This is the first post in a series on oncology nurse navigators.
As of January 1, 2016, more than 15.5 million people with a history of cancer were alive in the United States. Looking ahead one decade, the American Cancer Society estimates the number will increase to 20.3 million by January 1, 2026. A closer look reveals that 5-year relative survival rates, overall, have increased from 49% in 1975-1977 to 69% in the 2005-2011 period.
It’s wonderful that cancer is becoming more survivable. But associated with this good news are some challenges: cancer care is more complex than ever, and survivors have new concerns once they move from patient to survivor status. One way to see patients through is the practice of patient navigation, introduced in 1990 by Harold P. Freeman, MD, with the goal of removing barriers to care for cancer patients. Dr. Freeman and others have since demonstrated the value of navigation.
Oncology nurse navigators have rapidly become an essential part of the multidisciplinary team (MDT). Their positive impact on patient attitudes and outcomes is now well recognized by professional organizations. In fact, the presence of an effective patient navigation process is one of the criteria for accreditation by the National Accreditation Program for Breast Centers, as well as a requirement for certification by the American College of Surgeons’ Commission on Cancer.
The Academy of Oncology Nurse & Patient Navigators (AONN+) launched its certification program for nurse navigators and patient navigators in 2016. Certification promotes recognition of oncology navigation as a professional specialty and identifies competencies necessary to perform the role. More than 250 nurse navigators took the inaugural certification exam in November 2016.
Aegis recognized the importance of this audience and began working with clients in 2009 to provide nurse-to-patient education for navigators. We’d like to share some insights into just how navigators affect patient care and what you can do to help them.
1. Nurse navigators work with patients to expedite care and remove barriers.
Navigator roles in cancer care vary widely across practice settings (for example, rural versus urban), but streamlining care is a common thread.
“The audience is incredibly diverse, but regardless of setting, the most important role of the oncology nurse navigator is providing medical information so that the patient can make an informed decision about his or her treatment,” observes Linda Buckley, BSN, RN, CBCN, CN-BN, a retired nurse navigator in the Las Vegas area who currently presents educational programs to other navigators around the country.
A breast cancer survivor herself, Buckley knows how important it is to understand the details of both the disease and the proposed treatments. “Upon abnormal finding, one of the many roles of a nurse navigator is to help expedite and remove barriers throughout the continuum of care,” says Buckley.
Kshama Jaiswal, MD, a breast surgeon at Denver Health and Hospitals in Denver, CO, is a strong proponent of the navigator role. “The navigator is easier to reach, and follow-up happens more quickly,” she notes. “This helps us decrease the time to treatment for our patients.” This is particularly important at her hospital, where many patients lack adequate access to health services and may therefore be diagnosed at later stages of the illness.
2. Nurse navigators interact with all members of the multidisciplinary team.
The navigator is the linchpin in a patient-centric model of cancer care. “Oncology care is very complex. I tell patients to think of a wheel. I sit with the patient at the hub, and all the members of MDT are the spokes,” says Danelle Johnston, MSN, RN, OCN, CBCN, Division Director, Oncology Navigation, Sarah Cannon, Austin Texas Market. “Part of the navigator’s role is to facilitate MDT communication to ensure all aspects of patient care needs are being addressed.”
Navigators advocate for patients and provide emotional and social support throughout the continuum of care. It’s their job to understand the patient’s goal for treatment and to ensure that treatment plans are carried out in the smoothest way possible. And that’s not always an easy task.
According to Lillie Shockney, RN, BS, MAS, co-founder of AONN+, program director, and head of the AONN+ leadership council, navigators need to be sensitive to the stressors that affect all members of the MDT. “The projected shortage of oncologists is real, and what that means practically is that our doctors are seeing very sick patients all the time. It’s a tough environment to work in, and navigators have to learn how to interact and communicate with each member of the MDT to ensure patients get the best care while taking care of their colleagues. It can be a bit of a dance.”
3. Nurse navigators are a key source of education for patients and caregivers.
“I tell my patients to think of me like a really good travel agent,” says Jeneane Malone, BSN, RN, OCN, a nurse navigator at Banner Health’s McKee Cancer Center in Loveland, CO. “They are traveling to an unknown place, and I’m here to help. I’ve been to this place, and I have all kinds of resources available.”
Navigators provide patients with resources including educational materials about medications and side effect management, diet, and exercise. They also help patients access financial and other support services that help patients and their caregivers adjust to the challenges of cancer treatment.
Not all educational materials will make it into a patient’s hands, even if they are well written and produced. Universally, navigators say it’s critical that pharma marketers remember that many institutions do not allow them to distribute branded materials. Tools and resources that empower patients are always welcome … as long as they are unbranded and address key topics in plain, patient-friendly language. Otherwise, your hard work may be relegated to the supply closet or, worse yet, the dumpster.
Understanding not only what navigators do, but also who they are is crucial to communicating with them. Although they don’t prescribe, they are integral to the MDT and help patients make informed decisions about their care. Industry partners who develop ways to help navigators help their patients are a valuable resource.
Like to know more about how to reach Nurse Navigators, Contact Us … we’d love to have a conversation with you.
Next up: Our second post in this series will address the 5 things you may not know about nurse navigators but should (and #1 is a pretty big deal).
Sign up for our nurse navigator series below!