Center for Cancer Prevention and Treatment at St. Joseph Hospital

The Center for Cancer Prevention and Treatment at St. Joseph Hospital in Orange, California, is a stand-alone cancer center. It was one of the first to be designated as a National Cancer Institute (NCI) Community Cancer Center Program. The center offers all the services that a cancer patient will require within a single location. It provides clinical care supported by dedicated oncology-trained navigators (an advanced nurse practitioner, a physician assistant, and clinical nurse specialists), an infusion center, leading-edge imaging technology, multidisciplinary site-specific clinics and cancer conferences, cancer genetics consultation, education, pharmacy, clinical laboratory, clinical cancer research, comfortable amenities, and an appearance center to assist with prostheses and cosmesis. The center has 9 navigators, 1 for each cancer program, including an Asian-Pacific Islander lay navigator and a financial navigator.

The Oncology Nurse-APN/PA spoke with Enza Esposito-Nguyen, RN, MSN, ANP-BC, nurse navigator for the Urologic Oncology Program, about the benefits and challenges of her job at the Center for Cancer Prevention and Treatment.

What exactly is your role as nurse navigator in the Urologic Oncology Program?
Enza Esposito-Nguyen (EE-N): I am responsible for the care of a cancer patient throughout the trajectory of the continuum of care. I arrange appointments, diagnostic tests, and treatments and make sure nothing falls through the cracks. The goal is to provide a seamless transition throughout the journey of a patient with urologic cancer (prostate, bladder, testis, kidney cancer).

How do your efforts translate to better outcomes for patients?
EE-N: I can give you a specific example. This week I was involved in planning care for a 50-year-old underserved man with stage IV bladder cancer. His cancer had progressed because he did not seek treatment for a year after his diagnosis. I suggested that we present his case at our Urologic Oncology cancer conference, so that he could get the necessary scans and biopsies and have his history reviewed by our team of experts. I also liaised with our financial navigator, who was able to assist with insurance coverage. This exemplifies how I can assist in guiding a patient through the system to ensure that he or she gets the very best care. It’s a complete multidisciplinary approach.

What are you excited about in the field of oncology right now?
EE-N: I find it inspiring that we now have data showing that state-of-the-art cancer care can extend the life expectancies of patients with breast, lung, prostate, and renal cell carcinoma, due to several major advances in treatment. Thanks to new technology to manage early prostate cancer with active surveillance, we are able to save patients from the morbidity of unnecessary treatments.

What do you enjoy about your work?
EE-N: I have been a nurse navigator at the Center for Cancer Prevention and Treatment for the past 6 months, and I have over 15 years of experience as an oncology nurse. I love that every day is different, and that I can use all of my clinical skills plus my 15 years of experience in this job. We are looking for more ways of integrating my NP [nurse practitioner] skills into my role as nurse navigator.

What inspired you to become a nurse navigator in oncology?
EE-N: It was an opportunity to incorporate my skill set as a nurse practitioner and my experience in oncology in one role. I am now an educator, supporter, clinician, and patient advocate, and I use these skills every day in my practice.

What advice would you give to someone entering the field?
EE-N: Find a specialty that you love and where you can thrive. Then try to learn as much as you can about that specialty and gain experience. Also, further your career through education, and get your master of science in nursing. My colleagues and I agree that 5 years is the minimum number of years of experience as an oncology nurse that one should have before becoming a nurse navigator. You need at least that many years of experience to develop a full skill set.

What would you do if you weren’t a nurse navigator?
EE-N: I can’t picture myself doing anything else as a career. I have been an oncology nurse for 16 years. I have worked in medical, surgical, and radiation oncology, in infusion centers, and in the inpatient and outpatient setting. I have also worked inside the US and outside the US. I feel that I am in the most suitable job I could have.