This is the fifth article in a series of stories related to oncology nursing. You can read more articles in the series here.
Translating Clinical Care for Callers to NCI’s Cancer Information Service
Most oncology nurses are on the front lines of cancer care, interacting with and helping patients on a daily basis. But what if that front line is a few steps removed from the face-to-face contact of the clinic? That’s exactly the situation for the oncology nurses of NCI’s Cancer Information Service (CIS), a resource which handles approximately 100,000 calls, e-mails, and live chat sessions annually.
More than 70 information specialists, who are trained and monitored by experienced oncology nurses, tackle these requests for help and information, often engaging in lengthy discussions about treatment options with someone who has just been diagnosed with cancer, or with the spouse of a cancer patient who’s having a hard time taking care of their loved one and needs some help or guidance on what to do or where to turn.
Before they can begin direct engagement with callers, the information specialists undergo 6 weeks of intense training on everything from the basics of cancer diagnosis and therapy to proven treatments for nausea and pain. These specialists, in many respects, “are the voices of NCI,” said Randy Jacobs, an oncology nurse educator with the CIS.
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Jacobs’ charge is to help ensure that those voices are “empathetic, knowledgeable, and responsive,” she explained. As an oncology nurse, Jacobs understands the kind of impact a one-on-one interaction with patients and caregivers can have.
“My background in oncology and as a bedside nurse really helps to bring some of the clinical aspects of cancer care to the information specialists, who often don’t have that intimate level of knowledge,” she explained.
In her role with the CIS, Jacobs is heavily involved in nearly all aspects of the information specialists’ training, including how to develop a rapport with patients, providing education about specific cancers, and continuing education programs.
“We can help the information specialists understand the complexity of cancer and the patient experience,” said Judy Petersen, an oncology nurse who recently joined the CIS as an educator. “In this call-center environment, that’s where an oncology nurse is particularly helpful, because we can really put into context what patients and their families are going through.”
A Nurse’s Touch
An important part of their job, Jacobs explained, is helping the information specialists determine what each caller actually wants, without being able to rely on the telling physical cues that face-to-face interactions with patients can provide.
“Sometimes callers don’t want to share too much information, but other times they want to tell you everything,” she said. “They may be going through a very emotional time, they may be crying, or they may break down during the call. So the information specialists have to balance how much cancer knowledge the callers have, where they are coming from, what’s their state of mind, and try to give them the information they’re really looking for.”
And if, during a call, the expertise of an oncology nurse is needed, the information specialists can turn to the nurse educators for help. “A specialist will come to me and say, ‘Can you help me with this person who has stage III colorectal cancer and really wants to know more about the side effects of chemotherapy?’” Jacobs explained. “We can get very specific and provide the information the caller needs in real time.”
Nurse educators also play an important role by making callers aware of clinical trials, said Deborah Pearson, an oncology nurse who worked as a clinical and research nurse at the NIH Clinical Center for 9 years and now plays a dual role with both the CIS and NCI’s Public Inquiry Office. “These nurses are using their real world experience; information from NCI, including the wealth of information on Cancer.gov; and the patients’ situations to help the information specialists direct appropriate patients to clinical trials for which they may be eligible,” she said.
Keeping Up with the Research
One aspect of their positions that can be challenging at times, Jacobs and Petersen agreed, is keeping up with the constantly evolving nature of oncology care, changing care patterns and paradigms based on clinical trials, and other high-impact research.
“That’s one of the challenges of not being in a clinical setting,” Petersen said, “maintaining that awareness of how research outcomes are being translated into clinical practice.” That requires a lot of journal reading, attending conferences, and paying attention to reliable sources of clinical cancer news.
Overall, Petersen said, the CIS culture is ideal for an oncology nurse who, like herself, first entered the profession because of the relationships with patients and the opportunity to have such a profound impact on people’s lives.
“Everybody here is so open to learning and transferring that knowledge accurately and empathetically to our callers,” she said. “They all have a strong, genuine interest in helping people.”