Patient navigators have emerged as critical members of the oncology care team. This is particularly evident in community settings, where they play a crucial role in addressing health disparities and advocating for members of the communities in which they live and serve.
At the recent AONN+ Annual Conference, Zarek Mena, OPN-CG, a breast health program manager in Norwalk, CT, drew on her 17 years of experience in “boots-on-the-ground” patient navigation, sharing valuable insights into the evolution and responsibilities of the patient navigator, and emphasizing the importance of cultural competence, mentorship, and successful collaboration with clinicians and nurse navigators.
The history of patient navigation is rooted in nonclinical settings, with the first program established in 1990 by Harold Freeman, MD. This pioneering effort laid the foundation for subsequent programs, including the Native American Cancer Research Corp Native Sisters Program and Training in 1994, the American Cancer Society’s first patient navigator program in 2005, and the formation of AONN+ in 2009. These initiatives highlight the significant strides made in patient navigation, culminating in the establishment of the National Navigation Roundtable in 2017.
Modern-day patient navigators are tasked with reducing barriers to healthcare access, enhancing patient education, and ensuring patients receive timely screenings and follow-up care.
“Once I was in the role, I realized all of our unspoken responsibilities,” she noted. “We have to change the influence of frontline behavior, and we have to identify barriers proactively. We are uniquely positioned for opportunities to make change.”
Another critical component of the navigator’s role is addressing health literacy. Navigators work closely with administrators and clinicians to emphasize the importance of clear communication and understanding, ensuring that patients are fully informed about their health and treatment options. This advocacy for health literacy is vital in improving patient outcomes and satisfaction.
Ms Mena highlighted the importance of mentorship in the field of patient navigation. Early in her career, she sought mentors among clinicians and community leaders, which she credits with significantly shaping her professional development and positioning her to become a mentor herself. Programs like the AONN+ BOLD (Building Oncology Leadership & Development) Initiative facilitate formal mentoring, allowing experienced navigators to guide newcomers.
“I used to think of myself as lost, but it turns out that now I’m able to help others,” she said.
Navigators must also understand and practice role delineation within the multidisciplinary team, she added. Recognizing where they fit within the healthcare puzzle allows them to advocate effectively for policies and programs that promote patient needs. Successful collaboration between the “navigation trifecta” of nurse navigators, social workers, and patient navigators exemplifies this holistic approach to patient care.
Whether called patient navigators, community health workers, or patient advocates, their core mission remains the same: to guide patients through the healthcare system, breaking down barriers, and advocating for their needs.
Despite its evolution, the field of patient navigation faces challenges, including the varied titles and roles assigned to navigators. Whether called patient navigators, community health workers, or patient advocates, their core mission remains the same: to guide patients through the healthcare system, breaking down barriers, and advocating for their needs.
“There’s a hierarchical structure in medicine that lays this foundation of power, and it creates a harsh delineation between team members,” she said. “But we have a modern approach to being an inclusive multidisciplinary team, so we break that mold.”
Becoming a trusted member of the multidisciplinary team requires delivering a consistent message, she added. “Let our clinicians and nurse navigators guide us. Let them be our voice, mimic what they’re saying to the patient, and you will immediately be ingratiated into the clinical setting, because then you become someone they can trust.”
She pointed out some of the values that drive patient navigators: commitment to their profession, inventiveness, and a deep connection to their communities.
“We really do our best to help each patient with whatever resources we can find,” she said. “We’re ferocious; we’re resourceful.”
According to Ms Mena, one of the biggest draws of patient navigation in the nonclinical setting is that these navigators often come from the communities they serve, allowing them to provide a nuanced perspective, to foster trust among their patients, and to represent and advocate for their own communities.
As the field of patient navigation continues to grow, these navigators will remain vital in guiding patients through the complexities of healthcare, advocating for their needs, and driving systemic improvements for better health outcomes within their communities.
She concluded: “Always practice kindness, deliver a consistent message, be reliable, adopt and advocate for the Professional Oncology Navigation Task Force (PONTS) role definitions and standards, and finally, get out of your comfort zone.”
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