Julie Sachau, BSN, RN, is a breast cancer nurse navigator for Spectrum Health Cancer Center in Grand Rapids, Mich. She has served in this position since January 2017.
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Q: What is the most important work you do as a nurse navigator?
Julie Sachau: The most important roles that I have is being a single point of contact for our patients and families, being knowledgeable about our health care system, and being experienced in working with breast cancer patients. Our patients see three providers — breast surgeon, medical oncologist, and radiation oncologist — and all three are in different practices. This can be confusing because everyone is located in the same building, and although everyone works together, there are different charting systems and referral processes. Oftentimes our patients don’t know who to contact, especially when they are first diagnosed. In my role as a nurse navigator, I work closely with all of the offices to ensure no facet of patient care falls through the cracks. I communicate daily with these practices, making sure patients are getting the appointments, referrals, and follow-up care they need. I always tell patients, “When you don’t know who to call, I’m your person.”
Spectrum Health is the largest health system in West Michigan. We have many regional sites where our patients can be seen as well as many different services that are offered throughout the system. Understanding the different services offered at Spectrum Health and being able to explain these to our patients is invaluable. Many patients don’t realize they can receive their care close to home. This is so important when we have patients traveling over an hour for treatment.
Q: What do you like best about your job?
JS: When I started my new role as a nurse navigator, I had no idea how much I would love this job. I have worked at several premier hospitals all over the country, in adult and pediatric oncology, and had never heard of the navigator role. I was worried about not providing hands-on patient care anymore and losing some of my nursing skills. Since starting my role as a breast cancer nurse navigator, I have gained so many more skills, learned so much about breast cancer treatment, and still had the opportunity to impact the lives of patients and their families. Knowing that I have made a difference, helped expedite care, solved problems, and explained treatment options in terms that patients and families can understand are just a few things I love about being a navigator.
I meet patients at one of the most stressful times in their lives: the time they are diagnosed. I work closely with patients and their families throughout their treatment until either survivorship or end-of-life planning. I build strong relationships with these patients and get to know them on a personal level. Building these one-on-one relationships is something that I cherish about my position as a nurse navigator.
Q: What makes your nurse navigation program unique?
JS: At Spectrum Health, our nurse navigator program is unique because we have 14 oncology nurse navigators specializing in nine different disease types. One of the main roles of the nurse navigators is to help facilitate our multispecialty team clinics. In these clinics, patients who are newly diagnosed with cancer come for a consult with the entire medical team. They meet with a surgeon, medical oncologist, and radiation oncologist as well as an oncology social worker, genetic counselor, and nurse navigator.
During the breast cancer clinic, the team of consulting physicians, the pathologist, the radiologist, and the nurse navigators have a conference to discuss each patient’s case. This is important because each provider gives his or her treatment recommendation and it helps ensure everyone is on the same page with the treatment plan.
At the end of the clinic, the patient leaves with a personalized treatment plan, follow-up appointments, and an outline with what to expect in the upcoming weeks. The breast cancer population that we serve at Spectrum Health is so large that we have two breast cancer nurse navigators. The goal is for each patient who is diagnosed with breast cancer to have a nurse navigator.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
JS: I had a patient who was diagnosed with a reoccurrence of breast cancer. She was overwhelmed by this diagnosis, was in the middle of winter traveling, and was caring for her injured husband. As her navigator, I was there to help coordinate her care, but I was also an additional support system. I was able to look at all of her scheduling options and get her in to see physicians in a timely manner. I made sure her breast MRI was scheduled, the referral she needed for the lymphedema clinic was completed, and connected her with the oncology social worker to find out about local community resources.
She was also interested in a more holistic approach to her care along with traditional treatment. She felt like she wasn’t getting the help or resources she needed from her physicians to pursue the holistic approach she was looking for. I was able to connect her with various forms of supportive care offered at our facility. She was able to get involved with complementary music therapy, art therapy, massage therapy, yoga, and acupuncture. She was able to use many of these to help fight the depression that came with finding out about that her breast cancer had returned.
Without a nurse navigator it would have been much more difficult for her to find these additional forms of self-care and treatment. Throughout the course of her treatment, this patient has turned from a patient into a friend. I know about her family, her grandchildren, her hobbies, and her fears. I have attended music and art therapy classes with her, met some of her family, and just called to check in on her and say hello.
I think most oncology nurse navigators would tell you they have similar experiences with their patients, and that eventually, patients and families become more like friends who you support and navigate throughout their cancer journey.
Q: How do your colleagues view nurse navigation and care coordination?
JS: I am fortunate to work at a facility where nurse navigation is supported. This is not a new role within the Spectrum Health Cancer Center as the first oncology nurse navigator started nine years ago. Over time, the role has developed and changed into what I am fortunate enough to do today.
The physicians I work with are very appreciative of the role and the assistance we provide for our breast cancer patients. The navigators serve as an additional support system for each patient and we help facilitate sound communication between the providers and the patients. If there is a difficult situation, the navigator is there to problem solve.
We are always looking for ways to improve patient care, satisfaction, and make sure every member of the team is putting the needs of patients first.
Q: What would you say to an organization that is contemplating whether to implement a nurse navigation program?
JS: I would tell any facility thinking about implementing the oncology nurse navigator role to do it immediately! Our main role is to help patients get the best care possible. When dealing with a cancer diagnosis, in both the adult and pediatric populations, there are so many questions the patient and family has, from treatment options, when to see each physician, insurance questions, and symptom management. Having one person for the patient and family to contact can only improve and expedite care. Patients and families are comforted knowing they have a health care professional advocating for them, following their case closely, and walking with them throughout their cancer journey.