Breast nurse navigators help guide patients through complex system
Story by Madeleine Leroux
Photos by Sally Ince
Being diagnosed with breast cancer, it can feel like the world around you has stopped.
But it hasn’t. And now that the diagnosis has been made, there’s a litany of doctor’s appointments, treatment options and more to be dealt with.
It can be a bit overwhelming, to say the least.
And that’s where the breast nurse navigators at Capital Region Medical Center come in.
Julie Phelps and Kara Thrash are the two navigators at CRMC’s Goldschmidt Cancer Center. Their jobs are to be there for a patient dealing with breast cancer and help them along the way, whether it’s coordinating appointments or sitting with the patient during treatment.
Phelps has been working at the cancer center for three and a half years, switching to the role of breast nurse navigator in January 2018, when CRMC launched its Breast Center of Excellence. Thrash joined the team a couple of months later, but began working in oncology in 2006.
The Breast Center of Excellence is a program facilitated by a team of local experts who work to reduce the anxiety a patient feels when being diagnosed and treated for breast cancer. The goal of the center was to provide support to patients throughout the process and coordinate their care, with the two breast nurse navigators at the core of the program.
Phelps was part of the effort to start the new program, which has been revised and tweaked many times in the nearly two years since it began. She said the focus is bringing together all the different departments that need to interact in the course of a patient’s treatment to emphasize collaboration.
“Our providers really see this as a team approach,” Phelps said. “I feel really fortunate to be here and be a part of this.”
Both Phelps and Thrash have a background in oncology nursing, Phelps said it’s always been her passion and being able to be a part of the beginning of the Breast Center of Excellence was perfect for her.
“There’s something really special about oncology patients to me,” Phelps said.
Kara Thrash and Julie Phelps
Thrash had been focused on women’s health and, after graduation, there was an opening in oncology, where she found a perfect fit.
At CRMC, Phelps and Thrash work well together, even remarking often that they can’t believe how similar they are to each other. Through work, they built a friendship.
When it comes to their roles as navigators, Phelps and Thrash said they come in once to the process once a biopsy is warranted. That’s when one of them will reach out to the patient, walk them through the process and even offer to attend the appointment with them.
“We reach out to the patient and just answer any questions they may have about the procedure,” Phelps said.
Thrash said even those who have close family to attend appointments with them have opted to have Phelps or Thrash there too, since they can be in the room during the biopsy, while family members can not.
“Some are so nervous that they just someone to go back there,” Thrash said. “I think we go with them more than I thought we would.”
After the biopsy, Phelps said results are typically available within two business days. The pathologist calls Phelps or Thrash with the results, and they then contact the patient. Thrash said sometimes they can expedite results to help when someone is particularly anxious. She noted that they ask patients at the start of the process whether they are willing to get results by phone — so far, almost all have said yes.
“I just think they want to know,” Thrash said.
If the diagnosis is breast cancer, she said, they jump into action, first asking what medical facility the person wants to seek treatment from. Though Phelps and Thrash work for Capital Region Medical Center, the pair said they help cancer patients regardless of what hospital the patient uses.
It’s at this point that Phelps and Thrash begin helping to sort out what can be “information overload,” as Thrash put it. They help coordinate and make appointments, and advise the patient on who they need to see and how they need to move forward.
“Our goal is to reduce any type of sleepless nights they may have,” Phelps said.
In this type of position, Thrash and Phelps can see a full range of emotions from patients — and be there to experience them with each person.
“We have really high highs and we have some low lows,” Phelps said. “We get really close to the patients. … We rejoice when treatment are done.”
Thrash recalled one patient who she had worked with who told her that she would never forget Thrash’s name after the whole process. Phelps recalled another where she sat with her during treatments early on, when the patient was not quite ready to tell her family.
“It is very personal,” Phelps said. “It was very emotional.”
When it comes to women going through their own battle with cancer, Thrash was quick to advise to stay off Google.
“It’s going to scare you to death,” Thrash said.
But most importantly, she said, it’s not a death sentence. Thrash said people often assume all cancer is the same, but there are different types of it and each person is different. One person’s experience isn’t necessarily going to be another’s.
And find help and support, even if it’s just giving Thrash and Phelps a call at CRMC.
“We’re here to help you get through these next stages,” Phelps said. “Please use us.”
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