Kate Newgard, RN, BSN, OCN, is an oncology nurse navigator for the Leila J. Eisenstein Breast Center at Providence Medford Medical Center in Medford, Ore. She has been employed at the Breast Center since November 2006 and was responsible for developing and implementing the breast cancer navigation program. Newgard continues to develop the program. She also provides hereditary cancer screening, counseling, and testing for patients with a personal and/or family history of breast, ovarian, colon, or uterine cancer that meet National Comprehensive Cancer Network criteria.
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Q: What is the most important work you do as a nurse navigator?
Kate Newgard: I work in a somewhat rural community, so being flexible regarding patient needs after a breast cancer diagnosis is essential. It would be easy to get locked into the “one-size-fits-all” (navigation) approach after diagnosis, but that rarely works. There is definitely core information that is key for a patient to understand, but the most important aspect of navigation is assessment, conversation, education, and support. In other words, always considering how each patient responds and what their concerns are without assumptions.
For some patients, it’s needing to understand the diagnosis and treatment, and for others, it’s anything from transportation concerns to having a partner at home that requires caretaking as their priority.
The role of the navigator is to validate, assist, and guide the care based on patient need, and the foundation of the care should always comes from mutual agreement and shared conversation.
Q: What do you like best about your job?
KN: The most beautiful aspect of navigation is the opportunity to build relationships with my patients and become a part of their care experience here at Providence. It is an honor to be allowed into their lives at such a vulnerable time. Because of the vulnerability, there is a shared emotional intimacy that is life-affirming and deeply rewarding. I feel lucky to have found this role in nursing.
Q: What value do you think nurse navigation provides?
KN: The value of navigation is providing a steady touch and guidepost throughout the cancer journey, which ultimately provides for optimal patient outcomes. Cancer care — and for that matter all health care — can be very fragmented. Most often, patients don’t understand what the next step is along the way. Nurse navigators provide a vital role in patient education, advocacy, and empowerment, as well as giving each patient a consistent point of connection in the health care system.
Q: What is your biggest challenge as a nurse navigator?
KN: I always wish I had an endless way to provide funding and sometimes just plain old cash for those folks in financial need. So often, the problem is the basics: money for food, rent, child care, etc. There is some assistance out there, but not as much as you would think for basics of living while dealing with a cancer diagnosis.
Q: What do you hope for as the future for nurse navigation in the United States?
KN: I believe that support, education, and advocacy is essential to optimum patient care, meaning that it would be very helpful to have navigation not only for all patients with cancer but any complex disease, from multiple sclerosis, Parkinson’s disease, lung/heart disease to complex primary care.
People are living longer with more multifaceted health issues, and health care is rarely able to be provided under one roof by one specialty.
Navigation is key to helping patients understand, participate, and move effectively through all their needed care.