Even during “normal” times, a cancer diagnosis can turn a patient’s entire world upside-down. And over the past year, with the added difficulties and uncertainties of receiving medical treatment during a global pandemic, patients often have been left to navigate clinic visits, treatments and recovery on their own, or with limited in-person support. Without question, 2020 was one of the most challenging years for patients and their care providers. With that challenge, however, came opportunity—a chance for the Sentara Martha Jefferson team to find creative ways to provide a care experience that is second to none.
During the pandemic, nearly every aspect of health care had to be adjusted to protect patients and caregivers alike. Elective procedures and surgeries were postponed, and routine follow-ups were pushed back or transitioned to telehealth visits. While some specialties were a better fit for virtual care, oncology went through a more challenging transition. Due to the potential seriousness of any oncology visit, significant delays in diagnosis or treatment were likely to have negative impacts on patients.
Since our patients often require in-person evaluation and then receive their treatment at our infusion treatment center, the pandemic presented unique challenges, in terms of ensuring that our patients were treated in a safe and timely manner. Thankfully, the Sentara Martha Jefferson team proved to be adept at devising solutions to many such obstacles.
Addressing Numerous Challenges
Our infusion treatment center is a perfect example of this struggle. As a physician, while I may see a patient for 20 minutes or so on a particular day, a treatment session may actually last five or six hours. This extended time in the infusion center was never intended to be an experience that patients had to face alone—to help keep patients at ease and engaged, interactions during treatments with nurses, volunteers, support services and loved ones are typically frequent. Limiting the infusion center experience to only the patient and nurse, due to COVID restrictions, fundamentally altered our full-spectrum approach to care.
The importance of a patient’s personal support system has long been known, so pandemic-related patient isolation and loneliness have been very real concerns for caregivers. Limited patient interactions with friends and loved ones—including not being able to physically be together for appointments and treatments—has taken a toll on patient well-being. As well, when loved ones are forced to receive updates secondhand, largely unable to provide direct assistance, they can experience stress and anxiety.
Access to care during the pandemic also has been a troubling issue. Although many of us take for granted the easy access to and reliance on technology for everyday tasks, not all our patients have smartphones or reliable internet access. As a result, the pandemic has placed many of those without reliable access to virtual care in an even more precarious situation.
Another difficulty experienced by caregivers during the past year has involved our ability to connect with and comfort our patients. As oncologists we are frequently in the position of having to deliver difficult news. While we all have our own approach and style for doing so, the foundation of such conversations relies on developing interpersonal connections with our patients and their families. Having to deliver challenging news while socially distanced—behind a mask and refraining from offering a comforting touch or hug—has felt very unnatural to me. In fact, in such instances, I often had to remind myself to take a few steps back or put my hands at my sides in order to maintain proper COVID protocols.
The delivery of cancer care has long focused on creating a culture of support and empathy. Sentara Martha Jefferson team members constantly strive to support all aspects of a patient’s health—physical, mental and emotional. The pandemic, however, created a situation in which our healthcare providers not only had to adjust to the inconveniences of physical separation, but also had to find new ways, even amidst those circumstances, to deliver the same level of all-encompassing support to our patients and their loved ones.
Overcoming such challenges to care has been daunting, but in countless instances, I have seen our team rise to the occasion to care for our patients in keeping with Sentara Martha Jefferson’s Caring Tradition. Whether patients were new to our practice or with us long term, we wanted to provide the same services they had come to expect and rely on in years past. For example, we pivoted many of our support services and support groups to be offered virtually. For clinic visits, we regularly made efforts to include support persons via phone or video chat during clinic visits, to ensure that patients and their families could take in information and ask questions as needed. As well, our clinic and infusion center nurses have done an outstanding job stepping into the void created by the lack of visitor access, making extra efforts to engage and connect with patients. As a provider, during visits I also personally made a concerted effort to identify specific stressors brought on by the pandemic—often unrelated to a patient’s diagnosis or treatment—and ensure that those issues were being addressed as well.
Increased collaboration among caregivers also emerged as a valuable caregiving tool during the pandemic. Although oncology care has always been a multispecialty field requiring a high level of interaction and shared management of patients among the subspecialties, the pandemic called for even more coordination and shared decision-making than before. Complex decisions about whether to omit specific treatments, options for shorter courses of chemotherapy or radiation, and discussions about the actual benefit of a particular therapy were much more common over the past year than before the arrival of COVID.
While we have now largely adapted to our “new normal,” one in which fist and elbow bumps have replaced handshakes and hugs, the longing for closer human interactions persists. While I am heartened by the creative solutions developed by our entire care team to adapt to the pandemic, I am still concerned for those whose access to care has been reduced by COVID restrictions. Certainly, my perspective on the delivery of care has been forever changed.
And while the pandemic’s global toll around the world has been staggering, the care team at Sentara Martha Jefferson is stronger than ever, and we now have more tools at our fingertips to continue providing the high-quality care that our patients and their loved ones have come to expect.
The Sentara Martha Jefferson Cancer Center offers the following support services to our patients and their families:
- Certified cancer genetic counselor
- Cancer nurse navigators
- Case management, social worker and financial counseling
- Palliative care
- Cancer survivorship clinic and a “Living with Cancer: Facing Forward” class
- High-risk breast clinic
- Support groups
- Clinical trials
- The Something Special Shop—certified mastectomy bra and prothesis fitter
- Marianne’s Room—wigs, hats and cooling cap fittings
- Cancer rehab and renewal exercise support program
- Smoking-cessation specialists
For more information on Cancer Support Services, call our Cancer Resource Center at 434-654-8401.