team Members? from Patient Empowerment Network on Vimeo.

Acute myeloid leukemia (AML) care is not just monitored by an oncologist or hematologist – there’s an entire medical team. Dr. Jacqueline Garcia, an oncologist and AML researcher, shares an overview of the various members of the healthcare team and the role they play in overall care.

Dr. Jacqueline Garcia is an oncologist and AML researcher at the Dana-Farber Cancer Institute. Learn more about Dr. Garcia.

See More from Thrive AML

Related Resources:

Understanding AML Treatment Categories

 AML Treatment Decisions | Understanding Factors That Impact Your Options

 How Can You Thrive With AML Advice for Navigating Care.

Transcript:

Katherine Banwell:

Typically, there are a number of team members to care for a patient. Who is part of an AML healthcare team?  

Dr. Jacqueline Garcia:

Absolutely. We definitely cannot work on our own. Our team is very large, and it’s because these patients require a lot of support. At a bare minimum, a healthcare team will include at least one physician or an oncologist. The AML healthcare team might also include a second oncologist – that could be a bone marrow transplant doctor.  

Other members that are very critical include having a mid-leveler available that’s a physician assistant or a nurse practitioner. Often, an oncologist who runs a busy practice, who takes care of patients that could be very sick, like AML, they work in partnership with often very talented physician assistants and nurse practitioners. I know I do.  

In addition to that, I’m at an academic center so I’m super fortunate. I have really amazing and very smart hematology oncology fellows and residents that also follow to learn how to take care of patients. But we also, in the background, that patients don’t see – we have a pharmacist that helps us with making sure that drugs are prescribed correctly. They often call the patients with oral therapies to follow up. We have financial resource teams to help patients, to link them to LLS for support for bills that might come up, or transportation, or linking them up to other services that could help to defray or reduce costs.  

So, the healthcare team is quite extensive. But in terms of those that are patient-facing, it’s primarily the MDM that are mid-leveler. Some teams operate also with a nurse or a nurse care coordinator. That’s pretty common, too. And that person helps to not only schedule but also to answer pages or phone calls from patients if the medical team is not doing that.  

Katherine Banwell:

What about a social worker or psychologist? 

Dr. Jacqueline Garcia:

Oh. Yes. Yes. So, absolutely. So, every patient can be offered, if needed, access to an inpatient or outpatient social worker. Often, if my patients are admitted we have them see a social worker because that’s fairly seamless. Otherwise, for outpatient, if we identify any particular needs or there’s an interest, we’ll link them up with a social worker. This is the same that goes for physical therapy, or nutritionists, or those other ancillary services that can be really critical when patients are getting started.  

360 Myeloma Care | How Can a Social Worker Help?

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360 Myeloma Care | How Can a Social Worker Help? from Patient Empowerment Network on Vimeo.

When coping with a myeloma diagnosis, how can a social worker support you in your care? Yu Mee Song provides an overview of the role of a social worker in myeloma care and discusses the importance of speaking up about emotional issues and beyond.

Yu Mee Song, LCSW, OSW-C is a Social Work Program Coordinator at the Center of Excellence for Multiple Myeloma Program at Mount Sinai Hospital. Learn more about Yu Mee Song.

See More From Thrive CAR T-Cell Therapy

Related Resources:

How Can a Social Worker Help CAR T-Cell Therapy Care Partners

How Can A Social Worker Help CAR T-Cell Therapy Care Partners?

 The Value of Myeloma Support Groups and How to Join

The Value of Myeloma Support Groups and How to Join

 How to Access Myeloma Financial Resources

How to Access Myeloma Financial Resources

Transcript:

Yu Mee Song:

My name is Yu Mee Song. I am, a social work program coordinator in the Multiple Myeloma Program at Mount Sinai Hospital.  

Katherine Banwell:

Excellent.  

Yu Mee Song:

Thank you for having me.  

Katherine Banwell:

Thank you for joining us. Can you tell us more about the role of a social worker as it relates to myeloma care?  

Yu Mee Song:

First of all, I feel very, very fortunate to be working in the myeloma program amongst world-renowned myeloma specialists with a team of nurse practitioners, nurses, transplant and CAR T coordinators, patient navigators.  

And our social work team is a team of five. And we can receive referrals from any of these team members at any point in a patient’s journey, from the moment of diagnosis throughout their treatment trajectory in both the inpatient and the outpatient settings for emotional needs and support to practical needs. 

Katherine Banwell:

Yu Mee, when a myeloma patient comes to see you for the first time, what are some common concerns they might be having? 

Yu Mee Song:

That really depends on the – on the patient and – and where they are in their life situation when they’re diagnosed. You know, if they’re working, they may have considerations about reducing work or not working or not being able to. A lot of practical concerns, maybe the first issue that they have to deal with such as transportation and getting to and from the cancer center now three times a week, or navigating the healthcare system for the first time in their life, and insurance or just coping with the fact that you’re now dealing with the diagnosis of myeloma and what does that mean and how are you adjusting to this? So, it really varies.  

Katherine Banwell:

If patients are facing emotional issues, why is important for them to speak about it? And – and what support is available for them? 

Yu Mee Song:

That’s – that’s a great question that I always like to stress the importance of to the patients and also the caregivers because they’re usually the ones that first notice any changes, maybe in their mood or the emotional state.  

If you’re holding things in, you’re, you know, feeling like you’re alone in this fight or your fears of what might happen, that can increase your anxiety, it might lead to depression.  

So, it’s really important to speak about it, ask your care team about it. It may be as simple as, you know, that’s a side effect of a medication that you’re on, and maybe we can reduce the dose or maybe we can tell you to take it at a different time of day. 

And that’s so helpful to know that.  

