As Hurley Medical Center’s Breast Health Nurse Navigator, Marsha Schmit, RN, BSN, CBCN, guides women through the complex treatment options and emotional land mines of breast cancer, from diagnosis to treatment to recovery or acceptance. Schmit knew b
eing a Nurse Navigator, a job she moved into in 2008, would allow her to use her 20-plus years of nursing and administrative positions to improve experiences, outcomes and quality of life for Hurley breast cancer patients.
What she didn’t know is that her Navigator job would also point the way to help save her own life—an experience that has turned her new career into a calling.
Answering A Call
Schmit was less than a year into her job as a Certified Breast Health Nurse Navigator when she went for her own routine mammogram in late 2009. Though the results were normal, she knew a previous mammogram had revealed a spot that looked benign but that her doctors were watching. There were lingering doubts. Schmit recalls she discussed additional testing with her doctors, but was reluctant because it wouldn’t be covered by insurance. She eventually opted for a $250 screening that was a precursor of the breast cancer screening MRIs now used to find small or hidden cancers, especially in women with dense breast tissue. The second test was barely completed when her doctor walked into the exam room.
“‘Nothing about that looks good and we are going to make time for that MRI right now,’” Schmit recalls him saying.
Part of Schmit’s job as a Nurse Navigator is sitting down with patients right after diagnosis and showing them their tests and explaining the pathology report. Now, the cancer she was looking at was her own. “It was an invasive lobular cancer that often stays deep in the breast tissue and hides when the breast is compressed, so it usually is not caught until much later,”she said. “It was a huge blessing for me to be chosen to be in the job because it meant my cancer was caught earlier.”
Schmit faced her own cancer head on: a bilateral mastectomy (removal of both breasts) with immediate reconstruction, followed by four rounds of chemotherapy. She opted to work throughout her treatment, both for her own wellbeing
and also to continue to build and expand the Nurse Navigator program, which was still new. Her side effects were manageable, if not always comfortable or pleasant. “I could stay home and be miserable or come to work and be the best that I could be,” she recalled. “I was still going through certification (as a Breast Care Nurse Navigator) and I wanted to role model dealing with adversity to my children.”
First Hand knowledge
Having detailed knowledge about what to expect didn’t always make it smooth sailing, however. When her hair started falling out in clumps “I cried like crazy,” she said. “I cried all that day. Then I said ‘This is what I have to do’ and I went and got it all shaved off.”
That’s a lesson she shares with her patients: “You have to grieve your losses—your breast, your hair, the changes that occur. But you are going through those losses to gain years of your life. You need to stay in the land of the living.” She opted to tell only a few of her Hurley co-workers what she was going through. She asked her RN friends to accompany her to doctors’ appointments and chemo sessions instead of her husband, relying on him to keep the household and their family, which included two preteens at the time, functioning.
“I tell my patients that they need someone at their appointments taking notes. You just stop hearing what your doctor is saying when you hear cancer. It’s just too hard to process it all—to hear it, remember it,” she said.
Support for survivors
One place that she did share her diagnosis and treatment was at Hurley’s Breast Cancer Support Group, which she co-facilitates. Schmit said she let all the patients speak first because she wanted the focus to stay on them. Then she told them “I
’m now walking in your shoes.”
There were many tears, but it was heart-warming and ultimately uplifting for all, she recalls. “I told them, ‘you’re all survivors, you’ve gotten to the other side, you’re a great example,’” she said. “I had joined the club. I had the purpose-driven life that I had prayed endlessly for once.” That calling stays with her today.
The Patient Navigation Fund
Schmit also raises money for and administers a fund—the Patient Navigation Fund—through the Hurley Foundation. The fund allows her to help her patients with some of the financial challenges they face as they battle breast cancer. Schmit says breast cancer delivers a double or triple whammy to many women—not only are they sick, but their spouses or partners often leave, they may have to take sick time from their jobs, there’s no money coming in,
the bills pile up—it’s a snowball effect that has serious consequences on health. She always has a stash of grocery store cash cards and gas cards to help out in an emergency. She tells her patients to call her if they have a utility shut-off notice.
“One of my patients is a woman with a young daughter who has brain metastases. She is going to go to (renowned cancer center) MD Anderson to try to save her life. I called her and said ‘bring me some of your bills,’” she said. “They need to put their energy into healing, not keeping a roof over their heads.”
Hope to share
Schmit still shares her own breast cancer story with many of the 200 patients that are part of her caseload. “I share my experience, but I don’t ever want it to be about me. I want them to know I’ve been in their shoes and I know what they are going through,” she said. “I also share it to give people hope. They can look at me five years later and know there is life after all of this.”
By Brooke Lamson