A new cancer diagnosis encompasses multiple physician visits and procedures, and it produces overwhelming stress and emotion for all involved. To meet the psychosocial and educational needs of cancer patients and their family members Barb McDonnell, RN, MSN, CBCN, Carrie Friedman, RN, BS and Christine Stone, RN, MSN, OCN, led a team that restructured their institution’s nursing team, created a streamlined entry into the oncology services, and established oncology nurse navigators as primary contacts after patient triage. The project was presented in a poster at the 2014 NCONN Conference in Atlanta, Georgia.

Inova Health System (IHS) is a large multihospital, not-for-profit community health system in Virginia. Each year approximately 6,000 new cancer cases are diagnosed. Within IHS is the Life with Cancer (LWC) program, a team of nurses and social workers whose mission is to enhance the quality of life for those affected by cancer. The program provides information, education, support, and therapeutic services.

A team of LWC nurse educators and Inova Breast Care Institute navigators reviewed the responsibilities of the oncology nurse navigator (ONN) over a 6-month period. They accessed the expertise of the process improvement department and collected data on disease-specific cancer cases at all five IHS facilities. The team also researched other oncology centers similar to IHS to learn the job descriptions were developed at those facilities. Lastly, the team reviewed the ONS 2013 Nurse Navigator Core Competencies and assimilated these into a new ONN role.


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The changes resulted in a new framework and job description for navigation across IHS. The roles of oncology nurse educator and breast nurse navigator were merged into one. Due to the complexity and growing number of cancer patients, LWC restructured its nursing team. In addition, a centralized telephone number and email address was created for all cancer patients, families, and health care providers. The LWC straff triages the call, disseminating the information to the appropriate navigator across the IHS.

Next steps are to develop a New Cancer Diagnosis Orientation led by LWC social workers and ONNs. The orientation will include health care team expectations, preparing for treatment, LWC programs and services, distress screening, and survivorship care plan. A postdiagnosis survivorship class will address topics such as side effects, late effects, fears of recurrence, coping skills, who to call, returning to work, sexuality and fertility, nutrition, survivors offering support, and children support. Eventually, this will become a formal survivorship clinic.

The changes increased patient satisfaction and quality of life, reduced distress associated with a cancer diagnosis, increased physician satisfaction, and provides seamless care for patients with cancer and their families.


Presenters: Barb McDonnell RN, MSN, CBCN, Carrie Friedman RN, BS and Christine Stone RN, MSN, OCN