Joy Hennessy, BSN, RN, OCN, CBCN, is a nurse navigator at Gundersen Health System‘s Norma J. Vinger Center for Breast Care in La Crosse, Wis. She has worked at the cancer center for a little more than 30 years, with the last 12 years as a nurse navigator for breast patients. In October 2016, Hennessy received the center’s Paula J. Tower Memorial Award, which recognizes those who selflessly give time and energy working toward a future without breast cancer.
Q: What is the most important work you do as a nurse navigator?
Joy Hennessy: I believe being present for the patient/family is one of the most important things I do. Being with and listening to the patients is crucial. No two patients are alike, and you have to pay close attention to the verbal and nonverbal clues given to you.
Nurse navigators get “snapshots” of their patients when first meeting them to be able to determine their major issues. It is often not the cancer diagnosis that is the only concern. Issues such as finances, addictions, abusive environments, competency concerns, and untreated behavioral health disorders are some of the major ones I see.
As a nurse navigator, it is my job to identify the issues and utilize resources to start supporting the patient.
Q: What do you like best about your job?
JH: I love having autonomy to be able to be where I need to be. Unfortunately, that can change from minute to minute, but the autonomy allows me to consistently prioritize what I need to do and when I need to do it.
I love getting to know the patients and their families. Many have become long-term friends of mine. I learn from them, too, so I feel that I continue to grow as a nurse and a person.
Since I have been in the cancer arena for more than 30 years, I have been blessed getting to know many people. It makes me smile when I get to see patients years later and they are doing well. I’m a person who loves hugs, and in this job, I give a lot and I get a lot!
Q: What value do you think nurse navigation provides?
JH: I believe nurse navigation is invaluable to someone who has a cancer diagnosis. The nurse becomes a lifeline, a listening ear, a person to help translate medical terms, a shoulder to cry on, a cheerleader, and a familiar face and voice in the midst of confusion.
Nurse navigators also support the providers in a variety of ways. They can anticipate the needs of the physician, so when the patient is seen, the doctor can be as efficient and productive as possible. Then the navigator coordinates everything the doctor has recommended, such as other appointments, imaging tests, biopsies, labs, and genetic counseling. Navigators are patient and provider advocates, and so it is our job to use resources to make all the recommendations happen as quickly and seamlessly as possible for the patient.
I have a partner nurse navigator that also has been a nurse more than 30 years, and the majority of her experience is with surgical patients. Together, with her skills and my background in medicine, we have become a strong team. We have learned from each other throughout the years. I believe our patients have been able to have some pretty “seasoned” nurses!
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
JH: There are so many stories throughout the years. One story will always remain a part of me. About six years ago, I received a call from a rural provider who had a woman in her office with an obvious breast cancer that had eroded through her skin. She had been treating it with black salve. Her provider told me that “Sharon” had spent all of her life’s savings on alternative treatments. She asked me if I would contact Sharon and just talk with her.
So I did. We talked for well over an hour. In talking to her, it was obvious that Sharon was a spiritual person so I felt like I could bond with her as I have a strong faith as well. I encouraged her to come and see one of our surgeons — just to talk. I told her that we would always respect her wishes, and that maybe together we could develop a plan to help control her cancer. She agreed to come.
It took a few appointments and lots of conversation for her to begin to trust us completely, but eventually she did. She had a mastectomy, but declined chemotherapy and radiation. Sharon came for evaluation often, and each time we talked, we became closer. Sharon said to me that she wished she had come to see us many years ago. She said she finally felt like her beliefs were being respected and that she wasn’t being judged for her previous decisions. She was willing to work together to control her cancer.
A few years ago, her cancer recurred, and she then decided to have chemotherapy. That was a major step for her. We stayed in constant contact. We had a bond, and I knew she trusted me. With almost every medical decision she had to make, we discussed it. When she needed to find a new doctor because one of hers left our institution, she asked me who she should see. She eventually had radiation, and, again, we discussed who might be a better “fit” for her.
Unfortunately she is now metastatic, but still is continuing with traditional treatment.
Nurse navigation can look different for each patient. Sometimes it’s coordinating care, sometimes it’s more a listening ear, but it always is respectful.
Q: What is your biggest challenge as a nurse navigator?
JH: TIME. At any given moment as a nurse navigator, I may need to be in four different places at the same time, so I have to prioritize every minute and every hour of the day. There is so much I want to be able to do for the patients and providers, but reality hits me in the face when I realize I just can’t be present for everyone. Something or someone gets shorted, and that doesn’t feel good as a nurse.
Another challenge related to time is staying on top of all the test results, admissions, provider appointments, new concerns, new cancers, recurrent cancers, and patients who have become metastatic.
Just when I think I’m going to get a few things reviewed, my pager goes off and off I go, sometimes not to return for an hour or more. But that’s the job!