Encouraging Fitness and Fellowship

It is my pleasure to nominate Joanna M. Losito, M.S.N., RN, OCN, FNP-C, AOCNP, for the 2019 Extraordinary Healer® Award. Although I have met many medical professionals during both my cancer journey and my 18 years as a social worker, Joanna has made the biggest impression. She is an extraordinary oncology nurse practitioner whose compassion, expertise and enthusiasm have had a profound impact on my quality of life and on that of the many patients who participate in her Exercise for Energy (E4E) and Exercise for Strength (E4S) programs.

^{From left: Joanna M. Losito, M.S.N., RN, OCN, FNP-C, AOCNP, and Honora R. Miller, M.S.W., M.S.S., M.L.S.P. Photos by Kristina Rust.}

I met Joanna shortly after I received a diagnosis of multiple myeloma, when she encouraged me to participate in her E4E class during my initial cycle of chemotherapy. Her enthusiasm and insistence that I could manage it despite being on chemotherapy piqued my interest. Deep in a chemo fog and struggling with fatigue, I attended the first of many Saturday morning classes and was moved to tears by the room filled with strong women ranging in age from 20-something to 80-something, each in different stages of cancer treatment and survivorship, all determined to improve their health. Joanna was warm and welcoming and skillfully checked in with every woman in the room to encourage and assess. I remember struggling to follow the directions, having a hard time with balance and needing to rest frequently, but Joanna assured me that that was all right. I left feeling energized and hopeful and kept coming back.

A few months later, Joanna provided essential medical intervention to me when I had an intense allergic reaction to my chemotherapy. The fact that I knew her from E4E and trusted her helped me immediately accept her treatment plan when I was in distress. Nearly a year later, I began to see her on a regular basis for checkups, and she was the first (and only) oncology practitioner to help me manage the debilitating side effects I was experiencing from multiple lines of chemotherapy and a stem cell transplant.

I owe my current quality of life and functionality to her willingness to address my various side effects by making referrals to specialists and researching lesser-known side effects of my chemotherapy drugs during our session so that we could brainstorm solutions together. She also encouraged me to enter a medically supervised plan to lose the weight that I had gained post-stem cell transplant. Her support has helped me live with less pain and more movement and to now be 80 pounds lighter and working out regularly. Joanna’s commitment to treating the whole person, as well as her willingness to take the time to listen and collaboratively problem-solve, are exceptional, as are her unbridled enthusiasm and authentic warmth. She inspires patients like me to move forward, remain positive and have hope.

Joanna is legendary at the medical center for her E4E and E4S programs, which she offers in addition to her individual-patient medical practice. Through these programs, Joanna has affected hundreds of patients — many for more than a decade. What started in 2005 with 10 to 12 participants for a graduate-level research study (“The Effects of Group Exercise on Fatigue and Quality of Life During Cancer Treatment,” which appeared in Oncology Nursing Forum in July 2006) during Joanna’s nurse practitioner degree program has evolved into two programs involving 25 to 40 women and 20 to 30 men each week. (A few years after the success of the women’s program took hold, Joanna established the E4S program for men with cancer, which she runs on Tuesday evenings.) Several hundred participants have come through the programs over the past 13 years, and some have been attending consistently for nine to 10 years. Both programs are lauded by participants.

Joanna designed, implemented and directs the E4E program for women with cancer to integrate the wellness benefits of exercise with the powerful dynamics of group support. The program, which has been meeting nearly every Saturday morning for 90 minutes since 2005, focuses on increasing strength, endurance, balance and functionality for patients with cancer at various stages of treatment or survivorship who have the consent of their doctor. The class, co-taught by Joanna with Deanna Anderson, a highly skilled movement and dance specialist, provides a solid workout. It is also a medically supervised, structured opportunity for patients receiving cancer treatment to participate in a wellness-promoting activity that offers a sense of control and normalcy during a time in our lives when both are in short supply.

Joanna checks in with each woman in the class, greeting all with hugs and her infectious energy; on occasion, she skillfully jumps in to provide medical intervention when a participant feels unwell. Peter Giordano, a talented musician, provides live music that enhances everyone’s energy and enjoyment and adds to the feeling of camaraderie. The community of survivors that Joanna has fostered shares support, information and encouragement both inside and outside the class. I occasionally run into an E4E classmate at another part of the medical center, and whether we just wave or nod at each other or stop to chat, the fact of our known shared experience makes the medical matter that is being attended to feel a bit less isolating and a bit more manageable, because I am reminded again, in that moment, that we are part of a community of survivors.

The springboard for E4E was Joanna’s prior experience (30 years) on an acute-care medical unit at El Camino Hospital, where she provided medically supervised fitness instruction to patients with chronic obstructive pulmonary disease (COPD). She observed that, in addition to the positive effects of exercise improving their quality of life, her patients with COPD benefited from the fellowship and support emerging from that program.

At San Jose State University, Joanna earned her master’s degree as a nurse practitioner (2005) and her bachelor’s degree in nursing (1985), and she holds a bachelor’s degree in psychology (1981) from the University of California, Santa Barbara. Since 2005, she has been an oncology nurse practitioner at the Palo Alto Medical Foundation in Mountain View and Sunnyvale, California, where she works independently to educate, assess, evaluate and treat medical oncology patients in a private-practice setting with six oncologists in a 35-chair infusion center. Prior to her current role, she was a clinical nurse 3 at El Camino Hospital in Mountain View (1985-2005), where she provided direct patient care to complex adult medical/oncology patients in an acute-care setting. She received her advanced oncology nurse practitioner certification from the Oncology Nursing Society in 2008, her family nurse practitioner certification from the American Academy of Nurse Practitioners in 2005 and her oncology nurse certification from the Oncology Nursing Society in 1987.

Joanna brings considerable medical expertise along with exceptional caring, compassion and positivity to her patient care to help us achieve the most successful outcomes possible. She is an exemplary oncology nurse practitioner who is highly deserving of the 2019 Extraordinary Healer® Award.