As a patient navigator, you interact with a lot of different people. You can build trust and be more impactful if you are professional; thus, professionalism is an important skill to develop as a navigator—but what does this mean? It means being clear about your role to patients and healthcare team members, knowing and respecting patient privacy, avoiding conflicts of interest, and triaging patient needs that are outside your scope of practice.1
As a nonlicensed healthcare professional, your role is to coach patients to use their time effectively with their physician, help them find resources for resolving problems they face in completing cancer treatment, and advocate for patient rights. You can build trust with your patients and colleagues by being clear about what you can and cannot do, and being consistent with your boundaries. Sometimes, this might feel as though you are challenging colleagues—even physicians or supervisors; however, it is critical that you remain clear about your role and continually educate others about what you can and cannot do as a navigator, for your own safety, and for the safety of your patients.
You are a powerful advocate for your patients; you are the person who is best positioned to educate them about their rights and responsibilities, and are in a key position to impact timeliness, coordination, and quality of care for each of them.1 Invest in continually setting goals to improve your knowledge and personal development to best meet the needs of your patients, while simultaneously reinforcing appropriate boundaries to your role.
Case Study
You walk into work and can tell it is going to be a tough day. The medical interpreter is on vacation, and the physician you work with seems eager to get out the door to attend a holiday concert at her child’s school. The physician asks you to call a patient who only speaks Spanish, and share the results of his or her biopsy—thankfully, it is good news. You have some time on your hands before you see your next patient.
Check Your Knowledge
1. How do you respond to the physician?
a. You say, “Absolutely” because it is good news, you have a rapport with the patient, and are bilingual
b. Tell her you are not comfortable with it, but will do it this one time
c. Tell her you cannot call a patient with results, because that is not within your scope of practice
d. Tell her to go to the holiday concert; of course you will do this for her
2. What is the best strategy to develop trust with your colleagues?
a. Be immediately responsive to what they ask of you on a day-to-day basis
b. Be clear about your scope of practice, and refer to other colleagues based on their expertise
c. Tell them private things that patients have shared with you, so that you can help them make better medical assessments
d. Coordinate a team retreat to get to know each other better
3. You are concerned that a patient may be suicidal. What do you do?
a. Report the issue to a social worker or other qualified mental health professional, and ask him or her to speak with the patient
b. Explain to the patient that this is a normal reaction to a diagnosis of cancer
c. Talk to the patient’s spouse, and encourage him or her to be extra attentive
d. Tell the patient to go to the emergency department
4. A patient with significant financial problems asks you to lie on a form so that they can qualify for assistance. What do you do?
a. Modify the form so that the patient can obtain assistance
b. Tell the patient that they are behaving unethically
c. Explain that you have to follow the rules, and will continue to work to find a solution
d. Ask a social worker to get involved
5. Which of the following is not a patient right or responsibility?
a. The right to understandable information
b. The right to choose a provider
c. The right to complain about healthcare services or discrimination
d. The right to not pay your bills if you have a competing financial obligation
Acknowledgment: The authors are grateful to Elizabeth Rohan, PhD, MSW, Health Scientist, Centers for Disease Control and Prevention, Atlanta, GA, for her work on this component of the Oncology Patient Navigator−Certified Generalist examination.
Answers
1, C; 2, B; 3, A; 4, C; 5, D.
Reference
- Pratt-Chapman M, Willis A, Masselink L. Core competencies for oncology patient navigators. Journal of Oncology Navigation & Survivorship. 2015;6:16-21.