Let’s Talk About Cancer Nurse Navigation
Centra Pearson Cancer Center Nurse Navigator, Lindsay Lacey, joins Kate on this episode of the podcast to discuss her passion for her position and what she does to help cancer patients and their loved ones navigate difficult seasons.
Note: Due to extra social distancing during recording for the safety of all parties, some audio may sound more muffled than normal.
Announcer:
Thanks for joining us for this episode of Centra Scripts, where we talk health and wellness and practical tips for your everyday life. And now here's your host, Kate Kolb.
Kate Kolb:
Well, welcome to another episode of Centra Scripts. My name is Kate Kolb, and we are so glad that you are here with us again today to hear a little bit more about what's going on at Centra and some of the services that we have to offer. I am really excited to sit down today with Lindsay Lacey, who works at our Pearson Cancer Center here on the Centra campus. And thank you, Lindsay, for agreeing to do this. I know it was a little bit last minute, a little bit crazy this month, but it's so good to be here with you.
Lindsay Lacey:
Absolutely. Thanks for having me.
Kate Kolb:
Yeah. So Lindsay, tell us a little bit about your role here at Centra, how long you've been here and a little bit about what you do?
Lindsay Lacey:
Sure. So I am a nurse navigator and follow site specific cancers. There's many of us navigators now. I have been in this role for almost 13 years. So obviously, love what I do. I think it's a pretty fantastic role. And just being able to get to know patients and help them through their entire journey from start to finish is pretty remarkable, extremely rewarding.
Kate Kolb:
Yeah, I can imagine. So now, we've had this conversation a little bit recently about how we feel, like the word nurse navigator or navigation in the sense of healthcare. People might not understand what that is. So can you expand on that a little bit more and explain what navigation is in terms of how it interacts with your role?
Lindsay Lacey:
Sure. So as a nurse navigator, again, there's different site specific navigators to try to encompass and cover majority of all the cancers that someone could be diagnosed with in the area. And with all the ins and outs of different doctor's appointments, multiple doctors involved in your care, options of care that are easily very confusing and you feel like you're not an expert as a patient. You're not an expert. This is thrown at you, not something you ask for and to have someone come alongside you from the get go, to hold your hand, support you, to physically go with appointments if you are lacking support system and help to direct you, should you have financial concerns, whatever concerns, questions, any barriers to coming in for treatment that could be present. We help to refer you, to direct you kind of, one step at a time.
Kate Kolb:
So it's very all-encompassing care. I think sometimes maybe when we think about nurses and their interactions with going to the hospital and different things like that, we think of it as a very, almost transactional like it's coming and it's going, and it's very individual, but this is an ongoing encompassing piece of the care here at the cancer center, right?
Lindsay Lacey:
Yes. Absolutely. This is why one of the reasons I've stuck around for so long. Yeah. It's a special role.
Kate Kolb:
That's awesome. Well, and again, the smile on your face says it all with how you feel about what you do and that's always wonderful to see somebody that feels so connected to their work for sure. So at the cancer center then, what types of patients do you work with on a day to day basis?
Lindsay Lacey:
So I follow specifically breast cancers and any GYN cancers. We do cover each other quite often. So we tap into other roles and other cancer sites or specific cancers. And so we kind of get a taste of all the other ones as well, but those are just specifically what I follow.
Kate Kolb:
Yeah. You get very much a front seat to walking through cancer journeys with patients and their families. Do you feel like you get to know them well during that process, what does that sort of ongoing relationship look like as they go through that?
Lindsay Lacey:
Yeah, so we really do get involved in people individually and because we are there from initial diagnosis, we typically, at least in our role get in touch with ladies after they're diagnosed or gentlemen after they're diagnosed about a day or so later. That way they kind of have time to let the shock kind of settle and think through some questions. So from typically the day of, or day after they're diagnosed, we are on their care team. And therefore that initial conversation and those initial questions, fear, anger, whatever presents at that initial point and really kind of see them through that, their emotional journey, whatever that looks like as well.
Kate Kolb:
Yeah. Which is so huge. I feel very grateful that I've never had to walk through that myself, but I have had very close friends and some family members that have had to walk through that either for themselves or other people and it's such an overwhelming moment in your life when you get that diagnosis. And so it's an amazing piece to be able to offer that to a patient and to their families. And do you feel like that changes the care process for them to have somebody that walks through that with them?
