Oncology Nurse Navigators Take on COVID-19 Challenge

TON - August 2020, Vol 13, No 4

Oncology nurses and nurse navigators are positioned on the front lines of care, playing an integral role in patients’ battles against cancer. As part of the Association for Value-Based Cancer Care webcast series titled COVID-19 Impact on Cancer Care and Road to Recovery, Lillie Shockney, RN, BSN, MAS, HON-ONN-CG, Professor of Surgery at Johns Hopkins University School of Medicine and Founder of the Academy of Oncology Nurse & Patient Navigators (AONN+), led a discussion highlighting the ways in which the COVID-19 pandemic has affected patients with cancer, and how nurses have responded to the extraordinary challenges at hand.

Sharon Gentry, MSN, RN, HON-ONN-CG, OCN, Program Director, AONN+, opened the discussion by exploring some of the changes in oncology nurse navigation as a result of the crisis. Ms Gentry discussed information that nurse navigators have shared with her regarding the multitude of stressors that exist among patients and other caregivers in the field.

“Navigators went several ways. Some of them increased their workload with more distress from the patient, whether they were working from home, in office, or whether they were an alternating team assigned to decrease the exposure to COVID-19. Some were cross-teamed, some were furloughed and are returning, and some were furloughed and are now not returning.”

Ms Gentry explained that nurses are regarded in their communities as a “medical contact person, especially for family members, patients, neighbors, friends, church, and civic organizations. They represent a healthcare organization and they’re very, very trusted.” As a result, they become crucial transmitters of education and dispellers of myths, propaganda, rumors, and racism.

Brenda Nevidjon, MSN, RN, FAAN, CEO, Oncology Nursing Society, said that nurses are “a bit invisible in terms of what we contribute in terms of the healthcare,” but that the pandemic has shone a light on “the leadership that has been shown by nurses and the impact on the care of patients” in unprecedented ways.

“We are seeing the toll that the COVID-19 pandemic is having on nurses. Nurses are dying, as are other healthcare professionals. But more than that, many, many more are experiencing the personal stress of caring for patients in the hospitals. The stress, the anxiety, the concern for their own family, the choices that nurses have had to make. There is a mental health impact that is occurring on the providers and clinicians, and there is concern about potential posttraumatic stress syndrome,” said Ms Nevidjon. She also posed many questions about the future of nursing and of medical practice in general.

Topics such as telemedicine and home infusion were also discussed during the session, with an emphasis on the way in which these changes will affect nurses. Ms Shockney built on this point by noting that nurses will be exposed to potentially dangerous situations as these practices expand.

Andrea Dwyer, BS, Vice Chair, Colorado Cancer Coalition, and Co-Chair, National Navigation Roundtable, American Cancer Society, focused her comments, in part, on how nurse navigators can take the lead when it comes to educating patients, especially in the areas of cancer prevention and screening. “People have almost, on some level, lost faith in the medical decision-making, as well as understanding the role of our public health in our government in terms of making decisions and what information should they trust. And I do think that, as many have noted, the navigators play a huge role in helping with that authentic connection and trust,” she said, pointing out that this is especially true regarding cancer screening and outreach.

Sally Werner, RN, BSN, MSHA, Executive Director, Institute for Excellence in Psychosocial Care, Cancer Support Community, shed light on the experience of cancer survivors amid the stressful environment of the pandemic. “What we’re hearing from nurses and social workers and support services is they’re reporting a very high intensity of visits and concerns,” she said. This can put a strain on resources and on navigators.

In a question-and-answer period, the panel returned to the discussion of navigators and how they can remove barriers for patients, especially in the current situation where myths, misinformation, and propaganda abound.

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