Selected Podcast
Cancer Care and COVID-19
Paulina Bruns, RN, discusses cancer care during the COVID-19 pandemic.
Featured Speaker:
Paulina Bruns, RN, BSN, OCN
Paulina Bruns, RN, BSN, OCN is a Nurse Navigator at Mercy UC Davis Cancer Center. Transcription:
Cancer Care and COVID-19
Introduction: This is Hello Healthy, a Dignity Health Podcast. Here's Bill Klaproth.
Bill Klaproth: So what do you need to know about cancer and COVID-19 and what exactly is a nurse navigator? Well, let's find out with Paulina Bruns, a Registered Nurse and Nurse Navigator at Mercy UC Davis Cancer Center. Paulina, thank you so much for your time. So first off, what is a nurse navigator?
Paulina Bruns: Sure. A nurse navigator is someone that would offer assistance to patients, families, caregivers, to help them overcome healthcare system barriers and to also help assist them to receive kindly access, quality healthcare, and psychosocial care from the diagnosis all the way through the phases of the cancer experience. Let's just say for an example that we have a patient that has just come into our cancer center and they're newly diagnosed, both the patient and the family, and perhaps maybe their caregivers are coming with them, and they're there to meet with a doctor. And the patient is told you have cancer and there's going to be lab tests, various scans, appointments and other healthcare provider visits, and the patient, you know, you're going to be possibly starting chemotherapy, radiation, maybe taking oral chemotherapy. And that list goes on for the patient and the family members, they just heard the words you have cancer and everything else that the doctor's now saying is becoming overwhelming because they're still trying to process that new diagnosis.
Well that's where the nurse navigator is introduced because that navigator can provide assistance to them. Essentially it's like taking their hand and saying, I'm here with you to help you through this. Let me explain the steps with you. Let me help you, you know, write it out, create calendars, write down those dates and times of those appointments because the navigators can also reach out to other team members for assistance when needed. We have access to social workers that can use like distress screening tools, and those tools also help to guide the social worker to pair resources and interventions to help alleviate stress. We also have registered dieticians that can help provide nutrition counseling. We have reimbursement specialists that can help with insurance questions so that nurse navigator can help those patients make those connections to those additional resources. And that's the goal essentially of a navigator is just to help our patients successfully navigate through the healthcare system and overcome those barriers to their care.
Host: It's such a great service. Paulina, are you then with the patient or the family from start to finish?
Paulina Bruns: Yes I am. I usually will be introduced at the time they come into the clinic here with a physician. If the physician feels that they need a little additional help, then I'm introduced for sure with the patients and just to make that first contact with them, you know, introduce myself, give them my phone number as a way that they can reach out to me with any questions or concerns that they have.
Host: So Paulina, we're in the COVID-19 era right now. I know some people are reticent to go to the hospital for certain procedures. What are some of the precautions the Cancer Center is taking to ensure patients can receive treatment in a safe environment?
Paulina Bruns: Great question. So what we're doing here at the Cancer Center is that we are screening everyone that enters our building. We're also having everyone that enters, wash their hands. We also have hand gel that's provided right there at the door. They're also performing temperature checks along with screening questions so that if anyone does arrive with say a fever, cough or any shortness of breath, we immediately provide a mask, isolate them from the rest of our patients so that the nurse and our physician can assess them to provide further direction or instructions. And we're definitely following the CDC and State recommendations, enforcing social distancing throughout the Cancer Center. We're also at this time requesting that no visitors come into our facility just as an additional precaution to provide protection for patients and staff. And then we also, as another added protection we have a team that comes in and they come and they clean our high traffic areas throughout the day, which can include like handrails, tables, counters, or even door handles. So we're being really diligent about those little details that can keep our patients and staff safe during this time.
Host: And it's those little details that are really important right now. So you mentioned the strict visitor policy. I just want to make sure that we're clear on that. Can patients bring a family member or friend with them to treatment? And if not, what is the cancer center doing to help these patients feel more comfortable and supported? Because that's important as well.
