Miami Cancer Institute at Baptist Health South Florida offers patients with cancer cutting-edge, personalized therapy as well as a myriad of comprehensive services. The facility, located on the Baptist Hospital campus, consolidates several outpatient services, clinical research, and technology platforms in one convenient location. It serves patients through both the infusion center as well as the dedicated oncology, hematology, and transplant inpatient units at Baptist Hospital Miami, which is adjacent to the Institute on the same campus.
Miami Cancer Institute is a member of the Memorial Sloan Kettering Cancer Alliance, a dynamic and forward-thinking collaboration aimed at sharing knowledge and best practices to improve patients’ access to the latest and most effective advances in cancer treatment.
The Oncology Nurse-APN/PA (TON) recently interviewed Alessandra Alvarez, BSN, BHSA, OPN-CG, Patient Navigator, Head and Neck and Endocrine Cancers, Miami Cancer Institute, FL, who discussed her career path, the essential role that navigators play in assisting patients throughout their cancer journey, the rewards and challenges of her job, and the importance of achieving a healthy life/work balance.
Ms Alvarez: Before I began working at Miami Cancer Institute, I had never heard the term “nurse navigator.” I had graduated with a bachelor's degree in health services administration, and began my career here as the Navigation Coordinator. Working closely with the nurses in the navigation department helped me to realize how important their roles were. When I came to realize how I could help patients through the toughest times of their lives by being a navigator, I knew it was something I wanted to do. So, I enrolled in nursing school and recently obtained my BSN degree.
Communication is crucial in my new role as a navigator as I try to address barriers while coordinating care for patients, so it has been helpful that I already knew so many people across the Baptist healthcare system. I enjoy being the point of contact for a large team of cancer care professionals. Patients can become easily confused on who to call, what to address, what they need to remember, and so forth, and I am there to help them.
Ms Alvarez: I am currently transitioning from being the Patient Navigator to the official Nurse Navigator for Head and Neck and Endocrine Cancers. As I make this transition, many of my responsibilities will remain the same. Others are in progress as I learn from my fellow nurse navigators, who have been in the field for many years. I have been working with the multidisciplinary team for a few years now, collaborating daily with virtually everyone involved in our patients’ care.
I begin my day by reviewing the physician’s schedule a day ahead of time so that I can identify which patients will be coming in. Navigation requires a lot of “investigating,” which helps me to prepare for our patients’ visits. I firmly believe that in oncology, it is important to work with a sense of urgency and prioritization. Each day, we have new patients coming through our doors, and we go and meet them in person. During the initial consultation, I introduce myself, alongside the clinical team, and discuss my role as their patient advocate. Many of our patient cases are reviewed during tumor board conferences, and I am informed of any updates, including barriers that may have arisen that could possibly delay a patient’s treatment.
Ms Alvarez: What I absolutely love about the Miami Cancer Institute is the fact that everything is under one roof where we can address the physical, psychologic, social, and spiritual needs of patients and their caregivers through high-quality clinical care, education, and research across the continuum of care. Our Institute is constantly seeking to improve the quality of life and health outcomes of patients. Our Cancer Support Services Center offers social work services, oncology dietary counseling, acupuncture, massage therapy, exercise courses, mental health services, physical rehabilitation, pain management, and survivorship care. Renowned oncologists; internationally known, subspecialized cancer experts and surgeons; clinical researchers; and genetic scientists make up our impressive roster of professionals, many of whom were chosen from the nation’s best cancer hospitals. The latest radiation treatments are all available in one location through our comprehensive and advanced radiation oncology program, which includes South Florida’s first proton therapy facility. More importantly, our navigation program continues to grow. We meet with all newly diagnosed patients and become what I like to call “their person” from beginning to end, as we work to address all barriers to care and match them with the resources and referrals they need.
Ms Alvarez: A wise nurse navigator put everything into perspective for me. She said, “You might be doing things the nontraditional nursing route, but you will also experience things that a new nurse may never experience in her life.” I have witnessed patients’ struggles and have seen them face obstacles while receiving cancer treatment and so many of them still have a positive attitude. To me, this is proof of how important navigation can be. The fact that I can be there to guide these patients and their families through their journey, advocate for them, educate them, reassure them, and provide them with resources makes all the difference. Oncology is a calling but being part of a navigation team has put life into perspective for me as a nurse, a mother, and a friend.
Ms Alvarez: I think that one of the biggest challenges of my job is realizing that I am sometimes limited regarding the things that I can do for a patient, based on resources, funding, insurance, and even staffing availability. Ultimately, this is a role that requires me to work with many people and when dealing with a tumor site such as head and neck, I am working with more than 10 people from beginning to end. Documentation becomes an even bigger challenge because I am trying to condense so much information per patient and really highlight the key points on their current continuum of care. It is important to make sure that everyone involved is up to speed, especially when it comes to financial issues.
The clinical team resolves the treatment plans, but what happens when the patient has no transportation to get to the center or cannot afford lodging during treatment? Financial toxicity affects the way patients make clinical decisions. Recently, patients have become more at ease discussing their financial worries, so it is critical that the entire team is aware so they can see what can be done with the resources available.
Ms Alvarez: I think the best way to avoid burnout is to set realistic expectations. It is also important to work with anticipation, so that you are already preparing yourself for all the things that can go wrong. Keeping the lines of communication open with all members of the multidisciplinary team is vital so that you are all on the same page. For example, our intake nurses do an incredible job of getting all the information possible from the patient before they transition to the outpatient setting, which is when we meet them for the first time. With that intake note, I can usually anticipate what their barriers might be. Do they have family support? Do they have insurance? Do they have a primary care doctor? Do they have a dentist? By preparing myself with that information, I can inform the multidisciplinary team of what is to come and how we can get the ball rolling.
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