Nurse navigators guide patients through the physical, mental and emotional challenges they face having cancer.
Kathy Walker remembers how she and her husband Ken felt when they heard the dreaded words: You have a malignancy.
“Your head is just swimming. You have no idea what to expect,” Walker says. “My husband’s ears just closed off, and the doctor started speaking to me.”
For Kathy, who learned she had breast cancer last May, and her husband, who received a prostate cancer diagnosis in 2018, it was a time of overwhelming uncertainty, anxiety and fear. Walker feels enormous gratitude for the nurse navigator who became her “angel” throughout her treatment. Her husband wishes he’d had a navigator of his own. Both are doing well today.Stay up to date with the region’s business scene. Subscribe to Columbus CEO’s weekly newsletter.
Walker’s navigator, OhioHealth breast cancer nurse Casey Gallant, says she and other nurse navigators are there for patients throughout their cancer journeys—from the time of diagnosis to aftercare and surveillance. Their role is to make a frightening process less daunting and link patients to all the resources they may need, including financial, transportation and emotional support.
“We are their point of contact,” Gallant says. “We are their people. One of the main issues they face is loss of control. We try to do the little things that bring as much comfort as possible.”
Her first contact with patients comes not long after diagnosis. “Their heads are spinning, they’re scared. We focus on the most important piece, one piece at a time.” Often that means preparing for surgery, or reviewing their specific treatment plan.
In Walker’s case, chemotherapy came first. She was about to have her chemotherapy port placed and was in a large surgical waiting area when Gallant introduced herself. She gave her a cap, pillow and blanket for the infusion room, which is cold. “I was totally amazed. It makes you feel special. It was totally unexpected,” Walker says.
Gallant also gave her a three-ring binder containing information about the cancer treatment process, which moves rapidly and can be overwhelming.
“You get so much literature. It’s like drinking through a fire hose,” says Walker, who lives in Grandview Heights. She says Gallant was with her at every step, including a day she was so sick from chemo she couldn’t get out of bed. “The phone rang and it was Casey, and she could tell right away something was wrong,” Walker says. She urged her to call her oncologist immediately, which she did, and received new medication to help with side effects.
On the day of her double mastectomy, Gallant was there with the special items Walker would need after—a surgical bra, a pillow to place between her and the seatbelt. Navigators help prepare their patients for everything from dressing changes and drain care to the how their bodies will look and feel immediately after surgery. “It’s a life-changing event,” the navigator says. Navigators also connect their patient partners with OhioHealth’s integrative cancer program, which includes nutrition, fitness, art therapy and mind-body stress reduction techniques.
Cancer navigators are becoming more common in hospitals. The program started with breast cancer and has expanded to include other types. Their services fall generally into two categories: diagnostic and treatment. Diagnostic navigators join patients once they are called back for more testing up to the time of biopsy and diagnosis. The treatment navigators step in once the diagnosis is made and patients learn about their treatment plans. Larger systems such as OhioHealth have both types, with diagnostic navigators concentrated in major treatment sites (in OhioHealth’s case, Riverside, Grant and Dublin Methodist hospitals).
Hospital navigators link patients to community resources and are vital conduits between physician and patient, translating information and relaying messages. “That’s what I’m here for. I’m that extra person in their corner,” says Karen Keil, a breast cancer nurse navigator at Mount Carmel Grove City. Mount Carmel East and Mount Carmel St. Ann’s also have navigators.
Keil and others develop rapport with patients’ cancer team specialists and usually hear back from them quickly, she says. She is in close contact with them from diagnosis on to help patients anticipate and understand what is happening. “Some need a little more information, and some need to just hear it a little differently,” Keil says.
Navigators work with social workers and rely on community organizations such as Pink Ribbon Girls and the Columbus Cancer Clinic to make sure no need goes unmet. (Patients also can access services through the American Cancer Society in Ohio and the Cancer Support Community Central Ohio.) “We could not do this without social workers,” Gallant says.
Filling gaps for women without insurance, who may live in underserved communities and have more complex needs, also falls within the purview of navigator programs, such as those at Mount Carmel and Ohio State University Comprehensive Cancer Center-Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. The latter makes use of lay navigators who focus on eliminating barriers to care and work closely with clinical teams, says Chasity Washington, director of the Center for Cancer Health Equity.
Because those women may not see the same physician at every visit, Keil at Mount Carmel says she makes sure to be at all their appointments and arrange for interpreters when needed. “That’s where we really concentrate, to make sure they don’t fall through the cracks. Our role is all-encompassing. We want to be there from start to finish. Patients just really benefit from that.”
Walker says her cancer team and Gallant in particular helped her feel less afraid and more aware of what was happening throughout her cancer experience. “I felt like I wasn’t alone on an island. If it weren’t for Casey, there’d be a lot of ‘what ifs.’ It’s like having a little angel in your corner. It made me feel awesome.”
Laurie Allen is a freelance writer.