Nurse Navigator

special interest group newsletter

Volume 5, Issue 1, January 2014
Coordinator’s Message:
Getting Involved

Carol Bush, BS, RN
Wichita, KS

“If you are not at the table, you are on the menu.” I love this quote. According to my small attempt at research on the Internet, no one person can lay claim to the saying. Many seem to believe it originated in Washington, DC, sometime around 2000. Go figure.

To me, this saying means that no matter how much someone who agrees with you might try to represent you, having the unique experience of being you and being where decisions are made means volumes more. All too often, if you aren’t part of the decision-making, you likely will be left out or, worse yet, served on the menu.

One thing I learned early in my life was the importance of getting involved. In retrospect, I absorbed it through osmosis. I have been surrounded by aunts, uncles, cousins, parents, and grandparents who have been tenacious leaders and have modeled civic action. And yes, more than one of us have been labeled as a “trouble maker” in our lives.

As a young adult, I learned that communicating my beliefs only got me so far. Successfully giving voice to those beliefs required being in a position in which my input would be heard. I had to secure a place at the table.

As oncology nurse navigators, and members of the most trusted profession, each of us getting involved and giving voice to real solutions backed by evidence and common sense are more important than ever.

What makes someone the kind of person who gets invited to the table? I recently asked some key people in my professional network, and this is what they had to say:

Have something interesting to say.
Don’t you relish sitting next to someone who always has something interesting to say? For most of us, an invitation to any table comes with some lead time, so you don’t have an excuse not to have some interesting topics in your back pocket. Even an introvert can do this!

Know what’s going on in your industry.
People enjoy hearing about new, fresh trends and ideas. This boils down to staying curious and being open to new types of thinking and new ways of doing things. This is how you create a reputation of being an expert in your field  and become a person who others seek out to hear about what’s coming around the corner.

Show genuine interest in other people.
People love to be asked what they think about things and what ideas they have. Those we find the most charming are usually those who have the ability to draw us out and make us feel special and interesting. When you purposefully listen, you create trust and rapport. People who create trust and rapport get invited back to the table.

Study other leaders.
Continually observe key leaders in your social and professional networks. Study their communication skills. Take note of strategies they use to engage others to get things done. Apply what you observe. It’s not rocket science, but it does take tenacity.

To make sure you always have a place at the table—whether that’s in your career, community leadership, or otherwise—ask yourself if you’re demonstrating the types of characteristics of those who are sought after. If you’re not, then get out of your own way and start making changes today!

The following are just a few ways to secure your place at the table within ONS:

The Nurse Navigator SIG Newsletter is produced by members of the
Nurse Navigator SIG and ONS staff and is not a peer-reviewed publication.

Nurse Navigator

Special Interest Group Newsletter  January 2014

Member Spotlight:
Maggie Ward, MSN, APRN, AGCNS, OCN®

How long have you been practicing? At which facility do you practice?
As an RN, seven years. As an OCN®, six years. My advanced practice registered nurse certification as a clinical nurse specialist was earned in May 2013. I officially started as an oncology nurse navigator in September 2013. All but the six months of my career I worked as a traveling nurse in Denver, I have practiced at Via Christi Health in Wichita, KS.

What is your area of care (disease-specific or general navigation)?
General navigation and insurance navigation. In addition to my nurse navigator role, I am also the team lead for our insurance navigation program. Therefore, when we assist individuals with signing up for insurance through the Affordable Care Act, I provide education and resources available for appropriate cancer screening and prevention services available.

What sparked your interest in joining the Nurse Navigator SIG?
The opportunity to collaborate with other oncology navigators in the country, as well as to have access to additional resources in order to better serve our patients.

Have any patients stood out to you regarding navigation needs?
There are so many. The ones who I really want to focus on are the newly diagnosed and those who are between biopsy and seeing the oncologist. Unfortunately, we see too often an individual who is diagnosed with cancer but does not get to an oncologist in a timely manner due to a multitude of factors. My goal is to begin significantly reducing this wait time and providing an additional educational resource through myself for patients.

If you could serve as a nurse anywhere for any length of time, where would your dream job take you?
As a traveling nurse in 2008, I fell in love with Denver, CO. Ever since then, I would love to return my oncology nursing career to Colorado. However, with the most recent opportunity of developing a navigation program within Via Christi Health, I honestly can say that I do not want to be anywhere else. This is where I am supposed to be.

Do you have any tidbits of wisdom you would like to share with the membership (e.g., mantras you live by, pearls of practice)?
My hospital career started as a volunteer on the pediatric floor of Via Christi while in high school. During this time, I learned that if I could make a child smile for just one moment, and in that moment allow him or her to forget everything that he or she is going through, then my job is worth it. I continue to carry this perspective in my daily career. Patients with cancer are going through so many trials and tribulations all at one time. If we can help them forget their struggle and pain for just one moment, then I only can hope that I’m making a bit of a difference in their battle.