Paulina Bruns: Yes, it sure is. But at this time we are asking for no visitors in our facility. However, based on our patient population, we do recognize that there may be times when a friend or family may be requested and that is determined on a case by case basis in order to keep our patients and staff safe while providing quality care and keeping the patients at the center of our care. We understand that, you know, this is a big change in our practice for our patient population and they can feel separated from their friends and families. So we here at the Cancer Center, we want our patients to feel comfortable. One of the things we encourage them is that they can still bring their phones or tablets to be able to connect with their family or friends virtually using one of the many social platforms that are available. Also with prior approval from the physician or staff, phones can be used when patients are consulting with a physician, but again this is something that is determined case by case and with prior approval from the physician. Also the staff here is you know, really big on communication, so communicating with the patients, families or friends to keep them updated on how they're doing within our Cancer Center and when they're ready for pickup. And recently, due to this COVID-19 virus, we've had additional staff available to us on hand and they've been taking that extra time to sit with and visit with our patients so that they do not feel alone. Because our goal is to do our best and helping to make our patients feel comfortable, supported during this time.
Host: Hmm. That is so good. I love that. Comfortable and supported such great words that you use there and also want to ask you, are there other ways the staff are supporting cancer patients and their families during this time?
Paulina Bruns: Yes. At this time, through very generous donations, the Mercy UC Davis Cancer Center has been providing groceries to our more susceptible population, who are on active treatment and due to age and other health related issues puts them at a greater risk for contracting the COVID-19 virus. So our director here at the Cancer Center, Katherine and also our social worker Brittany, they have been making those deliveries to our patients who are the ones that are susceptible and at risk. And what's really nice is that this grocery program was put together to help protect our patients from possible exposure to the COVID-19 virus because otherwise they would be going to the stores to have to get those groceries themselves. So this just is another way to provide assistance and support to our patients during this time.
Host: That's so nice. So in other words, you're shopping for them basically. That is really nice. So speaking of shopping cancer patients are at a higher risk of illness from COVID-19. What are some things patients can do to help boost their immunity? And speaking of shopping, are there certain foods and other things that cancer patients should pay attention to?
Paulina Bruns: Right, great question. So we are still educating our patient population with the same information as before. When they're coming in for treatment, we do have a book on nutrition, it's called nutrition for the person with cancer during treatment and in there are specific suggestions that they can make to help boost their immune system. And a lot of the diets are different depending on what type of treatment that the patient is going through. So that's a book that we provide to our patients to assist them with that. It's something that we're already doing, but with the COVID-19 virus, we're just reemphasizing and reeducating them with this information. Also, another thing that they can do to help boost their immune system is just making sure that they're getting plenty of rest and most important to practice good hygiene habits. We're constantly educated through the news and through various things about making sure that we're practicing regular hand hygiene, staying away from people who are sick, washing our hands thoroughly with soap and water.
If we don't have the soap and water, then we're using an alcohol hand gel that contains at least 60% alcohol to fight that off. And it's also important to make sure that we're covering our costs and sneezes with tissues and throwing that away and rewashing hands. So lots of hand washing going on and making sure we're not touching our eyes, nose and mouth and making sure we're not doing unnecessary traveling or you know, being with crowds. Of course right now with the social distancing, that kind of helps with that aspect there. And then if we're, you know, we're at home more so we're just making sure we're disinfecting a lot of those high surface areas that we're touching and coming in contact with a lot. So just, you know, if you're not feeling well, make sure we're staying home and then if you aren't, you need to be giving the Cancer Center call and update us on how you're feeling so that we can provide further direction.
Host: And then Paulina for cancer patients, COVID-19 may put their stress into overdraft. I can't imagine what some of these people may be going through. What are some good ways to help manage stress and anxiety?
