Navigating the nuances of breast cancer care

COOKEVILLE – Most moms dream up big careers for their kids. Doctors, lawyers, and the like. While Lisa Morris always wanted to be a nurse, even when she was a child, it was her mom who wanted her to find a focus in oncology. And for pretty good reason: her mother had breast cancer, her middle sister has breast cancer and her younger sister has experienced cancer, too, endometrial stage three.

Morris, who had a background in women’s health and pediatrics, wasn’t exactly resistant about that specific career path, but she was unsure.

“I just didn’t know about it,” she said. “My mother really felt very strongly for years that’s what (I should do), especially when she went through that process herself with breast cancer. It was probably always in the back of my mind, but I never did it. Until the Lord really pushed me.”

That “push” came not long after a move to the Chattanooga area – where she also received her master’s in nursing from nearby Southern Adventist University. Morris, who says she’d never had a hard time finding a job before, suddenly found herself without work even after a series of applications. She, instead, was drawn to a particular position as a breast nurse navigator at Memorial Hospital in Chattanooga but continued to ignore the signs.

“God kept telling me to apply for this job, and I’m like, ‘no, I’m not going to apply for that,’” she said. “I had never worked in oncology. But it just kept coming and coming, and finally I said, ‘OK.’ They called me, I went in and was offered the position.”

She helped start the nurse navigation program at Memorial as part of a comprehensive breast center there. And today, she’s nearing one full year as just the second breast nurse navigator at Cookeville Regional Medical Center (CRMC).

She said she hopes to grow CRMC’s program and do more with survivorship – and possibly help add more nurse navigators for other cancer disciplines. While those longer-term goals are more difficult to define, it’s the day-to-day that seems to have the greatest impact.

Nurse navigators serve as advocates and a resource for patients undergoing tests and treatment for cancer. The impact? Improved patient satisfaction, positive changes in patient attitudes, increased understanding of the disease process and patient perception of more timely and accessible treatment.

CRMC reported a total of 150 breast cancer cases in 2012, the most recent year data was available.

“When you hear the cancer word, you freeze,” Morris said. “You just think, ‘I can’t believe this is happening to me, what am I supposed to do next?’ It’s not like having your gallbladder taken out: you go to the surgeon, he sets it up and you’re done. Breast cancer’s totally different. There’s imaging, biopsies, pathology, appointments here, appointments there. It is a maze for people to try to get through. It’s been proven time and time again that navigation decreases anxiety and fear for patients during this process.”

Morris steps in as soon as a patient receives news of abnormal imaging. She sets up a biopsy, educates the patient and talks them through what’s going to happen, even meeting them at the surgeon’s office for the procedure. If the pathology comes back negative, she may talk to the patient about breast health and the importance of regular mammograms.

In the event of a positive diagnosis, she’s there, too. After the surgeon goes over respective options, Morris talks to the patient briefly and makes an appointment for them to come to her office. Face-to-face, she goes over the pathology and reiterates the treatment plan. “My new diagnosis education (sessions) are driven by the patient,” she said. “That says a lot about our hospital, that they place such an emphasis on the patient and their breast cancer journey.”

Post-op, Morris helps make further appointments for radiation, etc. At that point, she steps back, “just a little bit,” she says, because patients are usually being seen every day. After treatment, she picks them back up, and carries them to “survivorship and beyond.”

“You form these lifelong friendships with these patients, because it is a journey,” Morris said. “From day one until the end, whether the end is death or total remission, we have a bond.”

And it’s not a role she takes lightly. She’s been able to help her sister through the process as well as close friends. Unfortunately, her mother passed away before seeing her daughter realize her dream.

“(It) would really make her day, to know this is what I did,” Morris said. “She always said, ‘Lisa, they need your hope, your smile. They need the encouragement you can give them.’ There are times when (this job is) sad for me, but I rely on my faith to give me that strength and help these ladies.”

Services are available to anyone in the Upper Cumberland, Morris added.

“It’s going great here,” she said. “The surgeons are great to work with, radiation oncology, medical oncology, the radiologists, pathologists, even people in the community, they’ve been great to work with.

“This is my calling, and I love it,” Morris continued. “I love what I do, because I have such passion for it, and because there is such a need.”

 

Lisa Morris is the breast nurse navigator at Cookeville Regional Medical Center. For more information about the nurse navigation program, contact Morris at The Women’s Center at (931) 783-2628 or lhmorris@crmchealth.org or visit www.crmchealth.org/find-care/centers-excellence/cancer-center/nurse-navigator-program.

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