Your Patient Navigator- A Personal Guide through the Healthcare System

What is a Patient Navigator?

Patient navigators are nurse practitioners or registered nurses that provide guidance through the healthcare system and work to overcome obstacles like misinformation, fear and medical costs, that are in the way of people receiving the care and treatment they require. They have a multi-faceted role that is integral to the experience of the patient. A breast health navigator is engaged with care recipients along the entire continuum of care from screening to diagnosis to treatment to survivorship. Relationships between the patient and navigator are long-lasting, for years in many cases.

The patient is always at the center of our circle. The navigator, an integral member of a breast health team of professionals, strives to make people feel that they receive comprehensive care, that all information and services are well understood, that they are a partner in decision-making, and that every interaction is compassionate. Essentially, patients should feel listened to and cared for.

What does a Breast Health Patient Navigator do?

People undergoing cancer treatment certainly need a compass to negotiate their way through the health care system. Navigators serve as a touchstone throughout diagnosis, treatment and during life as a breast cancer survivor. The goal of the navigator is to facilitate the timely delivery of care. After a breast cancer diagnosis, patients often feel that they need to do a great deal in a short amount of time. Navigation services are:
Personal: offering emotional support, facilitating support groups, securing counseling services when needed
Needs-based and barrier diminishing: identifying what the patient and his/her family needs, determining what is standing in the way, developing a plan to eliminate barriers and to provide easier access to care
Educational: informing patients about what their diagnosis means, explaining an upcoming procedure or treatment and what to expect afterwards, reviewing potential clinical trials, discussing the details of treatment: surgery, chemotherapy, targeted therapy, hormonal therapy, and radiation, reviewing potential side effects of treatment and how they will be addressed by the health care team
Practical: facilitating patient-provider communication, coordinating appointments, arranging transportation, securing a wig, reviewing a timeline for care so that a patient’s daily responsibilities can still be attended to

There is no charge for the services of a navigator and therefore no insurance required. Some patients need little navigation, and some need a great deal. While individual and varied, everyone has needs to be addressed during this challenging time.

Patients will often remark that the navigator eased the journey and “I could always count on my navigator.” While every day is different, a glimpse into a day in the life of a navigator might look like this:

• Conducting a needs assessment with a newly diagnosed patient
• A visit to the Infusion Center to check on a patient starting chemotherapy
• A phone session with a patient to review what to expect for an upcoming mastectomy
• Discussion with a patient about a sexuality issue after treatment
• Scheduling transportation for a patient in need of a mammogram
• Arranging an appointment for a physical therapy consultation for a patient after breast surgery
• Securing a pathology report from an outside laboratory
• Making an appointment with the genetic counselor

How do Patient Navigators Address Health Inequities?

Success as a patient navigator is defined as having all breast cancer patients receive timely, comprehensive care in a compassionate environment. However, not everyone has the same access to treatment. Ethnic and racial minorities and impoverished individuals often have higher rates of disease, fewer treatment options, and reduced access to care. Many underserved patients face many personal, physical and economic challenges which compete with receiving breast care in proper timeframes. The objective of the navigator is to assess the potential barriers to care, such as transportation, child care, lack of insurance, the need for a paycheck, etc. Once barriers have been determined, the navigator works to alleviate these barriers to enable patients to receive the care they need. A 2014 study published by the American Cancer Society found, “Patient navigators can break through literacy barriers, build trust, reduce fear, and support the improvement of patient-provider communication. In doing so, navigators can plan an integral role in the changing environment of health care delivery, with the potential to help in delivering better quality and more efficient care and ensuring that access to care is for all.” (1)