New at Navigation

AONN+ Blog published on November 10, 2011 in Novice Navigators
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
Editor-in-Chief, JONS; Co-Founder, AONN+; University Distinguished Service Professor of Breast Cancer, Professor of Surgery, Johns Hopkins University School of Medicine; Co-Developer, Work Stride-Managing Cancer at Work, Johns Hopkins Healthcare Solutions

If you've recently become a nurse navigator specializing in an area of oncology, you are among a growing number of nurses who have zeroed in on a new specialty, helping your patient travel along a pathway that can be riddled with confusing information, a myriad of decisions to be made regarding treatment, and other significant decision making along the way. It's rewarding when it works well. It can be frustrating for everyone when it doesn't.

Something that I recommend to anyone just embarking on a nurse navigator role is this-you cannot navigate a patient if you haven't walked in her shoes. No, you don't have to have had the disease she has, but you do have to have a bird's eye view of what this journey looks like through the eyes of a patient. So step 1-follow a patient, preferably several different patients, along the care continuum beginning with the screening process (ie, getting scheduled for a screening mammogram, colonoscopy, Pap smear, etc) and document the entire process all the way through. By doing so, you will be able to identify the inefficiencies that exist along the way, the delays in treatment, barriers to decision making, access to care issues, patient compliance problems due to lack of understanding of the importance of following treatment recommendations and other issues that will become your responsibility to help address. Removing barriers to care is a key function in your new job as nurse navigator. Some barriers may seem unsurmountable; others may be an easy fix. As patient advocate (which you are), your charge will be to work around barriers or eliminate them, so that she can get the care she needs.

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