Rebecca Hadenfeldt, BSN, RN, is an oncology nurse navigator at CHI Health St. Francis Cancer Treatment Center in Grand Island, Neb. She has served in this position since March 2016. Hadenfeldt was the recent winner of the Caring Kind award at St. Francis.
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Q: What is the most important work you do as a nurse navigator?
Rebecca Hadenfeldt: Being available for the patient, being able to provide education and notes during office visits or phone calls, connecting patients with needed services, and connecting the dots for patients as well as our staff who take care of the patients. I am with the patient during office visits and the oncologist will order tests/biopsies/labwork as well as talk about the treatment plan. I am hearing what the patient hears. I am taking notes for the patient, but also for the cancer team as well. I am able to help the other nurses and office staff connect some dots that may not be readily available in a history and physical or orders due to the unique needs or personality of the patient.
Q: What do you like best about your job?
RH: The challenge of each individual patient that I am helping. Every patient has their unique challenges to their cancer diagnosis and treatment, which makes my job never dull or boring. The challenges these patient face force me to get out of my comfort zone in order to find a new service or provide education in a way that best suits their needs. Then the emotional needs of the patients, the acceptance, and the denial as well as the anger all provide opportunities for me to get to know the patient, to understand them better and help them assess their own coping skills to get them through that stage of emotion.
I equally enjoy my co-workers and management as our team at CHI Health St. Francis Cancer Treatment Center is the best around. For a town of 50,000 in the middle of Nebraska, we are able to offer our patients top-of-the-line cancer treatment in a small-town environment which saves patients stress for traveling and lodging. Our nurses, pharmacists, clinical trials, radiation oncology, and other support services are all here for the cancer patient and help to give patients the best experience that we can.
Our patients are our neighbor, friend, cousin, and grandparent. We are able to provide a safe environment for our patients as well as a supportive atmosphere while they receive care and treatment here.
Q: What value do you think nurse navigation provides?
RH: The value of a nurse navigator provides the patient with a point of contact as well as a person who can spend time with them to provide education about not only their disease but how their journey will be planned. When I am first introduced to a patient as a navigator, I let them know they can contact me with any questions as I will help them find the answers. It can be as simple as the date and time of their next appointment to as complex as helping find services for a person who is living in their home and now needs to be placed in a facility due to the caregiver having been diagnosed with this cancer.
Navigation is a fairly new position in smaller practices, but patients who have been to a larger oncology center likely know exactly what a navigator is for and the value the position provides. For patients who do not know what a navigator is, they are comforted when I first meet them to know there is a person they can call or who will be with them to help them through this journey of the cancer world.
Typically, we (the navigators) are with the patient at the beginning of diagnosis through the beginning of treatment. I feel I have been successful when I am able to step back and not be as a big of a presence when the patient has started treatment and they are learning the system, including who to call and what questions to ask. I also feel successful when I am able to connect the patient with services to help reduce their stress. This allows the patient to concentrate on themselves for healing rather than the stressors of their lives.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
RH: One of my favorite success stories about nurse navigation was a particular patient who was diagnosed with cancer and was determined to work through chemotherapy and radiation. The patient did not ask for much and took a reduction in work due to fatigue and long days of chemotherapy. This patient accommodated daily radiation treatments into their work day.
This patient drove 30 miles one way for her work. The car was starting to break down and winter was coming. I was able to give the patient financial assistance for car repairs, provided through our wonderful foundations, that are made available to our cancer patients so that the patient could maintain their job and thus maintain medical insurance through this treatment as well.
Through another program in our community, we were also able to provide a Thanksgiving meal to this patient. The patient has since commented that if it wasn’t for this assistance, treatment may have ended earlier than planned, thus leading to a higher risk of recurrence or no cure. This patient stated those generous services had changed her life.
A common experience is setting up a breast cancer patient for a surgeon, radiation, and oncology consults. These patients are able to listen to the treatment plans from all modalities so they have all the information needed to make the best possible decision for themselves in regards to surgery and their treatment plan. By getting these patients appointments with each of these disciplines upfront, we notice that they accept their diagnosis, get to treatment faster, and are able to start healing quicker and adjust to their new role of being a cancer survivor.