Maggie McKay (Host): When you get a diagnosis of cancer, it's always scary, and it can send your mind racing with all kinds of questions. Today, we'll talk with oncology nurse and cancer nurse navigator, Cheryl Ryan, about how to maneuver the cancer journey at Community Memorial Healthcare.

Welcome to Wise and Well, a podcast presented by Community Memorial Healthcare. I'm your host, Maggie McKay. Thank you so much for joining us today, Cheryl.

Cheryl Ryan: Hi. Maggie. Thank you for having me.

Host: So, would you please introduce yourself to our audience and tell us a little bit about your background and education and experience?

Cheryl Ryan: Sure. My name is Cheryl Ryan. I'm a cancer nurse navigator. I have over 27 years of oncology experience, both inpatient as well as outpatient. I originally received my RN degree from Golden West College in 1997, and then my Bachelor of Science in Nursing from Western Governors University in 2014.

I initiated my RN program at Santa Barbara Cottage Hospital in the Inpatient Oncology Department. I worked for 10 years at Ventura County Hematology Oncology Specialist as an outpatient infusion nurse. I've been a nurse case manager at Community Memorial Healthcare. And then, most recently, I worked nine years at UCLA Hematology-Oncology as a charge nurse, a chemotherapy and biotherapy infusion nurse. I was working with clinical trials and educating patients and their families.

Host: What inspired or motivated you to become a nurse and eventually work with cancer patients?

Cheryl Ryan: Well, I think I just really enjoyed caring for people and hopefully being able to make a difference in their lives. I was introduced really early on in my career to oncology and I just always felt a strong calling. The oncology population, they're a very special group of people. And I've always enjoyed the relationships that I've developed and that I get to develop with both them, patients and their families. Oncology Nursing is very rewarding, and I've always felt drawn to be a part of the oncology care team.

Host: Tell us about your role as a cancer nurse navigator. Can you explain what that is in simple terms?

Cheryl Ryan: A cancer nurse navigator is a registered nurse who helps patients, families, and their caregivers with cancer care. A nurse navigator coordinates care, including helping with appointments, tests, and treatment plans. I help obtain records to make sure that they're there at the doctor's office when the patient goes to see them.

I use my knowledge and my expertise to educate patients and guide them through their cancer journey. Getting a cancer diagnosis is frightening and being a nurse navigator, I can provide emotional support. I can help be an advocate for the patients and their families. As a nurse navigator, we assess the patients and we identify and address their barriers to care. I work with all the entities in the county to facilitate care coordination. Most of all, I want to alleviate their fears and promote optimal outcomes for the patient.

Host: That's a lot of responsibility and probably a lot of organizational skills, I would think. Because I think back years ago when patients were kind of on their own and had to do their own planning and they're not feeling well and they're scared. So, thank goodness it's changed. How does your role differ from the role of an oncology nurse?

Cheryl Ryan: Well, I am a certified oncology nurse with the Oncology Nursing Society. I'm also certified in Administration of Biotherapy and Chemotherapy Medications. And an oncology infusion nurse is a very important role in the cancer team. But the difference of the role of a nurse navigator is that I get to offer individual assistance to patients and their families. I get to sit down with them, spend time with them, and help them overcome their healthcare system barriers, whatever those might be. I like to provide education and facilitate informed decision-making. It's real important to help them with timely access to quality healthcare. I can also help them with clinical trials, which can be a very important part of their treatment.

And it's very important to teach patients to be their own advocates, empower them to take control of their health, and make those informed decisions. At the Cancer Resource Center here at Community Memorial Health Care, we're focused on providing resources and facilitation of care. I work closely with our Oncology social worker to provide access to resources both internally and externally throughout our community. Whether it's their health, their psychosocial, it could be housing or finances, transportation, or even dietary. We work closely to get these patients to the health care that they need.

Host: Cheryl, what are the primary responsibilities of the Cancer Nurse Navigator at Community Memorial? Can you walk us through a typical day briefly?

Cheryl Ryan: Sure. I think my primary responsibility as a cancer nurse navigator is to identify the patient and their family's needs. Take that information and educate them and empower them. A typical day would look like for me, I might get a referral from a doctor from the Centers for Family Health, or maybe from the social worker in the hospital.

With that referral, I would either call the patient or I could visit them in the hospital. I would talk to them about their cancer diagnosis and answer their many questions. And among that, I would educate them about their cancer and their pathology and then take them on to the next steps, the treatment plans, what the doctor has in store for them and what the possible side effects of those treatments can be and how to manage them.

