Defining the role of the navigator can be challenging. Different types of navigators work in different settings, using different measures and facing different barriers. According to Melissa Hutchison, a nonclinical patient navigator at the American Cancer Society, there is technically a simple definition of patient navigation, but describing her role is more complicated than that.
“It’s a very simple concept: we’re addressing barriers to care,” she said at the AONN+ 2019 Midyear Conference. “But when people ask me what I do, that one sentence just does not seem to sum it up. I know what I do all day long, but trying to describe that, and make someone understand that, can be challenging.”
Although nurse navigators, nonclinical navigators, financial navigators, and social workers all fulfill different roles, collaboration among them is crucial. “At the end of the day, we’re identifying the unmet needs of patients, and they can be simple, but they can also be complex,” she said.
Meeting those needs requires the navigator to research and identify resources, and sometimes those have changed or no longer exist. But effective communication with the rest of the cancer team can facilitate the process of getting patients to the right resource at the right time, without duplicating efforts.
Communicating Through Collaborating
Collaboration starts with effective communication. It enables clearly defined goals so that everyone is headed in the same direction, added Heather Ciccarelli, MSW, Senior Manager of Patient Navigation at the American Cancer Society.
“Collaboration is not about saying ‘that’s not my job.’ It’s about working together as a team to make sure everything gets done,” she said. “But it’s also about trying to use your limited resources as wisely as you can.” If a person’s request is out of the navigator’s scope of practice, redirect them to the appropriate individual or resource.
That effective communication should extend to patients as well. Ms Hutchison stressed the importance of relaying to patients what you can and cannot do in your role, as they might have unrealistic expectations. “Just because you can do it, doesn’t mean you should be doing it,” she said. “But I never tell a patient ‘that’s not my job.’ I will make sure they’re getting that warm handoff. If I have to walk them down to financial or walk them to a coworker, I want to make them feel comfortable and get them to what they need.”
Teamwork vs Territory
What happens if a coworker can’t “stay in their lane”? According to Ms Ciccarelli, there is a fine line between teamwork and territory. “You want to make sure you’re presenting yourself in a manner that you’re helping someone,” she said.
She stressed the importance of taking a proactive stance toward patient care by addressing consistent issues that arise. Reach out to the patient ahead of time; if he or she only has reliable transportation service during a certain window, try to schedule their care during that window. “It prevents confusion down the road,” she said. “There’s a lot of work that can be done proactively to make sure things go smoothly,” she said.
Before patient navigation, patient care operated in a completely reactive environment, added Ms Hutchison. “No one had the time to address anything up front. Patients weren’t being prepared properly. It was all about putting out fires,” she said. If members of the cancer team aren’t spending enough time with patients because they’re being pulled in too many directions, ask how you can help, she advised, noting that a morning huddle works well to facilitate collaboration at her institution. “It’s only 15 minutes, but that time to check in is really beneficial,” she said.
In the best kind of collaborative teams, people are working with their strengths, said Ms Ciccarelli. Recognize and utilize those strengths in each member of the team to prevent burnout, to avoid duplication of services, and most of all, to benefit patients and their ability to successfully complete treatment.
Promote yourself and your services, added Ms Hutchison. “Refresh people’s memory of what it is that you do, and what you can offer patients.”