An Interview with Donna Moore Wilson, RN, MSN, CBCN, of the Virginia Cancer Patient Navigator Network
To facilitate the communication among navigators, the Academy of Oncology Nurse & Patient Navigators (AONN+) fosters the development of Local Navigator Networks (LNNs). These groups convene to provide networking opportunities, promote sharing of best practices, advance navigation as a profession, and ultimately to impact navigators’ ability to improve patient care.
Each year, LNNs are encouraged to submit an application to be considered for the AONN+ Outstanding Local Navigator Network Award. Last year, the award committee was delighted to select the Virginia Cancer Patient Navigator Network (VaCPNN) as the 2018 award recipient.
The VaCPNN, led by Donna Moore Wilson, RN, MSN, CBCN, comprises multidisciplinary team members, including nurse navigators, social workers, oncology community partner organizations, and the Virginia Department of Health. Their vision is to be a network of trailblazers creating a national model and leading a course of excellence in cancer and chronic disease navigation. Their mission is to eradicate barriers and enhance outcomes for patients, families, and the healthcare team through education, networking, and mutual support.
We recently had the opportunity to speak with Ms Moore Wilson about her career as an oncology nurse navigator, the creation of her LNN, and her advice for novice navigators.
JONS To start, can you tell us how you became an oncology nurse navigator and how you came to Massey Cancer Center at VCU Health?
Donna I encountered my first oncology patient—a woman with ovarian cancer—early in my nursing career when I was working at a small community hospital. I felt drawn to her.
Shortly after meeting her, I completed a 12-week course in oncology fundamentals and transferred to a different community hospital. There I met a medical oncologist who was looking for a clinic nurse. He asked me to be his nurse, and I began working for a private oncology practice as his clinic nurse. He strongly believed that everyone had a right to be treated regardless of their ability to pay—this is where I learned the importance of networking with pharmaceutical companies and advocacy groups as I began “navigating” the patients we treated on a charity basis.
During this time, my husband and childhood sweetheart was diagnosed with terminal cholangiocarcinoma. My passion for oncology deepened as I experienced the effects of a loved one going through surgery, radiation, chemotherapy, multiple hospitalizations, hospice, and end of life. For years, I took care of oncology patients and their families and was often thanked for my care. But I never truly understood the impact of a caring touch, words of encouragement, or a hug until I was on the other side of the stethoscope as my husband’s caregiver.
After his death, a new position became available for an oncology nurse navigator. My supervisor encouraged me to apply, stating it was perfect for my skill set, knowledge, and life experiences. In my first 2 years working in this position, I was able to show the value of navigation to the organization. As a result, the organization hired additional nurse navigators. I was instrumental in setting the foundation for navigation, obtaining and maintaining National Accreditation Program for Breast Centers accreditation. Ten years later, an oncology nurse at Virginia Commonwealth University Health (VCUH) reached out to me to see if I was interested in joining the program as a breast nurse navigator. At the time of my hiring, the navigation program needed revising and improvement. I accepted the challenge.
JONS Can you share how the navigation program at the Massey Cancer Center began, and how it has grown over the years?
Donna Massey had a leukemia and lymphoma nurse navigator for many years who provided navigation to her patients while also building a solid foundation for our navigation program. When I joined in 2016, the nurse who had been in my position concentrated on the weekly breast cancer conference, summarizing charts, gathering needed information for conferences, and reviewing charts that arrived from outside facilities. Her patient contact was minimal because she had to spend her time performing clerical duties. Before agreeing to come to VCUH, I confirmed that I would have clerical support to complete the weekly conference clerical work. It was a bit of a rough transition, obtaining the promised clerical support; but with that support, I was able to be present in clinic. At the beginning, several providers would say, “I’ve never had a nurse help me with this.” I would respond, “This is what a navigator does!”
While I was making changes in the breast health program showing a navigator’s value, the organization was proceeding with hiring disease-specific nurse navigators. We now have multiple disease-specific oncology nurse navigators and a supportive/palliative care nurse navigator in our oncology program supported by an administrative assistant to help with our weekly cancer conferences. Differentiating the roles and responsibilities of the nurse navigator versus the roles and responsibilities of the clinic nurse continues.
JONS We’d like to learn about the impetus for creating/joining an AONN+ LNN.
Donna VaCPNN was first formed in 2007. Originally, we called ourselves Virginia Coalition of Oncology Nurse Navigators. As time progressed, we realized the patient navigation model expanded beyond nursing to include other professionals, such as social workers and lay navigators. In 2012, we reorganized, renaming ourselves Virginia Cancer Patient Navigator Network (VaCPNN). Several key members of VaCPNN are also members of AONN+. As AONN+ grew and organized, we discussed with our membership at our quarterly meetings the benefits of aligning ourselves with AONN+. The benefits of networking, education, and the support AONN+ could provide our statewide coalition are the reasons we decided to register as an LNN.
