Oncology Ambulatory Care Nurse

Oncology Nurse Navigator
Oncology Nurse Navigators provide resources, support, assessments, referrals, education, care coordination and general guidance throughout the cancer care continuum. They help people "navigate" through the maze of doctors' offices, clinics, hospitals outpatient centers, insurance and payment systems, patient-support organizations and other components of the health care system. Services are designed to support timely delivery of quality standard cancer care and ensure that patients, survivors and families are satisfied with their encounters with the cancer care system. Navigators promote communication between the patient and health care providers, eliminate barriers to care, and ensure timely delivery of services. Licensed Registered Professional Nurse (RN) - Illinois Department of Financial and Professional Regulation (IDFPR), Education: College Diploma: Nursing, Work Experience: Navigators provide education and support to patients, caregivers, families, healthcare professionals, communities, etc.
Provides education to patients, families, providers, caregivers, multidisciplinary colleagues and the community about cancer and the role of the oncology nurse navigator
Serves as primary contact and advocate for patients
Acts as a liaison among the patient, family, caregivers, and healthcare team
Provides and reinforce education in all phases of cancer continuum including, but not limited to: treatment, care plan, symptom management and survivorship concerns
Develops oncology-related education materials
Possesses clinical trial awareness and promote trial types and requirements, and engage with research team as appropriate
Understands criteria for molecular testing and genetic counseling
Discusses physician visits with patients and families to assess understanding, interpret information as needed, and answer questions
Contributes to the knowledge base of the healthcare community through involvement in professional organizations, presentations, publications and research
Empowers patients with education and knowledge to help improve patient outcomes and satisfaction
Attends community health fairs and screenings; provides community education presentations as appropriate
Provides patient information on available services, community resources, and/or support groups.
Contacts patient at diagnosis, high stress points, pre- and post-surgery, time of initiation of therapy and any other flag touch point
Meets with patient by phone or in person "within designated time" following "designated event" and follow patient per navigator- or facility- specific guidelines
Facilitate and coordinate timely care coordination throughout the cancer continuum in collaboration with the multidisciplinary team.
Facilitates keeping care in the system by identifying opportunities to retain diagnostic testing, radiation oncology services, etc.
Communicates with ancillary departments to define and resolve specific problem areas and ensure timely delivery of patient care, including but not limited to diagnosis and treatment
Contacts patient at diagnosis, high stress points, pre- and post-surgery, time of initiation of therapy and any other flag touch point
Coordinates and schedules appointments with providers to ensure timely delivery of diagnostic services, treatment services, and appropriate survivorship or hospice/palliative care
Accompanies patients to appointments (particularly if there are multiple barriers to care) and/or providing clarification and literacy-level-appropriate education related to the visit
Assists with the post-treatment transition to survivorship clinic and/or primary care
Collaborates & communicates frequently and consistently with providers & other appropriate healthcare team members, ensuring seamless plan of care and follow-up care
Ensures timely delivery of test results to patient by a care team member
Assists in selecting patients to be presented at Tumor Board and gather necessary patient information to present patient to physicians for discussion
Provides telephone triage services (e.g. symptom management, emotional support, education, resource referral) for patients/families
Facilitates communication with patients, survivors, families and the health care providers to monitor patient satisfaction with the cancer care experience
Gets referrals that are needed, explaining the referral process and facilitating scheduling appointments with surgeon, medical oncologist, radiation oncologist, and other necessary services as appropriate
Follows patient through the care continuum/experience, eliminating operational barriers (such as scheduling, test results, etc.) Works closely with other healthcare disciplines to coordinate care and ensure timely appointments, result reporting, financial need and other referrals, communication, patient care and follow-up
Provides comprehensive documentation of patient's diagnostic testing, treatments, and referrals
Works with a variety of diverse and complex patients, families and both internal and external health care providers.
Nurse navigators utilize appropriate screening and assessment tools to make referrals that are appropriate for each individual patient based on their needs.
Assesses & identify patients' needs and make appropriate referrals based on patient's needs, which may include case managers, social workers, registered dietitians, financial assistants, genetic counselors, chaplains, counselors, psychologists/psychiatrists, PT/OT, speech, home care, hospice, palliative care, interpreters, multi-disciplinary conferences (tumor board), support groups, lymphedema clinic, oncology rehabilitation, survivorship clinic
Assesses for, identify, and assist in mitigating barriers to care and make appropriate referrals
Maintains/uses a comprehensive database of local, regional and national resources
Understands resources available to patients experiencing financial hardships and/or are uninsured/underinsured
Provides appropriate resources in a timely manner to meet patient's specific needs, local and national resource list in binder.
Facilitates individualized care based on culture, health literacy, ethics, psychosocial needs, etc.
Assists patients with advance directives, palliative care and end-of-life concerns
In conjunction with the Department Director, Navigators are responsible for systematically, and continually performing the functions of assessing, planning, implementing, and evaluating care according to the nursing process and the standards of accrediting bodies.
Performs data entry and prepares reports for Director to monitor program outcomes
Participates in tracking and monitoring metrics and outcomes
Ensures timely and appropriate documentation of all patient interactions into navigation tracking and documentation system and any databases to keep patient record up-to-date
Assists with ongoing navigation program assessment and identification of process improvement opportunities
Identifies, implements and measures quality and process improvement initiatives
Documents non-compliance of patients
Pursues continuing education opportunities related to oncology and navigation