The nurse navigator is a nurse who provides individualized assistance to patients, families, and caregivers to overcome barriers within the healthcare system and facilitate access to all the resources available to patients. The nurse navigator acts as a link between patients and care providers to facilitate clinical and supportive care services. The role is that of a single point of contact among referring providers, patients, and other clinical caregivers for the purpose of empowering patients in dealing with the disease and the treatment. The nurse navigator facilitates patient appointments for diagnostic procedures in the laboratory, imaging, and other specialty areas. The nurse navigator collaborates with the appropriate clinical resources as defined within his/her scope of practice.
- Provides patients access to/educational materials enabling them to make informed decisions.
- Participates in patient education by assisting patients and families in understanding their diagnosis, treatment options, and available resources.
- Collaborates with members of the healthcare team to design and coordinate an evidence-based plan of care.
- Conducts initial and ongoing comprehensive needs assessments of patients and families, communicating identified findings to appropriate members of the multidisciplinary team members.
- Documents in the electronic health record, as indicated, all interventions and clinical changes using established care guidelines.
- Encourages patients and families to participate in the care planning.
- Evaluates results of care planning, readjusting priorities as patient status changes.
- Facilitates scheduling of appointments for clinical consultations and support services inclusive of the medical care team, surgeons, radiation oncologists, social workers, pain consults, and dietitians.
- Follows an intervention plan from the time of patient referral, coordinates care among team members, reviews patients’ disposition for care, provides patient information and education, assists patients in obtaining a second opinion, follows patients during treatment, and evaluates care and changing priorities.
- Follows patients throughout the care continuum, including inpatient admissions, and collaborates with inpatient care management resources.
- Identifies new and established patients with a cancer diagnosis who require navigator services.
- Matches any unmet needs with appropriate referrals within the multidisciplinary team, including but not limited to, social worker, dietitian, genetic counselor and pastoral care.
- Provides emotional and educational support for patients and families.
- Serves as a patient advocate on the multidisciplinary team.
- Transitions patients from one phase of care to the next, including self-management and independence in self-care.
- Uses a case management system.
Leadership and Quality
- Adheres to established productivity benchmarks and submits data for the oncology dashboard.
- Articulates service and customer relations improvements to ensure patient retention.
- Coordinates clinical information for multidisciplinary treatment-planning cancer conferences.
- Develops patient education programs and written communication materials.
- Participates in collecting data for the oncology dashboard to monitor quality metrics and clinical outcomes.
- Participates in oncology service line performance improvement activities (e.g. Cancer Committee, Pulmonary Governance Committee)
- Maintains responsibility for outreach efforts to establish and maintain positive working relationships with key customers and community (e.g., providers, office staff, diagnostic laboratory staff, nurses, radiology staff, social services staff, radiation oncology staff)
Education, Experience, and Licensure
- Master’s degree in nursing from an accredited school of nursing preferred
- Experience in the oncology program system and departments of the hospital required
- State nursing licensure
- Basic life support (BLS) certification
- OCN® preferred
- ONN-CG preferred
Job Qualifications and Skills
- Ability to form strong alliances with referral and resource agencies in the community
- Ability to provide holistic care for patients with education and information about their illness
- Active listening skills
- Ability to anticipate change and react accordingly
- Clear and persuasive communication skills among all levels and audiences
- Able to assess, plan, intervene, and evaluate the physical, emotional, and educational needs of the patients
- Experience in conflict resolution
- Sensitivity to cultural and ethnic diversity
- Demonstrated leadership style that builds and maintains a climate of trust and inspires collaboration with medical staff and departments
- Expert knowledge in medical, surgical, and radiation oncology
- Knowledge of legal and professional guidelines and scope of practice
- Able to work efficiently and effectively both independently and as a member of a team
- Sound decision-making and critical-thinking skills
- Symptom management experience