Guiding Lights: The Role of Cancer Navigators

September 2023 | Episode 3

Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast

SPEAKERS: Casey Gallant, Katherine Ghilani, Marcus Thorpe, Missy Gleason

 

Marcus Thorpe  00:14

Welcome to the wellness conversation and OhioHealth podcast, a show dedicated to exploring health and wellness topics to inform and educate. I'm your host Marcus Thorpe and I'm joined by my co-host, Missy Gleason.

 

Missy Gleason  00:26

Thank you, Marcus. And thank you for joining us. Today we delve into a world that remains for many behind the curtain of cancer care where expertise meets empathy, and where the journey of a patient is navigated with dedication and heart.

 

Marcus Thorpe  00:40

We're talking about the incredible work of cancer nurse navigators. These caregivers play a pivotal role guiding patients through every twist and turn on their cancer journey, ensuring they never feel alone. And today, we are honored to have two such navigators with us. So whether you're curious, you're looking to learn a little bit more or you just want to appreciate the hands that guide so many through their most challenging times. This episode is definitely for you. So Missy, let's dive in.

 

Missy Gleason  01:09

Our guests today are two cancer navigators from OhioHealth Katherine Ghilani, and oncology social work navigator in Casey Gallant and oncology nurse navigator. Thanks for being here.

 

Katherine Ghilani  01:19

Thank you.

 

Missy Gleason  01:20

So first off right off the bat, what do you do as a nurse navigator?

 

Casey Gallant  01:26

So we get this question a lot, because we cold call patients and introduce ourselves to them and try to explain who we are and what we do specifically to help them. So my you know, I guess I would say sales pitch is that we work for OhioHealth we are a system provided resource to patients after the point of their cancer diagnosis and through the remaining treatment and or survivorship or, you know, chronic disease. So whatever that looks like for the patient, we help them during that process with additional education, support, eliminating barriers to care. And I would say that's why we have social workers on our team, making sure patients can get to appointments and have food in their home. So just some of the real basic needs. But we work with them throughout the whole process to make sure they can get what essentially is potentially their life saving care to treat their cancer.

 

Missy Gleason  02:33

Would you say that your part of your role is removing barriers to that care, like emotional and social and logistical barriers?

 

Katherine Ghilani  02:43

Oh, absolutely. I mean, we when we think of patients, we think that you know, of course, you can talk about chemo and radiation and surgery, but you can't focus on those things if you're being let go from your job. So you don't have an income and the financial toxicity creates such an impact in your life that you can't pay your rent, and you're about to be evicted. You can't pay for utilities, you can't even pay for food. You know, it's so many patients have to decide whether they want to pay for food that week, or if they want to pay for a medication that's being recommended to them by the physician. So that's our job is to intervene so that they don't have to make those difficult decisions. And we can help make sure that they have everything that they might need without sacrificing any basic part of their care.

 

Marcus Thorpe  03:26

We're excited about this conversation because I do think that cancer journey when you first get a diagnosis, obviously it's overwhelming. But then it's not just about the diagnosis. It's navigating through that world. How did you both get into this specific role? What drew you to becoming cancer nurse navigators with OhioHealth?

 

Katherine Ghilani  03:49

 So I didn't really choose. This is kind of what I wanted to do forever. When I was seven, my mom passed away from breast cancer. So breast cancer and cancer in general has always been super important to me. And it's something that I've really focused on. When I was an undergrad, I interned with the Susan G. Komen Foundation, and they asked me what I wanted to do when I was a real adult. And when I explained to them exactly what I wanted to do, they said that sounds like social work. So I went to grad school for social work. And navigation just kind of came next. When I mentioned that cancer, I wanted cancer to be my main focus. So cancer has been a big part of my life and navigation just made the most sense with what I want to do.

 

Marcus Thorpe  04:33

Casey, you've been here for 10 years at OhioHealth. Tell us about your journey a little bit. How did you end up here and especially specifically within this space?