Lindsay Lacey:
Yes. I know if I were going through that, I would really want that. Yes. Speaking of family members or friends, my father, who's not in the area was diagnosed with cancer in Northern Virginia, because of the way it's set up there, he didn't have a navigator and one of those patients who has lots of questions. So I really value that we have so many navigators here and we have kind of a nice system where we can really follow people well and support that.
Kate Kolb:
So talk about that for a minute then, because is this something that is new to cancer care? Or is it something, talk a little bit about how maybe it lacks in other areas or is it something that's pretty normal in other areas of cancer care?
Lindsay Lacey:
So from what I understand that Lynchburg at the Pearson Cancer Center has been an upfront beginner of the navigation roles. We actually had a different title back in the day. But it's been here for quite a while, following mainly lung and breast from [inaudible 00:06:33] ago. But it has really changed and evolved and improved as we've needed to, but, and grown certainly. There are navigator roles in other areas of cancer care around the states, but we have been definitely a leader here locally.
Kate Kolb:
That's pretty amazing to be able to say that we can offer something that is maybe different than other organizations are offering too. In some of my research, when I was going through to think about what questions I was going to ask you today, the word advocacy was something that just kept coming up over and over and over again, advocate, care, and advocacy. How do you feel like maybe that word in particular affects how you interact with your patients and why is that important for even extended family members in this journey?
Lindsay Lacey:
That's a great question. I think because of the special needs of these patients and their family members, as you mentioned, lots of different personal scenarios come into play, lots of different emotions, but also like you mentioned, like their support system [inaudible 00:07:38]. And when we initially talked to our patients, it's we are here for you, to advocate for you, to support you and your family because we understand it's not just happening to them. They rely on their family for not just emotional, financial, but also for transport and transportation and all the things that they were going to need at home.
Lindsay Lacey:
So it involves the whole care team. And if patients don't feel comfortable with a suggestion or recommendation from their doctors, we're happy to talk them through that. They often bring it up to us as nurses. Sometimes they don't feel comfortable for different reasons talking to their doctors about it. So we can bounce that back and forth, kind of help to clarify what the reasons behind those recommendations. And we've built a trust and a relationship with them from the beginning, where certain doctors might not play a role until a little bit later. So just to be that continuum, I feel like there is some trust that's formed that might be slightly different than in other roles of their care cancer care team.
Kate Kolb:
Yeah. That's a really great description and an idea of what that looks like on a day to day basis. How big is the navigation team here at Pearson Cancer Center?
Lindsay Lacey:
There are seven of us now.
Kate Kolb:
Oh, wow.
Lindsay Lacey:
And yes. So it's, and again, there used to just be three. Back in the day, we've seen the need to grow and to cover the majority in all of cancer, all the cancers that can come our way. And some roles and some, they're all different because of what the journeys that each cancer system goes through, which is why we have different, why there's not just one navigator for the whole cancer [crosstalk 00:09:22].
Kate Kolb:
Yeah. So, yeah. So when you start a journey with a patient, are you basically, for lack of a better term assigned to that patient for the duration of their treatment here, or is there different sections of navigating for different type types of care? How does that work?
Lindsay Lacey:
There are actually three of us that do breast cancers and GYN cancers, and because of our specific, or unique system and just with the breast and GYN, we don't get assigned specifically to those patients. I mean, kind of, if we feel like we really got attached to one particular person, but in other cancer, there are, people are assigned and there are patients who get attached to one of us in the three of our role. And they say, you know what, I'd rather just deal with whomever, just for that consistency.
Kate Kolb:
Right. So going back to, you said, you've been here 13 years and doing this and really love what you do. What is it about Pearson that really makes you want to stay here and choose to do your nursing career here?
Lindsay Lacey:
Well, I have been blessed beyond measure with my colleagues and my bosses and it's just been such a really unique, special gift to work here and to have kind of a small community feel that, you might not have other places. But I think because of, and just my own personal, not that I've been a patient here with cancer care, but in other roles, it's been, just to have that consistency with within Centra, but also just how they've supported me. My colleagues have supported me and to be able to be supported in doing what I love to do, that's a gift. It's not really something I want to just say, see ya. I've served my five years or whatever and I'm out of here. This is kind of a, a nice little home for me that it would be really hard to leave.
