Nurse navigators and nurse practitioners are crucial members of our team at the N.C. Basnight Cancer Hospital, UNC Lineberger’s clinical home. They play essential roles in the diagnosis and treatment of every patient who comes through the hospital’s doors. Their insights, guidance and compassion are vital to patients and their loved ones—effective and comprehensive care would be impossible without them.
This is especially true in pancreatic cancer, one of the most difficult cancers to diagnose and treat in a timely manner. November is Pancreatic Cancer Awareness Month, and to mark this important month, we sat with a few key members of our oncology team to discuss their careers and hear about the essential work they do in our clinics to provide their patients with invaluable care and support.
Leanne Ormsby, BSN, RN-BC, is a nurse navigator in the medical oncology clinic at the N.C. Basnight Cancer Hospital; Jessica Damiani, MSN, NP-C, is a nurse practitioner in the Division of Surgical Oncology specializing in upper and lower GI cancers, sarcoma and melanoma; Kathryn Hepper MSN, RN, AGNP, is a nurse practitioner in the Division of Surgical Oncology specializing in pancreatic cancer, colon and rectal cancers, and metastatic liver tumors.
Can you describe the path you’ve taken to your current position?
Leanne Ormsby (LO)
With 16 years of experience as a nurse with UNC Health, I have dedicated most of my career to providing care to patients, particularly those facing GI and head and neck cancer challenges. I gained invaluable hands-on experience caring for critically ill individuals as a bedside nurse for the first 14 years of my career, allowing me to develop a deep understanding of their needs and challenges.
Throughout my journey to become an oncology nurse navigator, I have worked to refine my communication and organizational skills, recognizing the pivotal role they play in guiding cancer patients through their treatment. Effective nurse navigation involves providing unwavering support and coordinating seamless care across a spectrum of health care providers and services.
Jessica Damiani (JD)
Before my current role as a nurse practitioner in surgical oncology, I spent most of my career as a bedside nurse in the intensive care unit. During the one year I briefly worked in the post-anesthesia care unit, I met some of
the surgeons in my current group. I really appreciated the work they do, their overall manner, and the relationship they have with their patients. When I finished graduate school, I looked for an opportunity to join their team, and I have now been in this role for four years. Treating such a large array of cancers involved a steep learning curve, but climbing it has been great and I’ve had excellent guidance along the way.
Kathryn Hepper (KH)
I have worked in surgical oncology for 13 years. However, I began as an RN in pediatric surgical trauma in the Cleveland area. I then spent a significant amount of time on the labor and delivery floor, switched to Infectious diseases research for a few years, and transferred to outpatient surgical oncology in 2011.
I was drawn to oncology for a few reasons: my mother fought breast cancer for 16 years before ultimately passing away from the disease at 64. I went to nearly every doctor, imaging and treatment appointment. Also, a close friend was diagnosed with breast cancer shortly after my mom passed away. I was supporting her and accompanying her to appointments when I met her surgeon, who was searching for a nurse. I applied for the position, which I did not get, but I was hired to another team in the cancer center, where I had amazing mentors.
I started at UNC in 2019 as a Surgical Oncology Adult Gerontology nurse practitioner. I am very grateful for my coworkers here at UNC. I enjoy working with the surgical oncology team and being able to offer significant treatment options to patients fighting this horrible disease. Interestingly, I visited UNC in 2011 to support my sister through her daughter’s open-heart surgery at UNC Children’s Hospital. I remember walking around the cancer hospital and bringing back suggestions to my Cleveland team about the patient education center and the impressive patient store, which had wigs, lymphedema garments and breast prosthetics.
What does your typical workweek look like?
LO
A typical week as an oncology nurse navigator is multifaceted, involving various responsibilities to support cancer patients and their families. The most important facet of nurse navigation is undoubtedly patient-centered care: putting the patient at the forefront of every decision and action, and tailoring support and guidance to their needs, preferences and values. Nurse
navigators serve as advocates for patients, empowering them to navigate the health care system with confidence and ensuring they receive timely, coordinated and compassionate care. This work includes:
- Clinic Prep: Scheduling and preparing for upcoming clinic appointments, ensuring Dr. Somasundaram has what he needs to make needed recommendations (i.e. recent scans, pathology reports, labs), reviewing patient barriers/insurance information and anticipating additional supportive services (nutrition, cancer support services, CCSP, palliative care).
- Patient Follow-up: Dedicating time to follow up with patients, addressing concerns and questions, providing additional education on treatment plans or side effects, and offering emotional support to them and their families.
