Cambria Nwosu, MSN, RN, CNOR, CSSM, is a neurosurgery nurse navigator at Abrazo Central Campus in Phoenix, Ariz. She has served as a nurse navigator since May 2017. Prior to that, she operated as a surgical line coordinator and a circulating RN in surgery for seven years.
Q: What is the most important work you do as a nurse navigator?
Cambria Nwosu: The most important work that I do as a nurse navigator is keeping my patients and their support system informed while also keeping them calm during such a high anxiety and stressful time in their lives.
Neurosurgery is still a mystery to not only the medical field at large but especially to patients that need it. As a result of my surgical nursing background, I can educate my patients ahead of their surgeries of what to expect and give them a realistic, step-by-step process breakdown on these expectations. To be my patients’ go-to person for anything during their time with us is what’s most important.
Q: What do you like best about your job?
CN: I like how multi-faceted it is and that all the moving pieces of the puzzle are directed toward optimizing the overall care of our patients. Every day is very different depending on my patient’s needs and concerns, along with my work assisting in many other aspects of growing a neurosurgical line. I am tasked on multiple occasions as a result of my surgical expertise on many administrative initiatives along with nursing and patient education, patient discharge planning, physician onboarding as well as multiple process improvement projects.
Q: Can you share any particular patient stories that demonstrate the value of nurse navigation?
CN: For one of my first patients that needed elective neurosurgery, I was able to proceed through the whole nurse navigation process starting with the pre-op phone call to answering any questions she had. I gave this patient my mobile number and explained that I would be there to see her in pre-op before surgery and would round on her everyday post-op.
The day before surgery, this patient was scheduled for pre-op testing at our outpatient facility. I received a call very early in the morning from the patient as I was driving into work. The patient told me where she was (admitting office), explained the purpose (pre-op testing), and that there were no pre-op orders written for her to receive appropriate testing. I assured the patient that this must be a mistake and that I would make some phone calls immediately to rectify the situation. The patient told me that she tried calling the surgeon and pre-admission testing RN but no one was answering the phone. She was glad that I did answer my phone so early in the morning.
I came to find out after some phone calls on my end that the orders were faxed to admitting; however, admitting never received the fax. So I ran to the pre-admission testing office once I made it to my hospital and had the orders re-faxed. I ran back to admitting, finally introduced myself to the patient in person, apologized for the miscommunication, and was able to get her started on the pre-op testing.
The next day was surgery. When I saw the patient in pre-op, she was so grateful to me for my assistance. Surgery was very successful, and during every day of rounding, I was able to educate this patient on discharge planning and keeping the lines of communication open.
One day, I rounded a little later in the day and the patient stated that she was wondering when I was coming to see her. The expectation of my presence was already set, which is nice to see.
After discharge, I called the patient, who told me she was grateful to everyone for the care she received. She was impressed with all of the special attention that she received from me and the entire care team.
I was very thankful that a communication error between departments did not deter the patient’s view of us during her stay with us. As one of my first patients in this navigation role, I was pleased that she felt comfortable reaching out to me regardless of the situation.
Q: What is your biggest challenge as a nurse navigator?
CN: The biggest challenge at the moment would be that since this is a new position, I am starting from scratch to develop the role and build it into a successful and meaningful asset to our patients and facility. Most colleagues, unless they’ve worked with oncology, have never heard of the nurse navigator role, so educating the masses will be a ongoing task.
Q: What technology do you use in your position? What tools do you wish you had?
CN: I currently have a work mobile phone that my patients can use to contact me at any time so they have that real-time access to me. I had to develop an spreadsheet to keep track of my patients and the different stages of navigation they are currently experiencing. I wish that there was an easier patient navigation software tool that can be used to keep track of our patients and pull appropriate reports when needed.
Q: What do you hope for as the future for nurse navigation in the United States?
CN: I hope that the role of nurse navigation continues to grow in other specialty service lines, especially since it solely focuses on the patients and easing their experience through a complicated health system. I hope that onboarding and maintenance tools specific for nurse navigation become more readily available to navigators. Continuing education, particularly in navigation that is not oncology-based, would have to be developed since we work in multiple aspects of the patients care in a different capacity.