Kate Kolb:
Yeah. Well, it definitely sounds like the support system from both within and with outside the organization is really good too. What do you think is the best thing about the cancer center and how they interact with their patients? Maybe what's a distinguishing factor that we might have that maybe somebody else doesn't?
Lindsay Lacey:
Thing that we hear the most, or I hear the most from patients is every person along the path, whether it be at breast imaging, the surgeon's office, over here at medical or radiation oncology, even the people that see me in the hospital for different reasons, everyone has been so kind. And I think there's a special sense of, from the moment you walk in the doors here at the cancer center, people who are screening because of COVID, the smiling face is there to the med techs to the, everybody has just been, there's a smiling face for everyone. And I think because there's a special sense of why people come in this building and there's an understanding of, there's a heaviness that can become, so there's, we all know that and we want to bring a smile to everyone's face. I don't know. I think it's pretty special over here.
Kate Kolb:
Yeah. Well, I definitely feel like that has echoed often when we hear stories from the community and from patients who have gone through treatment here. I know several people that I know personally that have gone through varying stages of treatment and things here, and they say exactly that. That it feels welcoming and warm and that there is a personal touch to the care that happens here that maybe they haven't experienced somewhere else, if they've been through different screenings or different treatments elsewhere. Not to say that it doesn't exist elsewhere, but I know the phrase that we hear often too, is my Pearson center or my Pearson Cancer Center family.
Kate Kolb:
And that word family is used a lot or just the way that they feel bonded to. Like you said, it can be a very heavy, dark experience obviously. And I think that it's just great, the work that you guys are doing as a whole, here at the cancer center, not only just in the navigation area, but it's impacting, it's impacting the community. The other thing that I feel like we hear often is just access to care, being able to be right here, in this town. Talk a little bit about that and how important that is in cancer treatment and being able to access that here?
Lindsay Lacey:
Absolutely. That is something that I think, because I've been in this role for so long that it was, the building was not, it was still kind of new. And so is this bright, shiny new thing and it was definitely a thing that people were, I can't believe we have this here. And I don't have to go to UVA, I can if I want to, but I don't have to go to Duke, it's here. Now of course we do see patients that from surrounding counties and things, but again, they would have to go even farther for cancer care. So to be able to have that access, I think is remarkable. And if people do live a little distance away and they have to come for daily treatments or frequent treatments, we have great resources to help with all of those things too. So, but yes, it's, I definitely heard it more when the building was newer, but yeah, it's true. It's pretty great to have it.
Kate Kolb:
Do you know, by any means sort of what the radius is of maybe distance of patients that we treat?
Lindsay Lacey:
I really don't know offhand. I do know. I would say that there are patients, an hour away is not uncommon, in all directions. So, but I don't know specifically so.
Kate Kolb:
Yeah, no, that's okay. Again, I just think to reiterate what you were talking about, just the effect of being able to have that and host that here in a community. And then couple that with the way that you all care for the patients here is just, it says a lot about, not only the central community, but this Lynchburg and surrounding area community as a whole and being able to welcome patients in, in a very hard, difficult, dark time. What's the typical length of time maybe that you work to navigate patients? Is there a pretty standard length of time that you would be dealing with a patient?
Lindsay Lacey:
Well, it depends on their treatment process and what that looks like, what their journey looks like. Some ladies, some patients just need surgery and maybe a pill, maybe not. And other patients kind of have a longer journey, can go a year, it's not uncommon, sometimes even longer now. We tell our patients, we never close the door officially on them. It's when they're kind of at a point where they're done with the majority of their hard treatments. And if they're on continuing maintenance things or treatments or things that they're not likely to present with new side effects, things like that, where even if someone's done and not any on anything else, we always say, we are here for you in the future. If anything ever comes, we are here to be a resource for you.
Kate Kolb:
Yeah. Which is great. I think that when you're dealing with something as difficult as this can be, and obviously we would want the prognosis and the outcomes to be as positive as possible, but that's a very daunting thing, I think when you're probably looking down the gauntlet of treatment and that sort of thing. So just being able to be open handed and open armed with the way that you care for patients is huge here. So thank you for that. Wanted to speak specifically for just a few minutes here, on the fact that October is breast cancer awareness month.
