Betty Price doesn”t remember much about that April morning at Baptist Memorial Hospital-Golden Triangle. She remembers the pain and the way she couldn”t stop crying. She remembers sitting next to her husband, Otis Price, and learning that her persistent cough was not pneumonia — it was lung cancer.
Most of all, she remembers how Oncology Nurse Navigator Amanda Mordecai wrapped her arms around her and held her until the sobs ceased.
“I went home, and I was at ease,” Price recalls, smiling. “I learned everything I know about cancer from Amanda.”
Mordecai is part of a growing trend: Registered nurses specially trained in cancer care and assigned the task of streamlining every aspect of a patient”s cancer experience, from diagnosis to treatment.
Nurse navigators “navigate” the sometimes confusing array of paperwork and prescriptions, appointments and options, helping patients make sense of it all. Thanks to a grant by Baptist Memorial Healthcare, Mordecai”s position was created in March. Baptist”s hospitals in Oxford and Memphis each have two nurse navigators.
The movement began in Harlem in 1990, when Dr. Harold P. Freeman noticed the difficulties poor and uninsured cancer patients had accessing treatment. Sometimes simple things like transportation caused patients to miss appointments. Other times, complex issues like poor reading skills, lack of health insurance or lack of family support undermined a patient”s journey.
In 2007, a $2.5 million grant created the Harold P. Freeman Patient Navigation Institute in New York. Today, officials at the Academy of Oncology Nurse Navigators, based in Monroe Township, N.J., estimates between 2,500 to 3,500 nurses have become nurse navigators.
”I”m just not afraid”
For Price, having a nurse navigator is a godsend. She admits that though Mordecai gave her some pamphlets, she didn”t read all of them. She read a few. And yet, every step of the way, she knows what to expect.
Five days a week, she undergoes radiation therapy. Once a week, she spends two and a half to three hours in chemotherapy. The tumor on her lung, which she says was “the size of a grapefruit,” is gone. The pain is gone. More importantly, the fear is gone. And though she lost 50 pounds over the past few months, her appetite is returning.
Every morning, Mordecai greets Price with a smile. It helps.
“I haven”t done much reading about it, I”m just not afraid,” Price says. “Amanda and the doctors … I figure they all know what they”re doing.”
When Price”s hair began falling out due to treatment, Mordecai worked with the American Cancer Society to get a stylish new wig for her. When Price”s daughter was unable to bring her to treatment due to work commitments, Mordecai arranged for free transportation. When she cries, Mordecai holds her. When her family has questions, Mordecai always answers the phone. It”s not a relationship of dependence; it”s a partnership of empowerment.
”She”s a miracle worker”
Mordecai wears many hats in her new role. She is, first and foremost, a nurse. But she is also a social worker, teacher, patient advocate and wrangler of insurance forms. She keeps track of side effects and symptoms. She makes sure drugs are taken and appointments are kept. She takes time to make sure Price — along with 30 other cancer patients — is OK.
Indeed, time may be the most precious thing Mordecai gives, especially in today”s fast-paced, complicated health care climate, says Sean T. Walsh, executive director of the Academy of Oncology Nurse Navigators.
A patient may see five different physicians, all handling different aspects of treatment. Staffs are sometimes short-handed, and while doctors try to answer every question, it helps to have one “point person” to make sure the patient doesn”t get lost in the process.
“In this day and age, with all that”s going on in the health care industry, there”s definitely a need for someone to … coordinate all those different things and make sure the patient moves through the health care system without hitting any barriers,” Walsh says. “It”s a key role that puts the patient first and makes the patient advocate someone embedded in the health care system.”
Likewise, Dr. Wail Alnas, who has been a medical oncologist at BMH-GT for seven years and has been in practice 14, says the addition of a nurse navigator to the staff is a good one, and the response has been “overwhelmingly positive.”
He tries to take as much time with patients as they need, but in the past, patients still forgot to show up for tests, or they had questions about other issues outside his usual parameters.
Though Mordecai can”t solve every problem — she doesn”t diagnose, treat, prescribe or advise patients on their course of treatment, for example — she serves as a connector, putting patients in touch with the resources they need, sometimes before they know they need them.
“It”s tremendous,” Alnas says. “It makes things work much smoother. The patient is happy, and the physician is much more productive.”
Price has a simpler explanation for the role Mordecai plays: “She”s a miracle worker.”
Sitting in the room where she was first told she had cancer, Price grins and envelops Mordecai in a spontaneous hug.
“I love you, Amanda,” she says.
“I love you too,” Mordecai responds, smiling. “It”s my job.”
Carmen K. Sisson is the former news editor at The Dispatch.
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