 

Casey Gallant  04:43

Yeah. So it's been a long road and I certainly like kind of like Katherine fell into it. I originally out of nursing school was working on a step down unit and quickly knew that that was not for me and my aunt happened to work in oncology and like a billing department. And she's like, we're hiring just come shadow. And so I did. And the rest is history, I started out in chemo infusion. And then I took a step. When I got to the point where I didn't have much more to grow there, I decided to go back to school, get my bachelor's, and then I came to OhioHealth. And at that point, I was in navigation, specifically for breast cancer. And then took a sideways turn and did survivorship for a couple of years. And now I'm back in navigation, again, specifically working with lung cancer and esophageal cancer patients. So it's kind of been all over.  Can you give an idea of what a typical day is like for you? So a typical day, one of the cool things is we have a lot of flexibility to really meet patients where they are. And I know a lot of us navigators really prefer to meet them in person if we can, making that face to face contact, really establishing that relationship and rapport with them earning their trust, so that we can help them along their journey. So kind of looking at your day, who's going to be in, you know, chemo? Who's going to be in the surgery office? Who's going to be in radiation? How can we make those connections, and then a lot of the rest of the time for me is is on the phone. So checking in making sure that side effects are being managed, that they're clear on their next steps, when their appointments are things like that.

 

Marcus Thorpe  06:33

You got into it a little bit there. But Katherine, I'll have you expand a little bit, can you talk about the role of the nurse navigator and how it's different from nursing or maybe other oncology roles within a traditional healthcare system.

 

Katherine Ghilani  06:46

So it's, like Casey said, there's a lot more flexibility. So we don't have a super defined role. And like what we focus on specifically, you know, like Casey mentioned, we have a list and we have a plan of what we want to do. But that's only about like, a quarter of the day, the rest of the day is getting cold calls from patients just kind of airing out some issues, like I can't pay my rent, I'm about to be evicted, the electricity was just turned off, I don't have a babysitter for my kids. So I can't come to chemo, I don't have a ride to my appointment. So it's really just waiting to hear exactly what the patient needs. We don't have like a, you know, a set guideline that we need to follow with what we do for each patient, the patient tells us what they need, and we see how we can meet them. In that way.

 

Marcus Thorpe  07:32

I love the fact that you both have such diverse backgrounds and what you've done even within the cancer space, right? You've done a lot of these different roles within even our cancer team. So when someone calls in, they have these questions. You've kind of lived those different worlds previously. So you have all that information, almost at your fingertips. Do you think that's an advantage for you to be able to connect? Because, you know, the inner workings of our cancer program? So well?

 

Katherine Ghilani  07:59

Oh, absolutely. I mean, we've both worked in patients. So it's like, you know, that side of when somebody's in an acute crisis, we both worked in survivorship. So we know the post cancer issues that come up. And now we're both in navigation. So we both work with patients kind of throughout the continuum of care. So it's, it's super beneficial to have every single piece of where we would need to help the patient and know exactly kind of what they might be going through at any specific time.

 

Marcus Thorpe  08:28

I know how hard you work. And when you're in your work, you don't have a chance sometimes to think about the impact as an outsider, I just hear and listen to the work that you do. And I think to myself, what the impact you must make on these on these families and on these individuals lives. So when you get that diagnosis of cancer, there has to be so much going on at that moment where it's hard just to understand and comprehend and be comfortable with even that treatment process. From an impact perspective. How do you play a role in understanding and being comfortable with just the treatment part of cancer itself?

 

Casey Gallant  09:05

That's a good question. You know, I think that we are background for me specifically really helps me have that comfortability having conversations with patients about, you know, their chemo and kind of having an understanding of what those drugs are and what the side effects are going to be and trying to be proactive and treating things and telling them when they need to call their medical oncologist or, you know, asking them what they know and if they need more information. Again, meeting them where they are. I think that's one of the main things that try to focus on when you're working with the patient through the process.

