Jean Sellers, RN, MSN
The Oncology Nursing Society (ONS) has issued a new position statement on oncology nurse navigation roles and qualifications that emphasizes not only the important role played by navigation in cancer care, but also that when it comes to coordinating care for patients with cancer, a nurse with oncology certification needs to play a central role in the process.
The statement comes at a time when navigation is receiving much attention, following on the American College of Surgeons Commission on Cancer’s (CoC) Standard 3.1 that all facilities seeking CoC accreditation have a patient navigation process in place by January 1, 2015; however, the CoC standard does not stipulate that an oncology nurse be part of that process. There is also a sense that patients need navigation now more than ever, as cancer treatment becomes more complex and costly.
Jean Sellers, RN, MSN, said that ONS decided to update its original 2009 position statement on navigation, in part, because there is still some confusion over the difference between oncology nursing certification and certificates issued for non-oncology–trained patient, lay, or community navigators. Sellers serves as clinical administrative director at the Lineberger Comprehensive Cancer Center Network in Chapel Hill, North Carolina, and is the coordinator for the ONS Nurse Navigator Special Interest Group (SIG), comprised of more than 2000 oncology nurses, and whose 17-member executive board developed the position statement approved by the ONS Board of Directors June 23, 2015.1
There is room for all of these roles, Sellers emphasized, but “the role of certification for the oncology-certified nurse is completely different from some of the certificate programs that are coming up. Our position is that the minimum certification nurses should have—if they are going to be in the role of the oncology nurse navigator—is certification through one of the National Commission for Certifying Agencies.” The position statement explains that these are “accredited certifications offered by the Oncology Nursing Certification Corporation—minimally, Oncology Certified Nurse (OCN).”
“If you look at the components of what is taught through the training that you get through the Oncology Nurse Certification, it really does speak to all of the skills that are necessary as a nurse when you’re caring for someone with cancer,” said Sellers. She added that if individuals are navigating in the oncology setting who are not nurses, oncology-certified nurses should be there at the table working with them.
Sellers stressed that when it comes to patient navigation, there is more than enough work for everyone, and “we all need to work together.” She praised certificate programs for patient navigators, such as that offered by the Harold P. Freeman Patient Navigation Institute. Sellers said that individuals who successfully complete a program like this one acquire essential knowledge to perform their role:
“That’s very, very important. If you’re going out caring for these patients, regardless of whether you are a nurse or non-nurse, you need to have additional education.”
Patient navigation also was the topic of a recent article in the Washington Post2
noting that research on the benefits of navigation is inconclusive and lacking in evidence of cost-effectiveness.
The ONS position statement acknowledges the limitations in current research on navigation, attributing them in part to the “absence of standardized navigation roles, job descriptions, and processes.”
Nevertheless, said Sellers, “We know navigation makes a difference … that is, overcoming barriers to care, whatever they might be.”
ONS has resources to assist oncology nurses—not only in performing their role as navigators, but also in defining it for hospitals and other institutions where they work ,many of which, Sellers and her SIG colleagues have found, still don’t fully understand what the role entails. These resources include a set of Core Competencies
for oncology nurse navigators, an e-book
, and a navigation toolkit.
1. Oncology Nursing Society. Oncology Nurse Navigation Role and Qualifications position statement. June 23, 2015. https://www.ons.org/advocacy-policy/positions/education/onn
2. Bernstein L. ‘Navigators’ for cancer patients: a nice perk or something more?” The Washington Post. July 3, 2015. http://wapo.st/1CjNQZo