Selected Podcast
Treating the Person, Not Just the Disease
In this powerful panel discussion Karen Ciardullo RN, BSN and Kiamesha Dolson-Ostrander, LMSW share information on the Littman Cancer Center's patient navigation program and the importance of helping patients deal with every aspect of their cancer journey.
Featured Speakers:
Karen Ciardullo, RN has been with the Montefiore St. Luke's Cornwall team since August 2013 and accepted the position with the Littman Cancer Center as Nurse Navigator and Clinical Coordinator in February 2018. karen was previously an inpatient nurse at the Newburgh campus where she routinely cared for and supported patients with cancer-related symptoms and needs. She has applied her medical experience and continued dedication to oncology care to address questions and concerns presented by patients and their families. Karen also coordinates the Lung Cancer Screening Program to promote early detection and treatment. She also facilitates support groups for cancer survivors two times per month.
Kiamesha Dolson-Ostrander, LMSW | Karen Ciardullo, RN, BSN
Kiamesha Dolson-Ostrander, LMSW joined the Montefiore St. Luke's Cornwall team in April 2018 as the Oncology Social Worker for the Littman Cancer Center. She has incorporated her extensive background in trauma-informed and evidence-based practices to support the patients and families experiencing psychosocial barriers and stressors related to their cancer diagnosis. In addition to oncology, Kiamesha has a pivotal role working alongside the MSLC Palliative Care team, providing support throughout difficult decisions regarding patients with advanced illness. AS the lik between oncology and palliative care, Kiamesha guides and supports patients and families at every phase of their cancer journey. She also facilitates support groups twice a month for caregivers and patients or family members who have been impacted by cancer diagnosis and treatment.Karen Ciardullo, RN has been with the Montefiore St. Luke's Cornwall team since August 2013 and accepted the position with the Littman Cancer Center as Nurse Navigator and Clinical Coordinator in February 2018. karen was previously an inpatient nurse at the Newburgh campus where she routinely cared for and supported patients with cancer-related symptoms and needs. She has applied her medical experience and continued dedication to oncology care to address questions and concerns presented by patients and their families. Karen also coordinates the Lung Cancer Screening Program to promote early detection and treatment. She also facilitates support groups for cancer survivors two times per month.
Transcription:
Treating the Person, Not Just the Disease
Melanie Cole (Host): If you’ve been diagnosed with cancer; your world is spinning. Where do you turn? Who do you talk to, to help you guide through that maze of cancer care? My guests to tell us about this in this panel discussion today are Kiamesha Dolson-Ostrander, she’s a Montefiore St. Luke’s Cornwall Oncology social worker and Karen Ciardullo, she’s a Montefiore St. Luke’s Cornwall Nurse Navigator and Clinical Coordinator of oncology services. Ladies, I’m so glad to have you with us. So many people go through this and they don’t know what to do next. So, Karen, I’d like to start with you. What is an oncology nurse navigator?
Karen Ciardullo RN (Guest): So, I’m a Registered Nurse with specialty in oncology. I’m chemo biotherapy certified, and it is up to me to be able to teach them about chemotherapy drugs, about their disease, answer any questions. Also we do navigation which is we try to find grants to help make it more feasible for the patient while they are in treatment and try and help them with community resources.
Host: Kiamesha, tell us what happens. You are a social worker in oncology. What happens when a patient first finds out that they have cancer? What is their first step? What are they supposed to do?
Kiamesha Dolson-Ostrander, LMSW (Guest): Usually what happens after they have met with their oncologist and their family to discuss treatment options; they usually meet with us when they start treatment. And what that involves is going over any psychosocial barriers that may have been identified before treatment starts. So, that could be financial, it could be working with family and partners for transportation, insurance and other physical limitations that come along with the disease.
Usually patients are very scared. They are nervous and they don’t know what to expect. So, we try to help them understand what the process looks like.
Host: How do they connected with you guy Kiamesha?
Kiamesha: Usually they are connected with us through a patient referral process from the medical oncologist or our radiation oncologist. So, they would contact us either by phone, email or fax to let us know the patient is in need.
Host: Karen, then speak a little bit about the Littman Cancer Center’s Patient Navigation Program. How fast as Kiamesha said, they get going with you guys. How long does all of this take? Because there’s a lot of moving pieces.
