APPs Offer a ‘Unique Lens’ to Myeloma Care

APPs play a unique an important role in treating patients with multiple myeloma, a nurse practitoner said.

Advanced practice providers (APPs) are essential in caring for patients with multiple myeloma, as they sit at the crux between bedside nursing, a close relationship with patients, and clinical training, explained Samantha Shenoy, MSN, NP.

Shenoy is a nurse practitioner at UCSF Medical Center in San Francisco. She recently sat down with Oncology Nursing News to discuss the APP’s role in myeloma treatment—and how she hopes to see that role evolve.

What is the role of APPs when it comes to the treatment of patients with multiple myeloma?

We're responsible for seeing all the patients with multiple myeloma before they start treatment and while they're getting treatment. Our role is to help manage the side effects of treatment, to communicate with other members of the health care team—such as physicians, nurses, pharmacists, social work, etc.—related to their treatment.

We also coordinate with outside oncologists. We're a major academic medical center, so we often coordinate with places outside [of academic institutions]… that may not be able to offer the treatments that we can offer at UCSF.

Basically, our role is to see these patients in clinic and help guide them through their treatment journey … helping them navigate the health care system, helping them with the emotional toll that having a very serious cancer like multiple myeloma [can bring]. Helping them understand the labs. So there's certain labs we monitor with myeloma, we go, we follow those labs with them, explain, what those mean, etc.

Have you seen, or do you predict any challenges in integrating APPs into myeloma care?

I don't see any challenges. I think we play such an integral and important role, and I can't even imagine what it was like before APPs.

We’re busy, but I always tell patients, [physicians are] even busier; they have so much going on. And I think without that APP role … a lot of us were nurses first. We knew what it was like to spend time at the bedside with a patient all day, and we really understood that. And then we, APPs, have had education; we're masters trained. So then we can see things through a provider lens. And so I think when you have someone who can both see a patient through a provider lens, but also through [the lens of] someone who's been a nurse at the bedside, creates this beautiful combination of someone. Not to say that I don’t think physicians get it as well. But I think nothing can replace having bedside experience and then also having provider experience. So you're really able to understand things in a way with such a unique lens, because you've played both roles.

How do you envision the role of APPs evolving the future myeloma care?

I would say there's always more that we can do. I feel passionate about education. For example, I'm giving a talk in a couple of weeks to the African American community in Oakland. And I think we have such a unique role. … The fact that we can then outreach to other communities can be a really powerful thing. We play an amazing role in education, not just the patients, but of nurses and other staff because of our experience. I think that can inherently continue to evolve, because we play such an independent role. I think that's what's really unique.

Where I work, specifically at UCSF, we see patients independently, and I think it's such a unique role to be able to do that. And then then we also collaborate with our physicians, so I have meetings with them every week. So in terms of how it could evolve, I think just the continuing of that.

We can just play bigger and bigger roles, I'd say, specifically for research. My role is really evolving, because I'm really taking a leadership role in identifying patients now who would be candidates for clinical trials, and I'm now that point person, because I have the vision of all the trials. I'm now keeping a list, basically, of patients who are potential candidates for clinical trials. So I'm constantly thinking about, “this is a trial where we have slots. This patient would be a great candidate.” I think in my role in particular, there's opportunity for a lot of evolution in terms of us taking that leadership role, because if you have one person who kind of has a pulse on every trial, versus the physicians are in charge of their individual trials, and it creates this ability to identify patients in a way that I think just streamlines the whole thing in a much more efficient way.