Alice O’Brien, RN, OCN, HP(ASCP), is a nurse navigator for MD Anderson Cancer Center at Cooper for Voorhees Township, N.J. She started working at Cooper in 1992.
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Q: What is the most important work you do as a nurse navigator?
Alice O’Brien: The most important work is to establish a connection with the patient and family that shows them that we, as a healthcare team, want to offer them the best possible options for the care that may be required. I work with a hard-working team: other nurses (navigators, clinical practice RNs and LPNs, APNs); social workers; dieticians; physicians; medical assistants; laboratory specialists; schedulers; billing specialists — the list could go on and on. These other team members, in both the inpatient and outpatient setting, all interact with the patient and family — but I want the patients to feel that I will always do my best to address any issues that arise that they view as obstacles.
I tell them I may not be the first person they should call — but I should be the last one they need to call.
I want to get the patient “plugged into” our system and then ensure the journey continues as smoothly as possible.
Then, if necessary, I need to make good on my offer to always try to assist if assistance is needed.
Q: What do you like best about your job?
AOB: I have the autonomy to make my own schedule and spend as much time as needed (usually) with the patient — either in person or by phone.
I assess the patient and try to determine each one’s needs: What does the patient know about the diagnosis, about the treatment options, about the prognosis, about the impact this “new reality” will have on the entire family? What does each patient know about his or her insurance — and how can the questions that arise best be answered? Also, anticipating questions that are not yet asked but will surface sooner or later — and being able to act as a resource to help get answers — if the answers are available.
Q: What value do you think nurse navigation provides?
AOB: Navigators offer patients the security of feeling they have a specific person in their corner — someone who knows them as a person, who will act in their best interest, who has that “connection” with them. I do not “follow” each patient for the entire treatment time, but I tell patients to keep my contact info in their back pocket in case I can assist in months (or years) later. And they do!
Q: What is your biggest challenge as a nurse navigator?
AOB: Role definition is an ongoing issue. Even among other navigators, we frequently have a variety of “tasks” that we may prioritize differently.
We all work on meeting new patients and families, and helping them get established in our center, but we all also spend significant time in a variety of efforts: prepping for and documenting follow-up plans for the multidisciplinary tumor boards we each run weekly; we have patient education meetings; offer in-service education (to internal and external staff) and lectures; we assist in transitioning patients from inpatient to outpatient status; we all volunteer for various cancer related causes.
Other staff members sometimes seem to see us as patient educators but also as schedulers and record retrievers.
We need to be more specific in our role, as well as better communicators to others in regards to all we do.
Q: What do you hope for as the future for nurse navigation in the United States?
AOB: Recognition of the nurse navigator as a valuable resource to all will help us to build the programs.
We, as navigators, need to continuously work at providing information to not only the patients but also our co-workers regarding our accumulated volume of information about a wide variety of healthcare issues. We all enjoy sharing our knowledge in order to better serve all our “customers” — just ask us!