Don Vaughan

Lauren Yakelis, B.S.N., RN, (right) was nominated for the Extraordinary Healer award by Kristin Linde, M.H.A., B.S.N., RN, BMTCN (right). 

To say that Lauren Yakelis' teen years were difficult would be an understatement. At 15, the star high school volleyball player was diagnosed with Chiari malformations of the brain that required two surgeries to correct. Then, in 2005, Hurricane Katrina destroyed her family’s home in New Orleans as well as the high school that Yakelis and her siblings attended. Three weeks after moving to Baton Rouge, Louisiana, for a fresh start, her father was diagnosed with stage 4 colon cancer, from which he died two years later.

Yakelis managed to rise from these tragedies to find her true calling as an oncology nurse. 

“The brain surgeries helped me understand pathology and the human body, and I started volunteering at Children’s Hospital to help other young patients,” she recalls. “I was a senior in high school when my father was diagnosed, so I became his caregiver while my mother worked. All of that is what drove me to where I am today.”

Yakelis decided to practice at Ochsner Medical Center in New Orleans, where she is manager of the Bone Marrow Transplant Clinical Program. Her extensive responsibilities include overseeing quality metrics for bone marrow transplant, managing the continuation of care between inpatient and outpatient settings, providing education to inpatient and outpatient staff regarding new treatments, and maintaining Foundation for the Accreditation of Cellular Therapy accreditation.

While recognizing the daily challenges of oncology nursing, Yakelis is quick to note that she finds her job to be rewarding. 

“I’ve had a passion for helping people since I was a child,” she says. “I love walking into a patient’s room with a smile and asking, ‘What can we do for you today?’ It brings me energy and life.”

Yakelis played a pivotal role in launching Ochsner Medical Center’s groundbreaking adult CAR-T cell therapy program, the first of its kind in Louisiana. CAR-T cell therapy uses the patient’s own T cells by “programming” them in the lab so they can find and destroy cancer cells.

“The first six patients to receive CAR-T cell therapy here have all been in remission since their day-30 scans,” Yakelis reports. “Patients from Alabama and elsewhere are coming to New Orleans for the treatment. We’ve also partnered with MD Anderson Cancer Center, so we’re one of their centers as well now.”

The CAR-T cell therapy program is a broad example of how Yakelis helps care for patients with cancer. Also, she strives to establish a personal connection that helps patients feel calm and comfortable. She recalls a recent patient who was stressed over having a central line placed in her chest. The procedure was performed, but the patient later complained of breathing difficulties. Yakelis learned that the patient’s lung had been punctured, and stayed at her side while the pneumothorax was repaired. “She successfully had her stem cells collected yesterday,” Yakelis says of the grateful patient.

Yakelis’ helping nature also extends to her colleagues, as evidenced by her role in the stem cell transplant department winning the coveted Patient Safety Department of the Year award. “At Ochsner, the quality metrics that we track allow us to improve every year. We monitor central line infections, catheter-associated infections, MRSA and patient deaths, among other things,” Yakelis explains. “We see trends and consider what we can do to improve.”

Yakelis investigated a rise in Clostridioides difficile infections and found an array of potential causes ranging from how dietary staff handled patient trays to the equipment used by environmental services to clean patient rooms. 

“I helped create changes not just for nurses, but other departments as well,” Yakelis notes. “For example, we found the central line dressing kits had the sterile dressings in the wrong order, which affected sterility. We reached out to the company that manufactured them, and the company fixed the problem. This award was given to us because we had great quality metrics, and our trends kept improving.”

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“I was a senior in high school when my father was diagnosed, so I became his caregiver while my mother worked. All of that is what drove me to where I am today," an oncology nurse explained.

A Passion for Helping People With Cancer

Jessica McDade, B.S.N, RN, OCN, like so many nurses before her, went into the profession as a result of a close family member’s experience with cancer. In McDade’s case, the patient was her mother, who overcame renal cancer when McDade was 15 years old.

Oncology nursing wasn’t McDade’s first choice, however. 

“After graduation, I took the first job I could find [in a cardiac step-down unit] and quickly realized it wasn’t for me,” she recalls. “It was on a very fast-paced, high-turnover floor, and I wanted a position in which I could develop relationships with my patients and follow them through the process from diagnosis to, hopefully, remission.”