Overall, I do my best to help alleviate their fears. Sometimes that means that the patient and their families come in and we sit down and we put together some questions for them to take to their practitioners to their next appointments.. Also, as a nurse navigator, it's really nice, I can accompany the patient to their appointments. A lot of times, I'll sit with them and I'll take notes and listen so that afterwards we can talk about what was said in there and just reinforce some of the treatment plans. Often, I refer them to resources at our Cancer Resource Center here. We have support groups, nutritional consults, we even have Reiki therapy. As we talked about earlier, the cancer, it's a journey, it's a continuum. Patients have differing needs at different times. And as a cancer nurse navigator, I really love that I get to develop these relationships with them and these relationships can last years.

Host: I love that you can go with them and take notes because a lot of people don't have the the luxury of having somebody else to go with them, you know, maybe their spouse or their children have to work and can't get off work. So, just the fact that you can do that has got to be so helpful. And you know what? I always know when I go to the doctor, I forget everything I wanted to ask and I forget everything he told me afterwards. So, that's amazing. How do you help patients navigate Community Memorial's healthcare system during their cancer journey? And how do you collaborate with other healthcare professionals like doctors, social workers, therapists to provide care?

Cheryl Ryan: Well, Community Memorial Healthcare System is accredited by the American College of Surgeons Commission on Cancer. Together, we have a team of medical oncologists, radiation oncologists. We have surgeons, pathologists, dieticians, palliative care team, and social workers. We hold quarterly cancer committee meetings, and we attend weekly tumor board meetings where we talk about some of the more difficult cases. As a nurse navigator, I have really good relationships with the entire cancer care team and we all work together to ensure patients get the best care they need. We all want the same thing. We want the best outcome for our patients.

Host: Cheryl, how does having a cancer nurse navigator benefit patients? What specific outcomes or improvements have you seen?

Cheryl Ryan: I think a patient benefits from having a nurse navigator by simply having someone on their side. It helps to reduce anxiety and stress, and it helps them to become their own health advocates. Having a nurse navigator can help patients take an active role in their care, and then they're able to make informed decisions.

I have an example of a specific outcome, the recent patient that I encountered. She had a mammogram a year ago, October, and they found a spot on the mammogram. She was so nervous. She waited until May, May of this year, to get her biopsy, and the biopsy turned out positive. When I finally met her at the end of June, she still hadn't moved forward with any sort of care or treatment for this cancer, and it was at a curable stage at that point. So, we sat down and we talked a lot about what that meant, and we talked a lot about her fears. I offered to help her put together some questions for her practitioners. And then, like we talked about earlier, I went with her both to her medical oncology appointment as well as her surgery appointment. I took notes for her while we were in those appointments. And then, afterwards we sat down and talked about how those appointments went. And I answered some of her questions. By the next day, she called me and said she was ready to move forward. She wanted to get her mastectomy and get this cancer out. And that's what she did. She got her surgery and even though she had that delay in care, she had a very good outcome. We were able to alleviate a lot of her fear and get her the critical cancer treatment that she needed. She's doing very well today, and I get to see her on a regular basis when she comes in for some of our services here.

Host: That's amazing. You did touch on this a little bit, but how does your role help reduce stress and anxiety for patients and their families? You said that it definitely does by going with them and taking a lot of the work out of it.

Cheryl Ryan: Yeah, I think taking a lot of the work out of it, but also making it clear to them, simplifying things. And, you know, sometimes it takes multiple ways of being described something before it really clicks. And I think being able to have the time, that's what I have. I have valuable time that I'm able to sit down and spend with them.

And I think that is the number one way of helping to reduce stress and anxiety. I'm not rushed. I can sit down and spend time with them. I can see the weight come off of their shoulders by the time we're done talking. It's really nice to empower these patients and their loved ones. It promotes confidence in their treatment decisions. And as I said, it allows them to participate in their own care.

Host: Cheryl, how can patients get in touch with you for your services?

Cheryl Ryan: Well, we're at 2900 Loma Vista Road. They can just walk in. I have walk-in appointments. They can call me at 805-948-5459 or like, I said, they can just come in and see me. A lot of times, they'll get a referral from their doctor, but they don't need a referral to come and see us.

Host: That's great. Well, thank you so much for clarifying some very important issues regarding cancer and treatment. We appreciate it.

Cheryl Ryan: Thank you. Thanks for having me, Maggie.

Host: Of course. Again, that's Cheryl Ryan. And if you'd like to find out more, please visit mycmh.org/programs-services/cancercare, or just mycmh.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you.

I'm Maggie McKay. Thanks for listening to Wise and Well presented by Community Memorial Healthcare.