Outstanding people are the Heart of the Hutch

Empowering patients motivates Fred Hutch nurse navigator

Michelle Hamilton was diagnosed with systemic lupus when she was 8 years old. By the time she got to college, the last thing on her mind was a career in health care. She’d spent years grappling with her autoimmune disease and needed a break.

“Who wants to work with sick people?” she thought.

Hamilton planned to become a teacher. After college graduation while she was figuring out what was next, she took a job at Fred Hutch Cancer Center. Hamilton split her time between the Patient and Family Resource Center and the patient and family education team, where she helped patients and their families better understand their diagnosis and treatment and worked with them to access support and survivorship services.  

“Within a matter of months of making these connections, I immediately knew I needed to go into nursing,” she said. “I had an aha moment: The sick people are here to get better, and I can help physically and emotionally by educating them. It was a shift from ‘No, I don’t want to be around sick people’ to ‘Yes, I can teach but through a nursing perspective and empower people to get better.’”

As a child and teen, Hamilton said she never felt empowered in her care. She just did whatever her doctor advised, even when she didn’t understand why. Managing her disease as a child was especially challenging because systemic lupus is more typically diagnosed in older women.

“I went through chemotherapy, steroids, immunosuppression — it was quite a roller coaster,” she said.  

Toward the beginning of her college years, her disease flared up and she had to manage it on her own, without her mother’s help. She tried chemo but relapsed within months, which prompted her to advocate for a different treatment.  

“For the first time, I stood up and said, ‘I need to find something else because I can’t keep relapsing,’” Hamilton said. “My doctor presented my case to other doctors for advice, and we found a balance of treatment that was a lot less aggressive. This was my first experience with feeling like an empowered patient.”

Guiding and supporting patients  

That memory inspires Hamilton’s work at Fred Hutch, where she is a nursing supervisor for the nurse navigation team. Nurse navigators help guide patients with a new or recurring diagnosis through Fred Hutch. They identify what appointments patients need prior to their first visit and help educate them about their diagnosis. They answer questions, help troubleshoot and serve as a clinical support person.

“I love being part of this program that holds a patient’s hand and helps them at a time when they feel fragile and confused because they have a new diagnosis,” Hamilton said.

Nurse navigation is a newer nursing subspecialty within oncology, but one that offers an opportunity to make an outsized impact on the patient experience, said Janelle Wagner, senior director of nurse navigation.

“Michelle’s passion is to advocate for patients, which is why nurse navigation struck a chord for her,” Wagner said. “This job brings all her passions for nursing together in one role.”  

Anna Gfeller, senior nurse manager of the nurse navigation program, is Hamilton’s supervisor.

“Michelle really believes in the program and is great at advocating for patients,” Gfeller said. “She has a real skill of connecting people.”

Hamilton worked as a transplant nurse at UW Medical Center-Montlake after she graduated from nursing school at the University of Washington, but she always planned to return to Fred Hutch. In 2011, she did just that, working as an infusion nurse before moving to the transplant clinic and transition nursing, where she helped organize the patients’ move from inpatient to outpatient care. She started as a nurse navigator in 2021 and was recently promoted to a supervisory position, where she helps grow the nurse navigation program at Fred Hutch.

“Nurse navigation makes a huge impact on patients and the quality of their care,” she said. “We use our knowledge of the health care system to help guide patients to their goal.”

When a referral comes in, it goes directly to a nurse navigator, who begins the process of assessing all the providers and tests that a patient should access based on their diagnosis.

“We make sure we have the right specialists involved,” Hamilton said. “I can be someone to catch patients when they feel they’re falling. It is an amazing part of this job.”

— by Bonnie Rochman

Experience as a sarcoma patient informs clinical research manager’s role

Erica Peters was working with sarcoma patients when she received her own myxofibrosarcoma diagnosis 10 years ago.

“I had been working in clinical trials for about three years when I was diagnosed,” said Peters, a clinical research manager for the Fred Hutch Cancer Center/University of Washington radiation oncology research team. “I’m working in sarcoma — what are the chances? It was like, ‘I’m in the same situation as the people who are here to get treatment.’”

Her ability to empathize with other Fred Hutch cancer patients has served Peters well over the last decade. She and her teammates coordinate clinical trials in radiation oncology, managing patient participants’ schedules and care and helping them navigate any adverse events.