Kate Kolb:
That was one of the pieces and the reasons that we wanted to be able to sit down with you today Lindsay, and have this conversation because of what you specifically focus on here. And I feel like maybe even in recent years, people here, oh, it's October, it's breast cancer awareness. Maybe there's not as much recognition or acknowledgement for it because it's just something that we feel like, it's every year, we hear it every year. Why though, do you feel like in your role, or even just beyond it as what you've seen here at the cancer center, why do you think that it is important to keep awareness key when we talk about breast cancer specifically?
Lindsay Lacey:
Well, early detection is key and we see that all the time. And I think with COVID, it's something that is on people's minds. Is it worth me, and maybe this year with vaccinations, it hasn't been as looming, but especially last year, people delayed getting their mammograms, delayed going to the doctor, getting things checked out, if there's something presents, you're more likely to push it on the back burner. So catching things early, that annual whatever your doctor recommends, screening, finding things as early as possible is going to be the best case scenario for you. And I think it can be scary for so many reasons, but when you catch that early, it really can save your life.
Kate Kolb:
Yeah. So let's talk very specific numbers here for just a second. So at what age do you need to start looking at having that first mammogram and those early detections, like you're talking about?
Lindsay Lacey:
So, different resources have different recommendations slightly, but we recommend going on the American Cancer Society recommendation starting at age 40. At least for that baseline. And we've seen benefit and resources and recommendations to go annually. Now, should someone have family history, of not just breast, but other cancers, talk with your doctor about going in earlier for even just a baseline mammogram. And again, we could talk about other cancers too, but I think specifically with breast, that's our recommendation.
Lindsay Lacey:
I think a lot of people think, oh, this is an older lady's disease, or even like 50 plus or whatever. Not that 50 is old… haha… but I'm saying like it used to be, oh, it's something like 70 plus. And now it's creeping. We've seen unfortunately a lot of younger. It's happening more and more, younger and younger. So it's being just aware of what's normal for you, talking to your doctor about those conversations, about what their recommendations are. And if you would like to seen earlier for that baseline, be an advocate for yourself and we kind of vouch for that. And I think that's hard for a lot of people to, they just trust their doctors and which you should, but to, if you feel strongly about something, get it done, get it taken care of.
Kate Kolb:
That self-advocacy is such a huge piece of wellness as a total package. And I think we've talked about that in other podcasts that we've done and just other areas of Centra as we have different meetings about care and different ways that we want to approach our care here. And I think a big piece of what I've heard over and over and over again from different providers and people that I've sat down with is just this idea that we don't want to only be the place that you visit when you're sick. We want to make sure that you are talking about your wellness and your health before something would happen. So outside of the mammograms and that type of early detection, is there anything else that women and men need to be aware of for early detection? What does that encompass if you were to put that phrase in quotes?
Lindsay Lacey:
Well, I think just having a, getting your annual physical even, that's even gone kind of to the wayside a bit, right? Yeah. Even personally, so I think-
Kate Kolb:
Yeah, I'm guilty.
Lindsay Lacey:
And my husband, but anyway, but getting, having those conversations, we're kind of getting older, right? Like, so it's, every year you get a little bit older, so you need to have that annual check in my opinion, and basic labs drawn, making sure everything else is looking okay. Not just cancer, right? So, and having those conversations about, okay, when do I start with colonoscopies? When do I start with prostate exams? When do I do, and specifically for you, kind of have that unique individual care and those recommendations voiced even from a younger age, just so you can plan ahead.
Kate Kolb:
Yeah. I think that that's really important. You mentioned a few minutes ago, how people have tended to view maybe certain cancers or certain diseases as older people diseases and that sort of thing. And I don't know if anybody else feels this way, but the older I get, I'm like, wait old doesn't seem as old as it used to be anymore. So I think that that piece of making sure that we are being self advocates for our care and being aware. I had a friend of mine that's probably about 20 years, my senior say the other day, she said, it just felt like I hit this certain age and then all of a sudden it was like a grocery shopping list of all the things that I needed to do with my health and-
Lindsay Lacey:
Overwhelming.
Kate Kolb:
Yes, it is. It's very overwhelming. So just that piece of, maybe start earlier than you think you might need to for some of these healthcare things.
Lindsay Lacey:
And then hopefully it won't be so overwhelming when the time presents and then you're not like trying to play catch up either.
