At Memorial Sloan Kettering, nurses are an integral part of our multidisciplinary care teams. Today, we’re putting the spotlight on our ten dermatology nurses, who treat patients with skin cancers as well as those whose skin is affected by other cancers or their treatments.
Like other MSK nurses, our dermatology nurses practice relationship-based care, an approach that emphasizes the nurses’ relationships with patients and their families, with colleagues, and with themselves. “This translates to patient and family care that is nurturing, compassionate, and individualized,” explains dermatology nurse Anna Skripnik.
In addition to managing the care of skin cancer patients, dermatology nurses also assess, control, and prevent side effects of anticancer agents that affect the skin in patients with all types of cancer. “We see many types of disease processes and must be experts in the fields of both dermatology and oncology,” says nurse Kathryn Ciccolini.
Because skin problems can negatively impact a patient’s quality of life, Ms. Skripnik says, “there’s [also] a psychosocial component to what we do. The skin is visible, so patients are aware of symptoms when they arise and whether they are improving or worsening.” She and her fellow nurses provide care and support to help relieve patients’ anxieties in addition to treating their skin disorders.
Below are just some of the many ways that our dermatology nurses contribute to patient care.
Care of treatment side effects
Many anticancer therapies can cause detrimental skin complications. For example, some targeted therapy medications, such as cetuximab (used for colorectal and head and neck cancers), can cause a severe acne-like rash on the face. Other side effects from treatment include hair loss, nail changes, pigment changes, and dry skin or itchiness. MSK has one of the few programs in the country dedicated to helping manage these treatment side effects, and dermatology nurses spread the word to other staff in the various services throughout the institution that such help is available for patients.
Assessment of skin problems related to cancer
Skin lesions vary greatly from patient to patient and can be related to infection, allergens, immunity, and psychological effects as well as cancer. A patient may come to the dermatology clinic to have a rash evaluated, not realizing that it may be related to the cancer. “It’s intriguing how disease inside the body may appear as signs outside the body, on the skin,” says Ms. Skripnik. It takes expert assessment skills to determine the underlying condition that may be causing a skin problem.
Outpatient consultation services for same-day symptoms
Dermatology provides a unique outpatient service for registered patients who need same-day care for skin problems. Many of these patients require dermatologic clearance before starting or continuing their anticancer therapy. “We triage patients all day long — deciding who needs to be seen, when they should be seen, and what their treatment should be,” says Ms. Ciccolini. With an arsenal of hundreds of therapies to choose from, the team must carefully evaluate each patient before making treatment recommendations.
Skin cancer prevention
Dermatology nurses work with dermatologists during MSK’s annual skin cancer screening each May (Skin Cancer Awareness Month), which is open to the public, patients, and employees. Nurses prescreen patients, review any skin care recommendations, and provide education and resources about reducing the risk of skin cancer.
Nurses participate in dermatology and oncology research and the production of publications. They also perform skin examinations to screen patients for clinical trials and monitor skin changes throughout the investigational treatment regimen.
“The skin is a fascinating organ, and it is important to keep it healthy through internal and external measures,” Ms. Skripnik concludes. “It takes a thorough assessment to manage patients and provide them with the highest-quality care.”