RN&R • Patient navigator
Peg Farrar prioritizes breast cancer patients at Saint Mary’s.
Peg Farrar is the nurse navigator for cancer patients at Saint Mary’s Regional Hospital. It’s a new position for the hospital, one in which she helps patients navigate the rocky terrain of cancer.
Why was there a need for your position?
There aren’t any other patient navigators within this system. What I do is help patients with education, support, referrals, and getting through the cancer process. The treatment is pretty comprehensive and not very pleasant. I’m prioritizing right now with breast cancer patients because very few of those ladies spend more than one night in the hospital. If they have a mastectomy, they may stay overnight. If they have a lumpectomy, they go home that day. Their chemotherapy is outpatient; their radiation is outpatient.
And that’s different from other cancer patients?
Yes, a lot of other cancer patients spend more time in the hospital with surgery and other treatments [so they have more time to ask questions and get answers].
I have a ton of information about their disease, the treatments available for it, the doctors in town that treat that kind of cancer. If they need to go out of town, finding doctors out of town. They are often on a difficult medication with lots of side effects or risks, and I can help them with that. They sometimes need help paying with some of these medications. Even with insurance, the co-pays can be $600 per treatment for some of those drugs. I don’t know about you, but coming up with $600 every couple weeks would be a challenge. And following them with phone calls, visits, checking on them to make sure they’re not having any problems. I also see people before and after surgery to make sure they’re not having any concerns or complications. And I go with people to their doctor’s office for support and making sure they ask all the questions they want to ask and so on.
Do you work with their families, too?
Absolutely, because when one person in the family has cancer, every family member has cancer. I give out my card to their family members to call me to ask questions they wouldn’t ask in front of the patient. I’m real comfortable talking about death and dying. A lot of the cancers we see—especially those in breast cancers in the early stages—are not going to kill this lady. But I bring it up because I know it’s a fear in the back of their mind.
How do you treat breast cancer patients differently?
There’s probably more hugging and more crying with them because of the nature of what they’re about to lose. Not only are these ladies going to have their breast removed or really deformed by surgery, but they may lose their hair, they may go on medications that cause them to go into menopause. A lot of the ladies I see are about my age—I’m 53—so I have some knowledge of what they’re dealing with before the breast cancer. And those ladies in their 50s have children, they may have a young family and also taking care of aged parents, and then they get hit with this diagnosis. It’s a lot.
Many other cancers are less disfiguring. There are many men walking around with prostate cancer, and you wouldn’t know it, but you usually can tell the ladies with breast cancer, and it’s certainly impacting their relationship with a significant other.
You also help them find transportation?
The Cancer Society has some transportation assistance. It looks like there’s going to be some gas cards made available for patients. There are at least four patients from Winnemucca, and I can’t imagine driving back and forth. Even people who live in the North Valleys, if you have 50 radiation treatments, and it’s 40 miles round-trip every day, that’s a huge amount of mileage they accrue.
Do you have a personal stake in this?
My mom died of breast cancer that was not diagnosed in time. But that was a long, long time ago. I’m quite sure had she been diagnosed today that it would have been a different trajectory. And my husband died four years ago of cancer. And being a nurse, I could take care of him, and he could die at home. I miss him terribly, but I don’t have any regrets about doing what was best for him.
So you know what people are going through.
Yes. And I know it from a really good standpoint, and I want others to have the kind of experience I had with agencies and caregivers. I want to do for them what I could do for people I love. It’s not easy. I don’t know how to explain it. We really walk people through the valley of the shadow of death with their cancer. But the good news is they come out on the other side. Especially with early stage breast cancer, that’s very true.