Perspective Is Everything â€¦ a Turning of the Tables
An oncology nurse navigator learns just how essential the role is, when her own husband is diagnosed with melanoma and a colleague provided just the right support.
Penny Bauman, RN, OCN
This past spring I had a personal experience which totally altered my view of my vocation as an oncology nurse navigator. I very deliberately use the word vocation, because for me, navigation opened the door to an occupation that utilizes all of my capacities as an oncology nurse. And, with that realization, came that wonderful sense of peace that comes with discovering one’s true calling.
And thus begins my story: I was attending an ONS Congress presentation when I got the text from my husband saying, "Yep! It's melanoma." He was referring to the results of a biopsy from a small, odd-looking freckle on his back that the dermatologist biopsied the previous week.
Not only did that get my attention, but I had absolutely no idea what the rest of the presentation was about, and as soon as it concluded, I called him to hear him say that the dermatologist would remove it surgically. I, of course, told him that he would be going to Jonathan Lee, MD, a superb surgical oncologist (specializing in melanoma) at Northside Hospital Cancer Institute where I work. I also informed Bobby (my protesting husband) that resistance was futile and having been married to me for 44 years, he quietly agreed.
The following Monday I returned to work and called Penny Bauman, RN, OCN, Northside’s melanoma/sarcoma nurse navigator, and asked for her help. She called me back and asked if my husband could see Dr. Lee at 3 PM that same day! She met us there and stayed with us all during that initial visit—which was lengthy—meaning she had to drive home in the thick of our notorious Atlanta rush hour. She left smiling, and true to her nature, hugged Bobby and me, saying she would be with us all the way.
That Friday I drove my husband to the hospital at 7:30 AM, registered in the pre-op area, and suddenly experienced a personal paradigm shift: I wasn't the lab-coated nurse gliding through my hospital with the "just-between us exclusivity" of my professional self. No, today I sat down next to my husband—with all of the other family members who sat by those they cherished—and I was afraid for him, as the word melanoma turned into a small, ugly monster in my mind's eye, and I recalled some of the wide excisions we did in the operating room when I worked in Florida … knowing that 'little odd looking freckle' can be merely the tip of something dangerous indeed.
Along came Penny B, with her smile and that warm hug, and she was our sunshine for that terrifying morning. She came in after Bobby was tucked into his pre-op stretcher and was quietly and warmly supportive for us. She checked to see how Bobby did during the surgery and later came to the post-op visit with Dr. Lee just in case there were any questions. She was a quiet warm support, ever smiling.
Because my husband was a patient with an oncology nurse for a wife, it might have occurred to Penny B that she could have used her time somewhere else, but what did occur to her, as it occurs to all of us who are nurse navigators, is that here was a patient with an emergent and frightening diagnosis who could use some support to get through the experience, and a wife who was worried and frightened and who had been transformed from the stable persona of her professional role into a fearful human being who could really use that hug and that smile and that warm sense of support. Thankfully, my husband's melanoma was stage I and required no further treatment, but it was an “aha” moment for us both.
As a nurse navigator, I've come in to the hospital at 5 AM to be with a family during pre-op for support; I've come to the hospital to be with a dying patient who had her daughter's wedding skyped in; I've gone to patient funerals so that the patient's family will know that I truly realized the uniqueness of their loved one, and I've visited long-term patients in hospice, so they know I didn't drop them from my list when they left the hospital.
I support my patients in many intangible, unquantifiable ways, and occasionally, I wonder if I am just being too expansive in my interpretation of the navigator’s role. Yet, after my experience as a wife who was by her husband’s side through his cancer diagnosis and surgery, I can say that I now fully understand the breadth—and the depth—of our role as nurse navigators.
Sometimes at our multidisciplinary conference, when a doctor is asked if the patient is appropriate for navigation, he or she replies that the individual has good family support, and hence, no need for navigator referral. Having now assumed both roles—as a navigator, and even more so as a wife—I believe that every patient needs that warm smile, hug, and touch to guide them through the fear that inevitably replaces reason, when a cancer diagnosis collides with our everyday lives.
Penny Daugherty is an oncology nurse navigator specializing in gynecologic oncology and multiple myeloma at the Northside Hospital Cancer Institute in Atlanta. Penny Bauman is an oncology nurse navigator with the melanoma/sarcoma program at Northside.