Navigating Patients With Hematologic Cancers
Barriers to care requiring attention are often present for survivors of blood cancers.
Adult blood cancer survivors are a heterogeneous population that often receives complicated treatments to live a longer life. Blood cancers account for 9.5% of all cancers. The most frequently occurring blood cancers are lymphoma, leukemia, and multiple myeloma.
Adult blood cancer survivors cycle through multiple health care settings and systems as they go through treatment, surveillance, relapse (at times), and start the process again.
An effective nurse navigator approach for this population is delivering patient and family-centered care across the continuum. This approach includes removing barriers from high quality care, like differences in health care delivery systems, ineffective communication, financial impediments, as well as fear and distrust.
Patients within this population may experience barriers to care. Collaborative communication techniques like “Ask, Tell, Ask” can be helpful in understanding their needs and life goals, these goals can then be incorporated into shared medical decision making.
Patient reported financial needs are an issue that nurse navigators frequently address. The solutions are often complex involving multiple team members, community resources, and patient self-advocacy. Returning to work is often successful when the patient has flexible hours and responsibility. Fatigue, sun sensitivity, and requirements of physical work can be deterrents from patients returning to their previous employment.
Nurse navigators are in a unique position to prepare patients and families to manage transitions successfully, and to teach them ways to promote their own health as they progress through the cancer care continuum.
As the role of the nurse navigator matures, measuring
the effect of the services they provide and the value they add is critical.
The role of hematology navigators ideally includes
- Counseling about fertility preservation, before treatment is given.
- Encouragement of exercise before, during, and after treatment.
- Connection with support resources.
- Setting expectations about healing.
- Documentation of patient issues and symptoms as well as the effect of nurse interventions.
In summary, nurse navigation focused on the patient and family across the continuum, can be an effective approach to guiding patients and families through the challenge of a blood cancer so they not only live longer but also live better.