Sharon Cosgrove, BBA, RN, OCN, is a breast nurse navigator at Sparrow Cancer Center in Lansing, Mich. She has served as a nurse navigator since October 2011. Sharon recently received a 2016 Excellence in Nursing Award — more specifically, the Unit/Departmental Nursing Leader Award — from Modern Healthcare.
Is there a nurse navigator you think should be profiled by NurseNavigation.com? Let us know!
Q: What is the most important work you do as a nurse navigator?
Sharon Cosgrove: It is really difficult to pick the most important role; there are so many roles that you fill. One of the important roles is trying to help make the journey from abnormal biopsy to treatment faster. Waiting can be one of the most difficult things a breast cancer patient can do. When is my biopsy? What are the results? What is my plan? My role is to make sure the next step is always happening. That is very important to a patient.
Being the liaison between the patient and the physicians is very helpful to the patient. They know I will call them back. If they have a question, I will try to make sure it gets answered in a timely manner. The support I am able to provide them while they are going through their journey helps to make things a little better. The fact that I work closely with our multidisciplinary team has improved patient outcomes and time to treatment.
Q: What do you like best about your job?
SC: I like working with our nationally accredited multidisciplinary breast clinic (MDC). I believe if a patient has a cancer diagnosis, working with a MDC is best practice; the patient gets an individual comprehensive treatment plan. I like the fact that each patient’s pathology and images are reviewed by the team, and an individual treatment plan is developed for each patient by the MDC. I also like the fact that our cancer program puts great emphasis on patient education and support
Q: What value do you think nurse navigation provides?
SC: I think patient navigation has helped decrease anxiety for patients and has improved the patient experience. The time from diagnosis to treatment has decreased in our facility since the breast navigation program was implemented. I am able to spend a lot of time with patients talking about their breast cancer diagnosis, treatments, exercise, lymphedema, how to minimize side effects of treatment and much more. I am able to assess what barriers a patient may have and try to help overcome them.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
SC: I have so many wonderful stories about patients that benefit from navigation. Many patients benefit from the extra support and resources to help get them through their treatment. I also have many women who are underserved or underinsured. It is very rewarding to help them get set up with programs that will provide diagnostic work up and help get them on Medicaid for their breast cancer treatments.
I recently had a patient that just got out of a homeless shelter and she moved into an apartment that was not furnished. She was happy to have shelter, but only had a bed to sleep on, sit on and eat dinner on. After hearing her story, we rallied some community members and they helped furnish her apartment. All she wanted was a comfy chair to sit in after her chemo treatments; she got much more than that.
That is the beauty of navigation; you hear what the needs are and you try to use your resources to fill that need. I have found there are amazing people in our community that want to help. One of the navigator’s roles is to make those connections.
Q: What is your biggest challenge as a nurse navigator?
SC: The biggest challenge I have as a navigator is not enough time to do all the things I would like to do.
Q: What do you see as ways or opportunities to improve nurse navigation?
SC: I navigate patients from biopsy to treatment. I also facilitate the support group. There is so much more that could be done to improve patient experience. I would love to offer pre-surgical classes and lymphedema classes and provide more programs for survivors. It would be wonderful to have time to do more community outreach. It would be nice to add more navigators to develop more programs. I feel we do a great job, but there is always more you can do.
Q: What technology do you use in your position? What tools do you wish you had?
SC: I use my computer and spreadsheets. I use our EMR system for everything. It would be nice to have a tracking system that interfaced with our computer system.
Q: How do your colleagues view nurse navigation and care coordination?
SC: I think at first it was hard for them to understand what I did. After the program was up and running, I think they saw the benefits of the navigation program. I think the navigator takes some of the load off of the clinic nurses. We are a great resource for them as far as patient information. Since this program has been implemented, many more navigators have been hired to take care of other cancer diagnoses (prostate, lung and gastroenterology). We also have a fabulous chemotherapy navigator.
Q: What would you say to an organization that is contemplating whether to implement a nurse navigation program?
SC: I would say it is the best thing you could do for your patients. Your facility must have a very dedicated team to implement a successful program. It is a multidisciplinary undertaking; many departments have to work together. Your team must respect each other’s disciplines and they must be fierce patient advocates.
Q: What do you hope for as the future for nurse navigation in the United States?
SC: Hopefully there will eventually be a standard training for nurse navigators. I think an oncology background is a must. Chemotherapy infusion is also important. You must know about survivorship and long- and short-term effects of treatment. I believe eventually that nurse navigators should be mid-level providers. They would be able to write prescriptions, order tests and make important referrals that are needed. This would streamline care even more.