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A recurring discussion among the attendees at the 2013 Academy of Oncology Nurse & Patient Navigators (AONN+) Conference was “What are different navigators measuring?” This appears to be a daunting task for nurse navigators, and I would encourage you to review previous expert commentaries on the AONN+ website.
February 13, 2014 | Articles & White Papers
At Johns Hopkins, we have had a breast cancer survivor volunteer team for 16 years. At my request, the first 5 volunteers—surgeons and medical oncologists—were selected by our oncologists. I figured that if they picked them, they couldn’t fuss if that specific person did not work out well in a volunteer role, assuming they wanted to volunteer at all.
When someone has just heard in the last day or so that they have cancer, their life is in a tailspin. So when I ask a patient, “Before you heard that you had cancer, what were your life goals?” commonly the response is, “It doesn’t matter what they were. Just please save my life.” But it does matter, because we should be striving to incorporate those life goals into the patient’s treatment planning process.
I am currently writing my 14th book. This one is a textbook for oncologists with the goal (hope!) that we can collectively improve communication with patients with metastatic cancer. All too often the doctor continues to offer another treatment because that is what they have been taught in medical school—“treat the patient.”
As the New Year starts off, many people resolve to improve their life in one fashion or another. Usually the goal is diet-related to eat healthy and lose weight or to decrease a type of intake, such as caffeine or fat. We know that gyms are busy in January and attendance dwindles in February. The New Year is a time to set improvement plans.
In 2013, the Institute of Medicine (IOM) released a workshop summary, Leveraging Culture to Address Health Inequalities: Examples from Native Communities. I was struck by a number of things that are both timely and applicable to the unique challenges faced by the cancer community in America and to patient navigators in particular.
Although the majority of patients diagnosed with cancer survive their disease and its treatment, there are certainly those who do not. Some specific types of cancer carry a high rate of mortality, such as pancreatic cancer. Oncology nurse navigators are more commonly seen as a member of a multidisciplinary team among those who care for patients who survive.
With the expanding role of navigation across the cancer control continuum, standardization of education and a certificate of competency are essential. The current landscape includes high-quality education through in-person didactic and online learning that may provide the navigator with increased competency, continuing education units (CEUs), access to consensus-recommended best practices, and limited evidence-based guidelines.
As part of our responsibility as navigators, we are expected to not just know the standards of care but also remain up to date on cutting-edge research that has recently been published. We are also confronted with patients or their loved ones who have spent hours on the Internet visiting many websites—some credible academic websites and others bogus websites that may look credible but aren’t—and they assume that any new research found on the Internet related to the type of cancer they have or even in a magazine for that matter is valid and is suddenly the new standard of care.
We all do a lot of community outreach in our own geographic area. Commonly, the focus is on cancers that are preventable or can be effectively treated through early detection. Breast, colorectal, melanoma, and lungs cancers are good examples. With the new human papilloma virus (HPV) vaccine available to prevent cervical cancer among young women, we have an opportunity to push the envelope a bit and consider jump-starting education about overall cancer affecting young people.
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