What is one thing you would like to see accomplished in the SIG over the next year?
A push for a generalized oncology navigator certification

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Nurse Navigator

Special Interest Group Newsletter  January 2014

Oncology Nurse Navigators:
Helping to Build a System to Deliver High-Quality Cancer Care

Jean B. Sellers, RN, MSN
Chapel Hill, NC

Oncology nurse navigators (ONNs) live and breathe coordinated care. And if you ask an ONN if our current healthcare system serves patients and their families well, you quickly will learn the serious barriers they face each and every day. Seeing the effects of cancer care that is not coordinated or communicated well is heartbreaking. Patients are left trying to navigate their own journey. Many times, patients do not receive adequate information regarding their prognosis, cost, treatment they are receiving, or the long-term side effects. They are unaware of psychosocial support or other resources that may be available. They often are filled with terror, wondering “Am I going to die?” or “How am I going to pay for this?”

A recent study found that about 70%-80% of patients with a poor prognosis actually believed their treatment was going to provide a cure for their disease (Weeks et al., 2012). Another study found that more than one-third of personal bankruptcies in the United States are due to medical expenses; of those, three out of four people who declared bankruptcy had health insurance (Himmelstein, Thorne, Warren & Woolhandler, 2009). Discussing out-of-pocket expenses for treatment is difficult when we don’t know what the final cost will be. Patients are spending money on treatment that won’t alter the course of their disease. Not only is transparency in the cost of cancer care lacking, communication is hugely divided regarding what patients want to know and the information they are given.

The National Academy of Sciences established the Institute of Medicine (IOM) in 1970 to provide guidance for ways to improve health. In 1999, IOM published Ensuring Quality Cancer Care with its recommendations. IOM published a report in 2007, Cancer Care for the Whole Patient, bringing attention to the psychosocial needs that patients have when facing cancer. The report states that “all patients with cancer and their families should expect and receive cancer care that ensures the provision of appropriate psychosocial health services” (IOM, 2007, p. 1). A recent publication by IOM (2013), Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis, was released in September. It was funded and supported by many, including ONS. The report brings to light the need for patient-centered coordinated care and enhanced communication. Patients, healthcare providers, and researchers, including federal and private organizations, are challenged to look at strategies that can ensure the delivery of quality cancer care for all patients, regardless of where they live and their barriers to care.

Included in the report are the following six recommendations for what a high-quality cancer delivery system should include (IOM, 2013).

Engage Patients

Patient-centered care should be at the core of a high-quality cancer delivery system. Cancer care teams should provide patients and their families with care plans that include information about prognosis, treatment benefits and harms, medications, palliative care, psychosocial support, and costs.

Patients and families should be included in conversations when making important decisions about their treatment.

Improve Healthcare Information Technology

Professional organizations and the U.S. Department of Health and Human Services (HHS) should create an information technology system that will integrate all systems and providers, regardless of where the patient receives care. 



Have an Adequately Staffed, Trained, and Coordinated Workforce

All members of the cancer team should have the appropriate skill and communication training supported by evidence-based training programs, certifications, core competencies, or credentials. Cancer care should be coordinated both inside and outside of the healthcare system.

Measure the Quality of Care

Professional organizations and HHS should develop a system for publicly reporting outcomes that includes a national quality reporting program for cancer care. This standardization would have the ability to provide necessary data that would improve the care delivered and ensure that patients and clinicians are kept informed of current trends.

Ensure Evidence-Based Care to Inform Clinical Care

Additional research is necessary on older adults with cancer, including those who have multiple health problems. This will help evaluate how cancer treatments impact quality of life. 

Ensure Accessible and Affordable High-Quality Care

Programs should be developed that help communities provide accessible and affordable cancer care to help eliminate healthcare disparities. Professional organizations should ensure that patients are aware of futile care. New payment models should be developed.

In summary, we all can agree that our healthcare system is in need of a change and that patients need our help coordinating care, regardless of where they enter the system. But we also can agree that much work already is going on to address some of these recommendations. Many cancer centers already are focusing on the new American College of Surgeons guidelines requiring the development of effective navigation processes, distress screening, individualized treatment summaries, and care plans for patients with cancer (American College of Surgeons. Commission on Cancer, 2012). However, addressing the healthcare disparities and barriers to care will require that all systems are patient-centered, collaborative, and community-focused. While the Commission on Cancer is careful to not to stipulate “who” should navigate, it does acknowledge that navigation processes are a way in which cancer centers can address healthcare disparities and barriers to care. The recent release of the ONS (2013) Nurse Navigator Core Competencies is a big step in supporting the role of the oncology nurse navigator. Many institutions already have seen the positive outcome that this role provides in terms of reducing barriers to care and improving the patient experience (McMullen, 2013). But more is required to fix the problem. All disciplines, including healthcare providers, hospital administrators, information technology staff, community advocacy groups, and patients need to work together to ensure that all patients have accessible and affordable quality cancer care, they are able to move rapidly across the continuum, and their voices are heard. Our patients deserve no less.