Paulina Bruns: Yes, we are definitely experiencing difficult times with this COVID-19 virus. Some may feel isolation because they may be by themselves or others might be, you know, together with their family, different circumstances but not being able to go out and do our daily activities as we used to can create high levels of anxiety and stress. So some of the recommendations that have been presented to us is to make sure that we are staying active as we can. We can still go for walks with social distancing in mind. We can also make calls to our friends and family, even see them virtually as we mentioned earlier, using various social platforms that help us to stay connected to one another cause that's important. I've also heard that some people are getting out older pictures and scrapbooking, some are drawing pictures, some are writing letters, mailing them to their friends and family. Just another way to stay connected. But one other really good piece of recommendation that was given to us was that we might need to limit some of the amount of news that we hear. Cause if we keep it on constantly and we're hearing it constantly, that can kind of create an increase in level of our anxiety and stress. So one option that they gave us for that was to maybe put on a movie instead or maybe watch a cooking show or whatever program. We really enjoyed watching something that makes us laugh. It might be a good idea too. So those are some of the suggestions that we've heard that can be good for helping to manage our stress and anxiety during this time.
Host: Really good suggestions again and like you said, turning off the news and just watching some TV that helps you escape for a while can really help you as well. And then Paulina, thank you for your time. This has been fantastic. Last question, what is the one thing you want cancer patients to know who may be unsure about coming to the Mercy UC Davis Cancer Center?
Paulina Bruns: Yes. We want our cancer patients to know that their safety is always at the forefront of what we do. With the COVID-19 virus, this has not changed our patients come first. That is why we've taken the extra steps to have that screener at the front door to monitor everyone. We have the additional cleaning staff coming in to clean those high surface areas, all in an effect to keep our patients safe. So that's the most important thing we want our patients to know is we're doing everything that we can to keep our cancer patients safe.
Host: Absolutely. Paulina, this has really been informative and insightful. Thank you so much for your time. We appreciate it.
Paulina Bruns: Thank you for inviting me.
Host: That's Paulina Bruns and to learn more about cancer services at the Mercy UC Davis Cancer Center, please visit dignityhealth.org/mersaid, and if you like what you've heard, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is Hello Healthy, a dignity Health podcast. I'm Bill Klaproth. Thanks for listening.
Cancer Care and COVID-19
Introduction: This is Hello Healthy, a Dignity Health Podcast. Here's Bill Klaproth.
Bill Klaproth: So what do you need to know about cancer and COVID-19 and what exactly is a nurse navigator? Well, let's find out with Paulina Bruns, a Registered Nurse and Nurse Navigator at Mercy UC Davis Cancer Center. Paulina, thank you so much for your time. So first off, what is a nurse navigator?
Paulina Bruns: Sure. A nurse navigator is someone that would offer assistance to patients, families, caregivers, to help them overcome healthcare system barriers and to also help assist them to receive kindly access, quality healthcare, and psychosocial care from the diagnosis all the way through the phases of the cancer experience. Let's just say for an example that we have a patient that has just come into our cancer center and they're newly diagnosed, both the patient and the family, and perhaps maybe their caregivers are coming with them, and they're there to meet with a doctor. And the patient is told you have cancer and there's going to be lab tests, various scans, appointments and other healthcare provider visits, and the patient, you know, you're going to be possibly starting chemotherapy, radiation, maybe taking oral chemotherapy. And that list goes on for the patient and the family members, they just heard the words you have cancer and everything else that the doctor's now saying is becoming overwhelming because they're still trying to process that new diagnosis.
Well that's where the nurse navigator is introduced because that navigator can provide assistance to them. Essentially it's like taking their hand and saying, I'm here with you to help you through this. Let me explain the steps with you. Let me help you, you know, write it out, create calendars, write down those dates and times of those appointments because the navigators can also reach out to other team members for assistance when needed. We have access to social workers that can use like distress screening tools, and those tools also help to guide the social worker to pair resources and interventions to help alleviate stress. We also have registered dieticians that can help provide nutrition counseling. We have reimbursement specialists that can help with insurance questions so that nurse navigator can help those patients make those connections to those additional resources. And that's the goal essentially of a navigator is just to help our patients successfully navigate through the healthcare system and overcome those barriers to their care.
