"You have to have compassion — the ability to put yourself in the patient or family’s shoes and know what they’re going through," said an oncology nurse who was a finalist for 2022 Extraordinary Healer® award.
Tammy Allred, RN, OCN, is one of those lucky people who always knew what she wanted to do with her life. Although her original plan of driving around the country providing nursing services to indigent children didn’t pan out, Allred still ended up in the nursing profession, with her first job at Alamance County Hospital in Burlington, North Carolina.
“I didn’t know much about oncology until I interviewed at a local hospital,” she remembers. “Since I was the newest employee, they trained me in oncology so I could help out in both medical-surgery and the oncology department, and it all sprouted from there. I fell in love with it because it’s always changing.”
Helping to arrange a last-minute wedding in the oncology ward for a patient who didn’t have long to live solidified Allred’s resolve that she had made the right career choice.
“That’s what sealed the deal,” she says. “It let me know that oncology was where I needed to be. I was in a place where I could help people, hopefully make a difference and even make dreams come true for some patients.”
Allred worked at UNC Healthcare in Chapel Hill, North Carolina, as a research nurse for five years, coordinating clinical trials and guiding patients through the process. She now works as an oncology navigator, although she still helps trial coordinators by placing orders and helping patients through the management of their side effects.
“I feel the position of oncology navigator was made just for me,” she says. “I’m involved in everything.”
One of the issues she repeatedly encounters is the misinformation that’s so rampant online.
“I tell my patients to avoid Dr. Google because he can lead you down the wrong rabbit hole,” Allred says. “When you find cancer information online, be careful to make sure it’s from a reliable source — a legal drug manufacturer or pharmaceutical company, for instance — and not some second cousin twice removed who used something once and thought it worked.”
Allred remembers a patient with colorectal cancer who bought “witch’s mushroom tea or something like that,” and, after taking it, went into liver failure and died. “He’d probably still be alive if he hadn’t done that,” she says. “I always caution patients not to take anything (over the counter) unless they clear it with us first to make sure it’s safe.”
When patients balk at their course of treatment, Allred asks them what they know about cancer therapy. What they tell her is often outdated or just plain wrong, and it gives her a chance to dispel those misconceptions. One myth is that patients with cancer should refrain from eating to avoid nausea, when the opposite is actually true.
“I tell them that keeping food in their stomach is the best way to avoid nausea,” she says.
Since she can’t always be there when patients have questions, Allred has a brochure that explains what an oncology navigator is and what they do, tells them who to contact and offers helpful tips about medications, possible complications and other facets of their treatment.
For patients who might be hesitant to enroll in a clinical trial, Allred explains that every step is controlled by the Food and Drug Administration and guided by its protocols.
“They might have the idea that it’s some mad scientist in a basement throwing solutions together to see what happens,” Allred says. “In reality, it’s a doctor who’s well-versed in the drugs being used, who knows what works. And we’re going to monitor you closely every step of the way. That usually makes them feel a little more relaxed.”
As for what skills are necessary for the job, Allred notes that “you need to be part detective and part teacher and have extensive experience working in other areas of cancer care. You have to have compassion — the ability to put yourself in the patient or family’s shoes and know what they’re going through.”
For Allred, the experiences she’s had with patients have been deeply rewarding.
“The best part is when patients come back and thank me for making a difference in their lives, even if it’s just telling them it’s OK to cry or scream and throw things. Having them come back after the worst is over and tell me ‘You were right – it wasn’t as bad as I thought it would be.’ Or in the end, if the patient has passed, the family coming back and thanking me for always being there for them,” she says.
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