“I’m Here to Fill in All the Gaps” – A Look into Oncology Social Work

Ulman Patient Navigator, Devon Ciampa, MSW, LMSW,
with Ulman House Resident.

Ulman Patient Navigators are specially trained oncology social workers who work with adolescent and young adult cancer patients and their families from diagnosis through treatment and into survivorship or end of life. Their work takes many forms, from helping with logistics—insurance, transportation, housing, and financial planning—to providing emergency counseling, hosting support groups, and fielding calls to our remote navigation hotline. There’s no such thing as a typical day.

One of the major challenges of the job is a lack of awareness about the work they do. Some doctors don’t understand that social workers are qualified to provide therapeutic care. Many patients associate social work with child protective services or addiction counseling and may think that they either don’t need, or don’t qualify for, help from social workers.

Devon Ciampa, MSW, LMSW, our Navigator at The Johns Hopkins Children’s Center, says she’s heard stories from other social workers about this. “They tell me that they really have to jump in and clarify their role initially, because when they introduce themselves as a social worker, some people ask, ‘why are you here? What are you doing here?’ or ‘you’re gonna take my kid away!’ I find it really frustrating constantly having to explain to people that, ‘actually, you know, I’m trained as a therapist’, or ‘I know how to do this aspect of care.’ We do have to know a lot of things.”

“I think a lot of the doctors focus on ‘how are we going to treat this patient? With what medication?’ And the mental health part is sometimes ignored.”

“Social Work is so important to have as part of the medical team,” Says Michelle Martinez, LCSW-C, Ulman’s Navigator at Walter Reed Military Medical Center. “I think a lot of the doctors focus on ‘how are we going to treat this patient? With what medication?’ And the mental health part is sometimes ignored.”

While most oncology social workers specialize in either inpatient or outpatient settings, our Patient Navigators follow patients through their entire cancer journey. For Megan Cannone, LCSW-C, OSW-C, OPN-CG, our Remote Navigator and Clinical Manager, being part of that journey is the biggest reward of the job.

“I’m thankful to be part of their whole process, just to be able to be present and have a relationship.” She says. “Being able to be outside of the hospital and get to just hang out. It’s a whole different level, when you get to go paddle boarding with someone, or you’re sitting in the backyard eating a hamburger with someone. It’s just a different relationship. And that’s the biggest reward. So I truly do value every single person, they’re not just a patient, they’re a person that I actually have true feelings for.”

Ulman’s Remote Navigator and Clinical Manager, Megan Cannone,
LCSW-C, OSW-C, OPN-CG spending time with a client.

“As social workers we’re really taught about boundaries, and about being aware of how much self you’re putting into a situation and everything.” Says Devon. “And of course, that’s always on my mind. But when you’re dealing with something like this, something that’s so personal, when you’re with them through every single step, it’s so rewarding. I don’t have to focus on one thing, I can focus on everything. I can focus on who they were outside of the hospital, who they’re going to be in the future. When I introduce myself, I say ‘I’m here to fill in all the gaps, I’m here to be your point person.”

Those close relationships between Navigators and patients can also be challenging. 

“When you lose someone, that’s the hardest part.” Michelle says. “They get hit with this cancer diagnosis at like 21, 25, you know, 30, whatever it is. I think it’s even harder when you see someone your age going through this, and you’re just like, ‘wow, like, this person is my age, they literally have a child the same age as mine,’ I cannot imagine what they’re going through.” She says it’s important to have raw and open conversations with patients, to remind them that they exist as a full human being outside of their illness.

For Devon, those raw conversations are essential to the job, too. “You get to the hospital, with these adolescents and young adults, and they’re dying. And it is so hard. I know that my instinct is to be like, ‘you’re going to get through this, we’re going to do this,’ to pump them up that way. But what I’ve had to learn is that it’s about being real and honest. And the honest truth is, I have no idea whether you’re going to get through this or not. And I don’t know what’s going to happen at the end of this. The only thing I know Is that when you feel like crap in that hospital, whether it is going to get worse or better, it’s just that moment, you’re not going to be stuck here for the next 20 years.”

These challenges inspire our Patient Navigators to work even harder to support their patients.

“You can get by being a good social worker,” says Devon, “but it’s hard work being a great social worker. If you don’t have a calling to do it, it’s really difficult to keep pushing through everything… you have to love it.”

“You can get by being a good social worker,” says Devon, “but it’s hard work being a great social worker. If you don’t have a calling to do it, it’s really difficult to keep pushing through everything. First of all, you have to love it. If you don’t love it, you’re gonna get burnt out in like two seconds. You have to be able to get something out of the job. That is not going to be respect or money. You’re going to be passed over for things, you’re going to be pushed to the back of things. But, you have to feel comfortable enough with what you do get, that that will lead you to do more and more.”

“You can’t tell me that a 34 year old with cancer has all their needs met.” Says Michelle. “There is something that they need help with. And it’s a matter of that social worker really digging deep, doing a complete psychosocial assessment to really see like, ‘what are your needs,’ right? I mean, you can’t just go into a room and say, ‘is everything okay?’ You need to establish a rapport—that takes time. I feel like that’s the difference between a good and a great social worker: who’s gonna go that extra mile?

“I feel like this is my calling. And I feel like there is no life without serving others. So it’s not just a job.”

Megan sums up her attitude towards her work like this: “I feel like this is my calling. And I feel like there is no life without serving others. So it’s not just a job. I hope to teach my children that as well. It’s just who I am. Social Work makes up, I’d say, at least 75% of me as a person. I love it.”

Megan Cannone, LCSW-C, OSW-C, OPN-CG, is Ulman’s Remote Navigator and Clinical Manager.

If you or a loved one is receiving treatment and would like to speak with a Navigator, contact Megan at [email protected]

Devon Ciampa, MSW, LMSW, is the AYA Navigator at The Johns Hopkins Kimmel Cancer Center.

If you or a loved one is receiving treatment at The Johns Hopkins Kimmel Cancer Center Division of Pediatric Oncology, contact Devon at [email protected]

Michelle Martinez, LCSW-C, is the AYA Navigator at Walter Reed National Military Medical Center.

If you or a loved one is receiving treatment at Walter Reed National Military Medical Center, contact Michelle at [email protected]

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