Jackie Smith, RN, is a nurse navigator for The Memorial Hospital at Craig in Craig, Colo. She is a three-year breast cancer survivor who has served as a nurse navigator since September 2013.
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Q: What is the most important work you do as a nurse navigator?
Jackie Smith: Although all of my job duties are important, even down to the paperwork, I think the most important aspect of my job is being there for the patient after they have been diagnosed with breast cancer. Most often, their mind is not able to comprehend or remember all the details they have been told. I think it is very comforting to the patient that I am there to let them know what the next steps are that they will have to take, help them find good surgeons and oncologists, and make them feel more organized, which in turn will make them feel more in charge of their situation.
Q: What do you like best about your job?
JS: Being a breast cancer survivor myself, I love the fact that my job allows me to connect with my patients on a personal level. I feel I am able to answer their questions and give them the support they truly need based on my personal experience. I also feel that they are more willing to confide in me and value our conversation more because of this. To me, it is more than just a job. While I am helping patients get through their difficult situation, it also provides me with satisfaction in knowing that I am doing everything I can to make it easier for these patients than it was for me when I was going through the process.
Q: What value do you think nurse navigation provides?
JS: I really believe that it helps put the patient more at ease before their mammogram, when being called back for additional views and/or biopsies, and definitely during a cancer diagnosis. They know that they have someone who really cares about their situation and will make sure nothing falls through the cracks during their numerous appointments after a cancer diagnosis. It also provides the hospital or breast center with one person they can contact with any questions about the patient’s care coordination.
Q: How do your colleagues view nurse navigation and care coordination?
JS: I am the first nurse navigator to have provided services in our rural hospital for the past two years. We see approximately 1,000 mammogram patients per year and I speak with each patient before their mammogram and complete the screening questions with them. I call each patient with their results. If they are abnormal, I explain the need for a diagnostic mammogram and/or ultrasound. If a breast biopsy is recommended by the radiologist, I assist with the procedure and complete the discharge instructions with the patient, as well as answer any questions they may have.
Once the results have returned, I immediately contact the referring provider so they can contact the patient. If a diagnosis of breast cancer has been made, I am in contact with the patient from that point on through their treatment, providing care coordination and support. All of my colleagues are very appreciative and supportive of the services I provide. They have stated that the time from mammogram to biopsy to cancer diagnosis is much shorter because I am on top of things, and that the system runs more effectively since I have been hired.
Q: What do you hope for as the future for nurse navigation in the United States?
JS: I would like to see a way for nurse navigation services to become billable. I applaud the administrators of hospitals who can see how the benefits of nurse navigators outweigh their financial investment. Most times, nurse navigators are able to keep the patient within their hospital network of specialty providers, surgeons, chemo and radiation services, which is profitable to the hospital, but it is unfortunate that numerous facilities across the country will not provide a nurse navigator due to the fact that their services are not billable.