Kate Kolb:
Yes. Yeah, for sure. So always a plug there for our primary care and making sure that you're doing those yearly annual visits with your doctors there as well. Now, just to kind of toggle back to what you do specifically in your role here with specifically breast cancer or even outside of that, and just the navigation role in general, what do you feel like that you have gained and learned from being in the role that you are, and that can be personally or professionally?
Lindsay Lacey:
Yeah. One thing that has always been a huge takeaway for me is seeing these patients who never had cancer on their label, right? It's just going about life, you don't think it's going to happen to you and then boom, it happens. And seeing that again, that emotional journey, but also what do they gain from it? When we have our early support group meeting, that was one of the favorite questions I loved to ask the group and honestly, some people were just, they weren't quite, at that point where they were really had learned a whole lot.
Lindsay Lacey:
They were still kind of just dealing with the trauma of everything. But I loved when I could hear, I got stronger. I emotionally may not have been able to stand up for myself, but now I feel like I can be that advocate that I need to be for myself, even spiritually and emotionally, just be able to tap into God better and just kind of know what their purpose in life is and just more clearer. And it's, that's kind of a really beautiful thing. So I think it's just not taking days for granted and your family for granted. So I think just being able to really appreciate what, who surrounds you, who supports you and really lean into that.
Kate Kolb:
Yeah. What a beautiful way to express that. I think that that hits me. I feel like this past year, maybe with, well, really, it's almost two years now, can you believe that? The COVID journey that we've been through, but I feel like there's just this sort of question of general humanity happening for so many people right now with what does life look like? Life looks more different than it's ever been before. How do we navigate this? How do we go about our day to day? And COVID is sort of this looming cloud over a lot of things that have maybe made us ask a little bit more intentional questions about how we live our lives. And so that sentiment that you just said about watching your patients have these moments of recognition and self-advocacy and victory through a journey. I think one of my favorite things here at the Pearson Cancer Center that I've gotten to be involved with over the years of being here at Centra is when people get to ring the bell outside. And so can you explain what that is for people that might not know?
Lindsay Lacey:
Sure. So we have a healing garden right behind the cancer center. It's beautiful. Come check it out. But yes, we had a bell, a beautiful bell place, and I can't think of how I can too donated it, but a beautiful bell and late patients, anyone, male, female, whatever can, as they're completing their treatments, their last treatment, can come and ring that bell and invite family take pictures. And when that bell gets rung, everyone can hear it. It's pretty loud. So, and how encouraging it is for everyone and they can really kind of identify and symbolize the end. And it's never something that patients usually think, okay, I'm always going to, it's always going to be something I'm going to be afraid of or whatever, but to be able to have that moment of really completion, and I did this, I accomplished, this a big deal, celebrate it.
Kate Kolb:
Yeah, for sure. So, just as we start to wrap things up here, first of all, just thank you again for being here and for having this conversation with us today. I think this nurse navigator role is such an important piece of the care that we offer here at the Pearson Cancer Center. And just being able to have that personal touch point, like you were talking about with the patients and their families is so huge through this process. So I guess before we wrap up and before we say goodbye for the day, is there anything else that you would want our listeners to know about either your role or the Pearson Cancer Center, or just in general about health?
Lindsay Lacey:
So I think there's a lot of resources that people don't know we have here. A lot of people think, okay, it's too far away, or I don't have the funding, financial insurance, lack of support. So there's a lot of resources. We have a patient support fund that can help with patients who are having issues, with funding of this or financing that, whatever it is. And we have social workers, financial navigators as well, and a slew of other support systems that I think people just don't know about. So I, that would be my, my last tip is that don't think that we are just here to give you meds and treat you, radiate you, surgery. There's lots of, there's all encompassing care and support groups, things like that too, to help in your recovery journey as well, so.
Kate Kolb:
And as always, we say this at the end of every podcast, you can find more resources at centratoday.com or centrahealth.com. There is a Pearson Cancer Center page and different resources listed on our main website at centrahealth.com. So be sure to check out those resources as Lindsay was just talking about and Lindsay, again, thank you for being here with me today. It's been such a pleasure to sit down and talk to you, and I wish that you could see the smile on her face, because she clearly loves what she does and that is, it just beams from you. So thank you for your care, for your patience and for your commitment to Centra and all of that.
Lindsay Lacey:
Thanks for having me.
Kate Kolb:
Yeah, absolutely. All right. Stay tuned for our next episode and we will catch you next time on Centra Scripts.