Smoothing and soothing the way

Nurse navigators coordinate care, translate complicated medical language and provide compassionate support.

Richard Crowers, a World War II veteran, a retired engineering consultant, a sports car enthusiast and an accomplished euphonium player, is so poised and polished that it’s hard to imagine that anything could stymie the 87-year-old human dynamo.

Not even a diagnosis of colorectal cancer — 20 years after being treated for prostate cancer — has slowed him down.

“I’m still greatly addicted to 80,” Crowers says of his love of driving fast.

And yet, Crowers readily admits that having a nurse navigator during his cancer treatment has been a godsend.

“It takes away from the dread that you might have if you’re battling cancer,” Crowers says of the nurse navigator program at Winship Cancer Institute. “All of a sudden, there is someone to make method out of madness.”

Engineers, of course, typically love method, but it’s hard to have much of it with the madness of a cancer diagnosis. Winship nurse navigators — registered nurses assigned specifically to newly diagnosed cancer patients to help coordinate medical care and provide psychosocial support — are angels and heroes to many. And, they are an example of how Winship is constantly striving to improve patient care.

“I am just so pleased with the idea of Winship establishing these positions. The system is good, and Bonnie is excellent,” Crowers says of nurse navigator Bonnie Josaphs, RN, BSN

Others apparently are equally pleased. In a survey of nurse navigator patient satisfaction conducted in March through April, two-thirds of patients said that Winship’s nurse navigator services influenced their decision to be treated at Winship Cancer Institute.

Winship’s first nurse navigator started in May, 2010. Heather Pinkerton, RN, BSN, OCN, was assigned specifically to navigate breast cancer patients, who make up the single largest population at Winship, through their treatment.

Winship leadership recognized that although new technology and advanced treatment options improve patient outcomes, they also make understanding and evaluating treatment options more confusing for patients. For example, new scanning technology gives a physician a much better picture of a patient’s particular case. But getting those scans and reports together in one place can be challenging. Nurse navigators make sure all scans, all lab reports and treatment notes are together. They then coordinate with other departments to schedule consultations, tests and procedures necessary for the patient’s first visit, explains Mary Potter, NP, who supervises the nurse navigators program.

“It’s the navigator coordinating all of that,” Potter explains.

The navigators often give patients their telephone numbers so that patients can call them any time with a question, things that may range from “what’s the difference between a radiation oncologist and a medical oncologist?” to “what are my chances?” to “how do I deal with this?”

Based on the great response of patients, Winship added more nurse navigators recently for lung cancer, gastrointestinal cancer and hematology cancers.

Pinkerton has navigated more than 185 patients since May, 2010, including one from Ivory Coast whom she helped guide through the astounding challenge of getting out of war-torn Ivory Coast, through Paris to pick up her tissue samples and then to Atlanta for treatment.

“We communicated through email, and I had everything arranged for her when she arrived,” Pinkerton explains.

Once patient Jeannette Danho Kakou arrived in Atlanta, Pinkerton’s work was not done. Pinkerton also smoothed out details – small but important – that were personally and compassionately as possible. Certainly patients have medical questions about their diagnosis, but they also have real-life issues.

“The patients just love the fact they can call me about anything,” says lung cancer nurse navigator Nancy McCormick, RN, BSN

“The idea is to really help facilitate services in a timely manner, trying to get them on a treatment plan as quickly as possible,” says Bonnie Josaphs, Crowers’ nurse navigator. “At the beginning, when they first get their diagnosis, part of the problem is in just not knowing what to expect.”

Another big problem can be not knowing what the doctor is saying. The specialized language of cancer is bewildering for newly diagnosed patients.

“Sometimes, someone will say ‘can you just go over that with me one more time?’” says Josaphs.

And she does, until she is sure that the patient understands his or her treatment plan.

Heather Pinkerton says that a key piece of the success of Winship’s nurse navigator program – and what distinguishes it from other navigator programs – is that the nurse navigator is an integral part of the treatment team.

“You’re getting real expertise when you get a navigator,” Pinkerton says. “I can present the patients’ concern to the provider and be the intermediary. It lets me be a patient advocate.” winship Magazine communicated with Jeannette Danho Kakou via email about her experiences at Winship Cancer Institute and the nurse navigator program. Following are Danho Kakou’s thoughts and feelings in her own words about her experience.

WM: How did you come to be treated at Winship Cancer Institute?

Danho Kakou: I was diagnosed for breast cancer in Paris after a check-up in October, 2010. got the results when I was on mission in Johannesburg. My colleagues and my cousin instantly recommended me to look for treatment in Winship Cancer Institute in Atlanta to increase my chance of healing.

WM: How did Heather Pinkerton help you?

Danho Kakou: My cousin who is living in Atlanta contacted the Winship Cancer Institute. He was fortunately directed to Heather Pinkerton, who made all arrangements for my appointments within the Emory Hospital in linkage with my insurance company. She also asked me to send to her all required documents. Her assistance and guidance were also helpful during my stay in the USA through all the process of treatment at Emory. I also benefited from counseling, knowledge and information sharing in management of breast cancer. crucial to Danho Kakou’s treatment. For example, while Pinkerton and Winship insurance specialists had pre-certified Danho Kakou’s insurance information, there was still a glitch. The insurance company had the wrong birthdate; birthdates are recorded differently in different countries. So the insurance company was unable to identify her.

WM: Do you think the nurse navigator program is important?

Danho Kakou: For my part, I feel very blessed. Meeting Heather Pinkerton on my way for healing is somewhat a blessing, as I was so far from USA and with no idea on how I could find my way to a best treatment. Moreover, the nurse navigator program is critical to ensure the linkages between the different units in Emory. Without a nurse navigator, one could feel very lost, especially when it is a foreigner.

WM: What are your feelings about Winship Cancer Institute? Are you happy you were treated here?

Danho Kakou: I sincerely think that Emory Winship Cancer is an excellent place for cancer treatment. People who are serving over there are so compassionate and very professional. was impressed by the fact that Winship Cancer Institute could provide comprehensive services in addressing breast cancer. The Institute ensures that each patient was treated with dignity in a holistic manner.

Indeed I was happy to be at Winship Cancer Institute. I met so many great and exceptional persons, and would like to thank each of them for their expertise, professionalism and kindness. God Bless Emory Winship Cancer Institute.

Pinkerton ironed out the wrinkles, and Danho Kakou was able to begin treatment on time.

That incident speaks to the complex issues that arise when a person is diagnosed with cancer and how Winship aims to meet those needs as expertly,

Pinkerton stays in touch with many of her former patients, whom she has been happy to turn over to the survivorship team at the end of their treatment. Many have given her gifts, which she treasures. Danho Kakou gave her an angel, saying that Heather reminded her of one.

Being the tough World War II vet that he is, Richard Crowers stops short of using the word “angel” to describe Bonnie Josaphs.

But he does have a word that he thinks fits her just fine.

“Perfect,” Crowers says. “She’s just perfect.”