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Patient Navigation in Cancer Care: A “New” Frontier

How many cancer patients or cancer care professionals are aware of the discipline of cancer patient navigation? Unfortunately, not many patients and health care professionals know about this emerging role in patient advocacy.

Patient navigation is defined by the National Cancer Institute as a “community-based service delivery intervention designed to promote access to timely diagnosis and treatment of cancer and other chronic diseases by eliminating barriers to care.”

This is simply a fancy way of saying that patient navigation is a service that helps the cancer patient and family to understand the complex cancer care system and navigate through it in order to achieve the best outcomes possible.

The following definition from the National Cancer Institute (NCI) dictionary, provides the most basic description of what a patient navigator actually does for the cancer patient. A patient navigator is a:

“person who helps guide a patient through the healthcare system. This includes help going through the screening, diagnosis, treatment, and follow-up of a medical condition, such as cancer. A patient navigator helps patients communicate with their healthcare providers so they get the information they need to make decisions about their health care. Patient navigators may also help patients set up appointments for doctor visits and medical tests and get financial, legal, and social support. They may also work with insurance companies, employers, case managers, lawyers, and others who may have an effect on a patient’s healthcare needs. Also called patient advocate.”

Often, a patient navigator is an oncology nurse working for a cancer center or cancer program. The oncology nurse navigator is a member of the team providing the care to the cancer patient. The unique aspect of the nurse navigator’s role is that he or she is the one healthcare professional who assists the patient and family throughout all phases of treatment. Typically, a cancer treatment plan includes surgery, chemotherapy, radiation therapy. A patient may have any of these treatments or all of them. Throughout this process, the nurse navigator is the point person for the patient and family at all times during their care.  Cancer treatment can be long and challenging with the potential for many obstacles, or barriers, to arise. A few examples of these barriers are financial such as health insurance costs, or lack of health insurance coverage. Other typical barriers include employment issues, transportation to and from treatment, cultural beliefs, lack of understanding about the way the healthcare system operates, or emotional fear that prevents informed decision-making about treatment.

Through the cancer journey, the navigator assesses the barriers that the patient and family encounter and helps identify resources to overcome these barriers. The navigator communicates the patient barriers to the rest of the healthcare team so they are aware of the patient’s needs at all times.

An equally important role of the oncology nurse navigator includes education for the patient and family. There is so much information related to a cancer diagnosis and treatment that it becomes overwhelming to take it all in and try to understand. The nurse navigator is available to answer questions and concerns and is often more readily accessible than the doctor or clinic.

The oncology nurse navigator will work closely with the patient and family to empower them to become their own advocates. When the patient feels empowered to ask questions, make informed choices, and speak up for their needs and desires, the quality of their experience is elevated. Many patients feel a profound lack of control over their lives after a cancer diagnosis. When they gain the ability and confidence to advocate for themselves, they gain back a sense of control. As a result, quality of life improves as well as a sense of satisfaction that they are doing everything they can to achieve the best outcome possible.

The discipline of oncology nurse navigation provides the patient, family and healthcare team with the ability to:

  1. Communicate effectively 
  2. Advocate for the patient’s individual needs
  3. Understand and overcome barriers to care
  4. Improve patient outcomes and satisfaction

    If you don’t have an oncology nurse navigator, you can ask your oncologist or the cancer center where you are being treated if there is a navigator available. If there is not, ask why not. Your journey to becoming an empowered cancer patient can begin today by working hand in hand with an oncology nurse navigator. Look for more information in future blogs. 

 

Tina Evans, RN, BS is a cancer survivor and has been an oncology nurse navigator for 17 years. She has spoken across the country about oncology nurse and patient navigation. Tina has mentored new navigators and worked with hundreds of cancer patients to navigate them through their cancer journey.

Samantha Skelton
ss@triagecancer.org