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Nurse Navigator


Mapping out care is critical for improving cancer outcomes.


When faced with a cancer diagnosis, Danielle McCullogh, RN, BSN, is the immediate help every patient needs. As the new nurse navigator at the Cancer Center at Touro, she’s one of the first appointments physicians recommend after the disease is discovered.

What is a nurse navigator?

A translator — putting complex medical information into a language patients can understand and use to make decisions.
A teacher — educating patients about the specifics of their disease, treatment options, side effects and management.
A GPS system — marking the map for directions to follow and potential barriers along the way.
An influencer — relieving stress and improving outcomes.

According to McCullogh, a nurse navigator can also: address issues like transportation, finances, housing, childcare, prescription costs and more; remove the complications of scheduling appointments, diagnostic testing and various procedures; and suggest clinical resources such as where to seek a second opinion and how to access reliable sources.

“The healthcare system can be confusing and complicated,” McCullogh says. “It can be a recipe for patients not following through on treatments. Some patients don’t have the resources or support to handle it on their own. A nurse navigator can make the system a little less complex and overwhelming.”

What is a typical nurse navigator experience?

Each individual has a variety of needs and various levels of concern, so there is no true protocol, McCullogh says. She shifts often to facilitate anything from physician and lab appointments to radiation and chemo infusion times to physical therapy and home medication schedules.

Transportation can often be an issue for the elderly, those on a fixed income and patients with no family nearby to help, so McCullogh researches what insurance will cover and contacts other resources — like the American Cancer Society’s Road to Recovery transportation fund.

“Not all patients need a ton of help; some have a good support system … some just need a friendly smile,” she says.

What are the qualities of a good nurse navigator?

McCullogh says the best nurse navigator is compassionate and masterful at multitasking.

“You have to stay organized, dealing with so many different patients and their different needs,” she says. “It’s usually easier to remember them by remembering their story. I try to connect with each patient; build a relationship so they trust me enough to let me help them.”

The former ICU nurse says experience also goes a long way.

“It’s good to work on the floors first and get the experience,” McCullogh says. “You learn a lot of critical thinking skills and see some of the things patients go through on that end. No matter where you come from, you bring something different to the table.”

Who benefits?

A nurse navigator can help empower patients to assume as much responsibility for their care as possible. Families and caregivers benefit too, as do cancer center staff.

“I’ve gotten great support from our staff at Touro, and compliments on how they’ve been able to focus more on delivering patient care,” McCullogh says. “When a person knows they aren’t alone, that they have a whole team of people here to support and care for them as if they are our own family, their diagnosis becomes a little less scary and they are more likely to trust and receive the treatment they need.”
What is the future of nurse navigation?

Oncology isn’t alone in the use of nurse navigators, McCullogh says. Navigation is spreading into other chronic disease areas as well. There is even a new oncology nurse navigator certification available, which McCullogh is working toward. As long as the complexities of healthcare remain, the demand for nurse navigators will likely only increase, she says.
How do program challenges lead to success stories?

McCullogh says every cancer program faces a unique set of barriers depending on the community they serve. But in overcoming these issues, she is able to intervene on behalf of patients and Touro, procuring treatments they wouldn’t have been able to have otherwise.

She knows she’s been helpful when her most overwhelmed or fearful patients finally crack a smile.

“I actually get that a lot,” she says. “I love this job. It’s been amazing. I get to help people all day with no strings attached. You don’t get to do that a lot in life.” touro.com/cancer

The History of Patient Navigation

In the 1980s, noted cancer surgeon Dr. Harold P. Freeman observed that poor and minority patients with advanced stage breast cancer were more likely to die from their disease. He tied this finding to low financial resources, transportation issues and sometimes language barriers.

Working with community lay providers to encourage early mammography screening and step-by-step assistance after diagnosis, Freeman recorded an incredible increase in patients’ five-year survival rates — from 39 percent to 70 percent. (Oncology Issues, 1989)