Rita Glaze, RN, OCN, CBCN, is a breast cancer nurse navigator for Mercy Cancer Center in Joplin, Mo. She has been a nurse for 26 years, serving as a radiation oncology and clinical trials nurse. Glaze became an oncology-certified nurse in 1997, and began her nurse navigator role in 2014. Se recently achieved the certified breast care nurse (CBCN) certification through the Oncology Nurse Certification Corp.
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Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
Rita Glaze: The story I would like to share is my own. I became a breast cancer survivor one year after becoming a breast cancer navigator. I have been very private about my diagnosis and only recently began to share my experience.
I learned quickly that revealing a breast cancer diagnosis is better served face to face. The physician’s office staff called me at work to give me the diagnosis. The first thing I noticed is I had to help her pronounce the words.
The only thing I could think to do was leave. I immediately grabbed my purse and exited the building with nowhere to go. I didn’t want to call my husband and disturb his day until necessary.
I arrived home with the intention of changing my clothes and processing what I had been told, which was very little. I realized 45 minutes later I was still in the closet trying to figure out what to wear.
I was very fortunate to work closely with the breast surgeons, breast center and cancer center, so I went to one of my comfort zones: the surgeon’s office.
I realized I needed a plan, but I didn’t have anyone to help me start preparing that plan.
It is true that you just hear “cancer,” but the most important thing is to know someone has your back and will put you on the right track.
I was lucky and had multiple staff members make my appointments and get me started. I asked stupid questions and smart ones. I was a breast cancer navigator, so I thought I had all the answers. Then I realized the old saying is true: There are no stupid questions.
Breast cancer is not invisible. Clinical and self breast exams and mammograms can save your life. A navigator will help each woman find her comfort zone by providing information and education needed to take control throughout the journey.
Q: What is the most important work you do as a nurse navigator?
RG: In knowing how nervous every moment can be following a breast biopsy, we created a post-biopsy breast clinic within the first year of starting the navigator program. The objective is to reduce patients’ “sleepless nights” and provide a definitive diagnosis in 24–48 hours after biopsy.
At Mercy, a radiologist gives all results and I am present for all cancer diagnoses. The patient needs to have time to process the diagnosis and understand what her pathology report means. She needs to be provided with information and education to prepare her for the next step. Patients may not remember everything you discuss, but in the days waiting to see the surgeon, information filters through and prepares her for the consultation.
Women are faced with a complex maze of physicians, treatment options and appointments. The navigator is that familiar face, a constant presence. There can be many obstacles to care: insurance, finances, child care and spiritual support needs.
The first thing I explain to the breast cancer patient is “this is not a sprint, but a marathon.” Anxiety is high, and the journey is long and can be very emotional. Nurse navigators can empower the patient with ways to take back control while making it possible to work with her treatment team.
Q: How do your colleagues view nurse navigation?
RG: Nurse navigation is not a single entity. The nurse navigator is successful because she is part of a team and provides assistance to her co-workers. I believe that assisting, rather than assuming duties that are not my expertise, builds a stronger bond.
It is important to recognize the value of experienced schedulers, registrars, financial counselors, social workers, specialty nurses, certified mastectomy fitters and breast center staff. The nurse navigator is a guide, educator and familiar face not only to the patient she serves, but to co-workers.
Q: What would you say to an organization that is contemplating whether to implement a nurse navigation program?
RG: A navigation program is not one size fits all. The program must be developed to the size, needs and mission of the organization. The navigator position is not a catch-all for duties that should be delegated to others. The development must include all specialties. Primary care physicians must be included in the development and how they can impact success.
The navigator needs to be an experienced nurse with the knowledge to provide facts, not opinions or treatment advice. The main goal is to assess health barriers and physical, emotional and social needs of the patient, along with educational support throughout the continuum of care.
Perhaps most importantly, each organization must recognize that the women served are unique and the program cannot be copied. When you have seen one navigation program, you have seen one navigation program.
Q: What do you like best about your job?
RG: I have been involved with many wonderful patients. Breast cancer patients are truly warriors. They make me stronger and thankful that they allow me to be part of their journey.
While always emotional, the journey is not always tearful and sad. Together, we realize that humor can be the key. Just ask the patient with tissue expanders! The simple things you do sometimes make the biggest impact. I feel honored to be a breast cancer nurse navigator.