My primary goal as a nurse navigator is to provide patient-centered care while facilitating timely access to the right providers. Nurse navigators have the clinical expertise to individualize both their education and assistance to patients and their caregivers throughout the course of the patient’s disease. My priorities are to assess for barriers that will prevent my patients from receiving care and to coordinate the proper referrals that will help expedite their treatment. Navigation is a new role in healthcare, and not all organizations have navigators. However, organizations that do not have navigators may have other clinical staff who function in that role in addition to their other responsibilities.
Often, my first contact with a patient is after they have been told they have a lung mass. Understandably, the patient and their family are terrified, but I am there to make a personal connection and develop a trusting relationship. I triage and direct their care, make appointments with the proper providers, request additional tests, and schedule their biopsy. During this time, I answer their many questions and try to quell their anxiety. I then follow up with the patient after their diagnosis to help them complete staging and make appointments with the right doctor for appropriate treatment. I also assess any challenges or barriers a patient is facing—including failure to thrive, lack of transportation, lack of social support, and insurance challenges—and initiate referrals to resources. I empower the patient and their caregivers throughout the care process by providing education and guidance. I provide them with basic lung cancer education and information on treatment options, including surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, combination therapy, and clinical trials.
I tell my patients that I am their “go-to person” at my facility. I encourage them at our first contact to save my name and number in their phone because I know they will interact with many people along their cancer journey. I make sure they know that if they have any questions or don’t know who to call, they can call me. Many times, when the patient meets with the oncologist for the first time, they are very emotional. It can be hard for them to retain any information and ask questions. This is especially true if they were told that their cancer is not curable. Once the initial shock and confusion wear off, however, patients often have a litany of questions that they may feel uncomfortable going back to their oncologist to ask. This is where I can come in. I encourage my patients to call me whenever they have questions about any aspect of their treatment. I can review their chart and answer the questions that they were not able to verbalize during their visit. If I don’t know the answer, I will find out who does and connect them with the right person.
As part of the tumor board, I can advocate for patients’ wishes, as I am aware of any barriers that might impede the plan that is being developed and coordinate the follow-up scans/procedures or specialty appointments that are advised from the meeting. Due to the COVID-19 pandemic, our tumor board has become a virtual meeting, which has increased participation and engagement of all team members.
Nurse Navigation During the COVID-19 Pandemic
The COVID-19 pandemic has brought a new level of anxiety to my patients, coworkers, and families. In the beginning, it was a challenge to answer questions and reassure patients about the safety of leaving their home for treatment or work-ups. When talking with patients, it is now part of my responsibility to assess their comfort level with technology. I spend time investigating their capability loading a new platform on their phone/tablet or making sure they have a laptop with a microphone and camera. If they are coming in person, I overview the logistical changes that our organization has made to make it a safe environment, including where to park since we no longer have valet parking. We now temperature check every employee and patient/visitors when entering the building. We have removed many seats in the waiting room to maintain social distancing. We stagger appointments, limit how many patients each doctor can see in-person each day, and limit the number of clinical staff in the clinic at one time. We rely on telehealth visits when appropriate for our patients. I make sure my patients know that we are doing everything we can to maintain their health and safety.
I meet patients at their most vulnerable part of their life. Having a nurse navigator who not only is an indispensable resource for information and guidance but also who shows compassion is important to patients and their families during this traumatic time. I find value in making this difficult process a little easier.