Coordinating Roles of ONNs, OSWs on Multidisciplinary Cancer Care Team

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Both nurse navigators and social workers may address a patient's psychosocial side effects.
Both nurse navigators and social workers may address a patient's psychosocial side effects.

Please clarify the role and responsibilities of oncology nurse navigators (ONNs) vs those of the oncology social workers (OSWs). Asking other nurse navigators has not produced consistent responses. Besides the obvious involvement with the medical aspects of a patient's care (eg, follow-up regarding side effects of chemotherapy), when and how does an ONN address psychosocial issues? — Name withheld on request

Their roles and responsibilities depend on the setting/institution, the number of nurse navigators vs oncology social workers (assuming both exist on the team), and the expectations of the larger multidisciplinary team. Both nurse navigators and social workers have knowledge about the psychosocial impact of living with cancer; however, social workers specialize in addressing psychosocial issues for patients, families, and caregivers as well as have the resources necessary to address these concerns. Thus a conversation with your OSW colleagues can help to synchronize your role and responsibilities with theirs. 

Psychosocial concerns and medical concerns certainly co-exist and often overlap. If a patient starts telling you about how the side effects of chemotherapy make it difficult to be the active parent he or she used to be and begins to cry, for example, then go ahead and listen, show empathy, or even normalize these concerns if appropriate. The next step may be to introduce the patient to the OSW on your team to assess what resources or support would be best to address the stated concerns. Both can work with patients seamlessly, albeit with some blurred responsibilities at times. 

If you'd like to read more about the scope of practice for oncology social workers, please visit: In addition, ongoing conversations within your team are highly recommended, as this can only help to establish some general guidelines. — Eucharia Borden, MSW, LCSW, OSW-C

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