Oncology Nurse Navigators (ONNs) provide individualized assistance to patients, families, and caregivers to help overcome health care system barriers and to facilitate timely access to quality medical and psychosocial care from prediagnosis through all phases of the cancer experience. These challenges may change throughout the patient’s cancer treatment and may never be eliminated. Patients with a cancer diagnosis may experience a range of and varying levels of anxiety or distress, but only small percentages of them receive help.
ONNs have the ability to address this anxiety and distress from the moment the nurse engages with the patient. The distress experienced by the patient can be an unpleasant emotional, psychological, social, or spiritual experience that interferes with the patient’s ability to cope with cancer treatment. At any time, a patient may experience strong emotions such as fear, anger, sadness, depression, anxiety, panic, and/or isolation. The lack of psychosocial support can interfere with a person’s ability to relate to family, friends, coworkers, and others throughout the normal routines of daily living. Social distress can be overwhelming. This social distress may be just as overwhelming as when the patient first heard the words “You have cancer.”
Cancer patients are often removed from the flow of life, spending their time getting treatment rather than being at work or with family. Cancer can be a very isolating experience. Patients and their caregivers need to be encouraged to reach out to family and friends or to join a support group to help establish these relationships. Because friends may not always know when or how to offer help, it is important that patients understand the benefits of talking with a mental health professional about their concerns and worries. The navigator may be the first care team member to recognize that a patient could benefit from meeting with a licensed clinical social worker or psychologist.
Based on the bond that patients build with the ONN, the nurse navigator relationship may make it easier for the patient to open up and express his or her concerns. The ONN can assist their patients by
- Listening closely to the patient’s concerns
- Show interest in the patient’s experience with cancer
- Ask who will provide support during cancer treatment; will it be family, friends, or someone else?
- Ask how the patient is adjusting to the cancer and treatment plan
- Encourage the patient to continue using coping strategies that are successful
- Suggest additional coping strategies to address the patient’s concerns
In addition, ONNs can use a distress thermometer. Based on a scale of 0 to 10, the tool is easy to use. Originally designed to be used by physicians to assess patient distress levels, it is available at www.nccn.org. The tool comes with a checklist to help evaluate and recognize distress in patients with cancer.
Because a diagnosis of cancer never interrupts a patient’s life when it is convenient or economically acceptable, the psychosocial well-being of your patient may never be addressed or will be addressed late in the patient’s treatment. ONNs can provide a comprehensive understanding of the patient to other members of the multidisciplinary team and take the lead role in assessing the patients’ needs for possible referral to a mental health specialist.