Role of the Oncology Nurse Navigator Throughout the Cancer Trajectory

Navigation in oncology has demonstrated benefits for people at risk for or diagnosed with cancer, such as shorter time to diagnosis and treatment, increased patient and caregiver knowledge, better adherence to care, and improved quality of life. In addition, benefits to healthcare institutions, such as cost reductions through reduced rates of emergency department visits and readmission and decreased outmigration of newly diagnosed patients, are being identified. The goal of navigation is to reduce cancer morbidity and mortality by eliminating barriers to timely access to cancer care, which may be financial, psychological, logistical, or related to communication or the healthcare delivery system. 

The Oncology Nursing Society ([ONS], 2017) defines an oncology nurse navigator (ONN) as “a professional RN with oncology-specific clinical knowledge who offers individualized assistance to patients, families, and caregivers to help overcome healthcare system barriers. Using the nursing process, an ONN provides education and resources to facilitate informed decision making and timely access to quality health and psychosocial care throughout all phases of the cancer continuum” (p. 4).

Effective navigation models use a variety of healthcare and non-healthcare (lay) personnel. ONNs provide added benefit because they are uniquely qualified to provide specific clinical support to patients and caregivers, such as holistic assessment, general and focused education, and decision-making support. ONNs have the skills and knowledge to coordinate quality, patient-centered care through effective leadership of the interprofessional cancer care team.

It is the position of ONS that 

•  Navigation services should begin with prevention and screening activities and facilitate care transitions through diagnosis, treatment, survivorship, and end-of-life care. 

•  The ONN should practice in accordance with the 2017 ONN Core Competencies as applicable to their practice. The core competencies of the ONN role include coordination of care, communication, education, and professional role.

•  The ONN role can be tailored to meet the needs of patients in each care environment but should fulfill the tenets of the ONS-defined competencies.

•  Nurses in ONN roles should possess strong oncology knowledge, as evidenced by certification through the Oncology Nursing Certification Corporation or other oncology nursing certification accredited by the National Commission for Certifying Agencies. 

•  The ONN advocates for adherence to evidence-based clinical practice guidelines and tools and participates in the collection and analysis of patient outcome data to optimize patient and organizational outcomes.

•  Determination of ONN workload and allocation of resources should be based upon data from reliable and valid metrics, including measures sensitive to the ONN contribution to the navigation process.

Approved by the ONS Board of Directors, March 2018