Today, as a charge nurse at the Dana-Farber Cancer Institute in Boston, McDade helps guide patients through their cancer journey while also mentoring newly graduated nurses. But she’s also looking to the future by continuing her education at Simmons University in Boston, where she is working toward a master’s degree in nursing education.

“I hope to use this degree to continue mentoring nursing students and to potentially move my career from the bedside into an education role at Dana-Farber,” McDade says.

McDade has worked as an oncology nurse at the Dana-Farber Cancer Institute for 16 years and derives a lot of gratitude from her job. 

“It makes me very grateful for my health and that of my family,” she observes. “I commute an hour each way three days a week, but I rarely listen to the radio; I just think and reflect on how grateful I am.”

She also benefits from the close relationships she develops with many of her patients. 

“I really try to relate to them on some level, whether it’s a mutual hobby or the fact that their children went to the same college as me, or we have children around the same age,” she says. “I always try to find something that I can share about me so they will feel comfortable.”

One of McDade’s most memorable patients was a woman who developed acute lymphoblastic leukemia in her early 20s. She was in a Ph.D. program at the time of her diagnosis and had to put her life on hold for a two-year course of treatment, McDade notes.

“I took care of her, and we became friends. We really bonded over the fact that we were both young and starting our lives, and then her life was put on hold because of her cancer diagnosis,” McDade notes. “My husband and I attended her wedding, and her parents send me a Christmas card every year. It’s nice to see that the care I helped provide led [her] to a successful life both professionally and with her family.”

Helping patients with cancer means addressing their emotional and psychological needs, as well as the physical ones. The floor on which McDade works has a relatively low nurse-to-patient ratio, which affords her time to talk with and get to know her patients. 

“It’s my hope that each of my patients feels like they’re my only focus,” she says. “Because I have years of experience, I often share stories of previous patients who have had similar experiences so that they feel like they’re not alone in their diagnosis. I can pick through my memories and find stories that they can relate to.”

Sometimes, McDade adds, the emotional aspect of her job comes to a head and she finds herself crying along with a patient. “People get angry when they feel there is no hope,” she explains, “and there’s obviously a lot of sadness there.”

McDade also excels as a mentor to nurses new to oncology, a complex and evolving specialty that requires close collaboration between numerous disciplines. 

“I discovered I love to teach,” she says of this aspect of her job. “I love to orient newly graduated nurses on our unit because I’ve been there for 16 years, I know the lay of the land, and I can be a good resource for them. I want to make them feel comfortable asking questions because errors are made when you don’t ask.”

Oncology nursing can be especially stressful for new graduates, and McDade does her best to help them appreciate what makes the specialty unique. 

“Oncology nursing can be overwhelming,” she admits. “But if a nurse wants to specialize, oncology is the way to go because it is a specialty with a lot of intricacies, and you also get to work with almost every body system. You see a little bit of everything.”

McDade loves her job and finds it personally uplifting. Those outside the medical profession, however, are often surprised to learn that her days aren’t entirely steeped in sadness. 

“When I tell a new friend or even my students that I’ve been in oncology for 16 years, they want to know how I could do the job for so long,” she says. “I tell them it’s not always sad, that there are some great stories out there. We make people better, and when we discharge a patient, I always say, ‘Don’t come back. I won’t take it personally.’”

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An interview with Jessica McDade, B.S.N., RN, OCN, an Extraordinary Healer award finalist.

Reflecting on Gratitude in Cancer Care

Meaghan Mooney, B.S.N., RN, OCN, winner of the 2024 Extraordinary Healer® award, spoke about her career during an interview.

Meaghan Mooney, B.S.N., RN, OCN, was leaning toward a career in maternity and pediatrics while in nursing school at Fairfield University in Connecticut, when a surgical rotation on an oncology floor sent her down a completely different path. “I felt drawn to oncology,” Mooney says. “It’s a tough specialty, but that made it even more rewarding. It seemed like the perfect fit for me.”

