Monday 5 September 2016

“So it’s cancer,” my friend said, telling me the sad news about her recent breast biopsy. “They have been watching this nodule for a little while and it just exploded. The Nurse Navigator just called to set up my PET scan and some blood work before I go to the oncologist next week. She really encouraged me because she had such a ‘can do’ attitude and she helped me feel more in control.”

We talked a while longer and then we hung up. As I put down my cell, I felt a mixture of shock, resolve and gratitude for this person, a Nurse Navigator, who could somehow help during this difficult time. Though my friend lives in another town, I began to want to learn more about our Nurse Navigator and just what the job entails.

Nothing Like a Nurse Navigator!

Nurse Navigators are becoming more plentiful as our health system shifts from one of inpatient, hospital-based care to a focus on preempting troubling symptoms and managing both complications and treatment on an outpatient basis.

In order to find out more about the Nurse Navigator role, I talked with...Sherri Lawson, RN, BSN, OCN. She graduated from nursing school back in the 80’s and has had a career centered on oncology, starting out an an aide, then an LPN, and going on to serve as a floor nurse, a nurse manager, a resource nurse. While working as a resource nurse Sherri did community outreach, cancer prevention initiatives and cancer education. As the Nurse Navigator Coordinator, she currently is in charge of five other professional nurses who serve in this capacity in two different hospitals.

What population do you serve? 

We work with all the patients who have a medical oncologist referral and we oversee the care of all oncology patients, watching for signs of complications. When a patient first receives their diagnosis, we are often right there, in the room. After the doctor leaves, we answer questions and schedule PET scans, Ports, Chemo Education, follow-up appointments.

Nurse Navigators’ positions developed in response to a need. Patients were getting lost in the system and showing up for their first oncology appointments without the necessary tests, so time was wasted. We want to make sure that treatment begins as soon as is possible, given the patient’s condition. It is our role to keep track of people, to stay connected with them, to help coordinate their care and to take some of the burden of worry away. We also become a person that they can call if trouble arises.

How long have Nurse Navigators been around?

It is a fairly new field in our area, with the first positions starting in the 1990’s. I was the first one and had to work out my own job description. Now we have Nurse Navigators for lung cancer, breast cancer and for lung nodule follow up. There may be more positions opening as the focus on outpatient-centered care continues. We see it as our job to do excellent work in planning ahead, symptom management and appropriate referrals. At times we also serve as informal counselors when patients need to talk and get answers to questions that we are qualified to help with.

What is your favorite part and your least favorite part of being a Nurse Navigator?

Without a doubt, the patients are my favorite part. It is good to feel that they know they have a contact person for questions or concerns. It’s like throwing them a lifeline.

The most challenging part is the sheer volume, trying to accomplish all that needs to be done. In an average day, we have contact with about 20 patients per day and make 30-40 phone calls. The Nurse Navigators generally attend the initial diagnosis-sharing physician visit and help answer immediate questions about what comes next. These appointments vary in duration but can take two hours or more. It is hard to do everything and maintain that high level of excellence that we know our patients deserve.

If you wanted to be a Nurse Navigator, how would you prepare?

In our area, the Nurse Navigators are RNs and have experience in oncology. They also tend to be independent workers, self-starters and people who are truly committed to quality care. Being able to work well with the medical staff, office staff and ancillary providers is also key. My long term experience in this hospital system is a definite asset and helps makes me more effective. But the most important part of being a great Nurse Navigator is doing it with heart and soul, having true compassion for the patients.

Like most nursing jobs, the role of the Nurse Navigator varies from hospital to hospital and area to area. This is a snap shot of one Nurse Navigator’s job, her training and some of what she does day-to-day. You may have a much different experience based on your location and the system you work for. I hope you will feel free to share variations on the role in your responses.


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