Nurse navigation is a fast-growing field, and clinics are scrambling to bring navigators into their practices. This is because nurse navigators are experts within their specialty and work to help patients through chronic illnesses and high-risk treatment regimens. Essentially, they navigate patients and their support team through the maze of health care.
In oncology, nurse navigators are used the most in the medical oncology setting, as that is the team you will be with the longest, versus surgery and radiation treatments which are short term relationships. When interviewing oncology teams for your treatment, it is important that you, the patient, ask about navigation services. Breast cancer treatment is complicated with many potential immediate and long-term risks, and the oncology nurse navigator is there to be your advocate. A nurse navigator’s responsibilities depend on the facility, but basic services should include education, side effect management, survivorship, and interdisciplinary support.
Continue reading to learn more about how nurse navigators accomplish these responsibilities on your behalf.
Education
The internet is like the healthcare system: large, complex, and difficult to navigate. Your oncology nurse navigator is a reliable, evidence-based source of information on cancer processes and treatments. Many navigators will meet with you and your support team to have an in-depth conversation before you start treatment. Sometimes called chemo counseling, this session should cover a range of topics like how chemotherapy and immunotherapy work, side effects, and the dos and don’ts of treatment. The more support team members that can be a part of this conversation, the better. This will help to unite the clinical (nurse navigator) and non-clinical (family, friends, etc.) in their common goal of supporting you. The material covered isn’t meant to scare, but rather to empower you.
Side Effect Management
Often called triage by clinical staff, side effect management is one of the most important services nurse navigators perform. Most facilities will have a dedicated triage line for you to call to report symptoms and receive guidance. Keeping side effects minimal and manageable helps keep treatment on track. If side effects cannot be managed with at home treatment tools, the nurse navigator will implement supportive measures as necessary. This could involve coming into the clinic for IV hydration, or simply sending in a new prescription to your pharmacy. The best-case scenario for you and the nurse is that you work together to prevent ER visits and hospital admissions. But this only works if you report symptoms. Remember, side effects are possibilities, not certainties.
Pro Tip: Make sure that a communication consent is signed that allows your support team members to speak with clinical staff about your care. Support team members should call in symptoms they are seeing if you are unable to, or if you are hesitant to self-report.
Survivorship
Navigation care does not end when chemotherapy/immunotherapy ends. Side effects might persist or even initially occur during treatment recovery. Plus, many patients transition to oral medication regimens, like Aromatase Inhibitors, and the nurse navigator should be available to you during this time.
They will, however, create a treatment summary of the infusion treatment you received. This is because many chemotherapy agents have a lifetime dose limit. For example, cyclophosphamide (cytoxan) is one of the most commonly used chemotherapies in breast cancer treatment, and it has a lifetime dose limit. The nurse navigator will create a care plan summary detailing which chemotherapy agents and amounts you received. You should receive a copy of this plan, and it will be kept on file with your oncology team. If you transfer care facilities, be sure to ask your care team for this information and keep it filed where you can access it easily.
Interdisciplinary Support
Most oncology navigation programs have recognized that the nurse navigator needs to be supported by a larger treatment team. This allows them to treat you not just as a cancer patient, but rather as a whole individual, because you are more than just your diagnosis. You may have other needs, like finding support groups, referrals to therapy programs or assistance in finding medical devices. Maybe you are facing financial hardship because of your treatment, or do not have reliable transportation. Perhaps you want to change your diet to support your body through treatment, but don’t know what’s a fad versus evidenced-based nutrition information. Many facilities hire social workers, patient navigators, and specially certified oncology dieticians to meet your unique needs.
Oncology programs that are part of a hospital system can easily meet your needs because they have all these services in-house. That’s not to say unattached programs do not have a way to meet these needs. Knowing whether or not there is a team dedicated to helping you through treatment is an important first step in choosing an oncology program. When choosing your care team, be sure to ask the oncologist who is supporting them to support you. Because you shouldn’t just survive treatment-you deserve to thrive.
By Amanda Kuller BSN, RN
Amanda Kuller has been a nurse for nine years and currently works as an oncology nurse navigator in the Scottsdale, AZ area. When not working or doing homework for her Masters in Nursing Education, she can be found with her nose in a book and a cat in her lap.
I appreciate how this article underscores the importance of empowering patients through education. The idea of involving the entire support team in treatment discussions is essential. It creates a united front, making the journey a little less daunting for patients. snake game's a simple yet addictive game that can be a fun distraction when you have a few moments to spare.