In the 1980s, enlightened practitioners at St. Vincent’s Hospital on Staten Island (now Richmond University Medical Center) felt that breast cancer patients should have a special program to serve their unique needs. The Mastectomy Rehabilitation Program was born.
Any woman who was slated for breast cancer surgery was automatically referred to the program whose services included an oncology nurse, social worker and physical therapist to help her navigate her breast cancer treatment. Before the patient left the hospital, she received referrals, financial resources and counseling to help her get through every phase of recovery.
“This groundbreaking program was the foundation of the breast cancer work that we do today at Richmond University Medical Center,” explained Marion Smith, RN, OCN, MS, Oncology Program Coordinator. “As resources became limited, the staff thinned out, and it was a challenge to keep remnants of the program operational.” But the program’s purpose has been restored. For the past five years, Richmond University Medical Center (RUMC) has brought back many of its original elements.
Healthcare on Staten Island is fragmented. The borough has no city or state hospital and with no subway line, transportation is difficult — creating a huge challenge for those who need care. Many people who live in RUMC’s service area are uninsured, minorities, undocumented individuals who are afraid of having their status revealed, and people for whom English is not a first language.
RUMC is in the third year of a Breast Health Patient Navigator grant from Komen Greater NYC. When it started in 2010, there was no formal program in place. Staff reviewed several models to create a structure, tweaked it and put it into place.
The program’s goal is to break down barriers to breast health and treatment. Nancy Bommer, RN, MS, is the Breast Health Patient Navigator at RUMC. The program provides a full continuum of care from the time of screening through diagnosis, treatment and survivorship.
The first step is to get women into the center to be screened. Wherever a group of women might gather, Bommer is likely to be there, armed with displays, DVDs, and bilingual materials, ready to help them break down any barriers to screening.
The period between screening and delivery of test results is especially difficult, because many patients are worried about the outcome. “We have them come back to find out what their results are,” explained Bommer. “But it is hard to get them to return, because they are afraid of what the results might be and are often overwhelmed by life.”
If the screening is negative, staff provides the woman with breast health awareness information and reminds her of the importance of an annual mammogram.
If the results are positive, the patient has a face-to-face meeting with a doctor who delivers the diagnosis and explains the next phase of treatment. Bommer then follows up to make sure the patient has all she needs to go through the process:
One of the most beneficial elements of the program is that it advocates for the patient with her doctors. This year’s grant from Komen will add a 15-hours/week Family Care Specialist, who will most likely be a social worker. She will screen every patient for psychosocial distress and refer those who need additional help to an appropriate counselor.
The grant also helps by underwriting little things that make a big difference — food vouchers for patients who are at RUMC waiting for tests, as well wigs, hats or scarves for uninsured patients.
“You’d be surprised,” said Smith. “Patients are really excited to have these small extras, thanks to Komen.”