Healing Over Decades

OVER MY 25 YEARS as an oncology nurse, I have had the privilege of working with many talented and dedicated clinicians. However, certain individuals stand out as being truly special because they bring a completely different level of professionalism and humanity to their interactions with peers and care of patients. Joanne Candela is such a person. Her unmatched compassion, integrity and commitment to her patients make her a truly deserving recipient of the CURE Extraordinary Healer Award.

I FIRST HAD the pleasure of meeting Joanne three years ago when I became her supervisor as nurse leader for the Survivorship Program at Memorial Sloan Kettering Cancer Center. Working as a survivorship nurse practitioner (NP) at Sloan Kettering, Joanne cares for a very complicated group of patients—young adult survivors and the adult survivors of pediatric cancers. The complex set of long-term and late effects experienced by these patients (which vary in terms of onset and severity) impact not only physical health, but also psychological well-being and social development. Monitoring for and managing the complicated late effects of chemotherapy, radiotherapy and surgery require astute assessment, detailed follow-up care and sophisticated coordination of services.

Joanne’s in-depth understanding of post-treatment effects such as cardiac disease, endocrine dysfunction and risk for second malignancies is essential to the timely identification and management of these serious and sometimes life-threatening issues.

But Joanne does not limit her practice to the medical management of these complex patients; rather, she works with each to address such critically important issues as employment, insurance coverage and social integration with peers. She is an expert at guiding them to local and national available resources. Joanne’s focus is on healing, an especially important and unique process for childhood cancer survivors that requires attention to immediate problems, anticipation of potential future issues, interventions and education to promote optimal physical and psychological function.

On par with Joanne’s exceptional clinical skills is her ability to establish trust and confidence with her patients. Their unending praise and appreciation for her skill and commitment provide some insight

into the difference she has made in so many lives. Patients have commented, “Thank you, thank you. You have no idea the difference that you make in my life;” “As always, thanks for your attention and follow-up advice. You make it easy, and that is no small gift;” and “I could not do this without you!”

Her attending physician colleagues write, “Needless to say, the patients love her. Joanne is a NP without parallel. I would not hesitate to entrust my dearest family members to her care;” “Joanne is remarkably dedicated to her patients and has a commitment to health and welfare that supersedes her everyday clinical responsibilities. She’s worked to address recent changes in Medicaid coverage, which have helped improve access to much needed care for poor or uninsured cancer survivors.”

Medical residents have acknowledged the insight gained through clinical rotations with Joanne, stating, “We spend much of our time in the hospital, working with sick, active treatment patients. I got to see the other side of cancer care, and what patients experience in the long-term, follow-up setting.

Observing how Joanne practices has given me perspective on what I’m working toward with my own patients. This rich experience has made me more comfortable with them. Joanne’s devotion to her patients is evident, and she serves as a role model for young clinicians striving to be caring and understanding providers through excellent clinical care and bedside manner.”

Nursing colleagues praise the calm demeanor and empathy Joanne brings to each patient. They comment on her resourcefulness and ability to solve problems, stating, “Joanne is a wonderful, motivational mentor. She is always imparting new knowledge she’s gained through reading or attending conferences to her nursing colleagues and other members of the healthcare team. She always has the answer to an obscure question! She inspires our entire team to learn, question current practices and grow.”

At our holiday gathering this past year, Joanne told a story of a patient she cared for on the pediatric inpatient unit at MSK in her first month working as a new nurse. Her young patient was a 14-day-old newborn diagnosed with a neuroblastoma. Joanne described her initial feelings of fear and doubt, which eventually gave way to hope. She included the new mother as much as possible in the baby’s care, and formed a bond with this mother that would prove fateful many years later. With tears in her eyes, Joanne described the phone

call she had received earlier that day from this former patient, now a woman in her 30s, grappling with endocrine and cardiac dysfunction. After all these years, the bond that had been formed between the new, terrified mother and the new (also terrified) nurse served to reunite this patient with her oncology nurse. Through her mother’s guidance, the patient reached out to Joanne to care for her once again. Not surprisingly, Joanne assisted the patient in navigating insurance issues and was ultimately able to see her in clinic and begin addressing her medical problems, again becoming the nurse caring for the patient she had first known as a newborn.

Intelligent, thoughtful and generous are qualities that come up repeatedly in talking with Joanne’s patients and colleagues. As a committed educator, collaborator and caregiver, Joanne has influenced and improved the lives of many, many cancer survivors. A role model for all oncology providers, both inexperienced and seasoned, Joanne reminds us why we chose this field and of how privileged we are to care for our patients and contribute to their healing every step of the way.