Selected Podcast
Cancer & Caregivers: Navigating Stress, Worry and Other Challenges
The cancer journey often involves a number of unknowns for patients and their families. That’s where oncology nurse navigators come in! Listen as Katie Brummer, an oncology nurse navigator at WakeMed Cancer Care, explains how they help patients and caregivers manage the information involved with diagnosis, treatment, survivorship and anything else in between.
Featured Speaker:
Katie Brummer, BSN, RN
Katie Brummer, BSN, BS, RN, earned a Bachelor of Science in Biology from Meredith College and a Bachelor of Science in nursing from the University of North Carolina – Wilmington. Katie began her career in health care seventeen years ago when she joined the Duke University Health System. Katie’s nursing experience includes working in the Cardio-Thoracic and Medical Intensive Care Units of Duke University in Durham. Katie has eight years of experience in oncology, with three years as an oncology nurse navigator. Katie left Duke Cancer Institute in June 2021 to help startup WakeMed Cancer Care, the Triangle’s newest oncology clinic. Katie has a true passion for oncology and working with patients and their families. Transcription:
Cancer & Caregivers: Navigating Stress, Worry and Other Challenges
Amanda Wilde (Host): Navigating the healthcare system can be challenging and stressful, but you can access a medical professional for support all along the way, and that is a game changer. Today we're talking with Oncology Nurse Navigator, Katie Brummer, about how to use a nurse navigator in the health system.
This is WakeMed Voices, a podcast brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. I'm Amanda Wilde. Katie, thanks for being here.
Katie Brummer, BSN, RN: Thank you for having me.
Host: So your job description must encompass a lot. How would you describe what a nurse navigator is and does?
Katie Brummer, BSN, RN: Well, I think that that's a common question for most people is what is a nurse navigator, since most people have never heard of one. And the role of a navigator, I'll start at the beginning. The role of the navigator was created in the 1990s at Harlem Hospital cause there was identified a need to help patients or essentially guide them throughout their treatment process.
And so the role has evolved over the years and become more tailored to disease processes. As we talk more today about the oncology world, there are so many moving pieces to a diagnosis. It's not just as simple as just showing up to a doctor's office. And so that's where the nurse navigator comes in, where we, on day one of your diagnosis, meet you and become your point person throughout your continuum of care and or your journey.
Host: How do I unlock that service? How do I access a nurse navigator?
Katie Brummer, BSN, RN: Well, in recent years, most hospital institutions have realized the importance of having nurse navigation and the role has become more popular. At WakeMed Oncology, we have nurse navigators per disease sites. So I focus on GI and GU. And when a person is diagnosed with, let's just say colon cancer, you automatically get hooked up with me as your nurse navigator. And so I've been doing navigation for about three years now. And over the course of the three years, it started off that you see navigation with the medical oncologist. But now in more recent time, the surgical oncologist is having nurse navigators, the radiation oncologist has a nurse navigator. And it's really wonderful cause we all work together so closely in making sure that these patients are being helped along every step of the way cause it can get very confusing.
Host: Right. I'm thinking with the complicated but more effective new treatments that keep coming out and all the developments in the medical world that are actually helping us. It does make it, like you said, there's a lot of moving pieces to work with and so you absolutely sort of have to have someone who knows the system.
Katie Brummer, BSN, RN: Exactly. So, we each approach it differently. However, when a patient gets diagnosed and I know that they're coming into clinic, I meet with them during their appointment with the medical oncologist. That way I'm hearing what's being said to them during the appointment. And you know, it's a very overwhelming visit when someone's getting diagnosed with cancer.
There's no doubt about that. It's just extremely hard. And so I'm there as listening ears to hear what's being said. That way when the appointment's over with, they get my card, they can call me directly and we can go over what was discussed at that meeting, again, and that way that they're completely comfortable with what's going to be done and what's being put into motion.
I also help coordinate any scans that might need to be done. Is there a biopsy that needs to be scheduled? I handle all of that for them. And then, I plug them back in when the time is, so they need to come back into the office. I'll see them again at that appointment, make sure that they're essentially tucked in and give them their schedule moving forward, along with educating on chemotherapy of what is to be expected over the next several weeks and basically I stick with the patient, until they're sort of what I like to say on their way once they get rolling and with treatment, normally people, are like, I get it, I understand where I need to show up when, some people need a little bit more handholding or loving during these times.
And so I kind of stay with them, but they always know that they can call me if they have any questions, which I think is the most comforting part of my job is that they have a direct phone number to me so they know that they can get me when they need me, or they know they can get a person, which I think can sometimes be the most frustrating thing is, you know, calling and not getting an answer or so they know that they have a person there in their corner. I think it's nice that they can see me in clinic, but they also can pick up the phone and call me if they have a question.
