Maria Malloy, BSN, RN, OCN, CBCN, is an oncology nurse navigator for the University of Pennsylvania Health System. She began working as a nurse navigator in January 2013 and is in her 25th career year as an oncology nurse.
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Q: What is the most important work you do as a nurse navigator?
Maria Malloy: The most important work I do as a nurse navigator is provide the support, guidance, and education a person needs to make an informed decision about their health care and treatments. There are so many specialty disciplines now involved in a cancer diagnosis. The questions of who, where, and when are discussed daily in multidisciplinary tumor boards. This is extremely confusing to the newly diagnosed. This is where I feel oncology nurse navigation has its greatest impact. To be a patient’s advocate, supporter, and educator, and by providing professional insight that the patient may need and use in their crucial next step. This, to me, is so overwhelmingly important to the outcome of the patient’s care.
Q: What do you like best about your job?
MM: I love the flexibility. One moment I am off meeting someone in the clinic I previously spent hours with on the phone and then return to my desk for the next phone call. I love being the calming voice of reason. The patients are so incredibly frightened and numb with the “unknowns.” On any given phone call, I can almost hear their thoughts racing. It is my job to calm them down and refocus them to the now. I just love that moment when I know I succeeded and together we can move forward and begin to set the appointments with the providers of their team.
Q: What is the biggest challenge as a nurse navigator?
MM: The institution is large, and many patients come for surgery and treatment. The doctors’ schedules can be tight, while there is sometimes a time issue at hand.
To overcome this challenge, many of the team members meet to discuss our options. We work up detailed plans, add on time slots, and do an incredible job of getting the patients in to be seen. The navigators work with the new patient offices to review schedules, triage the patients to the appropriate providers, and call patients to confirm the appointments. It is a place of frustration and concern at times, but a huge reward once it is all figured out and the patient is accommodated.
Unfortunately, there are so many diagnosed with cancer on a daily basis. This is what makes the navigator job so important.
Q: What do you see as ways or opportunities to improve nurse navigation?
MM: There are so many opportunities to improve nurse navigation. Many experienced nurses know upfront the barriers a newly diagnosed patient will face and need to overcome. We could provide insight to access, and build team navigation pathways and intake forms to better facilitate a patients plan of care.
A health system could use a nurse navigator out at the community. Our roles as educators in awareness and screening are a wonderful start. Nurse navigation can expand out to the community, hold health fairs and sign patients up for mammograms, colonoscopies, and skin tests, to name a few. This could be an opportunity to bring awareness to the population, informing them that if they are diagnosed, there are navigators who will assist you.
I believe navigators need to continue to document and publish their journeys and successful patient stories. This will continue to bring awareness to this wonderful and fulfilling role.
Q: What would you say to an organization that is contemplating whether to implement a nurse navigation program?
MM: I would say do it! The navigator role is a win-win for everyone involved. The institution will benefit in compliance and retention, the providers will have a more accurate assessment of the new patient they are going to see, and, most importantly, patients benefit. The patient feels supported and informed and therefore confident in their decisions about their care.