Host: It's such a great service. Paulina, are you then with the patient or the family from start to finish?
Paulina Bruns: Yes I am. I usually will be introduced at the time they come into the clinic here with a physician. If the physician feels that they need a little additional help, then I'm introduced for sure with the patients and just to make that first contact with them, you know, introduce myself, give them my phone number as a way that they can reach out to me with any questions or concerns that they have.
Host: So Paulina, we're in the COVID-19 era right now. I know some people are reticent to go to the hospital for certain procedures. What are some of the precautions the Cancer Center is taking to ensure patients can receive treatment in a safe environment?
Paulina Bruns: Great question. So what we're doing here at the Cancer Center is that we are screening everyone that enters our building. We're also having everyone that enters, wash their hands. We also have hand gel that's provided right there at the door. They're also performing temperature checks along with screening questions so that if anyone does arrive with say a fever, cough or any shortness of breath, we immediately provide a mask, isolate them from the rest of our patients so that the nurse and our physician can assess them to provide further direction or instructions. And we're definitely following the CDC and State recommendations, enforcing social distancing throughout the Cancer Center. We're also at this time requesting that no visitors come into our facility just as an additional precaution to provide protection for patients and staff. And then we also, as another added protection we have a team that comes in and they come and they clean our high traffic areas throughout the day, which can include like handrails, tables, counters, or even door handles. So we're being really diligent about those little details that can keep our patients and staff safe during this time.
Host: And it's those little details that are really important right now. So you mentioned the strict visitor policy. I just want to make sure that we're clear on that. Can patients bring a family member or friend with them to treatment? And if not, what is the cancer center doing to help these patients feel more comfortable and supported? Because that's important as well.
Paulina Bruns: Yes, it sure is. But at this time we are asking for no visitors in our facility. However, based on our patient population, we do recognize that there may be times when a friend or family may be requested and that is determined on a case by case basis in order to keep our patients and staff safe while providing quality care and keeping the patients at the center of our care. We understand that, you know, this is a big change in our practice for our patient population and they can feel separated from their friends and families. So we here at the Cancer Center, we want our patients to feel comfortable. One of the things we encourage them is that they can still bring their phones or tablets to be able to connect with their family or friends virtually using one of the many social platforms that are available. Also with prior approval from the physician or staff, phones can be used when patients are consulting with a physician, but again this is something that is determined case by case and with prior approval from the physician. Also the staff here is you know, really big on communication, so communicating with the patients, families or friends to keep them updated on how they're doing within our Cancer Center and when they're ready for pickup. And recently, due to this COVID-19 virus, we've had additional staff available to us on hand and they've been taking that extra time to sit with and visit with our patients so that they do not feel alone. Because our goal is to do our best and helping to make our patients feel comfortable, supported during this time.
Host: Hmm. That is so good. I love that. Comfortable and supported such great words that you use there and also want to ask you, are there other ways the staff are supporting cancer patients and their families during this time?
Paulina Bruns: Yes. At this time, through very generous donations, the Mercy UC Davis Cancer Center has been providing groceries to our more susceptible population, who are on active treatment and due to age and other health related issues puts them at a greater risk for contracting the COVID-19 virus. So our director here at the Cancer Center, Katherine and also our social worker Brittany, they have been making those deliveries to our patients who are the ones that are susceptible and at risk. And what's really nice is that this grocery program was put together to help protect our patients from possible exposure to the COVID-19 virus because otherwise they would be going to the stores to have to get those groceries themselves. So this just is another way to provide assistance and support to our patients during this time.
Host: That's so nice. So in other words, you're shopping for them basically. That is really nice. So speaking of shopping cancer patients are at a higher risk of illness from COVID-19. What are some things patients can do to help boost their immunity? And speaking of shopping, are there certain foods and other things that cancer patients should pay attention to?
