Penny Widmaier, RN, MSN, is an oncology nurse navigator for Beaumont Cancer Center – Farmington Hills located in metropolitan Detroit. She has served as a nurse navigator since August 2010.
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Q: What is the most important work you do as a nurse navigator?
Penny Widmaier: My most important contribution as a nurse navigator is to help smooth the cancer journey for patients and families as they face some of the most difficult days of their lives. Small things can make huge differences for those we serve. It may be holding a patient’s hand as she begins her first chemotherapy infusion, connecting patients to a financial navigator as they face overwhelming medical costs or just listening to a newly diagnosed patient and letting her cry. There are endless small things that navigators can do that truly help patients and families.
At Beaumont Cancer Center – Farmington Hills, I am fortunate to be a member of an exceptional care team that includes physician and nurse providers, an oncology social worker, a financial navigator, an amazing radiation therapy treatment team and a support staff who is truly engaged with patients and families. We regularly receive feedback that our excellent service and personal compassion help make our patients’ cancer journey tolerable. Our patients appreciate the cooperative nature of our work.
Q: What do you like best about your job?
PW: By far the best part of my job is the opportunity to interact face to face with patients and their families. Every day I touch a patient — either a handshake as we first meet or a hug as we meet again. I also enjoy a diverse role that includes participation in research. I value research and clinical trials because they are key to improving treatment and ultimately patient outcomes. I serve in a leadership role, focusing on quality improvement for our institution and look forward to many more quality initiatives.
I also enjoy the professional and collegial atmosphere at our cancer center. Each team member has value and the ability to improve the experience daily for our patients. Team members understand our patients’ challenges and focus on ways to help. Our physician leaders cooperate with the team and acknowledge team members’ professionalism and commitment. Our institutional leadership also recognizes the importance of exceptional cancer care and remains supportive of our efforts.
Q: Can you share any particular patient stories or experiences that demonstrate the value of nurse navigation?
PW: Last year, I received a call from a stranger who was crying. She knew something was terribly wrong with her breast, and she had been ignoring the problem for many years. She described her breast as being “eaten away with tumor.” She had not sought medical attention out of fear and for financial reasons. She was 61 and unemployed. She could not find another job and ultimately lost her medical insurance. Her call to me was prompted by her recent new medical coverage through the Affordable Care Act. I immediately secured an appointment for her with her assigned primary care physician, who told this patient to “find hospice care.” She had a subsequent appointment with an oncologist at Beaumont Cancer Center – Farmington Hills, and the patient was accompanied by her dear friend. This story turned very positive after her encounter at our facility. She now has had several surgeries, is halfway through chemotherapy and has met numerous times with me, our social worker and financial navigator, securing improved insurance and community support. She describes her life as having “turned around” and enjoyed Thanksgiving recently with family and friends, filled with a spirit of hope and gratitude.
During every meeting with this patient, her close friend has been with her. I am touched by their bond and unconditional love. Undoubtedly, the patient would not be in treatment without her true friend, who brings along a huge folder, takes notes, makes appointments and keeps everyone on task. She encourages, supports and basically manages this patient’s life and still has energy for her own family and full-time job. It has been a joy meeting these two exceptional women, and I am thankful for the opportunity to help them. They have given me pause to consider my own relationships and how I can be a better friend.
Q: What is your biggest challenge as a nurse navigator?
PW: Time is a huge challenge for me as a navigator. As with all nurses, I have to prioritize my work and often feel there are just not enough hours in a day. Cancer patients’ seemingly never-ending challenges can be very complex, often unexpected and mostly immediate. This can make time management and planning difficult. Sometimes I may receive an 8 a.m. call from a patient in need of transportation for chemo at 9 a.m. I may receive a call from a patient who cannot afford her medications. Or, researchers have asked me to review hundreds of medical records in one day! These challenges can only be overcome with my colleagues’ help. This demonstrates the importance of a cancer care team that functions at a very high level. My team members and I jokingly refer to ourselves as “Partners in Crime”, or “PICs.”
Maintaining a balance in my professional and personal lives can also be challenging. Serving patients with a cancer diagnosis can certainly create emotional challenges. I have found that what I anticipated to be “doom and gloom” working at a cancer center to be happiness and hope. I primarily serve breast cancer patients, and they generally have good outcomes. The challenge is helping them through the acute phase, including diagnosis and active treatment. I also see the happiness at treatment completion as my patients enter survivorship. It is impossible to never think of one’s professional life as a nurse while off duty. However, I am blessed with a loving, supportive family and have been successful in maintaining that tricky work-home balance.
Q: What do you hope for as the future for nurse navigation in the United States?
PW: I hope and anticipate nurse navigation to continue to grow in the U.S. and globally. Through research and role standardization, I believe this will happen. I serve on a national nurse navigator research committee and also write for and edit a national journal. These activities are important to me personally and also to the future success of the profession. I encourage navigators to engage in activities that will generate opportunities to interact with other navigators. Recently, I formed a local chapter of nurse navigators in Michigan. The initial meeting had only four attendees, yet was extremely important and valuable to us as we now share best practices and strategies to improve care. I encourage navigators to seek out local and national groups, to attend conferences and to share best practices.
For nurse navigators and all of nursing, I would like to see a standard entry-level degree for the profession, initially at the bachelor’s degree level. Without this standard, the profession will continue to struggle for financial parity and professional respect. I would also encourage one standard credentialing process for navigators. I find multiple letters and numbers listed as navigator’s credentials that, even as a navigator, I have no idea what they mean. This practice seems fragmented and senseless. Navigators should be nurses. Currently, you can be labeled a patient navigator in many settings without being a nurse.