Karen: Right. So, we meet them – we are supposed to call them within the first 24 to 48 hours if they are referred from outpatient. If we see them in radiation, we see them on their first treatment or their first treatment day. And we start working with them from that day through their whole process of treatment. We still continue to follow them after they are done with treatment if needed. But depending on what barriers they have; it take different amounts of time. Like if it’s transportation; there is not a lot of transportation services out there, but we try to invest all our resources being with grants. We will submit grants that day if we can find funding for that type of cancer. So, it varies but we start working on it immediately.
Host: Kiamesha, tell us how you help patients deal with so many different aspects in their cancer journey, not just the physical part as Karen discussed telling them about chemo and getting transportation. But there’s that psychosocial, emotional, the fear, family fear. Tell us about what you do.
Kiamesha: Usually what I try to do is to meet with the patients and their families and normalize their feelings and the concerns. They are not alone in this process. As we treat the patients, we are looking beyond the disease. So, looking beyond that disease includes looking at their hopes, their goals, their dreams, things that make them who they are and reassuring them that those things will not end because they have a cancer diagnosis, or they are going through cancer treatment. So, it’s a lot of reassurance, a lot of support, normalizing their fears and concerns as well as their families.
Host: What are some of their other concerns that they make clear to you?
Kiamesha: Some of their other concerns can be seeing their grandchildren either graduate high school, see them born, see their adult children getting married, spending the rest of their lives with their partner, being able to be home more, doing outside activities; all those things that were going on before they were diagnosed with cancer and before they started treatment. It’s almost as though there is this disruption in their life and their fear and concern is will that disruption ever end.
Host: Yeah, that’s a good point. Because it is certainly hard to see the end of the tunnel when you are just starting this whole process. So, Karen tell us a little bit about money. Because can you guys help them navigate that very confusing financial world of cancer treatment and is there a charge for patient navigation?
Karen: No, there is no charge for patient navigation. It is done like we said before, through the referral service. And it doesn’t cost the patients anything to be involved with navigation services. We do try to help them with their finances if needed by getting them the grants or helping them with bank statements or mortgage questions or stuff like that. But I mean obviously, we can’t fund everything, but we do go above and beyond to try to help make it a little bit better for the patient and their family. We also do – we also work with a company that will deliver food to the houses once a week if you have kids under 18 and I think that that’s a big thing for especially our younger patients that are worried so much about their kids and making sure that they have food on the table especially with copays and all that worry.
Host: What a great service that you ladies are providing at such an important time in somebody’s life. Kiamesha, tell us a little bit about support services. Are there groups where they can go and talk about their fears? Is it mostly one on one? Do the families get to go to some of these support services? Tell us a little bit about how that part works.
Kiamesha: So, we do have some support groups that we offer on campus at the Cornwall location. We offer those in the evenings on each Wednesday of the month. So, depending on what the group is; each Wednesday will be different. We have a survivors group, a caregivers group. We have a breast cancer options group and a general support group. So, what those do is they offer a platform for patients or patients that have already completed treatment and their families as well to come and sit down and discuss what they are going through. Seeking that support from each other, whatever stage they are at throughout their journey and getting that reassurance that that are not alone. So, families are more than welcome to come. Our caregivers group is more aimed at those who are caring for family members that are going through this illness, however, we do encourage them to bring their family members as well so that they can understand that this isn’t necessarily a burden, this is something that caregivers have taken on and they just need that emotional support as well.
Karen: We also have a nutritional support group to help patients that are having difficulty eating or to learn what things they can eat through this diagnosis. Because a lot of times, when patients lose weight, they don’t realize ways that they can bring it up. So, we do have a nutritional support group with a registered dietician.
Host: It is such a confusing time and besides the social aspect and the process; Kiamesha tell us your role as a palliative care and oncology – you’re kind of the liaison in that respect and tell people what you do with palliative care. What does that mean?
Kiamesha: So, palliative care is a supportive service that is usually introduced when a patient has a recurrent or metastatic disease. So, what that looks like is we have a palliative care physician, nurse practitioner and then a social worker which is myself and we are there to support patients and their families, help them manage symptoms and prepare them for what life looks like living with a chronic illness. So, we are kind of coming in sometimes during the later stages of the disease to really help them more look at quality of life over quantity. Because at the end of the day, what our patients and families want is that time together.
Host: That’s so important. Karen, first last word to you. What would you like the listeners to know about the Littman Cancer Center’s Patient Navigation Program, how to get in touch with you all and what you can do for them?
Karen: Well, I would like them to know that we’re here to help them and their families. They can call us either at the radiation center or they can call us on our cell phones. We do have rap cards that we give out to the doctor’s offices or they can just ask their doctor to refer them to us and we would be happy to help make their journey a lot better.