Host: So that all takes a lot of weight off the patient's shoulders because I'm thinking about the kind of stress that comes with this kind of diagnosis and how you help patients. And then do you also help the family around the patient navigate some of the challenges they are facing during the cancer journey?
Katie Brummer, BSN, RN: Oh, absolutely. Like I said, I meet with the patients in clinic and that's honestly the best time to get a feel for who's their support person, like who's coming to clinic with them? Are they coming by themselves? And then, if they're coming by themselves, is someone driving them? Are they driving themselves?
You start to put into your mind, okay, what is barriers for this person? Like, are they going to have transportation issues? Are they going to have support issues? Are they doing this on their own? Are they the breadwinner of the family. Are they going to lose their health insurance if they stop working?
And so as the navigator, you start putting all these pieces together as you meet the person and talk with them. And really just by observing and that way you're able to better help them, plug them in with what they might need. Do they need a social worker? Are they having a hard time with eating the right meals and getting the nutrients that they need?
Do they need to meet with one of our nutritionists? Do they need to meet with a financial care counselor? Financial toxicity associated with oncology diagnosis, is just so high. It is the financial burden, is unreal. So are there different organizations that I can put them in touch with that can help with gas cards.
There's all these different parts to unlocking that a lot of people have no idea because they've never experienced something like this, and that is part of the navigator. We can help guide them to this. I kind of like to compare us to being like the hub of the wheel and we're helping them with all the little spokes, like getting to where they need to be.
Host: Yeah, exactly. And you know all the right questions to ask as you've just demonstrated. You know what to look for and you know where to find the resources. You kind of touched on this just in answering that question, but I wanted you to tell us kind of what a typical day looks like.
Katie Brummer, BSN, RN: Sometimes you just hit the ground running, but typically in the mornings, it's answering any questions that might've come in from patients that have already been plugged in. And then I'm off into clinic and I'm seeing new patients with providers, identifying what needs to be done.
And sometimes, patients come in and all they had was a scan and it said, the scan said, well, that looks like cancer. You're going to go to an oncologist. Nothing has been accomplished. And so these poor people are just scared to death, because something was seen on a scan. So then it's okay, how fast can I get a biopsy?
And so typically I'm on the phone, begging IR to get me a slot as quickly as possible and negotiating okay, how quickly can I get them in, turnaround time for those biopsy results, getting them back into the clinic to discuss those results, and then putting into motion our plan. What does that mean?
What chemotherapy are they going to get? Do they need to see a radiation oncologist? Scheduling those appointments for them. And I always tell people when they first walk in the doors and they get a diagnosis and we're in the working up phase, it's the worst time cause you feel like time is moving backwards and my promise to them is that I'm going to work as fast as possible and I'm going to get things done as quickly as I can to get them the answers they need. And then that way we can get them on the track of moving forward. Because no one likes feeling like they don't have any control over their life, and you feel like you're in limbo during that time.
And so my role really is with these patients is to tell them that I've got them and that I'm going to help get those answers as quickly as we need to. And then, after meeting with new patients, I'm usually seeing people in infusion, checking in on my ones that have already started treatment, seeing how things are going, how are they doing.
You know, I had a patient the other day who, they're young and they had to stop working. And so we were going back and forth of what was going to be necessary for them to do. They were going to be losing their insurance. What did that look like? Can we get them on disability? And so then my next move was to email our social worker and say, Hey, I need you to connect with this patient.
They're going to need to go on disability. What is that going to look like? What's that timeframe? And can you talk with them? So it's just sort meeting with those patients and seeing what might be going on with them. And then usually in the afternoons I'm back at my desk and kind of finishing up anything that might have been not taken care of in clinic or any outstanding items that need to be done for patients.
Host: A good wrap of a good day. You really have to be so flexible and an effective coordinator. And I see where that, if you can put a bit of routine in there, in your day too, that just gives it that backbone it needs for you to be able to have that flexibility from. You know, it's the foundation of the day.
Katie Brummer, BSN, RN: Oh, absolutely. I had a navigator I worked with and she had a little badge pin that said chaos coordinator. And that's kind of exactly what we do, is we coordinate and put in and make things into pretty little packages, try and get everything cookie cutter and done and fixed.
Host: And far in the future, when you retire, you will have a more relaxing career herding cats.
Katie Brummer, BSN, RN: Yeah, exactly. I often say that that is part of my job is herding the cats.
Host: Yeah, it takes a special person. Katie, thank you just so much for sharing your expertise and thank you for this good work you're doing and being a powerful resource and support to all of your patients.