There may be help for you. You may be referred to a mental health professional, support groups, and would also improve your – your relationships within your family because obviously your emotional state it’s – it, you know, myeloma is just not impacting you but all of the loved – people around you.  

Katherine Banwell:

That leads us into the next question. Some patients don’t have a partner to help them go through this – this journey with their myeloma. So, do you have any suggestions for how myeloma patients can find support and where? 

Yu Mee Song:

I would say, first start with asking your care team or ask – speaking with an oncology social worker. Support doesn’t necessarily mean your – your partner. It can be in the form of support groups that are either in-person, there are many groups online.  

It could be a peer – one-on-one peer support. Someone who’s gone through what you’ve gone through.   

How Nurses Can Promote Patient Education?

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This year has marked a significant shift in the way the average person receives care. In an attempt to protect patients from the coronavirus, more care facilities are conducting virtual appointments through telehealth as often as possible. But what does this mean for patient empowerment and education?

While there are many benefits to telemedicine, this medium of care can make it difficult to educate cancer patients and address all of their concerns. However, nurses can play a significant role in promoting patient education whether it be through virtual platforms or face-to-face.

Patient empowerment through education is a key element of care. To make the most of any situation, nurses must understand their role in promoting patient education and develop useful strategies for educating patients across a variety of mediums.

Here’s what you should know.

The Role of Nurses in Patient Education

When President Trump declared a national emergency because of the coronavirus pandemic, it initiated a legal expansion of telehealth services for millions of Americans. This brought about an explosion in telehealth options that had previously been more common for rural patients. Now, however, everyone from cancer to behavioral health patients is making frequent use of these systems, often with great results.

The importance of telehealth for the treatment of issues like behavioral health has reshaped the role that many nurses have in patient care, but it has not damaged the effectiveness of care. In fact, the majority of healthcare providers said telehealthcare was the same if not higher quality than traditional care.

To maintain this quality, the emphasis has been placed on forging bonds of effective communication, empowered by patient education. Among the many tasks of nurses in this process are the following:

Communicating with a physician while providing in-home care.

Especially in cancer treatment, strictly telehealth options are not going to cut it. Often, nurses will continue with in-home care strategies, which then require information to be relayed back to a primary physician.

Part of the job of a nurse is to maintain clear standards with the patient and the doctor, keeping them both informed on current health status and next steps. Patient education in this role can be a powerful tool in ensuring that the patient feels secure and cared for.

Facilitating consultations.

Additionally, nurses will act as facilitators of new telehealth communications with physicians either socially distancing or quarantining. This helps to keep all parties safe while assisting patients in using new tech.

Patients will come into an office, be screened by a nurse, have their vitals checked, and then begin a telehealth conference with a physician. Nurses must be prepared to answer a series of questions about the process and what can be expected, including assuaging concerns about the quality of telehealthcare. Patient education may be the most empowering form of care a nurse can offer in virtual visits like these.

Navigating new technologies.

With shifts in care processes come the need for nurses to adapt to new technologies. This can be difficult and requires flexibility and consistent communication with colleagues and patients.

In this role, it may be helpful for nurses to educate patients roughly on the ways new tech has changed care provisions and data management. Patients don’t necessarily need to navigate these systems themselves, but by educating them on how their data is stored and handled, you can help empower their security.

All these roles and more require nurses to educate patients regarding the care they are receiving, what they can expect, and the way systems have changed in what has become the new normal of health care. Nurses are often expected to serve as a communication bridge between physician and patient. Effectively achieving this means keeping the patient informed and up-to-date.

Luckily, there are some beneficial strategies to help nurses manage this colossal task.

Strategies for Promoting Patient Education

No matter the time or the health crisis at hand, nurses are some of the most important figures in patient education. These care professionals are the focal points of communication between physicians and patients, and as such will play significant roles in ensuring all patient questions get answered.

Whether you are operating through telehealth or in-person care, nurses can better promote patient education with the following strategies:

1. Maintain an empathetic approach.

No matter what role you end up occupying as a nurse, compassion and empathy will help you maintain a high standard for patient education. Empathy is essential to healthcare, as it allows providers to step into the shoes of patients and work out from there how best to help patients.

Empathy allows nurses to ask themselves what they would want to know at any point in the care process. They can then relay that info back to the patient in the form of quality education. By maintaining an empathetic approach, nurses put the human aspect back into healthcare.

Self-compassion is necessary for nurses as well, as they face high-stress environments that can quickly lead to burnout. Take some time for yourself to relax and de-stress.

2. Empower your patients.

Information is one of the most empowering tools that nurses have to offer patients. With proper health care education, patients are positioned to make informed decisions about their care options, giving them greater decision-making and financial power.

Nurses are instrumental in providing this empowerment. You can take your patients through questions, policies, standards, and even payment scenarios to keep them as informed as possible. In doing so, you will raise the standard for care through education.

3. Integrate tech solutions.

Wherever possible, introducing patients to new technologies can be a successful method of promoting education. From applications to facility patient portals, showing your patients how to navigate helpful technologies will put the power into their hands. Patients will be able to review their own records and information and can even track some of their own metrics through apps and wearables.

Healthcare tech is a teach-a-man-to-fish situation. If nurses educate patients on how to use the tools available to them, they will be better positioned to make valuable decisions regarding their own health.

With each of these strategies, nurses will be better positioned to provide patient education regardless of the role pandemic shifts have them play. Empathy will be key, then empowerment and tech solutions can offer patients unprecedented levels of quality in the outcome of their care. Promote patient education however you can to ensure that healthcare needs are met even in the middle of a public health crisis.

Additional Resources

  1. Tips to Improve Patient Education
  2. Teaching With Empathy: Why it’s Important