Pioneering nurse navigator helps cancer patients maneuver through the system
by Eric Johnson
As breast cancer navigator at GHSU’s Cancer Center, Nicole Aenchbacher’s goal is to make sure every breast cancer patient’s journey is as smooth as possible, starting from the very beginning.
“My job on the front end is to help these patients get access to our system in a timely fashion,” she says. “So they can call me — or if they have a physician they’re seeing elsewhere, they can be referred — and I can get them an appointment usually within a week or two of the phone call, depending on exactly what’s going on.”
The process starts with the multidisciplinary clinic, where their case is evaluated by every physician that’s part of the treatment team, which could potentially include a surgeon, a medical oncologist and a radiation oncologist. After the patient sees the first physician, they break for conference, where the first physician presents the patient and explains what’s going on. From there, everyone else on the team weighs in — the surgeon says what kind of surgery is recommended, the medical oncologist puts in his or her opinion regarding chemotherapy and the radiation oncologist says what radiation options might be available.
“When they walk out the door, they have a treatment plan and they have all of their appointments set up until the next step scheduled for them,” she says.
In the end, the team comes up with the plan and it’s up to Aenchbacher to carry out the plan and make sure everyone stays on track, the patient as well as the physicians.
Though the breast cancer navigator program has been in place at GHSU for approximately five years, they implemented the navigator concept in nine other cancer sites last March, so while Aenchbacher continues to be the breast cancer navigator, she’s also the nurse manager for the entire navigator program.
Patient navigation was started in 1989 by Dr. Harold Freeman, who at the time was the president of the American Cancer Society. He saw a need for underserved people in the Harlem, New York, area who were victims of healthcare disparities, so he started the navigator program in order to target that specific population, starting with breast cancer. In 2005, President Bush signed a healthcare act that earmarked funding for patient navigator programs. Nationally, about 50 navigator programs were started with this funding, most dealing with breast cancer, though now hospitals are deciding to implement navigators with other cancer types as well as other types of disease processes.
Before navigators, a lot of different people were involved in the management of a patient’s treatment, each doing a little bit of something, but not necessarily working cohesively. Often, the onus was on the patient to be the common link, which wasn’t necessarily the most effective way and certainly added stress to the patient at a time when it wasn’t needed.
Last year, GHSU had 156 new breast cancer patients who were diagnosed and treated there. Depending on the stage of the cancer and the type of treatment, breast cancer patients can remain in the system between three months and a year and a half.
Now that the navigator program has expanded, Aenchbacher feels a special satisfaction.
“It’s very exciting,” she says. “And it’s nice to have some help, because although I wasn’t involved in the other cancer subtypes, I was expected to participate in certain things because they needed a navigator represented. Now that there are other navigators, I can delegate those things so I’m not at a gazillion meetings all day long.”
Her efforts aren’t just limited to coordinating health issues, however.
“If you call me and you’ve got complaints of nausea and vomiting — I can take that ball and run with it,” she says. “But if you need transportation, money for your medicine or they’re going to cut off your electricity, I can get you with somebody quickly to help you out.”
And while the navigator program was initially developed to help the underserved, it’s now there for everyone to use.
“Am I more involved with patients who are underserved?” she asks. “Yes, but probably just because they have more needs than patients who have insurance and patients who have a good support systems.”You Might Also Like: