Navigator Orientation (Multifacility Model)

November 2018 Vol 9, NO 11
Lisette Morris-LaPerriere, RN, MSN
Sarah Cannon Cancer Institute
Nicole Centers, RN, BSN, OCN, CBCN, CN-BN
North Texas Division Director, Oncology Navigation
Sarah Cannon

Background: The orientation/onboarding process is neither standardized nor well understood across the oncology navigation industry.

Objective: To consider processes used among varied tumor site navigators with differing experiences within one large national organization.

Methods: Due to the large size of our organization, a voluntary self-reported survey was performed to obtain information on the standardized onboarding at every level of the network. New navigators, onboarding to our company, have access to similar tools during their orientation while the individual’s timeline fluctuates. The navigators in this grouping are all actively employed registered nurses with a focused population of oncology patients. The benefit of using this sample population is the volume of navigators, the volume of facilities, and that all navigators are evaluated based on the same metrics and outcomes related to the success of the navigation. Responses were blinded. Questions were in multiple choice format and open response survey. A Likert scale was utilized when appropriate, and Benner’s scale of expertise was used for nursing proficiency in the survey. The scales were explained in detail in the survey. Seventy-nine oncology navigators were queried over a 7-day period. Questions pertained to level of navigator expertise, length of time in nursing, time in role, and orientation-based questions.

Results: A total of 57 navigators (56 women, 1 man) from 9 states responded. Representation from all age-groups was well distributed with 23% age 25 to 34 years; 25% age 35 to 44 years; 20% age 45 to 54 years; and 30% age 55 to 64 years. Over 75% have been nurses for more than 10 years, with over 60% having over 5 years of oncology experience. Sixty percent have been oncology nurse navigators for more than 2 years. On several dimensions measured by the Benner level, self-reported responses were similar with approximately 25% competent, approximately 45% proficient, and 25% reporting as expert. Average length of orientation/onboarding was more than 4 weeks for 65%. Fifty percent of total surveyed reported this length of time was appropriate. Orientation strategies utilized were 8% online, 78% shadowing, 53% textbooks, 69% videos/Webex, and 47% navigation staff meetings. Overwhelmingly, the study revealed satisfaction with the onboarding process with education and tools utilized during the process but did show more shadowing time was a request with 69% disease-specific, 58% with mentor, 50% with physicians, and 46% with other navigators.

Conclusion: The current orientation/onboarding process of those responding to this survey indicate that the process is successful in training competent, proficient, and expert oncology nurse navigators. The navigators reported continued use of materials provided, education provided, and tools received. Ongoing education is part of the routine working environment, with continuing education provided frequently and often after the orientation period has concluded. However, one aspect of the survey did show additional time in specific modalities of shadowing would be beneficial. This validates the current process used by this enterprise that is orchestrated by the education department and navigation leaders. It should be noted that there is a true gap in published data on how best to orient a new oncology navigator.

Sources

Braun KL, Kagawa-Singer M, Holden AE, et al. Cancer patient navigator tasks across the cancer care continuum. J Health Care Poor Underserved. 2012;23:398-413.

McMullen L, Christensen D, Haylock PJ, et al. 2017 Oncology Nurse Navigator Core Competencies. Oncology Nursing Society. www.ons.org/sites/default/files/2017-05/2017_Oncology_Nurse_Navigator_Competencies.pdf. Accessed June 18, 2018.

Strusowski T. Creating a Navigator Orientation Checklist. Association of Community Cancer Centers. http://mynetwork.accc-cancer.org/blogs/acccbuzz-blog/2016/11/29/creating-a-navigator-orientation-checklist. Accessed June 18, 2018.

Related Articles
Assessment of Side Effects (SEs) Impacting Quality of Life (QOL) in Patients (Pts) Undergoing Treatment (tx) for Advanced Breast Cancer (ABC) in Clinical Practice: A Real-World (RW) Multicountry Survey
November 2022 Vol 13, No 11
To examine how SEs impacting QOL in pts with ABC are perceived.
Intracranial Activity of Tepotinib in Patients with MET Exon 14 (METex14) Skipping Non–Small-Cell Lung Cancer (NSCLC) Enrolled in VISION
November 2022 Vol 13, No 11
To provide analysis of the intracranial activity of tepotinib in patients with METex14 skipping NSCLC with BM from the VISION study to aid oncology nurse navigators who manage this population of patients.
MOMENTUM: Phase 3 Randomized Study of Momelotinib (MMB) versus Danazol (DAN) in Symptomatic and Anemic Myelofibrosis (MF) Patients Previously Treated with a JAK Inhibitor
November 2022 Vol 13, No 11
MF is a rare bone marrow cancer characterized by fibrosis, abnormal blood cell production, and dysregulated JAK/STAT signaling.1,2
Last modified: August 10, 2023

Subscribe Today!

To sign up for our print publication or e-newsletter, please enter your contact information below.

I'd like to receive:

  • First Name *
    Last Name *
     
     
    Profession or Role
    Primary Specialty or Disease State
    Country