Nurse navigator: The person you need in your corner during breast cancer treatment

November 16, 2018 Providence Health Team

Oncology nurse navigators walk with patients through their cancer treatment.

Nurse navigators can answer questions and provide a wealth of resources.

They serve patients with a variety of cancers, including breast cancer.

A breast cancer diagnosis means you’re entering a whole new world with a lot of unknowns and a lot of questions. How will treatment affect you? How will your body change? What kind of effect will it have on your career and relationships with your loved ones? Nurse navigators can help you find the answers. As the job title implies, their role is to guide you and walk with you through this challenging time.

“When patients hear the word ‘cancer,’ they can feel scared and overwhelmed with the amount of information that is coming their way. My job is to ease that process from diagnosis to survivorship,” says Gassia Dabbaghian, an oncology nurse navigator for breast cancer at Providence Saint Joseph Medical Center in Burbank, CA. “I am available to them from the onset of the breast cancer diagnosis to provide education, resources and support.”

Dabbaghian is one of three oncology nurse navigators at Providence Saint Joseph Medical Center. They serve patients with lung, head and neck, colorectal and gynecological cancers in addition to breast cancer. All patients get individualized care, according to their tumor site and their particular needs. “We try to break down any barriers a patient may have,” she says.

For instance, a breast cancer patient who will be having surgery is referred to physical therapy for a lymphedema rehabilitation evaluation. She will receive a pre-surgical arm measurement, as well as symptom and risk reduction education.

That’s just one of the many services Dabbaghian provides to her patients, whom she likes to meet with in person or talk over the phone, whether it’s after a biopsy or when they come in for surgery. Topics can include the patient’s medical team and questions about resources offered at the Roy and Patricia Disney Family Cancer Center and in the community.

“We discuss specific needs such as genetic counseling, integrative medicine, nutrition, lymphedema management with our specialized physical therapist, and psychosocial support services,” Dabbaghian says. “We can help with financial needs and fertility concerns, and if they are interested in any clinical research we have that here. Our integrative medicine department itself has a lot of resources such as acupressure, acupuncture and tai chi, and we have an excellent exercise center where they do yoga for cancer every week. We also work closely with the American Cancer Society, which provides services at our center, including free manicures, pedicures and wig fittings. We know that our patients are more than their diagnosis so we make sure to give them everything they might need and are looking for.”

Patients can meet with their nurse navigator as often or as infrequently as they wish. Some patients are independent, while others may need more guidance and support. Typically, nurse navigators work with patients until their course of treatment is complete, usually about six months to a year, Dabbaghian says. “We are very fortunate to have our set of nurse navigators. When we have a patient come in our office, shut the door and start crying and say they’re scared and don’t know where to start, we’re easing that way for them.”

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Living Well Through Cancer Treatment and Beyond

When they’re not working with patients or coming up with resources for them, nurse navigators stay busy with other job duties. They prepare survivorship care plans, which summarize all of a patient’s cancer treatment so the information is available in one packet to share with their primary care physician. Nurse navigators also perform community outreach by attending health fairs and talking about early detection, cancer screening and prevention, and the free health classes like those at Providence Saint Joseph Medical Center that are open to the public.

Given their wide-ranging responsibilities, it’s no surprise that Dabbaghian says the nurse navigator role is very complex. Ideally, nurse navigators should have a strong background in oncology — Dabbaghian herself worked in oncology since 2000 before taking on her current position at the beginning of 2018 — as well as certification through the Oncology Nursing Society. “We also need to have excellent communication skills, organizational skills and critical thinking,” she says. “We have to collaborate with other disciplines, both internally and outside in the community. We have to make phone calls to other physicians, run tumor boards and have a good working knowledge of insurance and available resources so we can meet patients’ needs. We have to do all that with compassion — we have to have empathy to work with patients who are going through some difficult times.”

It’s that one-on-one work with the patients that is a job highlight, Dabbaghian says. “I would say that the most inspiring part of the job is the strength and resilience the patients have. One patient told me breast cancer was just an inconvenience. She went about her daily business and said, ‘I’m going to get through this.’ Most of our diagnosed cases are successfully treated if they are detected early, and we have a brand-new 3-D mammogram machine that has helped us increase our early detection by 41 percent.”

“I like to make sure patients stay in a positive mindset. I would say that it’s important to participate in your care and be involved in decision making and ask questions, but it’s also very important to keep a positive attitude,” Dabbaghian adds.  

For more information on the Nurse Navigator program at Providence Saint Joseph Medical Center, click here.

If you have questions about cancer or women’s health issues, find a health care provider in our physician directory.

CA: Roy and Patricia Disney Family Cancer Center; Providence Holy Cross Cancer ServicesJohn Wayne Cancer Institute; St. Jude Crosson Cancer Institute

OR: Providence Cancer Institute

WA: Providence Regional Cancer System; Providence Regional Cancer Center - Spokane; Swedish Cancer Institute; Kadlec Oncology Program; Pacific Medical Centers

MT: Montana Cancer Center at Providence St. Patrick Hospital and Providence St. Joseph Medical Center

AK: Providence Cancer Center

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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.

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