JONS Can you speak of the process of creating an LNN?
Donna In 2007, I had been a navigator for 3 weeks when one of my longtime pharmaceutical colleagues stopped in my office. She saw the value in aligning the navigators across the state. She organized our first meeting in 2007. There were 12 of us at that first meeting. We brainstormed our roles and what we were doing for our patients and organizations. Since patients often cross organizations to receive care, we realized the importance of networking and collaborating to provide seamless transitions for our patients.
JONS How did you connect with other navigation programs in your area?
Donna Short answer: Networking. Whenever I met with a pharmaceutical colleague, I would tell them about VaCPNN. As they traveled across the commonwealth, they would talk about VaCPNN and give our contact information to other navigators. When I meet with a patient who is coming from another organization, I ask if they have a navigator, and if so, I will reach out to that navigator not only to facilitate communication about the patient but also to tell the navigator about VaCPNN.
The Glen Allen, VA, American Cancer Society office has supported us from the beginning and has spread the word about VaCPNN to other navigators. Our statewide cancer control program, Cancer Action Coalition of Virginia (CACV) is made up of the cancer community for Virginia. VaCPNN members are involved with CACV; navigation is included in the CACV as one of the goals for the Cancer Control Plan.
JONS How many navigators participate in your LNN?
Donna Presently we have 159 members on our roster. Of these, 90 are navigators. Our steering committee currently consists of 6 members, but we prefer 9 or 10. We divide the work for the quarterly meeting planning, continuing education credit process, Facebook posts, and record keeping.
JONS What are the goals of the LNN?
Donna Our primary goals are to provide education, networking opportunities, and mutual support to the navigators across Virginia. When we reorganized in 2012, we created a vision and mission statement to guide our organization. Our vision is to be trailblazers creating a national model and leading a course of excellence in cancer and chronic disease navigation. Our mission is to eradicate barriers and enhance outcomes for patients, families, and the healthcare team through education, networking, and mutual support.
JONS Can you describe the accomplishments to date of your LNN?
Donna The sustainability of VaCPNN—12 years and counting—is our biggest accomplishment when you consider we are all volunteers. We continue to meet because of our passion for navigation. We’ve had a presence on Facebook since our inception. For the past 5 years we have been providing continuing education credits at our all-day quarterly meetings. For the third year in a row, one of our quarterly meetings focused on financial toxicity. Besides dynamic speakers, we have pharmaceutical financial specialists present at booths available to share resources along with nonprofits that support our patients. In May 2019, VaCPNN partnered with CACV, allowing us to be under their 501(c)(3) designation. This allows us to obtain funding. We plan to place a contact list of navigators in Virginia on the CACV website. Our goals for 2020 are to establish a grant allowing Virginia navigators to attend conferences and offer honoraria to speakers. We also provide financial assistance to navigators to travel to our meetings if their employer is unable to reimburse for the expense.
JONS What are the benefits of joining an LNN?
Donna Networking, educational opportunities, support in defining one’s role, and sharing of best practices. The collaboration among navigators in an LNN has the potential to benefit patients as collaboration leads to improved communication and seamless transitions from one organization to another.
JONS How would you encourage the development of more LNNs?
Donna Start small within your local community and reach out to other navigators and organizations such as AONN+, the American Cancer Society, and the Oncology Nursing Society for support. Our pharmaceutical partners provide education and are sometimes willing to host a dinner. Use that event to invite navigators, open a discussion, and assess if there is interest in joining together to support one another.
JONS What advice do you have for new oncology nurse navigators?
Donna Meet with all the stakeholders in your organization. Identify a physician champion who supports your work and understands your role. Find out the goals of the organization for the navigator. Define your responsibilities and how you fit on the treatment team. Assess the needs of your patients by using the community needs assessment and talking with social workers, clerical staff, nurses, and financial counselors at your organization. Review the metrics AONN+ has assembled and pick 2 or 3 to measure your value and the program’s value. Pfizer offers a free toolkit for navigators; obtain it and share it with your team. Find an experienced navigator and ask if they would be willing to mentor you. Attend the national AONN+, Navigator Summit, and Oncology Nursing Society conferences. And if you can come to Virginia, come visit us at one of our meetings!
JONS Thank you so much for your time today, and our best wishes to you and your LNN for continued success.