Olivia Washinski, BSN, RN, CBIS, is a neurosurgery nurse navigator for Bayhealth Medical Center. She has served in this position since December 2013. Washinski recently received the DAISY Award for providing extraordinary nursing care. The DAISY Award is given by the DAISY Foundation.
Q: What is the most important work you do as a nurse navigator?
Olivia Washinski: The most important work that I do as a nurse navigator is being that consistent support person to both patients and their families during some of the most difficult times in their lives. Whether it is a new diagnosis of cancer, trauma, ruptured aneurysm, or complex spinal surgery, having that one person to sit with you, be a familiar face in a sea of providers, and truly give that one-on-one attention needed during these stressful times is so important and meaningful. I feel this provides continuity in care, and I am able to help coordinate the care between the different service lines.
Q: What do you like best about your job?
OW: What I enjoy most about being a navigator is that I get to follow a patient throughout their course of treatment and through the recovery process. I am able to develop a relationship with my patient and their family. When I worked in the emergency department, I would always wonder what happened to my patient after they were admitted. It is such a rewarding feeling to see a patient that has come through a critical diagnosis walk back onto the unit or into the office and thank you.
At times, it is not always joyful. I help run our multidisciplinary neurooncology clinic as well. I become very close to these patients and their family members. It can be difficult when they have progression and pass away, but I find solace in knowing I was able to provide some extra individual attention and support them through this process.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
OW: There was a gentleman who came through our service line with a suspected brain tumor. He required an open MRI, which is provided at another campus. Due to his ICU status, he needed to be transported to this test with an ACLS-certified nurse. We were waiting most the day to get him there so a confirmation could be made. When we still had no available nurse to go by mid-afternoon, I volunteered to go myself as the patient was getting anxious. We got to spend time talking during the transport and develop a relationship.
I followed him closely throughout his treatment and was there to answer questions about his diagnosis of a glioblastoma multiforme. I spoke to his wife monthly during his course of post-op recovery and treatment. When he became symptomatic a year later with concern for progression, I was the first person his wife called when she was unsure how to proceed. I helped arrange his testing and appointments with the correct providers. As his cancer progressed, I was there to help him and his wife discuss his wishes and explain the process of the disease in regards to having a terminal diagnosis.
Since his passing, I have remained in contact with his wife. She thanked me for explaining what the end-of-life process would be like and that it made it easier for her to bring him home on hospice. I find comfort knowing I was able to be there to provide that support and I was able to make this difficult process easier for both of them.
Q: What is your biggest challenge as a nurse navigator?
OW: The biggest challenge has been developing the role and job duties for my position. Nurse navigators are a new role in the organization I work for. My responsibilities and job duties are ever-changing and evolving as our service line grows. I am frequently making changes to my workflow to meet the needs of my patients, their families, and my service line.
Another challenge is that each navigator that works in my organization has different responsibilities. At times, we overlap each other. We work collaboratively with each other to make sure the patient has everything they need but this can get confusing.
We recently moved to a new computer system which has made our multidisciplinary approach much easier and efficient. It is still a learning process for staff and providers to fully understand what we are doing for the patients and how we can help with care coordination.
Q: What would you say to an organization that is contemplating whether to implement a nurse navigation program?
OW: I would highly encourage it. I feel having navigators helps with continuity of care and improves patient satisfaction. It is that personalized resource to patients and their families. Most nurse navigators come with previous work experience in multiple areas of medicine. This allows them to use their previous experiences to educate patients, provide support and understanding of different disease processes, explain a diagnosis and treatment plan, and answer other questions that may arise. I find I am most beneficial in our multidisciplinary clinic as I am able to keep all providers and treatment teams up to date on the patients and any changes. This, in turn, helps us provide the patient with a well-organized treatment team.