Sarah Wilmowski, RN, BSN, is a structural heart nurse navigator for Abrazo Arizona Heart Hospital in Phoenix. She has served in this position since August 2016.
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Q: What is the most important work you do as a nurse navigator?
Sarah Wilmowski: Educate, support, and follow up. These three things are the pillars to navigation. Patients who are educated are more compliant, more confident, and usually at peace. Patients who feel supported are more apt to reach out if they have questions or concerns, allowing for early intervention for any health care issues that may arise.
Facilitating a smooth transition from hospital to home is key to ensuring understanding — about medications, activity restrictions, follow-up appointments, etc. — as well as discovering any items that may need to be addressed; facilitating follow-up appointments for all specialties on each patient’s case; and checking in with patients to make sure they were able to pick up all their new medications.
Patients know someone is concerned about them, and there if they need them. This leads to satisfied patients. They also feel encouraged and empowered to take ownership of their own health.
Q: What do you like best about your job?
SW: My patients. They are why I do what I do. I like being able to be their familiar face on the day of surgery, as well as the consecutive days after in the hospital. It brings a sense of peace knowing there is a cohesive team, and a person who they can reach if they need to, someone who is going to navigate them through the myriad of testing, and be there when it’s over. They know someone will be available to answer that ‘silly’ question, and someone will be checking in on them when they get home. I am honored to be that ‘someone’.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
SW: We had a patient who was particularly nervous about her surgery. When she arrived for her pre-op testing, she was exhibiting definite anxiety. As I did her pre-op testing, we developed a bond. I was able to more thoroughly explain step by step what she might experience after surgery and what her stay would most likely look like, answering all her questions. I promised her I would be there the morning of her surgery and hold her hand as they took her back.
Her son told me on the day of the surgery that as they were getting ready, she was starting to get very anxious again. He said, “Remember, Mom, Sarah will be there with you.” He told me that knowing someone familiar would be there really made a difference for her.
Another patient illustrated the importance of education and repetition. She called me the day after she was discharged. We had done extensive heart failure education, which proved to be valuable for her. She told me, “Sarah: I have gained two pounds since yesterday. My legs and hands are swollen, and I am not urinating as much. I called the doctor’s office a half hour ago and heard nothing back.” I was able to facilitate with the physicians to get her seen and allow her to receive appropriate, timely treatment. She felt her voice was heard and she was important. It’s so rewarding to have such amazing patients!
Q: What is your biggest challenge as a nurse navigator?
SW: Right now, my biggest challenge is educating others in the health care field about what nurse navigation is and encouraging them to use me as a resource. Nurse navigation is not only to navigate patients but physicians and hospital staff as well. Navigators facilitate communication between physicians and ancillary staff as well as identify process improvement opportunities, allowing us to continually improve the way we care for patients, listening to their voice, and making changes based on patient preferences and concerns.
Q: What technology do you use in your position? What tools do you wish you had?
SW: I have a cell phone so I can be easily accessible to patients. They can email me or call my office line as well if they would like. In a perfect world, I would say that being able to communicate with them via video chat would be wonderful. In reality, the majority of my patients are seniors and that could be more cumbersome for them.
It would also be beneficial to have the ability to share electronic medical records between hospitals. This would allow us to better care for our patients, not duplicating testing, and ensure a more detailed history.
Q: What do you hope for as the future for nurse navigation in the United States?
SW: I would hope to see nurse navigation become the new norm. Nurse navigation should be the gold-standard, pulling back from attitude of “just getting patients through,” and reminding others that we are dealing with individuals, one at a time. This is not only for the best medical outcome possible but for the best experience possible; allowing health care to be truly patient and family centered.