Charting The Course Nurse navigators help patients find the care they need hen Linda Lindberg learned she had stage IV colon cancer it wasn’t what she expected. After all, she was scheduled for a hysterectomy to treat what she and her doctor thought was uterine cancer that same morning. One last test, a colonoscopy the previous day, revealed colon, not uterine cancer. Not only was it a different kind of cancer than she expected, but the cancer had spread. Emotions were high. “My diagnosis was an emotional rollercoaster,” Lindberg remembers. Living in Stockton, Mo., a town of 2,000 people, meant Linda’s access to treatment was limited. The nearest big city, Springfield, was more than an hour away. While she could start basic chemotherapy, her physicians advised her to seek advanced care. “My option was to try multiple rounds of chemotherapy, but then the party would be over,” Lindberg says. “They said if I was willing to travel I could go to a place where they could do surgery and clinical trials.” The many treatment options sent Lindberg on another rollercoaster ride. She didn’t know where to start. She needed an advocate. Her son, a physical therapist in Colorado, knew she could get good care on the University of Colorado Anschutz Medical Campus, but he needed to find the right contact. An internet search led him to Julie Banahan, RN, BSN, OCN, a nurse navigator for the Gastrointestinal Oncology Program at the University of Colorado Cancer Center. “Julie was a critical contact person,” Lindberg says. “I didn’t have a lot of faith in how fast things would start moving with treatment, but I wanted things taken care of right away.” Julie Banahan helped make that happen. A few days later, Lindberg traveled 750 miles for her first appointment—a feat that wouldn’t have taken place without Banahan, her nurse navigator.
BY KIM CHRISCADEN
gastrointestinal cancer, and Christine Frodella, RN, BSN, OCN, in blood cancer and bone marrow transplant. “We were getting so many new patients, but we weren’t getting them where they needed to be in a timely manner,” Banahan says. “We needed to rein in the program.” At no additional charge, Banahan and Frodella are the first point of contact for all new patients in their clinics. Beyond scheduling appointments and collecting medical records, they offer tips on dealing with treatment side effects, referrals to support services, and clarity to the treatment plan. In short, as navigators, they provide roadmaps for patients’ cancer journeys. “I’ve been told we’re the concierge of nursing,” Banahan says. Frodella agrees. “I’m their welcoming committee. Those first few days after diagnosis are one of the most important times for patients,” she says. “I hear patients’ sighs of relief when they finally contact someone who can walk them through the process step by step.” On average, Banahan and Frodella navigate 12-16 new patients into their clinics each week. In order for a new patient to be seen quickly, they ensure all blood work, scans and staging have been done prior to patients seeing a physician. And, instead of seeing one physician at a time, new patients meet with a multidisciplinary team of medical, surgical and radiation oncologists, pharmacists and nutritionists all in one visit. That timely coordination was what patients like Lindberg need. PATRI CK CAM PBELL
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TH E R I G H T C ON NE C TIO N Originally created more than 20 years ago to help reduce patient barriers to healthcare, patient navigation now includes not only helping patients find the best treatment, but following patients along the care continuum, from diagnosis to survivorship. While the concept is not new, CU Cancer Center did not have a nurse navigator until five years ago when it hired one focused on breast cancer. Three years later, as patient referrals increased, the Center added two more navigators—Banahan, in
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NUTRITION
Christine Frodella, RN, BSN, OCN, a nurse navigator for the Blood Cancer and Bone Marrow Transplant Clinic, serves as the first point of contact for all newly diagnosed patients.