Integrating careConsidering <strong>the</strong> Whole PatientCancer Coordinator Clare Wilson,RN, MS, works closely with cancerpatients. Picture here, left to right,Susan Selph with Clare Wilson.Judith Ramirez, EdD, Manager <strong>of</strong>Psychosocial Services and Outreachat Tunnell Cancer <strong>Center</strong>Whe<strong>the</strong>r in <strong>the</strong> workplace, in <strong>the</strong> gym, or on <strong>the</strong>playing field, pr<strong>of</strong>essional coaches help peopleto visualize <strong>the</strong> future, to set goals, and to determinewhat <strong>the</strong>y need to do to achieve <strong>the</strong>m.<strong>Beebe</strong> <strong>Medical</strong> <strong>Center</strong> is taking <strong>the</strong> sameapproach to wellness. Clare Wilson, RN, MS, forinstance, is <strong>the</strong> Cancer Care Coordinator at <strong>the</strong>Tunnell Cancer <strong>Center</strong>. Ms. Wilson, who has both anursing degree and a master’s degree in counseling,is a certified well coach at <strong>the</strong> center. She’s joined by<strong>the</strong> center’s o<strong>the</strong>r two well coaches, Jude Johnson-Shupe, MSW, a psychosocial service specialist, andKim Westcott, a registered dietitian. The <strong>Beebe</strong>CAREs program also has a well coach on its team(see page 4).Similarly, Cancer Nurse Navigator Kathy Cook,MSN, RN, helps patients through <strong>the</strong> <strong>Beebe</strong> BreastHealth <strong>Center</strong>. Located at <strong>the</strong> Bookhammer Outpatient<strong>Center</strong> on Route 24 in Rehoboth Beach, <strong>the</strong>center is <strong>the</strong> region’s only facility devoted to breastcare, diagnosis, and treatment for men and women.Well coaches and navigators address <strong>the</strong> patient’sentire well-being. They integrate care as <strong>the</strong>y focuson <strong>the</strong> individual needs <strong>of</strong> each patient.Ms. Cook, who is notified when one <strong>of</strong> herpatients needs to return for more diagnostics, isa one-stop source to answer any <strong>of</strong> <strong>the</strong> patient’squestions.“Kathy educates women requiring fur<strong>the</strong>r breas<strong>the</strong>alth testing about <strong>the</strong> next step,” says JudithRamirez, EdD, Manager <strong>of</strong> Psychosocial Services andOutreach at Tunnell Cancer <strong>Center</strong>. “If it’s a biopsy,8
Well coaches and navigators address <strong>the</strong> patient’s entire well–being. They integratecare as <strong>the</strong>y focus on <strong>the</strong> individual needs <strong>of</strong> each patient.she explains <strong>the</strong> procedure. She might provide informationabout an ultrasound or a lumpectomy ormastectomy.”Not only does she answer questions, but she’llalso help patients make appointments for fur<strong>the</strong>rtesting. She’s happy to accompany <strong>the</strong>m to <strong>the</strong>irappointments, and some patients take her up on<strong>the</strong> <strong>of</strong>fer. “I try to meet whatever <strong>the</strong>ir need is,” saysMs. Cook, who has received a certification in breas<strong>the</strong>alth navigation. “I’m <strong>the</strong>ir point <strong>of</strong> contact.”In addition to digital mammography, breast ultrasound,and minimally invasive breast biopsies, <strong>the</strong>Breast Health <strong>Center</strong> also provides care for peoplewith benign breast disease. Ms. Cook calls patients tomake sure <strong>the</strong>y’ve scheduled <strong>the</strong> appropriate followupappointments. She also teaches <strong>the</strong>m how to selfexamine<strong>the</strong>ir breasts.Most patients are happy to have someone to talkto, she says. Dr. Ramirez agrees: “In <strong>the</strong> six monthssince we started <strong>the</strong> nurse navigator program, I’vereceived many kudos for Kathy’s services. It’s allabout <strong>the</strong> emotional connection.”Forming an emotional connection is also part <strong>of</strong><strong>the</strong> work that Clare Wilson does as <strong>the</strong> Cancer CareCoordinator. “Patients are not just <strong>the</strong>ir cancer and<strong>the</strong>y are not just patients; <strong>the</strong>y are a whole person.We integrate <strong>the</strong> mind, body, and spirit,” she says.Consider <strong>the</strong> patient who recently completedradiation or chemo<strong>the</strong>rapy, an occasion TunnellCancer <strong>Center</strong> marks by inviting patients to ring abell. Heard more than 1,000 times a year, <strong>the</strong> soundstands for courage, hope, triumph, strength, faith,and love.Ms. Wilson helps cancersurvivors define who<strong>the</strong>y are in <strong>the</strong> presentand envision <strong>the</strong>mselvesthree months down <strong>the</strong>road. “Coaching alwaysstarts with a vision,” sheexplains. “It should be aBreast cancer survivor Esselee Davisrings <strong>the</strong> bell at <strong>the</strong> Tunnell Cancer<strong>Center</strong>, signifying courage, hope,triumph, strength, faith, and love.powerful statement and an active statement, suchas ‘I am strong and back to work,’ or ‘I am livingpeacefully.’”The vision statement leads to goals. The goalsmeet wellness objectives, such as starting a healthydiet, gaining strength, or becoming more active.Once vision and goals have been identified, Ms.Wilson and her client discuss <strong>the</strong> unique strengths<strong>the</strong> person possesses that can help <strong>the</strong>m realize thatgoal. They also review any barriers, and <strong>the</strong>y talkabout how <strong>the</strong>y might overcome <strong>the</strong>se challenges.Jude Johnson-Shupe and Kim Westcott, in <strong>the</strong>irwell-coaching roles, work in <strong>the</strong> same manner withpatients.Well coaches are available to meet with caregiversand family members. They counsel those who havelost loved ones. Ms. Wilson also coordinates carebetween o<strong>the</strong>r facilities for those patients who divide<strong>the</strong>ir time between residences or who have soughta second opinion or specialized care outside <strong>of</strong>Tunnell Cancer <strong>Center</strong>. Both Ms. Wilson and Ms.Cook agree that navigating and counseling patients,and supporting <strong>the</strong>m in <strong>the</strong> integration <strong>of</strong> <strong>the</strong>ir careand in focusing on <strong>the</strong>ir individual goals and vision,is indeed a rewarding endeavor. nRight, Kathy Cook, MSN, RN,Nurse Navigator at <strong>the</strong> <strong>Beebe</strong>Breast Health <strong>Center</strong>, guidespatients who have received apositive diagnosis for cancer through<strong>the</strong> process <strong>of</strong> scheduling appointments,treatments, and surgery.9