American College of Surgeons. Commission on Cancer. (2012). Cancer program standards 2012: Ensuring patient-centered care v1.1. Chicago, IL: American College of Surgeons. Retrieved from

Himmelstein, D., Thorne, D., Warren, E., & Woolhandler, S. (2009). Medical bankruptcy in the United States, 2007: Results of a national study. The American Journal of Medicine, 122(8), 741-746. doi:10.1016/j.amjmed.2009.04.012

Institute of Medicine. (1999). Ensuring quality cancer care. Retrieved from

Institute of Medicine. (2007). Cancer care for the whole patient: Meeting psychosocial health needs. Retrieved from

Institute of Medicine. (2013). Delivering high-quality cancer care: Charting a new course for a system in crisis. Retrieved from

McMullen, L. (2013). Oncology nurse navigators and the continuum of cancer care. Seminars in Oncology Nursing, 29(2), 105-117.

Oncology Nursing Society. (2013). ONS nurse navigator core competencies. Retrieved from

Weeks, J., Catalano, P., Cronin, A., Findelman, M., Mack, J., Keating, N., &nSchrag, D. (2012). Patients’ expectations about effects of chemotherapy for advanced cancer. New England Journal of Medicine, 367(17), 1616-1625.

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Nurse Navigator

Special Interest Group Newsletter  January 2014

Exclusive Articles Available Before Print

The Oncology Nursing Forum (ONF) and the Clinical Journal of Oncology Nursing (CJON) have unveiled advanced print exclusive articles to give our readers access to important, cutting-edge content ahead of print. Articles from the journals are available on the main ONF and CJON pages. These articles are open access, meaning they are available to members and non-members alike, until they appear in print at a later date. At that time, the content will become password-protected like other articles that appear in print as online exclusives in the journals.

The latest article to receive the advanced print exclusive designation is “Telephone Calls Postdischarge From Hospital to Home: A Literature Review” by Kristin E. Hand, BSN, RN, OCN®, and Regina S. Cunningham, PhD, RN, AOCN®. The purpose of this CJON article is to provide an understanding about postdischarge telephone calls in patients with cancer. Check out this timely and informative article today.

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Nurse Navigator

Special Interest Group Newsletter  January 2014

Journals Available in Digital Format

Did you know that the Clinical Journal of Oncology Nursing (CJON) and Oncology Nursing Forum (ONF) are available in digital format? To access the digital editions, click on the journal you wish to view at and follow the instructions featured prominently in the top center of the page. The digital editions are a members-only benefit, so make sure you have your ONS username and password handy.

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Nurse Navigator

Special Interest Group Newsletter  January 2014

Check out the ONS Connect Blog

The official blog of ONS is written by oncology nurses for oncology nurses on a variety of topics of interest, including facing day-to-day challenges at work, juggling busy lives at home, and keeping up to date with the magnitude of information available for practicing nurses.

This month, you’ll find the following new discussions.

As a reader, join in on the conversation and connect with other oncology nurse readers by posting your own stories, tips, ideas, and suggestions in the comments section at the end of each blog post.

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Nurse Navigator

Special Interest Group Newsletter  January 2014

Five-Minute In-Service

The latest Five-Minute In-Service explains how Treatment Complexity Is a Key Factor in Overadherence to Oral Oncolytics.

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Nurse Navigator

Special Interest Group Newsletter  January 2014

Ask a Team Member

The latest Ask a Team Member column answers the question What Models Can Help With Decisions to Refer Patients for Genetic Testing?

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Nurse Navigator

Special Interest Group Newsletter  January 2014

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Nurse Navigator

Special Interest Group Newsletter  January 2014

Nurse Navigator SIG Officers

Coordinator (2013-2015)
Jean Sellers, RN, MSN
Chapel Hill, NC

Ex-Officio (2013-2014)
Loir McMullen, MSN, RN, OCN®
Ewing, NJ

Dominique Srdanovic, RN, OCN®, MA
Stamford, CT

Co-Virtual Community Administrator
Marie Borsellino, RN, BSN, OCN®, CBPN-CMA


Co-Virtual Community Administrator
Ellen Carr, RN, MSN, AOCN®  

ONS Nurse Navigator SIG Liaison
Jean B. Sellers, RN, MSN  

ONS Copy Editor
Jessica Moore, BA, BS
Pittsburgh, PA

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To print a copy of this newsletter from your home or office computer, click here or on the printer icon located on the SIG Newsletter front page. Print copies of each online SIG newsletter also are available through the ONS National Office. To have a copy mailed to you or another SIG member, contact Membership/Leadership Specialist Carol DeMarco at or 866-257-4ONS, ext. 6230.

View past newsletters.

ONS Membership & Component Relations Department Contact Information

Brian K. Theil, CAE, Director of Membership and Component Relations Department

Diane Scheuring, MBA, CAE, CMP, Manager of Member Services

Carol DeMarco, Membership Specialist—SIGs

The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability.

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