It’s a demanding job that requires both intense focus and organizational skills, but Peters only has to glance at the scar that runs the length of her left arm to remember her own experience with radiation, surgery, recovery and physical therapy.

“I am definitely more empathic and understanding now about what patients are going through,” Peters said. “From the coordination side of things, my work is very much about schedules and timing. But I know these people are going through so much in their life that scheduling a blood draw is the least of their worries. Looking at my arm is a daily reminder of that.”

Patient-to-patient connection

While there are over 80 subtypes of soft tissue cancers, or sarcomas, Peters said hers was more benign and slow growing, “but it was still cancer and still needed to be addressed.”

Luckily, the sarcoma was detected early when Peters followed up on a strange skin reaction to a routine tuberculosis test. Treatment was no picnic, but she said she does appreciate the perspective the experience gave her. 

“I connect with patients on a different level now,” she said.

She's happy she can connect other cancer patients with a treatment that proved effective for her.

“With me, the plan was to radiate the tumor first to potentially shrink it before surgery,” she said. “I went through six weeks of radiation, five days a week, about 20 minutes in and out. My coping mechanism was to count the number of seconds the beam was on.”

Her other coping mechanism, she said, was continuing to work in cancer research.

“I went to work early every day,” she said. “For six weeks, I worked full time, then went to radiation, then went home. It helped keep my mind busy.”

Surgery — followed by physical therapy — helped her regain full use of her left hand and fingers.

“The first time I tried to snap my fingers I screamed in pain,” she said. “I wasn’t ready yet. I had to relearn some things and gain strength enough to lift grocery bags. There were some functional issues. But I had a really good prognosis.”

Shane Hoffmann acts as 'ray of sunshine in a very dark time and place' 

Shane Hoffmann, the flamboyant blonde in the pink bowtie, is the first person that patients encounter when they enter the lobby of the original South Lake Union clinic building. Patients often refer to Hoffmann as the “face of Fred Hutch,” but Hoffmann prefers the term “head cheerleader.”

“I’m a little overbubbly,” they said. “The job brings that out in me.”

As patient service representative, Hoffmann sees their role as an enthusiastic and empathic concierge. They direct patients to their appointments, answer the phone, give directions and offer recommendations for where to grab a bite to eat or go for a walk to calm patients’ nerves.

“It’s easy to see in someone’s face when I’ve had an impact,” said Hoffmann.  

One interaction in particular stands out. A patient showed up for her first appointment to the wrong location. She was crying, and Hoffmann listened to her, then set her up with a shuttle that would take her to her intended destination. Afterward, she swung back by the front desk to thank Hoffmann for reassuring her and calming her down. “She said she was fully composed by the time she reached her appointment,” Hoffmann said. “Now every time she is back in the clinic, she makes a point to come by and say hello.”

Hoffmann understands the need for empathy from personal experience. Hoffmann’s sister had multiple surgeries as a child, and Hoffmann watched as the weight of caregiving fell to his mother. "When you see someone who’s your best friend constantly crumbling, it makes you want to make sure other people don’t feel that way,” said Hoffmann. “I don't need to know exactly why someone is at Fred Hutch to know why they are at Fred Hutch. I know they’re dealing with cancer in some way, and I see it as my role to listen and connect with them, to acknowledge them as human and make things less confusing for them."

Patients have noticed; Hoffmann’s positive attitude was highlighted recently in The Seattle Times’ “Rave” section:

RAVE to the front desk manager for the Fred Hutchinson Cancer Center in Building 1. They have a smile for every patient and family member who walks through the door, and they know the “regulars” by name. Dealing with sad, scared cancer patients and their loved ones can’t be easy, and they are a fabulous ray of sunshine in a very dark time and place. They give directions, answer questions and soothe the weary and worried, all without missing a beat. It’s like watching an air traffic controller or a symphony conductor!

That recognition resulted in Hoffmann — who spreads cheer from the front desk dressed in vibrant colors and bold patterns — being named the first recipient of Fred Hutch’s newly established Service Excellence award, which recognizes employees who excel at putting patients first. 

To promote that mindset, all clinical operations staff are expected to complete a new 90-minute training, Approach to Service Excellence 101, by early 2024. Hoffmann, not surprisingly, has been tapped as a substitute teacher. 

— by Bonnie Rochman