The COVID-19 pandemic has rapidly forced people from all over the world and all walks of life to change how they interact—no more hugs; no more handshakes; no more life as we knew it—at least for now.
As individuals were told to work from home, healthcare took a turn toward telehealth and stay-at-home orders swept the country, patients with cancer, as well as their providers and caregivers, had to quickly adapt to the “new normal.” At the AONN+ 2020 Midyear Conference, Sharon Gentry, MSN, RN, HON-ONN-CG, AOCN, CBCN, provided this year’s virtual attendees with the knowledge to empower those around them in the post-COVID era, while also alleviating fear of uncertainty.
“Your patients need care now more than ever,” said Ms Gentry, AONN+ Program Director. “But navigators are flexible. It’s one of your strengths; it’s one of your skills.”
Patients with cancer are at high risk of contracting COVID-19; as a result, cancer centers have shifted their efforts to caring only for the people in urgent need of care to prevent unnecessary exposure to the virus. As the cancer landscape began to shift, navigators began to take on additional responsibilities. According to Ms Gentry, talking with navigators around the country about these added roles revealed some key themes: they reported dispelling myths and rumors associated with COVID-19, a “skyrocketing” in the amount of education and care coordination required as patients and family members continue to reach out with questions in regard to delays, changes, and cancellations of cancer care, as well as constant requests for COVID-19 screening.
Many navigators have stepped into nursing roles in addition to their navigation roles to free up their oncology colleagues to go where they’re most needed. Many are operating in extreme work environments, simultaneously collaborating with teammates working from home on alternating schedules, all the while having to navigate the new technological landscape required to connect with patients and colleagues. Meanwhile, no matter where they’re working, many have had to worry about nonvoluntary furlough or reassignment.
Hundreds of clinical trials were halted due to constraints on the healthcare system, the only exceptions being certain studies involving patients with life-threatening conditions who had few or no other therapeutic options. According to Ms Gentry, many navigators were tasked with deciding if the extra visits required for their patients’ participation in a clinical trial were worth the risk of contracting COVID-19. In addition, many centers no longer had the staff available to run clinical trials, and navigators had to break the news to their patients.
“Navigators have been a calming voice for patients as they reschedule nonurgent follow-up visits,” she said. “This has been a reassuring voice to a population that needs connectivity to care.”
As always, navigators have been working to break down barriers to care during this time, working on critical issues like expanding eligibility for paid family medical leave and removing the arbitrary time limit of 2 weeks on paid leave, as well as addressing logistical issues like getting food delivered to patients unable to shop for their own, and arranging for prescriptions to arrive by mail.
Navigators have also had to deal with their patients’ fears while confronting their own. According to Ms Gentry, it’s important to acknowledge and confront those fears rather than trying to ignore them. Support from colleagues; online support groups; Zoom “happy hours” with friends and family; and remembering to unplug and take time for self-care by prioritizing sleep, movement, and mindfulness have all become invaluable resources during this time of uncertainty and high anxiety. The AONN+ COVID-19 Toolkit has been added to their website and is continuously updated with new resources to empower navigators (https://aonnonline.org/education/navigation-tools/covid-19).
“As we take a proactive look at the future, we can only imagine what it’s going to look like,” said Ms Gentry. She cautions navigators to be ready for an influx of new patients who delayed screenings due to the pandemic, increased hours as patients return to clinics and care sites, and heightened surveillance to monitor public outbreaks in the future.
“You’re taking more time than ever with your patients. You’re settling their fears because you know how to overcome fear yourselves, and you’re still navigating them to the right person to talk to,” she said. “You are fearless navigators going forward to work in these unchartered waters, and you’re doing all you can.”