 

Marcus Thorpe  09:48

Yeah so important because, you know, you spend that initial time with your physician, but then you've got all this empty time to fill at home where you're, unfortunately I know I do this I'm sick, I go online, I start looking at things that are the wrong answers and are not where I want to be, but then to have you and your expertise available to people beyond that initial diagnosis must be so valuable for families. And I can imagine that going to the expert sources exactly where I would want to go. And that's why we have you on this team. And I think it's so incredible to think about.

 

Missy Gleason  10:22

We're joined today by cancer navigators, Katherine Golani. And Casey Gilad. One is Social Work navigator and one a cancer nurse navigator. So I would love to know, like, there's not a lot of organizations that have cancer navigators. So are there any common misconceptions when you first have that initial time with your patients that they are like, oh, is this what you do? And you have to kind of steer them in the right direction?

 

Katherine Ghilani  10:51

I think  the term social work or the career social work is just so broad, and the scope is so wide that people don't realize that getting involved in healthcare is something that we can do. They think of, you know, the protective services, part of social work and the emergency services, but they don't really think about helping somebody through a cancer diagnosis. So that's when I introduced myself as a social worker, I do get a lot of alarm from a patient, not really sure what angle I'm going to be approaching them at.

 

Marcus Thorpe  11:22

How about challenges maybe that you face in your everyday role? And how do you overcome some of that? I would imagine earning somebody's trust right off the bat. I mean, that's, that's a bit of a challenge. You know, you're walking into somebody's world for the very first time, I don't know if that's a challenge, or if there's other things that you see in your everyday work that you consider a challenge.

 

Casey Gallant  11:41

Yeah, I mean, there are a lot of challenges. One of the things I still feel like we deal with a lot is the stigma of cancer. And immediately, patients thinking that it means that they're going to die. And that's not the case. And very far from the case a lot of times nowadays. So educating, really like, identifying if there's medical literacy concerns, and just trying to meet the patient at the level that they're at. So we can help them understand really what we do, and terms that they can understand and getting them through. I think that's one of the big ones. I deal with a lot.

 

Katherine Ghilani  12:31

Yeah, and trying to help somebody understand, you know, a lot of people have this distrust of the medical system. So letting them know that I'm there to help them. My main focus is helping the patient, no other, you know, agenda, they're just letting them know that I want to help them any way I can, through kind of the complexities of the medical system that they already don't trust too much.

 

Missy Gleason  12:54

So I would say that probably earning that trust is very rewarding. But are there other moments and instances in your job that just feel like, this is why I do this.

 

Katherine Ghilani  13:05

We see a lot of people from a lot of different backgrounds, and a lot of social situations, whether they'll be homeless, not a citizen, you know, just very low health literacy. So being able to help somebody to get them a comfortable place to stay, getting them, making sure they have clothes on their back, making sure they have food in their home, just making sure that they have their most basic needs that people really take for granted. Making sure that they have everything that they might possibly need available to them and letting them know that there, there's always somebody there that they can ask for help or assistance. And that's not you know, specific to Casey and I it's the infusion nurses, it's the medical oncology team. It's the surgical team, it's, you know, everybody, there is there to work with them and for them and the community as well. I mean, there are so many cancer specific organizations that are there to assist financially, emotionally, logistically.

 

Marcus Thorpe  14:06

Yeah, it's a lot and to have partners is amazing. I'm sure to have people that are willing to step up and say, What do you need, we've got whatever you need is, is awesome. We've seen over the last year or so OhioHealth rolling out the keep making plans and specifically to the cancer space within the communities that we serve. How do you encourage your patients to keep making plans? I know it's one of those things where we want them to keep you know, during cancer treatment and knowing that there's, you know, a light at the end of the tunnel that we still want you to go out there and and spend time with your family and spend time with your friends. How do you encourage that within the work that you do every day?

