Direct. Empower. Guide. Navigate: Where Does the New Oncology Nurse Navigator Start?

What are the functions of an oncology nurse navigator (ONN) and what are the expectations? Understanding the history of navigation is usually the best place to start when trying to describe the role of the ONN to a newcomer. Oncology nurse navigation, or patient navigation, is not a new role in the healthcare field. The shift to nurse or oncology nurse navigation began in the 1970s. The first individuals to function in the role were nurses who performed case management. The role of the case manager, generally a nurse or social worker, was to ensure safe, effective, and efficient patient care. Initially, case managers evaluated patient needs and then linked the patient to the appropriate resources. After some time, case managers discovered that there was a significant value in involving patients in this process.

Nurses interested in oncology nurse navigation should have a broad scope of medical knowledge regarding cancer and issues faced by oncology patients. These general core competencies include knowledge of diagnostic evaluation processes and available tests, including types of biopsy and diagnostic methods for different cancer types. The ONN working as a breast navigator, for example, would know the mammography process and understand advanced diagnostic tools such as breast magnetic resonance imaging; however, the knowledge base does not stop here. ONNs must also understand tumor pathology and biopsy results; treatment options such as surgery, chemotherapy, and radiation; clinical trials; genetic and high- risk evaluations; survivorship care needs; and end-of-life issues. In addition, ONNs must have an understanding of why patients are unable to successfully access care or standard treatments. The ability to address barriers to care is essential, and ONNs must be adept at communicating with patients. ONNs must have the ability to educate patients on their disease and treatment plans, while also addressing the psychosocial and nutritional issues patients may face during their cancer treatment in a way that is simple for patients and their families to understand.

Taking the time to learn the multiple steps and stops your patients must touch through their journey to survivorship is a good way to become more in tune with your patients’ real-time needs. It can be helpful for ONNs to start where the patient starts: at the time of an abnormal finding. The ONN would then literally travel the same path the patient takes. Finding the time to make a flow chart that begins at the time of your patient’s diagnosis, including places and people your patient will encounter on his or her journey, can help effectively navigate the patients throughout the continuum.

Nurses new to navigation may benefit from net- working with other ONNs. One way to do this is to join a professional organization like the National Coalition of Oncology Nurse Navigators (NCONN), the Association of Oncology Nurse Navigators (AONN), or the Oncology Nursing Society (ONS), which support and promote the role of the ONN. Attending conferences may also be helpful in increasing the knowledge base of the ONN and in providing additional networking opportunities.

Sharon Francz, LPN, BSHA, is the oncology nurse navigator at Shady Grove Adventist Hospital, Rockville, MD, and president, National Coalition of Oncology Nurse Navigators (NCONN).