RN Nurse Navigator Oncology

The Blood Cancer Nurse Navigator functions as an expert clinician responsible for the coordination and facilitation of care for patients with complex hematologic malignancies, throughout the continuum of care and across inpatient and outpatient settings.

· Consistent point of contact for patient management needs, the Nurse Navigator enhances care team coordination and communication across disciplines, while providing ongoing needs assessment, monitoring and assistance, as well as education and psychosocial support for patients and caregivers.

· Provides blood cancer program support and community interface activities are also a part of the role of the navigator.

Duties include but are not limited to:

· Monitors and serves as consistent point of contact for patients and caregivers during all phases of cancer-related services including prevention/screening, diagnosis, treatment, survivorship, palliative, and/or end of life care.

· Acts as a liaison/advocate for patients and caregivers as they navigate health care systems from first suspicious finding to survivorship and follow-up.

· Routinely contacts patients to check on health status and/or service needs.

· Assesses medical, social, psychosocial and other care needs for patients on an individual basis, using appropriate tools to identify need and potential resolution. Facilitates referrals for resources as indicated.

· Provides education to patients and caregivers (e.g. understanding diagnosis and treatment, access to supportive care, financial support and return to work. Develops educational materials, hosts educational groups or classes).

· Identifies health disparities and assists in addressing barriers to care e.g. issues with insurance, transportation, childcare, financial resources and language.

· Facilitates scheduling of treatment, diagnostic tests, procedures and provider appointments for patients.

· Participates in the creation and communication of patient treatment calendar as indicated. Clearly outlines initial plan of care, and updates with any necessary changes based on physician’s treatment plan.

· Ensures smooth transitions between care modalities, facilities and providers, including introduction of patients to appropriate personnel to promote continuity of care.

· Works with other care team members to establish algorithms, documents and formalized processes for transitions in care.

· Assesses patients via phone and face-to-face encounters; monitors for reactions to therapy and symptom management needs; communicates results to medical team as indicated.

· Reviews follow up/restaging laboratory and radiologic test results and communicates with physician as necessary.

· Provides referring physicians and other care providers with timely data on patient progress.

· Collaborates with financial coordinators to confirm verification of third-party payer coverage throughout treatment plan.

· Regularly attends inpatient and outpatient multidisciplinary rounds, serving as an expert clinical resource to inpatient and outpatient physicians and/or staff.

· Attends patient care planning conference and other meetings as necessary. Ensures that appropriate patient data are available and that patients are appropriately assessed and documented at patient care planning conferences, including identification of appropriate clinical research study options.

· Uses navigation software for documentation of patient data and interventions. Documentation is completed in a timely manner.

· Supports definition of datasets and ensures appropriate data are collected to track system interventions and outcomes.

· Maintains up-to-date patient list and presents patient updates as necessary during patient intake meeting.

· Responsible for timely follow up with patients and caregivers.

· Understands and monitors patient treatment plans in order to ensure they are followed as directed by the physician.

· Develops and maintains patient care forms such as order sets, practice guidelines, and consent forms.

· Participates with implementation and adherence monitoring for disease-based pathways.

· Assists in the development of, and adherence to, regulatory standards, participates in regulatory Center of Excellence (COE)/Commission on Cancer (COC) surveys and site visits.

· Ensures reporting is in place to demonstrate program outcomes and support performance improvement activities. Makes appropriate recommendations for changes to the current program both locally and at a corporate level, and assists in delivering program improvement.

· Participates in marketing/community service events that promote the facility/program. Establishes and maintains positive working relationships with key internal and external customers (including physicians, nurses, radiology staff, social services staff, radiation oncology staff, business office staff, etc.).

· Participates in activities that promote professional growth.

· Educates all constituents on the role and benefits of a navigation program and high quality cancer care.

· Recognizes scope and limitations of role and regularly accesses clinical supervision as a support to the