 

Casey Gallant  14:47

I think for me, I'm always kind of encouraging to celebrate the milestones, you know, it's getting through your first treatment, okay, like got that down. Now we can move forward and once we get nearer to the And like celebrating the small every day things of, of getting through it. And I think also, sometimes having that conversation about the perspective is, it shifts, you know, when the storms, winds change, I guess I've heard this quote, you adjust your sales, you know, sometimes we look at cancer more as a chronic disease when we're dealing with it long term. And so trying to help the patient recognize that and know that they're still treatment options, and we're still moving forward, if that's what their goal is, and until things change. So trying to help them see that

 

Katherine Ghilani  15:43

There's a term we talk about a lot with patients and traumatic growth, where, you know, obviously, this is one of the worst things that can happen to a person, it's usually one of the worst things that happens in their life. But taking it and making it into a positive understanding that they have family and friends that are there that they probably didn't realize that they had, and previously, understanding that they're stronger than they think that they are, and really learning from, I guess, the difficult times that they've gone through and growing because of it.

 

Casey Gallant  16:15

And that happens so much of the time, patients realize at the end, that you know, they are stronger and something, they gained a pearl from it. It's not a desirable thing. Nobody wants to go through cancer, of course, but that's something good comes out on the other side.

 

Marcus Thorpe  16:33

It's awesome. Yeah, and you have a front row seat, and you're helping navigate them in that direction to which just got to warm your heart. It's why you do what you do. It's why you get up every day and work so hard to see that light go on or that pearl and it's awesome. It's really neat to think about it that way to talk about your role when it comes to just the the emotion of cancer and treatment and those than those things. I know you help with the logistics and and you help navigate and you help connect and those kinds of things. But this is an emotional journey for individuals and families. What role do you play when it comes to, you know, the mental health and the heart of it all? And things like that? What role do you think you play for these families and individuals in those cases,

 

Katherine Ghilani  17:21

I think it's easy to feel like you're alone. And that, you know, you can have a million people on your side family friends saying we're here for you let us know how we can help but it's still so isolating. So just being there to normalize what they're feeling and what they're experiencing, and letting them know that, you know, nothing that they're saying is unreasonable or outlandish, and that they have every right to feel the way that they do. I mean, we can't fix the way that they're feeling. But we can let them know that this is all part of the process. And that things will get better eventually, it's just taking things one day at a time.

 

Casey Gallant  17:56

I think listening for me a lot of especially when I was working in breast cancer navigation. As a female, we have so many emotions and hormones and all the things that play into it. And so listening and just being that set of ears that's there to support them. And a lot of patients don't really want to bombard their families with their worries, and they have children and you know, so they hold it all in until they can talk to someone who is at their level and can help them and so when we identify that a patient has a little bit more need than we can do through listening and you know, supporting, we do refer to social work or integrative care, we have a counselor, so we really try to help them along with some interventions that they might need more long term in those scenarios.

 

Marcus Thorpe  18:53

What about for you? I mean, this is heavy work. I mean, you're dealing with people's emotions daily, how do you take care of yourselves and your teammates? And when you know that somebody's gone through a rough stretch? How do you lean on each other for that I it's got to be important, I would imagine.

 

Katherine Ghilani  19:11

I think the job itself, sorry, is it's comforting and it's emotional, but it's seeing the patients get something out of it and seeing them, you know, start to brighten up and become more comfortable with us. Like that's, that's therapeutic in itself. We all do lean on each other and talk to each other about difficult cases. And I think that we have more positive stories than we do negative stories, and that makes all the difference in the world. It's nice though, to have nurses and we have dieticians on the team as well and just people that we can lean on to say this is a horrible situation and I can't imagine what this person is going through but somebody else can can be there to relate and understand what we're seeing from from our point of view

 

Marcus Thorpe  19:59

Your listening to the wellness conversation and OhioHealth podcast have a question or a topic suggestion, you can email us at podcasting@ohiohealth.com.

