Toby's Take: The Nurse Navigators

You know the person who becomes so good at her job, she’s elevated to a leadership role? After a while, she misses the day-to-day?

Or this example: I had a police friend years ago who served 4 years as an undercover narcotics officer. He survived the job but, after being wounded on duty, was assigned to a desk job. He hated it.

Corrie House, RN, BSN, doesn’t have war stories quite like that. She’s asked all the time whether she misses the in-person interaction with a patient. The answer’s yes, by the way. Yet she couldn’t be happier in her role as nurse navigator.

“This position is not for everyone,” House said.

For those who love it, they really love it.

Nurse navigators have the clinical background of a nurse and are often the first voice a patient hears after a cancer diagnosis. Someone, scared and confused, calls The University of Kansas Health System call center and is connected with a nurse navigator. Within minutes, the navigator has talked them through the whole process, already setting up appointments, requesting medical information and images and providing a compassionate ear.

Before navigators, patients might show up at their first appointment, get assessed and then feel like they were practically starting over with each step.

“We’re like a lifeline to them,” House said.

Teri Banman, RN, director of nurse navigation, knows. She’s been an oncology nurse for 30 years, 20 at the health system. She first heard about navigation after joining our team, right at the time she really began investigating barriers to cancer care. Then she saw the phrase.

“What the heck is a nurse navigator?” she wondered. “I started reading everything I could get my hands on.”

Like all good nurses and visionaries, she has a story.

Banman recalls a man in his 30s who had been diagnosed with esophageal cancer. He eventually found his way to the health system, but 3 weeks had elapsed. It was going to be a while until he could be seen again.

With navigators, a path can already be set for a patient in the first visit.

A generous grant from Tom and Teresa Walsh, who received a Hall of Fame Catalyst award from the health system in 2014, funded the first navigator in honor of Teresa’s dad. Now, we have 28 navigators assigned to cancer, 6 in cardiac care, 3 in palliative care and a handful in other areas.

The program certainly drew in Carol Are, RN, BSN, OCN.

“It was my husband who said that maybe oncology might be a good way for me to use my faith, my desire to support people in their time of need,” she said. “You get to help teach patients about what a next round of chemo might entail, how they might make it easier.”

I spoke to House and Are for this blog post on a videocall, and I told them I fully expected it be my best call of the week. It was a Monday, so a bold prediction. That panned out. You could just see the joy in their faces as they talked about nurse navigation and triage. They truly see it as a calling, and I don’t doubt that for a second.

“I tell you, that is the crux of what we are doing,” House said. “We’ve heard it all. ‘Glorified schedulers.’ And we do that. We are assessing and scheduling those appointments. But we talk them through this process and answer their questions in a very vulnerable time. And isn’t it better that I’m scheduling them on the phone instead of passing them off to someone else?”

In point of fact, sometimes they do miss seeing patients face-to-face. They’ve also had to adjust to not seeing each other very often. When COVID-19 hit, the health system looked to send as many employees to work from home as they could, without compromising care, to slow the spread of the virus. Navigators are nurses, but they also do almost all their daily work from a computer.

“We are in communication with each other all the time,” House said.

She and Are say it’s worked out better than anyone could have anticipated. For the patients, too.

Next week: There is at least 1 nurse navigator at the health system who sees patients daily. I'll share her story next week.