Upon graduation, Mooney took a job at Memorial Sloan Kettering Cancer Center in New York City, then moved to the oncology floor at Seton Medical Center Austin, part of the Ascension health care system in Texas. After about a year, she transferred to Texas Oncology, also in Austin, where she worked for almost nine years. In 2019, Mooney rejoined Ascension as a quality and patient safety nurse for Ascension Medical Group before stepping into her concurrent role of chief of staff.

“As a Catholic health organization, Ascension promotes a culture of caring for the poor and vulnerable,” Mooney says. “That translates to the care provided for patients, especially those who are uninsured or underinsured. I appreciate that service to the community.”

Mooney’s position as chief of staff has taken her out of patient care, but she still helps patients with cancer and their families as a member of the board of directors of Wonders & Worries, a nonprofit organization that provides support to children and teenagers during a parent’s serious illness or injury.

“While Wonders & Worries provides support for several types of medical conditions, the majority of their clients [include children with a parent] with a cancer diagnosis,” Mooney says. “They explain the parent’s diagnosis in an age-appropriate manner, and also help children work through any feelings or concerns they are experiencing. All of their services are provided free to the families.”

Mooney joined the board of Wonders & Worries in 2019 and quickly found herself in an advisory role because of her nursing background. “I also help with outreach and development, looking for ways that the organization can expand and connect with other referral bases,” she notes. “I’ve also chaired their annual fundraising gala for the past two years.”

Mooney really came through for Wonders & Worries when the organization needed a hospital room in which to film an educational video that would show young people where and how their loved ones receive treatment. Finding an available room locally proved challenging, so Mooney reached out to her alma mater, Fairfield University. “They have simulation labs that are set up to look exactly like a hospital room, so I asked if they would allow Wonders & Worries to film there,” she says. “It ended up being a great alternative that allowed Wonders & Worries to complete the project.”

Mooney has also mentored nurses who were new to oncology. “When you come out of nursing school, you’re just overwhelmed and scared that you’re going to make a mistake,” she explains. “I tried to make them feel comfortable asking questions. And I’m the kind of person who likes to do research, so I also created binders and cheat sheets regarding the most common things they would see and have to manage. I let them shadow me and explained to them why we were doing a particular procedure or test. Things like that helped them feel more connected to the care team and the patient.”

Mooney acknowledges the emotional challenges of working in oncology but finds the work personally satisfying. “It can definitely take a toll on you because you have ups and downs,” she says. “You’re trying to find the small wins, whether it’s a patient whose symptoms have resolved or who had a good lab result, or someone who was able to go out to dinner with their children. We like to celebrate those little victories with them, so their victory is our victory, too. I’ve become an expert silver lining- finder. I will find it, and I will remind the patient of it.”

Oncology nurse, Meaghan Mooney, B.S.N., RN, OCN, winner of the 2024 Extraordinary Healer® award, celebrates the “small wins” with her patients. 

Finding the Small Wins as an Oncology Nurse

The biopsy had clear margins and (my team) would be following me for the rest of my life. Today I’m cancer free.

Anna Bass, 62, of Victoria, Virginia, had been a longtime smoker, so she was not surprised in October 2016 when she was diagnosed with adenocarcinoma in her right lung. Her doctor had noticed a small spot on a CT scan two years earlier after she quit smoking. She had opted to hold off treatment, hoping that the lesion would not grow larger.

Bass, a secretary at Victoria Baptist Church, underwent a lobectomy to remove the top right lobe of her lung. She was happy to learn that she required no further treatment. 

“My brother-in-law is an oncologist, and he said if they didn’t tell me to get chemotherapy or radiation therapy, it was because they weren’t necessary,” Bass recalls.

Throughout her cancer journey, Bass received an array of supportive care from her medical team, friends and family. Nurses addressed her pain, helped her learn to breathe properly again and demonstrated how to use an oxygen concentrator. She was encouraged to exercise, so she started walking.

But the most significant support Bass says she received from her care team was reassurance that her cancer had a good chance of being eliminated and likely would not reoccur. 

“They told me that the cancer had been slow growing, the biopsy had clear margins and they would be following me for the rest of my life,” Bass says. “Today I’m cancer free.”

