Amanda Bruffy, RN, BSN, CNRN, OCN, is an oncology nurse navigator at Centra’s Alan B. Pearson Regional Cancer Center in Lynchburg, Va. She has served in this position since February 2014.
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Q: What is the most important work you do as a nurse navigator?
Amanda Bruffy: The most important thing that I do as a nurse navigator is provide a focus of comfort for patients during a whirlwind of uncertainty. When patients are diagnosed with cancer, they are terrified. Knowing that there is a single point of contact when there are so many practitioners involved gives them peace of mind.
Being available to patients and their families is invaluable to them during this experience. Patients show up for visits or call me in a panic. Being able to calm their fears and provide them with the answers that they need to give them even a moments worth of peace is beyond rewarding.
The emotional support that I provide in my role is, without a doubt, one of the most important parts of my job. Educating patients and arming them with the information that they need to make the most informed decision that they can possibly make regarding their treatment plan is another important aspect of my job.
Q: What do you like best about your job?
AB: My job offers a unique opportunity to impact patients in a way that most nurses will never experience. I have contact with patients from the time that they are initially diagnosed, through their treatments, and into survivorship or end-of-life planning. This contact gives me the opportunity to provide education to patients and offer support to make them feel like they are more than just a number and more than just a diagnosis. Often patients will call me as a navigator for simple things that they would be afraid to ask their physician about or with questions that they feel like their physician doesn’t have the time to answer. I help facilitate symptom management and better disease understanding that ultimately impacts office visits and hospital admissions.
Being able to calm fears and help them to better understand their diagnosis and treatment enables patients to face their diagnosis head on. Providing them with comfort in an uncomfortable situation is invaluable. Bringing a smile to their face while doing it is simply an added bonus.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
AB: In February 2015, I was diagnosed with Stage I kidney cancer. I went from holding a patient’s hand in our cancer center to being a patient in our cancer center. While this was a terrifying experience, it has given me an insight that I would never trade. I now have a level of empathy that I would never have understood otherwise.
I rarely inform my patients that I am a cancer survivor as I don’t want them to shift their focus to me. However, if I know a patient can glean some inspiration from my story, I am happy to let them into this particular part of my life. I know what it is like to be told that you have cancer. I know how scary the word is. Having experienced what it’s like to be told that you have cancer and the rollercoaster of emotions that you experience when you’re processing this information allows me to be a better navigator.
Q: What do you see as ways or opportunities to improve nurse navigation?
AB: One of the biggest barriers that we face as oncology nurse navigators are the different computer operating systems and electronic medical records present within our health care system. At present, my organization is transitioning to an electronic medical record that would unify the inpatient and outpatient world. Once this happens, it will improve communication. However, there are still so many practitioners involved in patient care and so many decisions that need to be made that there is still room for improvement in communication.
My facility is piloting a HIPAA-compliant electronic communication tool in hopes of unifying all providers from pathology starting with initial diagnosis through treatment with specialists and as far reaching as primary care. The premise of this is to promote better communication among providers and ensuring a continuity of care far beyond what has ever existed.
Q: What would you say to an organization that is contemplating whether to implement a nurse navigation program?
AB: To any organization considering implementing a nurse navigation program, I would say that the value of the position is measured by the experience of the patient. Not every patient will do well through treatment. The nurse navigator plays a pivotal role in the experience that a patient has through their journey. If someone’s mental, emotional, and spiritual needs are met during their journey, then they are more apt to accept where they are in life physically.
We can’t cure every cancer, but we can ensure that every cancer patient has their needs met to the best of our abilities and that their journey is satisfying to them on every level that we can control. Nurse navigators embody that presence that is needed to guarantee that experience. Without someone to tie up the loose ends or to keep the proverbial “ducks in a row,” patients are subject to be lost in the health care system.
To any organization considering the implementation of nurse navigators, I challenge them to try to navigate the system themselves. Try to process what these patients are having to process. Try to have your world turned upside down with no understanding of the right direction or the next step. Having cancer is a terrible thing to even comprehend, let alone to try to figure out what happens next. Having an oncology nurse navigator to hold your hand through this process gives the patient the best possible experience during a devastating life event.