Host: Kiamesha, tell us what you want patients to take away from this segment about the need and the way to ask for help. Because sometimes people don’t want to, sometimes the caregiver doesn’t want to, but kind of wrap it up for us in how important it is for patient navigation, palliative care, all of these support services when someone is diagnosed with cancer.
Kiamesha: What I would like patients and families, anyone that is going through this kind of situation is that reaching out and asking for help is okay. Cancer is a disease that is not just affecting the individual, but it affects the entire family. As I mentioned earlier, it’s a disruption to their everyday life. So, I would hope that patients, physicians, family members, anyone that is listening to this understands that they are not alone and asking for that additional support is for them to improve their quality of life, to help them through this process, to take away some of the stress and burden that comes along with it.
Host: That’s great information. Thank you, ladies, for coming on and thank you for all the wonderful work that you are both doing to help cancer patients. It’s such an important position. Thank you again. For an appointment please call the Littman Cancer Center at 845-458-4444 or go to www.montefioreslc.org for more information and to get connected with one of our providers. If you found this podcast informative, please share on your social media and be sure to check out all the other helpful podcasts in our library. I’m Melanie Cole.
Treating the Person, Not Just the Disease
Melanie Cole (Host): If you’ve been diagnosed with cancer; your world is spinning. Where do you turn? Who do you talk to, to help you guide through that maze of cancer care? My guests to tell us about this in this panel discussion today are Kiamesha Dolson-Ostrander, she’s a Montefiore St. Luke’s Cornwall Oncology social worker and Karen Ciardullo, she’s a Montefiore St. Luke’s Cornwall Nurse Navigator and Clinical Coordinator of oncology services. Ladies, I’m so glad to have you with us. So many people go through this and they don’t know what to do next. So, Karen, I’d like to start with you. What is an oncology nurse navigator?
Karen Ciardullo RN (Guest): So, I’m a Registered Nurse with specialty in oncology. I’m chemo biotherapy certified, and it is up to me to be able to teach them about chemotherapy drugs, about their disease, answer any questions. Also we do navigation which is we try to find grants to help make it more feasible for the patient while they are in treatment and try and help them with community resources.
Host: Kiamesha, tell us what happens. You are a social worker in oncology. What happens when a patient first finds out that they have cancer? What is their first step? What are they supposed to do?
Kiamesha Dolson-Ostrander, LMSW (Guest): Usually what happens after they have met with their oncologist and their family to discuss treatment options; they usually meet with us when they start treatment. And what that involves is going over any psychosocial barriers that may have been identified before treatment starts. So, that could be financial, it could be working with family and partners for transportation, insurance and other physical limitations that come along with the disease.
Usually patients are very scared. They are nervous and they don’t know what to expect. So, we try to help them understand what the process looks like.
Host: How do they connected with you guy Kiamesha?
Kiamesha: Usually they are connected with us through a patient referral process from the medical oncologist or our radiation oncologist. So, they would contact us either by phone, email or fax to let us know the patient is in need.
Host: Karen, then speak a little bit about the Littman Cancer Center’s Patient Navigation Program. How fast as Kiamesha said, they get going with you guys. How long does all of this take? Because there’s a lot of moving pieces.
Karen: Right. So, we meet them – we are supposed to call them within the first 24 to 48 hours if they are referred from outpatient. If we see them in radiation, we see them on their first treatment or their first treatment day. And we start working with them from that day through their whole process of treatment. We still continue to follow them after they are done with treatment if needed. But depending on what barriers they have; it take different amounts of time. Like if it’s transportation; there is not a lot of transportation services out there, but we try to invest all our resources being with grants. We will submit grants that day if we can find funding for that type of cancer. So, it varies but we start working on it immediately.
Host: Kiamesha, tell us how you help patients deal with so many different aspects in their cancer journey, not just the physical part as Karen discussed telling them about chemo and getting transportation. But there’s that psychosocial, emotional, the fear, family fear. Tell us about what you do.
Kiamesha: Usually what I try to do is to meet with the patients and their families and normalize their feelings and the concerns. They are not alone in this process. As we treat the patients, we are looking beyond the disease. So, looking beyond that disease includes looking at their hopes, their goals, their dreams, things that make them who they are and reassuring them that those things will not end because they have a cancer diagnosis, or they are going through cancer treatment. So, it’s a lot of reassurance, a lot of support, normalizing their fears and concerns as well as their families.
Host: What are some of their other concerns that they make clear to you?
