Masterful storyteller, Rachel Naomi Remen, MD, Clinical Professor of Family & Community Medicine, University of California San Francisco School of Medicine, CA, reminds readers of Kitchen Table Wisdom that a story is a container for meaning. Reflecting on my personal path to oncology nursing has given me the chance to find the deeper meaning in why I love this work. Being a nurse navigator is not a job—it is a joy. I could have never imagined a more fulfilling professional role.
Hearing the Call
My decision to attend nursing school came as a surprise. Unlike many of my nursing colleagues, I never aspired to be a nurse. I was working as a successful cosmetologist, and I remember talking with one of my clients who was pursuing a professional degree. I wondered aloud why anyone with a family would want to add the stress of higher education to the mix. Notwithstanding, my curiosity and need for a change overrode my initial apprehension. My aptitude for learning had been rekindled after successfully completing the American Council on Exercise certification examination for aerobic instruction. I knew I could learn and test well, so I enrolled in the Weber State University nursing program and embarked on my life’s work of becoming a healer.
Stepping Stones to Navigation
It seems I have a 5- to 7-year itch to change things up, and nursing has provided many such opportunities. My career path has included perioperative and postanesthesia nursing, developing an outpatient pain clinic, and finally finding my way to oncology as a nurse navigator 6 years ago. The navigation program at Intermountain Southwest Cancer Center was in its infancy, and with much collaboration and support from my wonderful team members, the program is now robust and flourishing. The continued development of protocols and clinical pathways provides me with a creative outlet, but above all, seeing the monumental difference that navigation makes in patients’ lives provides rewards beyond measure.
All our experiences in life prepare us for the one we are in right now. Because of my experiences in the fitness and beauty industries, I was prepared with the skill set I needed to facilitate support groups and to develop programs that reinforce survivorship for patients with cancer. Who would have envisioned that I would also be so suitably prepared to help women with wigs and skincare by volunteering with the American Cancer Society’s Look Good Feel Better program?
Advanced Education and Support
Just before attaining the nurse navigator role, I received my baccalaureate degree in nursing from Southern Utah University. I did not foresee the need for further schooling, and I was content with the study required to certify as a breast care navigator, a holistic nurse, and then as an oncology certified nurse (OCN) through the Oncology Nursing Society (ONS). As I was investigating the OCN certification, I came across the advanced practice role of the clinical nurse specialist. In reading the role competencies, I realized that this would be my next career step.
I have 1 semester left before graduating from Loyola University in Chicago, IL, with a graduate degree that would prepare me to be licensed in the advanced nursing role of an Adult/Gerontology/Oncology clinical nurse specialist. The entire program has been online and has given me the chance to receive education from such a rigorous, oncology-focused program while residing 1000 miles away in Utah. I was honored to receive the American Cancer Society graduate scholarship and an ONS Foundation masters scholarship. Tuition reimbursement was also offered through my institution. I encourage nurses to grow in the profession through certification by attending national conferences and educational events, and by pursuing advanced degrees. There are many wonderful resources to help nurses achieve their dreams and advance their education even further.
Doors Flung Open
Advancing my education in oncology has opened many doors for networking with other nurses and with people across the country. I develop new friendships annually by attending national conferences and by participating in nursing roundtables, where navigators work together to advise developers on patient programs and resources.
I have attended all but 2 of the Academy of Oncology Nurse & Patient Navigators (AONN+) national conferences and joined AONN+’s newly named Evidence into Practice Committee 2 years ago. Because we all work together to support patients with cancer, the recent expansion of AONN+ to include lay navigators was very forward-thinking. The depth and breadth of AONN+ as an organization and as a resource for all navigators is impressive.
Presenting posters at AONN+ and at the American Holistic Nurses Association conferences was a great first step in daring to step into the publishing arena. I began blogging for ONS and was encouraged to become a contributing editor for the ONS newsmagazine, ONS Connect. What a great opportunity to interview and share the insight and best practices of other oncology nurses and specialists. Oncology nursing leadership was something I had viewed from afar, but not because I did not want to get involved. Toward the end of 2014, I accepted the position of newsletter editor for the ONS Nurse Navigator Special Interest Group. Participating in the leadership council of this group has expanded my view of what oncology nurses can do when they come together with like-minded ideas and vision.
This is also the reason I attend national nursing conferences annually. The AONN+ conference has been an annual event, because the inspiration and passion of oncology nurse navigators is contagious—and that’s a good thing.
Becoming an AONN+ Committee Member
My involvement in the AONN+ Evidence into Practice Committee has been exceptionally helpful in supporting my participation in research. When a nursing fellowship research grant opportunity was offered within my institution, my fellow colleagues and I embarked on a research study looking at the effect of functional movement exercise on the incidence and severity of chemotherapy-induced peripheral neuropathy. Currently, well into the second year of the study, anecdotal evidence supports this intervention.
Committee members have graciously shared their insights on how to develop and revise the study, as well as motivated ideas for future projects and collaboration. I recall being at an Advisory Board meeting with Elaine Sein, RN, BSN, OCN, CBCN, Co-Chair of the AONN+ Evidence into Practice Committee, and telling her about this study. It was great to share our ideas and have the common link of curiosity and research methods. Nurse and patient navigators, social workers, and other members of the oncology team affect the lives of the patients in their care. Through best practice interventions and continued research, support for patients and their care circle expands and evolves. Each of us has the opportunity to make a difference in an assortment of ways, including research.
Many nurses are scared of research, and although it can be a daunting task, it is well worth the effort in the end. Even if a hypothesis turns out to be incorrect, nurse researchers are still adding to the body of nursing knowledge in some way. My advice for nurses who have even a small inkling to participate in frontline research is to work with a mentor first. Becoming a member of this AONN+ committee is a great first step.
The Benefits of Advanced Nursing Education
During my first semester of graduate school at Loyola University, I took a nursing theory class taught by renowned nursing theorist Nola J. Pender, PhD, RN, FAAN. Dr Pender inspired and mentored me toward submitting a manuscript to the Advances of Nursing Science journal. My persistence, coupled with Dr Pender’s patience and insight, paid off, and my manuscript was published in the April 2015 edition of the journal. The publication, “The Health Change Trajectory Model,” is a synthesis of 2 theories, specifically, Mishel’s uncertainty in illness theory and the Corbin and Strauss chronic illness trajectory.
My experience in assisting patients with cancer, and the uncertainty surrounding a cancer diagnosis, fear of recurrence, and end of life motivated me to look at uncertainty at different trajectory points (acute, stable, downward, comeback) of the cancer journey as defined points at which nurses could educate and support patients’ unique needs and perceptions.
Publishing in such a prestigious journal could not have been possible without advanced education. There is so much to learn and experience in nursing. Nurses who take the opportunity to further their knowledge through certification, continuing education credits, and higher learning will benefit professionally and personally. I know I have.
As I merge my advanced oncology knowledge with my role as an oncology nurse navigator, my vision continues to widen to foresee engaging healthcare systems and nurses in recognizing and supporting the needs of people who are going through the oncology experience. When I pause to reflect on the stories and faces of the patients and their loved ones who have been such a meaningful part of my life, I am honored to be a nurse navigator, and I am inspired by a rewarding future with people I have yet to meet and stories I have yet to hear.