The patient navigation team: from left, Katherine Doria, RN, BSN, OCN, Navigator; Melissa Dowers, MBA, Navigator; Meghan Ryan, BS, Intake Coordinator; Angela McCabe, MSW, LCSW, OSW-C, Director; Margaret Correale, RN, BSN, OCN, CN-BN, Senior Navigator; Susan Garawitz, MPH, MSW, Vice President Oncology Services; Saimah Ali, RN, BSN, Navigator. Not pictured: Moira Davis, RN, BSN, OCN, ONN-CG-Surgical Navigator; Linda Abate, RN, BSN, RN-BC, Breast Surgical Navigator.
Oncology patient navigators are here to guide patients every step of the way.
In 2017, Diane Darpino Duran, 59, of Cedar Grove, received a diagnosis of colon cancer. The diagnosis was followed by an operation, chemotherapy, further testing and the news that the cancer had spread to her liver.
“This has been such a difficult time for me, but there’s one person, Moira Davis, who keeps me going through it all,” Diane says. An oncology certified nurse and patient navigator, Davis has been by Diane’s side from the beginning. Davis is responsible for coordinating all aspects of patient care, from scheduling appointments with a team of multidisciplinary experts to communicating results and treatment options.
What makes her and the other members of the Saint Barnabas Medical Center (SBMC) oncology navigation team so special is that they do this with compassion and understanding at what is often the most overwhelming time in patients’ lives.
“Whenever I go to the office, Moira will come out and greet me, and I always get my hug,” Diane says. “I can call her whenever I need to and she answers all my questions and calms my fears.
“I call her my angel.”
HELP AT A HARD TIME
Davis and the other oncology patient navigators have all received special training and certifications in the field. Their work helps patients feel more connected, leading to more timely diagnosis and treatment, and resulting in better patient outcomes.
Navigation at SBMC begins immediately when a patient is diagnosed with cancer.
“The goal of navigation is timeliness to care and reducing potential barriers. Our navigators are a single point of contact, providing a direct link between the patient and the oncology care team,” says Angela McCabe, LCSW and Director of Psychosocial Support, Community Outreach and Oncology Navigation Services at SBMC.
“Patients are often very emotional during this time and find that much of what is communicated to them is often forgotten or misunderstood.”
“Once we connect with them, they don’t have to figure out whom to call next, where to go, or which specialist can help with a problem they have,” says Margaret Correale, RN, Senior Nurse Navigator.
The relationship between navigator and patient can last for years. “We follow patients throughout their continuum of care. I have some patients that I have been working with for 15 years and continue to assist with aspects of their care,” Correale says. “From diagnosis to the time they are cancer-free, we track their office visits and test results, make sure they understand their plan of care, and provide support for both them and their loved ones.”
BEYOND THE MEDICAL OFFICE
Finding the right path can be difficult, given the emotional and complex nature of a cancer diagnosis and the myriad next steps. Patient navigators must coordinate with a wide range of professionals—not only cancer specialists, but physical therapists, financial counselors, home care, support groups, social workers, mental health professionals and more.
The navigation team must approach each patient and cancer diagnosis individually. For example, a patient with head and neck cancer may need a dental exam or dental care before treatment can safely begin. However, getting that exam may not be straightforward.
“If someone has not visited a dentist recently, we want to understand why,” McCabe says. “Do they have a fear of the dentist, lack insurance or have no transportation? The more we understand about our patients, the more we can help.”
Research shows that this kind of one-on-one attention can help people with cancer both mentally and physically. A study by the Group Health Research Institute found that people who had access to a patient navigator felt better supported emotionally, were more involved in their own care, and felt better prepared for the future. And research published in JAMA Oncology found that older cancer patients who had navigators experienced reduced numbers of hospitalizations and Emergency Department visits, and received fewer unnecessary services.
“Cancer care is very complex, and there’s an emotional aspect to it that can also impact patients’ everyday life,” says Michael Scoppetuolo, Jr., MD, Chief Medical Officer of The Cancer Center at SBMC. “We want our patients to know not only that our care is state-of-the-art and comprehensive, but also that we’re compassionate. Patient navigators are an important part of that effort.”
“It’s a necessity to have one person who understands every aspect of the disease and what you’re going through emotionally,” says Diane Darpino Duran. “Moira is just so reassuring, and her hugs are like Christmas. She’s a calming force. She tells me, ‘Whatever we and you have to deal with, we’ll get you through it.’”
To make an appointment at the Cancer Center at Saint Barnabas Medical Center, visit www.rwjbh.org/beatcancer.