Cancer's nature as a life-threatening disease means that compassion has to ride along with navigation. Robinson-Hawkins stresses that the navigators are not counselors, but they are there to recognize the signs that a patient may have a social or behavioral issue that could affect his or her outcome, and to connect that patient with a broader support team of social workers, chaplains, and psychologists. Robinson-Hawkins recalls a cancer patient who was about to be discharged, but started talking about suicide. With the intervention of a social worker, it was clear that the patient was not suicidal, but alone.
"The social worker figured out there's nobody there to help him along," she says. "So then we have all of these community resources that you can utilize. And you've just got to keep a closer eye on him because he is by himself." Another patient who had head and neck cancer was not responding well to treatment at another hospital and had become withered and lost his voice. One of the navigators was able to find a physician with a new course of treatment, and the therapists and nutritional counselors to help him recover, Robinson-Hawkins says. Navigators at their best can intervene to put patients in the right place, but the rest is up to the patient.
"It's very important for patients to understand that if they're not participatory in their care, it's not going to work," Robinson-Hawkins says. "We do all we can to make sure that they're involved. But while we can tell patients all day what to do, they've got to be willing to participate and be involved in it."
Too often the missing piece in service is hardest to measure: compassion. "There is no question that we don't get to have a bad day," McWhorter says. "Our staff cannot have a bad day, because these patients just received news that is the worst news they've ever received. So, no question, service has to be at the forefront of everything we do."
This article appears in the October 2012 issue of HealthLeaders magazine.