Deborah L. Danko, RN, OCN, is an oncology nurse navigator at Cayuga Medical Center in Ithaca, N.Y. She has served as a nurse navigator since April 2014.
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Q: Since becoming a nurse navigator, what are some of the highlights of your work?
Deborah Danko: As an oncology nurse navigator, I have developed and coordinated our survivorship care plan program; coordinated the “Shine the Light on Lung Cancer” event to raise awareness of lung cancer for the second year in a row; coordinated the Blue Ribbon Colorectal Awareness event, which is coming up on its second year in March; created a monthly workshop — “Living Well with Cancer” — in three of our healthcare system locations. I’m also continuing to develop our low-dose lung cancer screening program, and am directly involved in creating and implementing our first annual Oncology Teaching Day here at the hospital.
Q: Many people are still unfamiliar with the work of nurse navigators. How would you describe what you do?
DD: When I introduce myself, patients ask , “What does a nurse navigator do?” Occasionally, a joke or two about the boat I’m navigating will come up. I go on to explain that, as an oncology nurse navigator, I offer education, resources to facilitate informed decision making, coordination of appointments in a timely manner and help overcome barriers to care, such as finances, transportation, child care, work issues, etc. As an oncology nurse navigator, the most important element of my job is communication. Essential to my work is assuring that my patients, families and caregivers know I am available to help address questions, concerns, issues or provide a shoulder to lean on. By making myself available to them, whether it be via phone, email or visiting my office, I can be the central agent and the go-to person that can individualize assistance for them.
Q: What value do you think nurse navigation provides?
DD: Even prior to obtaining the oncology nurse navigator position, when I worked as a chemotherapy nurse, oncology case manager or oncology nurse manager, I feel I naturally filled the role of navigator for my patients. In general, nurses want to help their patients. Healthcare is constantly improving, but it still can be frustrating, time consuming and difficult to understand.
Therefore, as centers become busier, the roles of office nurses, chemotherapy nurses and providers also become busier. This increased tempo is why the position of nurse navigator is a necessity. It not only helps the patient, but also the health care system as a whole. It is the big picture we have to take into account. The oncology nurse navigator works on positive patient outcomes, but also promotes positive systems outcomes using interdisciplinary communication and patient retention. Oncology nurse navigators save our healthcare system crucial dollars by reducing missed appointments, enabling patients without the financial ability to get necessary medication, providing education and symptom management so that patients understand their treatments (which keeps them out of the ER and hospital) and managing barriers of all kinds.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
DD: We, as oncology nurse navigators, also become friends, mentors, social workers and family to many of our patients. My job is a privilege — a godsend for which I will always be grateful. Here are a few examples: I recently helped a patient get an outdoor rocking chair to enjoy the outside during the spring; assisted someone in getting to Cuba for a vaccine that he desperately wanted; I have provided many patients with laptops to keep in touch socially; and I have helped patients get makeovers for occasions and take family trips.
As navigators, we provide the ability for patients to have second and third opinions. We utilize Hope Lodge for lodging through the American Cancer Society and find transportation for these patient who have to travel. We acquire lift seats and stair glides to assist with patient’s independence. Improving quality of life and decreasing stress and frustration for our patients is a daily goal.
Q: What technology do you use in your position?
DD: Healthcare technology has significantly improved the quality of patient care by providing better preventative measures, more specific testing, custom therapies and less invasive procedures. Technology has been able to provide patients with access to screenings for early stage diagnosis; resources for housing, finances, grants, transportation in and out of the community; and better communication with patients, family, providers and institutions. The use of FaceTime and Skype have allowed us to include family and friends, as well as caregivers, who cannot physically be present to still participate in office visits and the plan of care, thus providing comfort and reassurance.
Q: What are some of the resources you find helpful with your position?
DD: As a navigator, I’m always finding new resources and thanking old ones. Small Comforts Foundation of Tompkins County; Corporate Angels Network, served by Corning, Inc.; Leukemia & Lymphoma Society; American Cancer Society; Cleaning for a Reason; multiple co-pay assistant programs; and the Cornell bus that takes patients to New York are just a few which I am so very grateful. They are all very giving.
There is a resource that is unique to Ithaca and the surrounding area: Cancer Resource Center of the Finger Lakes. This is a locally based non-profit organization that depends on the support of the community through donations and events. They have eight support groups, offer gentle yoga classes and help with the cost of acupuncture. They provide financial advocacy volunteers, a boutique and so much more. For a community hospital, we have a wealth of resources that make my job easy. Actually, it doesn’t even feel like a job sometimes. The ability to help by giving or just being there is my blessing.
Q: How do your colleagues view nurse navigation and care coordination?
DD: My colleagues recognize the need for patient navigation, and they keep me in tune with the needs of patients, their families and caregivers or even sometimes a staff member in need. They are an amazing group of caring, smart women and men. I depend on them and they depend on me. We have a mutual respect for each other’s expertise and collaborate in an ongoing manner. The providers are in constant contact with me regarding their patient needs. It’s a team, it’s a village!
Q: What do you hope for as the future for nurse navigation in the United States?
DD: I hope that someday all areas of medicine will have nurse navigators for all patients.