Bass’s story illustrates the many benefits of supportive care for patients with lung cancer, a population that tends to skew older and have more comorbid conditions than those with other forms of cancer. Bass, for example, has chronic obstructive pulmonary disease and is a recovering alcoholic, which restricts her use of opioids to alleviate pain. 

When started early in the treatment continuum, guidelines show, supportive care can help patients live longer, improve their quality of life and cope better with the side effects of their disease and treatment, as well as comorbid conditions.

The terms supportive care and palliative care are sometimes used interchangeably, but there can be differences. The Multinational Association of Supportive Care in Cancer defines supportive care as “the prevention and management of the adverse effects of cancer and its treatment. This includes management of physical and psychological symptoms and side effects across the continuum of the cancer experience from diagnosis through treatment to posttreatment care.”

Palliative care, according to the Center to Advance Palliative Care, is “specialized medical care for people living with serious illnesses. It is focused on providing patients with relief from the symptoms and stress of a serious illness — whatever the diagnosis. The goal is to improve quality of life for both the patient and the family.”

Lung cancer is a prevalent disease with a high incidence rate, so it has received a lot of attention from researchers over the years. This has led to advances in treatment and supportive care. 

“This patient population still has a lot of needs, but the good news is that their prognosis and their experience have gotten better,” says

Dr. Jennifer Temel, co-director of Massachusetts General Hospital’s Cancer Outcomes Research and Education Program and professor of medicine at Harvard Medical School in Boston. 

“Targeted therapies and immunotherapy have (become) more effective, so patients are living longer. And for the most part, the physical symptoms associated with these treatments are less. This doesn’t obviate the need for supportive and palliative care for lung cancer patients, but I think their needs have changed over time and they are becoming more like other advanced cancer populations.”

Supportive and palliative care for patients with lung cancer commonly involve the entire care team, observes Betty Ferrell, director of nursing research and education and a professor at City of Hope in Duarte, California. A care team includes physicians, nurses, social workers, physical therapists, occupational therapists, nutritionists, chaplains, psychologists and psychiatrists. Other aspects may include such novel approaches as music therapy, art therapy, acupuncture and massage.

“There are four key disciplines in (patient) care: medicine, nursing, social work and chaplaincy,” Ferrell says. “Physicians evaluate the patient’s medical condition, while nurses do a lot of symptom management and handle other responsibilities. The social worker assists the patient and family with issues such as finances, transportation, and in-home services — you can’t provide good palliative care without a social worker. And chaplaincy addresses the patient’s spiritual needs. Chaplaincy is critical.”

Dr. Arif Kamal, chief patient officer with the American Cancer Society and an associate professor of medicine and population health sciences at Duke University School of Medicine in Durham, North Carolina, agrees that spiritual support is vital. 

“Chaplaincy can help when patients have existential questions, such as ‘Why did the cancer happen to me? I’ve always been a good person,’” he says. “That question usually does not have a scientific answer, but a chaplain can be very helpful in helping the patient work through it.”

On the medical side, supportive and palliative care can address symptoms unique to patients with lung cancer, Kamal adds. These include shortness of breath, cough, difficulty swallowing, loss of voice, coughing up blood, confusion and issues around brain metastases.

Almost all accepted treatment guidelines recommend that supportive and palliative care be started at the time of diagnosis in order to address the symptoms and side effects of treatment before they become debilitating. However, this often is not the case, Ferrell says. 

“When people come to us with lung cancer, everyone is focused on treating the cancer — no one wants to talk about palliative care,” she explains. “Everyone’s response is, ‘It’s not time yet, let’s just start chemotherapy, then maybe later we’ll start palliative care.’ As a result, patients may not receive the supportive care they need until months after they should have. By the time they receive it, their quality of life has been severely impacted.”

Temel says, “We as a research and clinical community still have to find that sweet spot of figuring out how and when to integrate palliative care at the best time. But based on the data, early integration of palliative care for patients with challenging physical or psychological symptoms is still the best strategy.”

According to Temel, Massachusetts General Hospital was among the first institutions to demonstrate the benefits of initiating supportive and palliative care at the time of diagnosis. 

“More than a decade ago, we published a paper that showed that when you involve palliative care early in the course of illness for patients with incurable lung cancer, they have a better experience with their cancer and have better outcomes,” she notes. “They have better quality of life, fewer symptoms of depression, spend less time receiving chemotherapy and have better outcomes at the end of life.” 