Paulina Bruns: Right, great question. So we are still educating our patient population with the same information as before. When they're coming in for treatment, we do have a book on nutrition, it's called nutrition for the person with cancer during treatment and in there are specific suggestions that they can make to help boost their immune system. And a lot of the diets are different depending on what type of treatment that the patient is going through. So that's a book that we provide to our patients to assist them with that. It's something that we're already doing, but with the COVID-19 virus, we're just reemphasizing and reeducating them with this information. Also, another thing that they can do to help boost their immune system is just making sure that they're getting plenty of rest and most important to practice good hygiene habits. We're constantly educated through the news and through various things about making sure that we're practicing regular hand hygiene, staying away from people who are sick, washing our hands thoroughly with soap and water.
If we don't have the soap and water, then we're using an alcohol hand gel that contains at least 60% alcohol to fight that off. And it's also important to make sure that we're covering our costs and sneezes with tissues and throwing that away and rewashing hands. So lots of hand washing going on and making sure we're not touching our eyes, nose and mouth and making sure we're not doing unnecessary traveling or you know, being with crowds. Of course right now with the social distancing, that kind of helps with that aspect there. And then if we're, you know, we're at home more so we're just making sure we're disinfecting a lot of those high surface areas that we're touching and coming in contact with a lot. So just, you know, if you're not feeling well, make sure we're staying home and then if you aren't, you need to be giving the Cancer Center call and update us on how you're feeling so that we can provide further direction.
Host: And then Paulina for cancer patients, COVID-19 may put their stress into overdraft. I can't imagine what some of these people may be going through. What are some good ways to help manage stress and anxiety?
Paulina Bruns: Yes, we are definitely experiencing difficult times with this COVID-19 virus. Some may feel isolation because they may be by themselves or others might be, you know, together with their family, different circumstances but not being able to go out and do our daily activities as we used to can create high levels of anxiety and stress. So some of the recommendations that have been presented to us is to make sure that we are staying active as we can. We can still go for walks with social distancing in mind. We can also make calls to our friends and family, even see them virtually as we mentioned earlier, using various social platforms that help us to stay connected to one another cause that's important. I've also heard that some people are getting out older pictures and scrapbooking, some are drawing pictures, some are writing letters, mailing them to their friends and family. Just another way to stay connected. But one other really good piece of recommendation that was given to us was that we might need to limit some of the amount of news that we hear. Cause if we keep it on constantly and we're hearing it constantly, that can kind of create an increase in level of our anxiety and stress. So one option that they gave us for that was to maybe put on a movie instead or maybe watch a cooking show or whatever program. We really enjoyed watching something that makes us laugh. It might be a good idea too. So those are some of the suggestions that we've heard that can be good for helping to manage our stress and anxiety during this time.
Host: Really good suggestions again and like you said, turning off the news and just watching some TV that helps you escape for a while can really help you as well. And then Paulina, thank you for your time. This has been fantastic. Last question, what is the one thing you want cancer patients to know who may be unsure about coming to the Mercy UC Davis Cancer Center?
Paulina Bruns: Yes. We want our cancer patients to know that their safety is always at the forefront of what we do. With the COVID-19 virus, this has not changed our patients come first. That is why we've taken the extra steps to have that screener at the front door to monitor everyone. We have the additional cleaning staff coming in to clean those high surface areas, all in an effect to keep our patients safe. So that's the most important thing we want our patients to know is we're doing everything that we can to keep our cancer patients safe.
Host: Absolutely. Paulina, this has really been informative and insightful. Thank you so much for your time. We appreciate it.
Paulina Bruns: Thank you for inviting me.
Host: That's Paulina Bruns and to learn more about cancer services at the Mercy UC Davis Cancer Center, please visit dignityhealth.org/mersaid, and if you like what you've heard, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is Hello Healthy, a dignity Health podcast. I'm Bill Klaproth. Thanks for listening.