Nurse navigator programs help lead patients through cancer treatment process

When a patient is diagnosed with cancer, he or she could face surgery, radiation and chemotherapy.

But before he can complete the treatment regimen prescribed by his doctors and get healthy, he also may face 20 or more barriers to successfully navigating the health care system.

Things such as transportation to and from chemotherapy and radiation treatments, child or adult care, financial woes, literacy and language all can serve as impediments to completing treatment, said Dr. Michael T. Brown, director of the McGlinn Cancer Center at Reading Hospital.

Enter the nurse navigator.

Reading started a nurse navigator program in the oncology department in 2009 to help patients through the treatment process.

“When someone is diagnosed with cancer, it is obviously a crisis moment for their health,” Brown said. “More than just the disease, depending on where they are, their financial status, their family support system, all impacts on our ability to treat them.”

In addition to personal matters, cancer therapy also has become more complex in recent years.

“It’s a very complex process to go through,” Brown said. “More and more we are taking very complicated care and applying it to someone who generally is over 65 and has other medical conditions.”

On top of that, Brown said, tests show patients only absorb about 50 percent of what their doctor tells them during a normal visit.

“So, that one visit to the doctor is no longer sufficient,” he said. “If you tell a woman she is going to need six months of chemotherapy, she can accept that, but then she asks, ‘Who is going to take care of my children or my elderly mother?’ ”

Those kinds of difficulties are now the realm of the nurse navigator.

Ashley Shuey said she worked for 16 years as a chemotherapy nurse. She now works as one of four nurse navigators at the cancer center where she specializes in blood cancers.

“We have a list of resources in the community, and we also work closely with the hospital social workers,” Shuey said. “We also have an American Cancer Society navigator in the hospital that we work closely with.

“At first I think the process is so overwhelming that the patient kind of has to take a step back. That’s the critical point where we come in and educate the patient and help them through the process. They don’t know where to start.”

Shuey said she will sometimes go to appointments with cancer patients.

“A lot of times, they’re just not hearing what their doctor is saying, and we explain it to them,” she said.

Lisa Spencer of Lebanon was recently named Breast Care Patient Navigator in St. Joseph Medical Center’s cancer program. Spencer’s background is in radiation therapy, and she has worked as a department manager at several hospitals over the past 20 years.

“She brings more than 20 years of executive experience in health care settings,” said Michael Jupina, vice president and spokesman for St. Joseph. “In the Breast Care Patient Navigator role, Spencer will function as a liaison between the breast cancer patient, the cancer center and referring physicians, including a very active role in our Multidisciplinary Breast Care Clinic.”

Spencer said she welcomes the opportunity to get out from behind a desk and work more closely with patients.

“I have been very involved in both radiology and oncology, and actually created a breast cancer navigator position, and then worked that position,” Spencer said. “I want to be able to walk along side our breast cancer patients and help them navigate through what can be a very confusing, very scary system.”

Spencer said the navigator serves as a friend to the patient entering an health care system with which they are completely unfamiliar.

Brown said the nurse navigator role has been growing in the medical field.

“There is now a national nurse navigator association, and it is now a requirement in order for a hospital to have a cancer center,” he said.

Jupina said St. Joseph also has patient navigators at work in the emergency department and for heart failure, stroke and chest pain patients.