Katie Brummer, BSN, RN: Oh, absolutely. I absolutely love my job, and I'm so thankful that I found this career path and I love going to work every morning. I enjoy being there. I enjoy working with these patients and it's such an honor to be able to work with oncology patients because it's just such an amazing group of patients. They have such resilience, and I'm lucky to be able to walk with them during this journey.
Host: Sounds like inspiration comes from both ends.
Katie Brummer, BSN, RN: Yeah, it does.
Host: That was Katie Brummer, Oncology Nurse Navigator WakeMed Cancer Care. To learn more about WakeMed Cancer Care, please visit wakemed.org/cure. And if you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. I'm Amanda Wilde with WakeMed Voices brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina.
Cancer & Caregivers: Navigating Stress, Worry and Other Challenges
Amanda Wilde (Host): Navigating the healthcare system can be challenging and stressful, but you can access a medical professional for support all along the way, and that is a game changer. Today we're talking with Oncology Nurse Navigator, Katie Brummer, about how to use a nurse navigator in the health system.
This is WakeMed Voices, a podcast brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. I'm Amanda Wilde. Katie, thanks for being here.
Katie Brummer, BSN, RN: Thank you for having me.
Host: So your job description must encompass a lot. How would you describe what a nurse navigator is and does?
Katie Brummer, BSN, RN: Well, I think that that's a common question for most people is what is a nurse navigator, since most people have never heard of one. And the role of a navigator, I'll start at the beginning. The role of the navigator was created in the 1990s at Harlem Hospital cause there was identified a need to help patients or essentially guide them throughout their treatment process.
And so the role has evolved over the years and become more tailored to disease processes. As we talk more today about the oncology world, there are so many moving pieces to a diagnosis. It's not just as simple as just showing up to a doctor's office. And so that's where the nurse navigator comes in, where we, on day one of your diagnosis, meet you and become your point person throughout your continuum of care and or your journey.
Host: How do I unlock that service? How do I access a nurse navigator?
Katie Brummer, BSN, RN: Well, in recent years, most hospital institutions have realized the importance of having nurse navigation and the role has become more popular. At WakeMed Oncology, we have nurse navigators per disease sites. So I focus on GI and GU. And when a person is diagnosed with, let's just say colon cancer, you automatically get hooked up with me as your nurse navigator. And so I've been doing navigation for about three years now. And over the course of the three years, it started off that you see navigation with the medical oncologist. But now in more recent time, the surgical oncologist is having nurse navigators, the radiation oncologist has a nurse navigator. And it's really wonderful cause we all work together so closely in making sure that these patients are being helped along every step of the way cause it can get very confusing.
Host: Right. I'm thinking with the complicated but more effective new treatments that keep coming out and all the developments in the medical world that are actually helping us. It does make it, like you said, there's a lot of moving pieces to work with and so you absolutely sort of have to have someone who knows the system.
Katie Brummer, BSN, RN: Exactly. So, we each approach it differently. However, when a patient gets diagnosed and I know that they're coming into clinic, I meet with them during their appointment with the medical oncologist. That way I'm hearing what's being said to them during the appointment. And you know, it's a very overwhelming visit when someone's getting diagnosed with cancer.
There's no doubt about that. It's just extremely hard. And so I'm there as listening ears to hear what's being said. That way when the appointment's over with, they get my card, they can call me directly and we can go over what was discussed at that meeting, again, and that way that they're completely comfortable with what's going to be done and what's being put into motion.
I also help coordinate any scans that might need to be done. Is there a biopsy that needs to be scheduled? I handle all of that for them. And then, I plug them back in when the time is, so they need to come back into the office. I'll see them again at that appointment, make sure that they're essentially tucked in and give them their schedule moving forward, along with educating on chemotherapy of what is to be expected over the next several weeks and basically I stick with the patient, until they're sort of what I like to say on their way once they get rolling and with treatment, normally people, are like, I get it, I understand where I need to show up when, some people need a little bit more handholding or loving during these times.
And so I kind of stay with them, but they always know that they can call me if they have any questions, which I think is the most comforting part of my job is that they have a direct phone number to me so they know that they can get me when they need me, or they know they can get a person, which I think can sometimes be the most frustrating thing is, you know, calling and not getting an answer or so they know that they have a person there in their corner. I think it's nice that they can see me in clinic, but they also can pick up the phone and call me if they have a question.
Host: So that all takes a lot of weight off the patient's shoulders because I'm thinking about the kind of stress that comes with this kind of diagnosis and how you help patients. And then do you also help the family around the patient navigate some of the challenges they are facing during the cancer journey?
Katie Brummer, BSN, RN: Oh, absolutely. Like I said, I meet with the patients in clinic and that's honestly the best time to get a feel for who's their support person, like who's coming to clinic with them? Are they coming by themselves? And then, if they're coming by themselves, is someone driving them? Are they driving themselves?