Whereas a patient’s care team addresses the physical and emotional impacts of treatment, friends and family also play a critical role in supportive care. But there is always the risk of burnout. 

“If you’re caring for someone with lung cancer, you’re a 24-hour caregiver,” Ferrell says. “That can be a huge burden on some family members.”

Lisa, who asked that her last name not be used, is a writer and publisher in Raleigh, North Carolina. She was a caregiver for her older sister during her lung cancer journey starting in 2014. She assisted her sister with everything from housing and meals to transportation to and from treatment. 

Although she was happy to help, Lisa admits that the two years of caregiving were extremely stressful.

“There were times when my sister could be so critical that it was hurtful,” Lisa recalls. “Things were so hard at times that my goddaughter and I would go away so I could regain my composure. We would have a vent session and try to reboot my compassion meter.”

The family caregiving experience was far less dramatic for Christy Dawkins, 51, of Batesburg-Leesville, South Carolina. When she received a diagnosis of stage 3 non-small cell lung cancer in December 2019, her husband enthusiastically jumped into the role of caregiver. He took a monthlong sabbatical from work to care for her, doing all he could to keep her spirits up. 

Christy Dawkins learned how critical a support system is during cancer treatment and beyond. 

“He was there for me through all of the trips to receive radiation treatment and everything,” Dawkins says. “He really helped me through it.” Meanwhile, family friends created a meal train on Facebook so that the family wouldn’t have to worry about cooking during such a stressful time. 

We had people dropping off meals every night,” Dawkins recalls. “That was a huge help.”

Because lung cancer is more commonly diagnosed in older people, many family caregivers are older themselves and may be dealing with their own health issues, such as diabetes, heart failure and arthritis, Ferrell says. But their involvement can be extremely important to the patient. They are an additional pair of eyes and ears, and they often are directly involved in making sure the patient receives the care they need. 

But the heaviest burden they may bear is managing the patient’s emotional symptoms.

“We often don’t realize the role that caregivers play in helping patients
to keep going despite depression or anxiety,” Ferrell notes. “There’s a lot of fear, anxiety and emotions associated with living with lung cancer.”

Though supportive care for patients with lung cancer has been an integral part of treatment for many years, misconceptions still persist. 

“Most common is the belief that palliative care and hospice are synonymous, so that when we talk about palliative care, sometimes patients and their  families have worries that that means they’re at the end of life,” Temel explains. “It’s up to doctors, nurses and social workers to explain the distinction between palliative care and hospice care and the role of both services to allay those fears so patients are more accepting of the involvement of palliative care.”

“There must be educational campaigns that teach people how the emphasis during these conversations is not on end-of-life planning,” he says. “In my clinical practice, most patients are not dying. I have a large number of patients who have been seeing me for years because what we’re talking about is long-term distress, as opposed to an acute end-of-life type plan.”


Ideally, supportive and palliative care discussions are initiated by the patient’s medical team at the time of diagnosis. If that doesn’t happen, the patient and family caregivers should inquire about needed services, Ferrell says. “If my spouse or a parent is diagnosed with lung cancer, what do I want as a spouse or daughter? I want them to receive the best care possible,” she says. “So that’s the question every patient and caregiver should ask: ‘What about palliative care?’”

Concludes Temel: “I often remind my patients and their families, especially if I think they would benefit from something like palliative care but are resistant, that having cancer is hard for everyone and they should at least be open to accepting any support we can give them. Patients and their families talk about how it takes a village on their side to get through a cancer diagnosis. But it also takes a village on the clinician side. As an oncologist, I’m always going to do whatever I can to support my patients and their families. But the struggle is significant, so I rely on my colleagues who are social workers, nutritionists and psychologists to help out. Patients should take advantage of all of the services we have to help them navigate this very challenging time in their life.”

More awareness is needed to understand the benefits of both supportive care and palliative care in lung cancer.

Don Vaughan

A Passion for Helping People With Cancer

Reflecting on Gratitude in Cancer Care

Finding the Small Wins as an Oncology Nurse

Early Supportive Care Extends Life, Eases Cancer Symptoms

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