Published on February 12, 2010

Cancer Nurse Navigators

Leading the way for patients at the Genesis Cancer Care Institute

You've been told you have cancer. You hardly have time to digest the news before it feels like you've been swept up in a whirlwind of tests, treatments, unfamiliar technology and multiple health care providers.

You fear the unknown. Your family wants answers. If you had a personalized map to guide you through the cancer treatment maze, you would buy it.

Instead, the Genesis Cancer Care Institute has something better: Two new nurse navigators, Chris Kuehl and Wendy Ballou, who can be a compassionate compass and provide directions to patients during their cancer journey.

"Once people learn they have cancer, they're usually reeling from the news. They're scared and anxious. They're listening but not really hearing what's being said. It's easy for them to get confused or misinterpret what they've been told," says Kuehl, R.N.

It's hard to focus on what the physicians have said. Their questions usually come after the appointment is over, when they're at home pondering the uncertain future they face, she explains.

"If they have questions after they talk to their physicians, they can call us. We can reiterate what the physicians have said and instruct them again. We're that one-onone contact person, resource and guide. We can educate and communicate so that patients and families understand their treatment options or what their treatments, tests or procedures mean."

Cancer nurse navigators can be particularly helpful because cancer treatment usually requires an entire interdisciplinary team.

A Complex Disease
"Cancer is a complex disease," says Wendy Ballou, R.N. "Patients can end up seeing 3-5 physicians during their treatment process -- from their family practice doctor to a gastroenterologist, pulmonologist, urologist, surgeon, medical oncologist and radiation oncologist. They can either have surgery, chemotherapy, radiation therapy, or a combination of those -- depending on their diagnosis and stage.

"We help guide them as they go from doctor to doctor, appointment to appointment and treatment to treatment. We answer the little questions they don't like to bother the doctor's office with like ‘Do I bring my medication to the hospital?' or ‘Why do I have to see so many doctors?' We can reassure them; answer their questions; and, be a support person for them and their families."

The nurse navigator program is the latest of many accomplishments at the Genesis Cancer Care Institute over the past year.

All the strides, however, don't take away the worries and stresses faced by cancer patients and the labyrinth of health providers, tests and treatments. That's why cancer nurse navigators have emerged in the U.S. over the past decade to respond to the complexity of cancer management, says Sally Werner, Director of the Genesis Cancer Care Institute.

"Patients and families can easily be overwhelmed with information and have difficulty getting to the right place at the right time," Werner says. "Navigators are guides, supporters and communicators who work to smooth the pathways for patients and families. The Genesis Cancer Care Institute understands that care coordination is key to the support of our patients and the quality of their care."

Meeting T he Navigator
Cancer patients typically meet a nurse navigator at diagnosis. The navigator makes contact with the patients at various times during the cancer journey, but mostly lets the patient decide how often he or she needs assistance.

Some patients call more frequently. Others may not call as much because they have strong family support or better know the health care system.

"You're helping people through what may be the worst time in their life," Ballou says. "Cancer is life-changing and there will be a lot of questions -- not only from the patients but from family members. A nurse navigator teaches, listens, supports, repeats as many times as needed and is always there to help the patient and his or her family. We consider it a real privilege to help them through this life-changing event."

Nurse navigators perform a comprehensive needs assessment for each patient to pinpoint their medical, social, spiritual, and financial needs. That can lead to other referrals, such as to a social worker, dietitian or the hospital's finance department, for example.

"What we hear from patients a lot is, ‘Oh, it's so nice to have just one person to call,' " Kuehl says. "We may direct them to someone else, but they appreciate not having to make multiple calls to figure out who to call about a particular problem."

Navigators are with cancer patients from the time of diagnosis, through treatment, and also survivorship, Kuehl says.

"What we find is that sometimes patients feel let down after they finish their treatment...they're so used to being seen and followed so closely. We can also support them through that time and give them reassurance. Most important, our job is to care and have compassion for patients who need our services."

To learn more about the cancer nurse navigator program at Genesis, call Chris Kuehl at (563) 421-1029 or Wendy Ballou at (563) 421-1030.