 

Missy Gleason  20:08

So looking ahead, I know that, you know, cancer navigators are something that we have at OhioHealth that not a lot of other health systems have. But obviously, we are not an organization that sits back and says, check done. So how has the role of like being a cancer navigator evolved over the years that you've been one? And how do you possibly see it changing in the future as well?

 

Casey Gallant  20:35

It's really grown. In the time I've been in cancer navigation. We've kind of I feel like spread our wings, you know, we're establishing our role more identifying where we can help more hiring on social workers and dieticians. So really offering those services for free to get patients through the process.

 

Katherine Ghilani  21:01

I think we have so much support from like administration and management that we can make this role kind of what we want it to look like, we have so much freedom that if we see a need, we can find a way or we can kind of pitch it to management and administration to say this is something that our patients really need, and they take it seriously. And, you know, especially when it comes to financial issues or medication issues, it's it's always taken seriously. So I feel like we kind of have we have more of a voice than the patients do. We have kind of those connections to the OhioHealth world to advocate for our patients. So it's really it's really cool to you know, we're growing in numbers, but we're also growing to help patients, I guess, get what they need the most.

 

Marcus Thorpe  21:49

We look at the future workforce. And you know, we've just started this new relationship with Columbus State. And we're looking for young talent that are coming through that pipeline, maybe there's some nurses or social workers that are maybe looking for a change in careers, and they might hear this and go, Oh, my gosh, that's where I need to be. I want to be on that team. Do you have some advice for those may be interested in looking into the cancer navigation space? What advice would you give someone who may be looking to either jumpstart a new career or maybe they are just getting started in this career?

 

Katherine Ghilani  22:22

I think volunteering and getting involved in cancer specific organizations is the absolute best thing I've ever done. Just knowing what's out there and being able to actually meet patients and understand what they're going through. I mean, the Susan G. Komen Foundation, Columbus Cancer Clinic cancer support community, like we have so many local cancer specific organizations that are you know, you can volunteer at and kind of get a front row seat to understanding exactly what patients need and what the job might entail or look like. Plus, I mean, you're making connections and you're networking.

 

Casey Gallant  22:59

I agree. And I think for me, having my background and oncology, just within fusion and navigation and survivorship, you kind of as you get your feet wet, kind of like they do with the new nurses on the floor. Stay in med surg for a little while, get to know it, feel comfortable with it, I feel that way about oncology, like, start out doing the groundwork, you know, figuring out what a patient goes through, and then all the pieces start to come together. And then when you're in navigation, you get the whole spectrum. And so then you've had it with your previous roles, and then you can bring it all together in navigation.

 

Missy Gleason  23:37

That's awesome. Casey, and Catherine, thank you so much for being here today. I really do hope that this episode serves as a way to help cancer patients or newly diagnosed understand your roles. Is there anything we missed today that you want to make sure we you let people know about your your jobs?

 

Casey Gallant  23:55

 I don't think so. Thank you guys so much.

 

Marcus Thorpe  23:58

Yeah, it's neat. You know, we both been in the organization for an awful long time, but to have folks like you come on, it just opens our eyes to the possibilities of that, what you said at the very beginning, you're not alone in this journey, like you have someone who's with you and an organization and team members like you that that want to be there anytime you need them. And I think that's, that's special. That's really neat. So we appreciate your time and your expertise. And we look forward to talking with you again sometime soon. Thank you. Thank you. So we thank you for joining us for this episode of the wellness conversation and OhioHealth podcast. Before we wrap up, we do invite you to follow us on all the major social channels to stay up to date on new episodes, and other health and wellness topics. And if you're looking for more information on OhioHealth services and locations, be sure to visit ohiohealth.com

 

Missy Gleason  24:48

And the information in this episode will also be available in written form on the OhioHealth wellness blog. You can find that@blog.ohiohealth.com Thanks for joining us and be sure to subscribe as we continue Our exploration of important health and wellness topics with OhioHealth experts