- Coordination of Care: Acting as a liaison between patients, health care providers, and cancer support services; coordinating appointments, procedures, tests and treatments to ensure seamless care delivery.
- Multidisciplinary Team Collaboration: Uniting surgeons, radiologists and other specialists to develop and adjust treatment plans.
- Community Resources: Connecting patients and their families with community cancer resources, financial assistance programs, and counseling services through CCSP to help enhance their quality of life during treatment and beyond.
JD
I am in clinic every day of the week either working with our surgeons or seeing patients in my own clinic. I attend two multidisciplinary tumor boards regularly, and care for a wide range of patients with upper and lower GI cancer, melanoma and sarcoma.
KH
My work week usually includes multiple shared clinics with surgeons as well as my own clinics. I am in clinic every day of the week and I currently work with four surgeons. I am at the Hillsborough location on Mondays and Tuesdays, the main campus on Wednesdays and Fridays and UNC Panther Creek on Thursdays. I also personally have a pancreatic cyst clinic and see many surveillance follow-ups in colorectal, appendiceal, thyroid and melanoma.
How do you explain treatment plans to a patient who might be nervous about or intimidated by treatment?
LO
When explaining treatment plans to my patient who is nervous, it is essential to approach the conversation with empathy and clarity. I start by building trust and assessing their understanding of the condition and treatment options that have been reviewed. I often use visual aids and written material to supplement discussion. I follow up with patients after their initial appointment, checking in to address additional questions and concerns and hear any thoughts they have regarding their diagnosis and treatment plan.
Conflicts can arise between a patient’s preferences and what is medically advisable. Ultimately, the goal is to reach a shared decision-making process where patients feel empowered and supported in making informed choices about their health care, while also ensuring that their medical needs are adequately addressed to optimize outcomes.
Can you tell me about the most memorable experience you’ve had with a patient?
LO
There have been so many beautiful memories over my 16 years as a nurse. I can honestly say that my role as nurse navigator has been the most rewarding. It has given me the opportunity to build lasting relationships with my patients and their families.
I recently had a patient with stage IV colon cancer, and we formed a deep connection that extended beyond medical care, his family included. He had a passion for photography and traveling to various state parks in the U.S., with Yellowstone being his favorite. I remember visiting him during a hospital admission, and he had brought me tons of brochures and a map of Yellowstone. It has always been a dream of mine to take a family trip out west and visit Yellowstone. He knew this and helped me plan a trip for my family. We hope to take that trip next year when our youngest turns five. The patient also gifted me a calendar that he made with pictures he had taken from his last trip to Yellowstone with his brother. I still have the calendar hanging in my office, and it always reminds me of him. Although he’s no longer with us, I think of him and his family often, and I look forward to taking that trip soon to experience a place that meant so much to him.
JD
I have had many memorable moments with patients, some solemn and serious, but the ones that stick out in my mind and make me happiest are the times a patient or family member says something humorous that catches me completely off guard. This lightens the mood of our conversation and alleviates some of their anxiety. Laughing is restorative.
KH
I have many very memorable patients and patient situations. We as a team are always happy to tell patients that surgery was successful, the tumor has been completely removed and they currently have no evidence of disease. Although bittersweet because I miss the patient, the best is getting them to the five-year survival visit and letting them graduate to their primary care for long-term management.
What keeps you motivated in your role?
LO
Several factors motivate me. I always want to have an impact on patients and families, making a meaningful difference in the lives of cancer patients and their families is incredibly rewarding. It’s also so important to me to build relationships—developing strong bonds between my patients and their families allows me to witness their strength, resilience and courage.
At the same time, I’m driven to grow in my profession. The field of oncology nursing is ever-changing, with endless opportunities for continuous learning and development. It’s also a highly collaborative environment; I get to work closely with a multidisciplinary team to benefit our patients. Ultimately, the opportunity to positively impact the lives of patients with cancer, the relationships formed with patients and colleagues, and the constant opportunities for growth and learning all contribute to my motivation and dedication as an oncology nurse navigator.
JD
I’m motivated by seeing patients recover from surgery and going on to challenge the odds. I love when we’re able to see someone through their surveillance phase and they’re able to “break up” with us and put their cancer diagnosis behind them.
KH
I truly enjoy working with patients, educating them about their disease process and the treatment options, helping them through the treatment plan process and surgical recovery. I also enjoy getting to know my patients over time, meeting their family members, and seeing them in surveillance. I feel that because of my personal experience with cancer I bring a perspective of empathy and care that is quite valuable.
—Tyler Rice, UNC Lineberger Pancreatic Cancer Center of Excellence