Research Medical Center
April 15, 2014

Carolyn Tessler, RN OCN

by Carolyn Tessler | Reprinted courtesy of KC Nursing News

Some days I refer to myself as a human GPS.

As a registered nurse and breast navigator with specialized training in breast health and breast cancer, I am able to offer my patients the one-on-one time they need during the extremely stressful time of diagnosis and treatment.

It’s a privilege, as a point of contact and patient advocate, to help ensure my patients receive quality care with the least amount of delay from an abnormal finding to start of care and through survivorship.

Breast navigation has become an important part of a woman’s breast cancer journey and for very good reason.

Barriers to patient care can surface at any time requiring immediate attention. Patient needs vary—from lodging and transportation needs to translator services and psychosocial support. In addition, referrals may be needed to community agencies such as the American Cancer Society, Cancer Action and Gilda’s Club Kansas City, among others.

If a lump or abnormality is detected through breast self-exam, by a medical professional or at the time of a woman’s mammogram, the nurse navigator is the link. Abnormal mammograms with a BI-RAD of 4 or 5 result are sent to me daily. The patient’s physician is notified of the abnormal findings and recommendations. An order is obtained for a biopsy. Contact is made with the patient. Individualized, specific screening, education and instructions are discussed with the patient regarding her plan of care. The biopsy is scheduled.

On the day of the biopsy, I meet the patient and follow up with a phone call the next day. Pathology results are relayed to the physician as soon as it becomes available.

Patients can be referred to breast navigators at any point during their care where extra time and attention is required. I call this the point of entry. Any healthcare provider can refer a patient for breast navigation.

If pathology is malignant, the nurse navigator—under the direction of the physician— coordinates the referrals to specialists that may include a medical oncologist, radiation oncologist, surgeon, certified genetic counselor, plastic surgeon and in some cases, a lymphedema specialist. The burden of scheduling these visits is removed from the patient and her family—which is priceless.

At Midwest Cancer Care, which is part of HCA Midwest Health System, we recognize the need for high-risk breast cancer screening. Patients now complete a brief questionnaire regarding their breast risk factors. If the patient is at high risk and wants to proceed with screening, an appointment is made to see a medical oncologist and genetic counselor.

Oncology Breast Navigators at Midwest Cancer Care provide a vital role in coordination of the multidisciplinary, breast tumor board conference comprised of medical oncologists, radiation oncologists, plastic surgeons, pathologist, radiologist, certified genetic counselor, nurse practitioner, nurse navigator and lymphedema specialist. Shared decision-making allows the patient, when possible, to make informed choices in the treatment of her breast cancer and breast cancer treatment.

Midwest Cancer Care recognizes and supports the need for oncology breast nurse navigators.

Breast navigation is provided at all HCA Midwest Health System hospitals in the Kansas City metropolitan area: Research Medical Center, Menorah Medical Center, Belton Regional Medical Center, Overland Park Regional Medical Center, Lee’s Summit Medical Center and Centerpoint Medical Center.

Oncology breast navigation allows me to work with a dedicated group of physicians, and fantastic patients and gives the feeling at the end of the day that I made a difference in someone’s life.

To me, that is priceless.

Photo by Arley Hoskin/Nursing News Photo