I’ve heard the fear in people’s voices as they wonder why someone from Macmillan Cancer Support is contacting them. When I make that first phone call they’ve asked: “Do you know something I don’t?”
In my role as a Macmillan cancer navigator, I work closely with the clinical nurse specialist team. I’m here as a familiar contact point for patients.
Starting any kind of treatment for cancer can feel frightening. There’s so much to take in, so many worries and questions. Will it be painful? What are the side effects? What are the chances of the treatment working?
I can get information and answers to questions from leaflets or books but our holistic approach to caring for an individual, seeing the human beyond the patient, makes the difference.
Whatever concerns patients have, they’re not trivial. Some patients simply don’t have the headspace to deal with other everyday issues that might be easily resolved if their mind wasn’t filled with thoughts of cancer.I can help getting the other stuff sorted and show patients they’re cared for and are being heard. This is personalised care.
Practical examples
One patient had COVID and couldn’t get out to collect his hearing aids. I phoned audiology and got them delivered to him. It didn’t take long to organise, but he was so thankful.
Another patient needed help with arranging accessible parking. I spoke to the relevant organisations and started the process for her.
I spoke to one patient who was receiving palliative care. I asked him if he minded me calling. “No,” he said. “I don’t talk to anyone else.” Obviously, I made sure I contacted him regularly from then on. So much is online now, it’s important to make that human contact.
Diane’s career journey
How it began
I’ve worked at Velindre Cancer Centre in Cardiff for 12 years and previously worked in the booking centre as a team leader. I wanted more patient contact, so I applied for the cancer navigator role.
A typical day
I spend the mornings calling patients asking them about their needs. I allow an hour to focus on each patient. Some calls can be over in five minutes, others take longer. It’s important to make that time available. My afternoons vary. They might involve supporting clinics, covering phones, ordering stock or documenting in clinical notes. This is important to ensure other team members know what we’ve done or talked about with the patient.
My responsibilities
I work with clinical nurse specialists and alongside my work with patients I continually evaluate the navigator service and have led on projects to improve the patient journey. I’ve developed a training plan for the navigator role, reviewed patient needs and developed a navigator steering group to continue networking and sharing best practice.
How the role has changed
Four of us attended a nationwide Macmillan Cancer Support conference which was an ideal opportunity to learn from shared experiences and network. On our return, we approached our line manager with a proposal that going forward we should concentrate on our allocated cancer sites. For me, this was gynaecology and colorectal. This focus ensured we could learn about specific treatments and side effects so we could be better informed to be able to support patients and this has allowed growth in our roles.
The best bit
Talking to people – finding out about their lives, their hobbies and making that personal connection.
The issues now
We absorb so much each day and you do get close to patients, but I have excellent supervision and opportunities to offload and share within my team. Self-care is especially important if you work in an isolated position. Buddying is something I encourage – we use an email network and we’re there for anybody. I’ve developed networks and links with other cancer navigators in GP surgeries and other hospitals.
Valuable work: reflecting on the role
"A cancer diagnosis is never easy to receive. It can feel overwhelming and can affect a person for the rest of their life," says Ofrah Muflahi, RCN UK Professional Lead, Nursing Support Workers.
"Diane and other Macmillan cancer care navigators work closely with the clinical nurse specialist teams and other clinicians to offer people living with cancer an opportunity to have additional one-to-one, personal conversations about what is important to them throughout their cancer treatment.
"Diane’s work is so valuable. Navigators will often signpost people living with cancer to the right information and support services based on their needs which include money worries or feelings of anxiety.
"Many people associate Macmillan Cancer Support with end-of-life care, but as the work of Diane demonstrates, the role of the cancer navigator involves being a point of contact for patients and their loved ones, offering support and guidance through their entire cancer experiences from diagnosis, through treatment, to living with and beyond cancer."
Further information
- Diane won the Health Care Support Worker Award in the RCN Wales Nurse of the Year Awards 2021. Find out more about the awards.
- Join the RCN Cancer and Breast Care Forum.
- Read the RCN subject guide on cancer care.
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- Read the RCN case study on moving into a cancer navigator role.