You start to put into your mind, okay, what is barriers for this person? Like, are they going to have transportation issues? Are they going to have support issues? Are they doing this on their own? Are they the breadwinner of the family. Are they going to lose their health insurance if they stop working?
And so as the navigator, you start putting all these pieces together as you meet the person and talk with them. And really just by observing and that way you're able to better help them, plug them in with what they might need. Do they need a social worker? Are they having a hard time with eating the right meals and getting the nutrients that they need?
Do they need to meet with one of our nutritionists? Do they need to meet with a financial care counselor? Financial toxicity associated with oncology diagnosis, is just so high. It is the financial burden, is unreal. So are there different organizations that I can put them in touch with that can help with gas cards.
There's all these different parts to unlocking that a lot of people have no idea because they've never experienced something like this, and that is part of the navigator. We can help guide them to this. I kind of like to compare us to being like the hub of the wheel and we're helping them with all the little spokes, like getting to where they need to be.
Host: Yeah, exactly. And you know all the right questions to ask as you've just demonstrated. You know what to look for and you know where to find the resources. You kind of touched on this just in answering that question, but I wanted you to tell us kind of what a typical day looks like.
Katie Brummer, BSN, RN: Sometimes you just hit the ground running, but typically in the mornings, it's answering any questions that might've come in from patients that have already been plugged in. And then I'm off into clinic and I'm seeing new patients with providers, identifying what needs to be done.
And sometimes, patients come in and all they had was a scan and it said, the scan said, well, that looks like cancer. You're going to go to an oncologist. Nothing has been accomplished. And so these poor people are just scared to death, because something was seen on a scan. So then it's okay, how fast can I get a biopsy?
And so typically I'm on the phone, begging IR to get me a slot as quickly as possible and negotiating okay, how quickly can I get them in, turnaround time for those biopsy results, getting them back into the clinic to discuss those results, and then putting into motion our plan. What does that mean?
What chemotherapy are they going to get? Do they need to see a radiation oncologist? Scheduling those appointments for them. And I always tell people when they first walk in the doors and they get a diagnosis and we're in the working up phase, it's the worst time cause you feel like time is moving backwards and my promise to them is that I'm going to work as fast as possible and I'm going to get things done as quickly as I can to get them the answers they need. And then that way we can get them on the track of moving forward. Because no one likes feeling like they don't have any control over their life, and you feel like you're in limbo during that time.
And so my role really is with these patients is to tell them that I've got them and that I'm going to help get those answers as quickly as we need to. And then, after meeting with new patients, I'm usually seeing people in infusion, checking in on my ones that have already started treatment, seeing how things are going, how are they doing.
You know, I had a patient the other day who, they're young and they had to stop working. And so we were going back and forth of what was going to be necessary for them to do. They were going to be losing their insurance. What did that look like? Can we get them on disability? And so then my next move was to email our social worker and say, Hey, I need you to connect with this patient.
They're going to need to go on disability. What is that going to look like? What's that timeframe? And can you talk with them? So it's just sort meeting with those patients and seeing what might be going on with them. And then usually in the afternoons I'm back at my desk and kind of finishing up anything that might have been not taken care of in clinic or any outstanding items that need to be done for patients.
Host: A good wrap of a good day. You really have to be so flexible and an effective coordinator. And I see where that, if you can put a bit of routine in there, in your day too, that just gives it that backbone it needs for you to be able to have that flexibility from. You know, it's the foundation of the day.
Katie Brummer, BSN, RN: Oh, absolutely. I had a navigator I worked with and she had a little badge pin that said chaos coordinator. And that's kind of exactly what we do, is we coordinate and put in and make things into pretty little packages, try and get everything cookie cutter and done and fixed.
Host: And far in the future, when you retire, you will have a more relaxing career herding cats.
Katie Brummer, BSN, RN: Yeah, exactly. I often say that that is part of my job is herding the cats.
Host: Yeah, it takes a special person. Katie, thank you just so much for sharing your expertise and thank you for this good work you're doing and being a powerful resource and support to all of your patients.
Katie Brummer, BSN, RN: Oh, absolutely. I absolutely love my job, and I'm so thankful that I found this career path and I love going to work every morning. I enjoy being there. I enjoy working with these patients and it's such an honor to be able to work with oncology patients because it's just such an amazing group of patients. They have such resilience, and I'm lucky to be able to walk with them during this journey.
Host: Sounds like inspiration comes from both ends.
Katie Brummer, BSN, RN: Yeah, it does.
Host: That was Katie Brummer, Oncology Nurse Navigator WakeMed Cancer Care. To learn more about WakeMed Cancer Care, please visit wakemed.org/cure. And if you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. I'm Amanda Wilde with WakeMed Voices brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina.