Lori Gross, RN, is an orthopedic nurse navigator at Abrazo Central Campus in Phoenix, Ariz. She has served in this position since April 2017. Gross previously helped to develop and implement a nurse navigator program in Wyoming, focusing on providing education and coordinating care for patients with the high readmission diagnoses of chronic obstructive pulmonary disease, pneumonia, and congestive heart failure.
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Q: What is the most important work you do as a nurse navigator?
Lori Gross: Patient education! Patient education has always been a passion and focus of mine. I believe that the more informed and educated a patient is about their procedure, hospitalization, and recovery, the better prepared they are to participate and be fully vested in their care.
It’s important for my patients to understand what will happen before, during, and after their surgery and to be educated in a way that they understand. I try to create a “safe zone” so that they feel comfortable enough to ask any question and discuss any concern. If they believe that no question is a silly question, then the door to education is wide open.
My patient education process begins with the first phone call to discuss their upcoming surgery, answer any questions they may have, and invite them to our pre-surgical total joint replacement class. Education continues at class, during post-surgical daily rounding, and during the post-discharge follow-up phone call. My patients know that they can call me at any time, and they have, to answer any questions/concerns that have surfaced.
Q: What do you like best about your job?
LG: We have a great multidisciplinary staff that works cohesively together at Abrazo Central to provide exceptional patient care. Working together, we create seamless patient care transitions. What I like best about my job though are my patients! They are the reason I became a nurse and the reason I continue to be a nurse.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
LG: Making my initial phone call to a patient one day to invite her to our total joint replacement class, she had many questions and concerns that hadn’t been addressed. We took each question/concern separately and discussed them. At the end of our phone conversation, she said that she was so grateful I had called. She said that she needed the phone call at that moment. She said that I had helped to alleviate the anxiety she was feeling and helped her to prioritize her preparation. I told her that if she had any other questions prior to her attendance at class, to please call me. She called me each day over the next three days. During these phone calls, we would discuss her questions/concerns.
She attended class and reiterated how grateful she was I had called her on the day she needed answers. She expressed her gratitude for the class as well. She said that she was feeling more prepared and less nervous. I told her that I would see her in pre-op before they took her into surgery to give her that extra encouragement.
The morning of surgery, I walked into the waiting area. She greeted me with a smile and said “I knew you’d come.” She looked around the room and said “This is Lori, she’s my nurse navigator.”
She arrived on the floor later in the evening. I did not round on her until the next morning. When I stopped in to see her, she was experiencing an increase in pain. I found her nurse to address her immediate pain needs and then her nurse continued to work with her throughout the day to get her onto a pain regimen that worked.
In follow-up, she expressed her gratitude again for my help, the education, and just being there.
I had another patient whose surgery had been cancelled but was not told why other than she needed to see her primary care physician (PCP) because of pre-op lab work. She called me in a panic because it was late on a Friday, the weekend would be here, and she thought something terrible had showed up on her labs. We were able to review her lab work and discuss why she needed to follow-up with her PCP. Being able to assist her and answer her questions helped to relieve her anxiety and help her identify the next steps in her health care.
This is why I do what I do — to serve others, to be a constant and a familiar face in a stressful, anxious time.
Q: What is your biggest challenge as a nurse navigator?
LG: The biggest challenge is developing a new program from the ground up and educating everyone on how I can be an effective asset to the patients, staff, and physicians. Nurse navigation is a fairly new role in service lines outside of oncology. My goal is to change the question of “Now, what is it you do?” to “Let’s get Lori, she’ll take care of that.”
Q: What technology do you use in your position? What tools do you wish you had?
LG: My cell phone is my best buddy right now. It helps me to communicate with patients and members of the health care team in real-time.
I’ve developed an Excel spreadsheet to help me track my patients. It would be a lot easier with a computerized navigation program.
I also use Outlook to help me schedule my patients and issue reminders.
Q: What do you hope for as the future for nurse navigation in the United States?
LG: Health care can be so disconnected at times. Patients need an advocate on their side that sees the whole picture of their care from pre-, present, to post-. They need someone who has the time to focus on them, who is knowledgeable about their disease process, and will help them to connect the pieces. This is what the nurse navigator does.
I hope nurse navigation continues to grow across the country in every service line. I hope that it is seen as a valuable piece that helps to complete the health care puzzle.