The healthcare journey of cancer patients can be overwhelming, tumultuous and intimidating. Nurse navigators can help to ease patients’ worries, supporting them and their families by providing care and comfort, while educating and informing them about the disease.
Here we look at the role of nurse navigators in oncology trials.
Nurse navigators need to know how to engage their patient community but also must coordinate care and care transitions, advocate for patients, provide access to psychosocial support services and end-of-life care, according to Catherine Cantwell, nurse navigator at JFK Comprehensive Cancer Center.
One of the main focuses of nurse navigators is to act as intermediary between patients and healthcare teams. This helps to ensure patients’ needs are met and healthcare teams are accessible and their messaging understandable to patients. In their report in the International Journal of Integrated Care, Shelley Doucet and fellow researchers say that patient navigation can improve the integration of care in a fragmented system.
They refer to the NaviCare/SoinsNavi example that aims to help children and youth with complex care needs. The patient navigation focuses on a personalized family-centred approach. Two patient navigators work with clients to understand what they need and then help the healthcare team meet those needs.
Researchers publishing in the Journal of Advanced Nursing write that without nurse or patient navigators, patients can get lost in the healthcare system. The result is that their conditions deteriorate. Navigators help provide patients with responsive care that pays attention to clinical, social and practical requirements.
Essential to all of these responsibilities being carried out effectively is a nurse navigator’s ability to build rapport with patients to facilitate open communication with them.
At all points of the patient journey, nurse navigators are facilitating patients’ access to healthcare. Oncology nurse navigator Megan Roy says the role starts with setting up patients with the relevant doctors at the correct time. The next step is to ensure patients have transport and other support systems they need in place to make their appointments.
The team at the University of Kansas Cancer Center says nurse navigators help patients understand their diagnosis, prepare them for their visits to doctors, and support both the patients and their caregivers emotionally.
It’s helpful to think of nurse navigators as the glue that binds patients and healthcare teams together. Prostate cancer nurse navigator Frank dela Rama says the nurse navigator role was born with ties to clinical nurse specialists, case managers and utilization management nurses. In short, they are essential to the success of cancer programs.
The nurse navigator starts to educate patients from the first biopsy to help patients make the best decisions, he explains.
The importance of nurse navigators has become increasingly recognized over the years. For example, the Dana-Farber Cancer Institute in Boston runs a CAR-T cell therapy program. In 2016, just one nurse was tasked with helping patients navigate their healthcare journey. Now, 150 nurses run a dedicated program, says Susan Moench, Ph.D. at Clinical Advisor.
The DCFI says the nurse navigator role provides consistency in patients’ lives and helps to ensure that each patient receives quality care.
Nurse navigation roles vary depending on the healthcare institution but there are certain core similarities. An article in the Journal of Oncology lists these as having a strong clinical knowledge to treat patients, being able to guide patients through each stage of the healthcare journey and, importantly, educating patients and their families or caregivers.
Educating patients equips them with the necessary knowledge to make the best decisions available to them. Nurse navigators help patients and their caregivers become more literate in terms of medical jargon and terminology.
Nurse navigator Diana Vasquez says one of the most important parts of her job is to give patients hope.
Vasquez is the first point of contact for patients that have just been diagnosed with breast cancer. She immediately tries to ease some of the patient’s worries and fears by providing accurate and accessible information about their disease and treatment options.
However, even with all the relevant information, a cancer diagnosis can feel like a death sentence. Vaquez says her role is about giving hope to patients.
“I might be the last person someone sees or talks to at [the medical center] on any given day. So, I do my best to always keep a smile on my face. Because the most important part of my job is sharing hope,” she writes.
Improving patient outcomes is important for all healthcare workers but nurse navigators can help to achieve this by reducing time to treatment. Nurse navigator Carolyn Ruffing launched the nurse navigator program at Wilmot Cancer Institute in Rochester, New York, in 2017 with the primary aim of time to treatment. She has managed to cut the time from diagnosis to treatment by 16 days, which has boosted patient and provider satisfaction.
“Nurses have the ability to understand the diagnosis and referral information such as scans, and we can assess acuity to see who needs the most support,” says Ruffing.
Incorporating the patient perspective is vital to successful healthcare and clinical treatment. Nurse navigators bring this perspective into healthcare teams to ensure patients receive the best treatment. Sara Heath at Patient Engagement Hit refers to a survey by healthcare consulting firm Sage Growth Partners that shows that 57 percent of leaders think patient navigation is vital to ensure a patient-centric approach.
Patient navigation connects patients with the necessary preventive and primary care, and helps them through any bureaucratic requirements. Heath notes that 67 percent healthcare centers with patient navigation programs saw patient engagement and patient outcomes improve, 65 percent reported better patient adherence to treatment and 54 percent saw improved patient retention.
Cancer patient and former medical assistant Amy Butler says patient or nurse navigation programs helped her to manage her treatment experience. She refers to a group called Colontown that hosts private patient-led groups focusing on different stages of colon cancer disease and treatments. This offered her both information and emotional support, by connecting with other patients.
Putting patients first is a useful mantra for all clinical researchers and healthcare workers. It’s important but not without its challenges. Healthcare professionals are under pressure — time, financial, operational — to deliver top-quality care to patients. Building in roles and processes to facilitate this delivery is vital.
The nurse navigator becomes the glue that binds or the bridge that connects patients to the healthcare system. The nurse navigator helps patients on their healthcare journey by championing their voice, understanding their needs, and helping them grasp that while many challenges lie ahead, there is hope.
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