Kiamesha: Some of their other concerns can be seeing their grandchildren either graduate high school, see them born, see their adult children getting married, spending the rest of their lives with their partner, being able to be home more, doing outside activities; all those things that were going on before they were diagnosed with cancer and before they started treatment. It’s almost as though there is this disruption in their life and their fear and concern is will that disruption ever end.
Host: Yeah, that’s a good point. Because it is certainly hard to see the end of the tunnel when you are just starting this whole process. So, Karen tell us a little bit about money. Because can you guys help them navigate that very confusing financial world of cancer treatment and is there a charge for patient navigation?
Karen: No, there is no charge for patient navigation. It is done like we said before, through the referral service. And it doesn’t cost the patients anything to be involved with navigation services. We do try to help them with their finances if needed by getting them the grants or helping them with bank statements or mortgage questions or stuff like that. But I mean obviously, we can’t fund everything, but we do go above and beyond to try to help make it a little bit better for the patient and their family. We also do – we also work with a company that will deliver food to the houses once a week if you have kids under 18 and I think that that’s a big thing for especially our younger patients that are worried so much about their kids and making sure that they have food on the table especially with copays and all that worry.
Host: What a great service that you ladies are providing at such an important time in somebody’s life. Kiamesha, tell us a little bit about support services. Are there groups where they can go and talk about their fears? Is it mostly one on one? Do the families get to go to some of these support services? Tell us a little bit about how that part works.
Kiamesha: So, we do have some support groups that we offer on campus at the Cornwall location. We offer those in the evenings on each Wednesday of the month. So, depending on what the group is; each Wednesday will be different. We have a survivors group, a caregivers group. We have a breast cancer options group and a general support group. So, what those do is they offer a platform for patients or patients that have already completed treatment and their families as well to come and sit down and discuss what they are going through. Seeking that support from each other, whatever stage they are at throughout their journey and getting that reassurance that that are not alone. So, families are more than welcome to come. Our caregivers group is more aimed at those who are caring for family members that are going through this illness, however, we do encourage them to bring their family members as well so that they can understand that this isn’t necessarily a burden, this is something that caregivers have taken on and they just need that emotional support as well.
Karen: We also have a nutritional support group to help patients that are having difficulty eating or to learn what things they can eat through this diagnosis. Because a lot of times, when patients lose weight, they don’t realize ways that they can bring it up. So, we do have a nutritional support group with a registered dietician.
Host: It is such a confusing time and besides the social aspect and the process; Kiamesha tell us your role as a palliative care and oncology – you’re kind of the liaison in that respect and tell people what you do with palliative care. What does that mean?
Kiamesha: So, palliative care is a supportive service that is usually introduced when a patient has a recurrent or metastatic disease. So, what that looks like is we have a palliative care physician, nurse practitioner and then a social worker which is myself and we are there to support patients and their families, help them manage symptoms and prepare them for what life looks like living with a chronic illness. So, we are kind of coming in sometimes during the later stages of the disease to really help them more look at quality of life over quantity. Because at the end of the day, what our patients and families want is that time together.
Host: That’s so important. Karen, first last word to you. What would you like the listeners to know about the Littman Cancer Center’s Patient Navigation Program, how to get in touch with you all and what you can do for them?
Karen: Well, I would like them to know that we’re here to help them and their families. They can call us either at the radiation center or they can call us on our cell phones. We do have rap cards that we give out to the doctor’s offices or they can just ask their doctor to refer them to us and we would be happy to help make their journey a lot better.
Host: Kiamesha, tell us what you want patients to take away from this segment about the need and the way to ask for help. Because sometimes people don’t want to, sometimes the caregiver doesn’t want to, but kind of wrap it up for us in how important it is for patient navigation, palliative care, all of these support services when someone is diagnosed with cancer.
Kiamesha: What I would like patients and families, anyone that is going through this kind of situation is that reaching out and asking for help is okay. Cancer is a disease that is not just affecting the individual, but it affects the entire family. As I mentioned earlier, it’s a disruption to their everyday life. So, I would hope that patients, physicians, family members, anyone that is listening to this understands that they are not alone and asking for that additional support is for them to improve their quality of life, to help them through this process, to take away some of the stress and burden that comes along with it.
Host: That’s great information. Thank you, ladies, for coming on and thank you for all the wonderful work that you are both doing to help cancer patients. It’s such an important position. Thank you again. For an appointment please call the Littman Cancer Center at 845-458-4444 or go to www.montefioreslc.org for more information and to get connected with one of our providers. If you found this podcast informative, please share on your social media and be sure to check out all the other helpful podcasts in our library. I’m Melanie Cole.