Robin Ison, RN, is the nurse navigator for the Health First Breast Center in Melbourne, Fla. She has been employed by Health First for 13 years and has worked with breast patients 11 of those years. Her initial duties were at the Health First Diagnostic Center and involved educating, supporting and caring for patients undergoing breast biopsies. When Health First opened its new Breast Center in April 2016, Robin transitioned into the role of nurse navigator.
Q: What is the most important work you do as a nurse navigator?
Robin Ison: The most important work I do, in my opinion, is being the patients’ advocate throughout the continuum of care. I facilitate questions the patient and/or patient’s family might have for the radiologist, surgeon or any of their other healthcare professionals.
When patients get the news that they have an abnormal mammogram or ultrasound, the radiologist and I will meet with the patient and the patient’s family, if they are present. After the radiologist discusses the findings and the plan of care, I will educate the patient and family regarding their biopsy and what to expect, step by step. If their ordering provider is in agreement, I will expedite the biopsy scheduling. I am always available to answer their questions and hopefully, alleviate some fears, misconceptions and anxiety.
I will share my contact information to start the navigation process. I encourage the patient to call with any questions or concerns once they leave and are able to process the news. Sometimes just having a familiar voice or face to connect with during this difficult time has a calming effect for the patient. At times, the patient just needs an empathetic ear, a hug or a hand to hold. My goal is to reduce as much fear and anxiety from the patient as possible. One of my favorite quotes from author Maya Angelou is: “People will forget what you did. People will forget what you said. But people will never forget how you made them feel.”
Q: What do you like best about your job?
RI: The patients are what make me get up in the morning. They are so grateful to have someone “in their corner,” someone who will guide them through one of the most difficult times in their lives. There is nothing more rewarding than making a positive difference in someone’s life.
Sometimes a patient needs someone to call when they need to talk. A patient may live alone or not have family or friends for support. No one should ever have to go through a cancer diagnosis alone. This is just one aspect of nurse navigation, but to me it is the most rewarding.
Q: What value do you think nurse navigation provides?
RI: I think nurse navigation is invaluable to patients. To have someone navigate and educate them throughout the process is so important. To support the patient emotionally and educationally will decrease their fear and anxiety. My job as a nurse navigator is to make this process less stressful for patients by navigating and educating them through each phase of this process.
When patients learn they have an abnormality on their breast imaging, they are immediately overwhelmed. The fear begins as early as the call back from their screening mammogram and multiplies with each step as they go through this journey. I schedule their diagnostic testing from diagnostic mammogram and ultrasound through to biopsy to expedite the diagnosis, which leads to timelier treatment.
By educating our patients, they feel more empowered to fight this difficult battle. At our breast center we have provide a resource room for patients and their family. Our resource room contains reading materials and a computer for educational tools regarding their biopsy and breast cancer.
Q: How do your colleagues view nurse navigation and care coordination?
RI: To provide the best care for our patients, we need to work as a multidisciplinary team. Our team at the Health First Breast Center includes our radiologist, who has over 20 years of experience in mammography, our breast surgeons, plastic surgeon, medical oncologist, radiation oncologist, pathologists, nurse navigator, a team of nurses, registered diagnostic medical sonographers, mammography, MRI technologists, and numerous other staff members.
We have four hospitals in our Health First integrated delivery network. If a patient has a mammogram and the radiologist has some concerns, he/she can immediately contact the nurse navigator to reach out to those patients. It may be that they have a normal mammogram but a strong family history and are interested in genetic testing. If so, we can find the best path for the patient and help facilitate an appointment with the appropriate healthcare provider.
For the physicians in the community, I think it is a source of security knowing that our patients will not get lost in the system. We have someone dedicated to tracking our patients to ensure they get the best and most efficient care.
Q: What is your biggest challenge as a nurse navigator?
RI: The biggest challenge for me would be having a patient with financial struggles who is delaying healthcare due to this issue. I want them to continue to receive the best healthcare possible, and it is my job as nurse navigator to inform the patient of all the resources that can help them get to the appropriate places so they receive quality healthcare as soon as possible.
Our patients need to know they are not in this fight alone and we will assist them in every way possible, whether it is financially, emotionally, or medically. We are there for the patient — I make sure they fully believe that.