The day that someone learns they have cancer is the day that marks the start of one of the most complex, challenging and uncertain journeys of their life. It’s a journey almost impossible to navigate without expert guidance and support along the way.
Multidisciplinary team meetings help chart the right course for individual patients through the maze of diagnostic tests, imaging studies, treatments, and post-treatment evaluation. Commonly known as tumour boards, these meetings bring together medical oncologists, radiologists, laboratory physicians, surgeons, pathologists, and other healthcare professionals involved in cancer care.
Nurses have long been part of tumour boards, observes Judy Koutlas, Manager of the Oncology Navigation Program at Vidant Medical Center in Greenville, North Carolina. Their role has expanded over the past several years, with many experienced oncology nurses now serving as tumour board coordinators – that is, as nurse navigators.
The running of a tumour board is both time and labour intensive. Patients’ medical histories, biomarkers, tumour information, imaging studies, microscope slide images, pathology reports and electronic medical records have to be collected and organised. A comprehensive understanding of cancer diagnosis, treatment and patients’ needs is essential.
Team members highly value what nurse navigators bring to tumour boards. Serving as the bridge between patients and physicians, nurse navigators provide vital information that can transcend clinical data. During a tumour board, for example, the nurse might explain that the patient has difficulty travelling to the clinic, doesn’t have enough support at home to deal with a treatment’s side effects, or that the proposed treatment isn’t covered by the insurance plan.
“We present the side of the patients that the rest of the cancer care team might not see,” says Rebecca DiPatri, Oncology Nurse Navigator, Life with Cancer at Inova Schar Cancer Institute in Falls Church, Virginia.
Nurse navigators contribute significantly to tumour board discussions, notes Darcy Burbage, Supportive and Palliative Care Nurse Navigator & Oncology Nursing Advocate at Christiana Care Health System in Wilmington, Delaware. After the meetings, the nurse navigator is often the one who sits down with patients to describe the tests, therapy and follow-up in clear language they can understand.
“Patients and their families rely on us,” Darcy says. “In addition to our clinical expertise and knowledge of the healthcare system, an oncology nurse navigator needs to have excellent communication skills, effective time management skills, and the ability to multitask.”
The role requires solid experience in oncology nursing, advises Teresa Parent, Thoracic Nurse Navigator at Vidant. The nurse needs to understand the entire treatment plan, including all the drugs the patient is taking – and not just for cancer but for other conditions as well. In addition, navigators should be familiar with continuing medical education (CME) processes because tumour boards can count as CME for participating healthcare professionals.
To raise awareness about the contributions these nurses make, navigators like Teresa are sharing their experiences with nurses in training and offering shadow opportunities at cancer clinics. By being part of tumour boards, nurses can gain valuable insights into the latest cancer diagnostics and treatments as well as the healthcare data revolution.
For these nurses, oncology navigation allows them to combine their skills, knowledge and compassion in a unique way. They are welcomed into patients’ lives at a very difficult time and stay with them and their families from diagnosis through survivorship and in some cases through the end of life, Darcy observes.
Adds Rebecca: “I feel like I have the most valuable job in the world. Being a navigator is the most rewarding job in nursing that I’ve ever had – it gives you the opportunity to have a deeply positive and lasting impact on patients and their families.”
Special thanks to the
Darcy Burbage, RN, MSN, AOCN, CBCN
Rebecca DiPatri, RN, BSN, OCN
Judy Koutlas, RN, MSN, OCN
Teresa Parent, RN, BSN, OCN
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