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Role of the Navigator

In a Cancer.net podcast, AONN+'s Program Director and Co-Founder Lillie Shockney, RN, BS, MAS discusses her presentation “The Value of Patient Navigators as Members of the Multidisciplinary Oncology Care Team” she made at the 2016 ASCO annual meeting. Come hear what she has to say on this significant topic.
Medical oncologist Richard J. LoCicero, MD, believes navigators fill in the patient care blanks offering their value as coordinators, shoulders of support, and negotiators.
I recently attended a meeting where leaders from various organizations representing a variety of aspects of navigation were present. One of the speakers showed an advertisement from a newspaper about a well-known nationally recognized comprehensive cancer center. The advertisement was about their navigation program.
Although we know that there are definitions of “patient navigation” that have become standardized, there continues to be the (attempted) implementation of navigation at some institutions that lack clarity and direction. When there isn’t a mission and clear goals for the navigation process, things rarely go as they should.
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.
Healthcare continues to change with a focus on prevention and outpatient care versus the long-standing way of reactive, inpatient acute care. There continues to be a role for inpatient care in oncology, but payer sources will reward the limitation of hospital visits in the future.
One of the dilemmas navigators experience—being able to plan their time well, as well as to explain to others in designated blocks of time how their time is allocated on a given day or throughout a given week. Some time measurement is easy—3 hours spent conducting a community outreach event, for example.
How many metaphors can be used to describe a navigator’s job? It was interesting and visionary to hear all the descriptions given at the 2011 Navigation and Survivorship Conference.
After a recent navigation presentation, a participant approached me and commented, “Thank you, now I understand what our navigator does in her role.” The comment caused me to reflect...could that be the case where many of us work? Do people in our healthcare system know what we do?
When working with systems that are contemplating a navigation program or when navigators visit our site because they have been hired to navigate but can not seem to find their niche, this is a question everyone asks at the beginning. It is stressed throughout the navigation world that there is not a standardized navigation program that can fit everywhere.
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