Clinicians have an implicit—if not explicit—obligation to advocate for their patients. However, as health care’s complexity increases, independent advocates can help patients navigate systematic challenges throughout the continuum. Independent advocates follow the patient, not the reimbursement constraints, a chief distinction between us and clinical, facility, or agency case managers.

Patients with cancer, especially those from underrepresented groups or who are experiencing racism, inequalities, social determinants of health factors, and other barriers to care, need oncology nurse navigation now more than ever before. Developed as a “strategy to improve outcomes in marginalized populations by eliminating barriers to timely diagnosis and treatment of cancer and other chronic diseases,” navigation has made a difference for patients since its introduction in 1990.

Where there’s cancer, there are oncology nurses. It’s been that way even before 1971, when President Richard Nixon established and signed into law the National Cancer Act to fight the “war on cancer,” which had just become the second leading cause of death in the United States. Born from the act, the National Cancer Institute (NCI) celebrates its 50th anniversary in 2021. As part of the celebration, it named three oncology nurses and ONS members on its champions and changemakers list—Betty Ferrell, PhD, FAAN, FPCN, CHPN, Deborah Watkins Bruner, RN, PhD, FAAN, and Christine Miaskowski, RN, PhD, FAAN—in recognition of their contributions to cancer prevention, early detection, and symptom science.

My role as a nurse navigator, for both patients with cancer and in the neuroscience arena, is the culmination of a 40-year career in oncology nursing. I got my start in nurse navigation 11 years ago. At the time I was working in Hoag’s brain tumor program and noticed that those patients had needs that we weren’t meeting. So, I shared my concern with the program directors and today Hoag continues to develop its brain tumor navigator role.

In February 2019, my colleagues and I published a retrospective analysis of patient-reported satisfaction comparing those who had contact with an oncology nurse navigator (ONN) and those who did not. We analyzed surveys from patients with outpatient oncology infusion or radiation oncology visits in a 24-month period. First, we sorted the surveys into two groups—self-reported ONN contact (n = 315) and self-reported no contact with an ONN (n = 172)—and compared satisfaction.

In the 30 years since its inception in 1990, oncology nurse navigation has continually evolved and grown in response to patient and healthcare needs.

As early detection, treatment modalities, and symptom management advance in oncology care, we are seeing an increase in the number of adult and childhood cancer survivors. Added to the unique challenges of comorbid conditions in an aging population, oncology nurses have a lot to juggle in the spectrum of patient care. The relatively new role of the oncology nurse navigator was developed to enhance care coordination in patients with cancer.

The preliminary outcomes for performance in the first year of the Oncology Care Model (OCM) have shown modest but interesting results for the value-based payment model. Centers for Medicare and Medicaid Services’ year-one evaluation examined the initial impact of the new payment model on practice in terms of outcomes related to total cost of care per practice, unplanned hospital and emergency department visits, hospital visits, and patient-reported satisfaction with care for six-month episodes of chemotherapy for beneficiaries from July 1, 2016–June 30, 2017.

Professional development needs of oncology nurse navigators (ONNs) have not been clearly identified, both for novice and more experienced navigators. Although some work has begun to define training for novice ONNs, most information about education for experienced ONNs comes from evaluation data and anecdotal reports.    

Nurses should initiate financial conversations with patients early and offer resources to improve access to cancer care, speakers at the ONS Center for Advocacy and Health Policy’s third annual policy summit on November 13, 2018, concluded. The event, held at the Hyatt Regency Hotel on Capitol Hill in Washington, DC, brought together nurses and industry and government experts to address the issue of financial toxicity in today’s cancer care.

As a continuation of the National Cancer Moonshot legacy, the Biden Cancer Initiative (BCI) announced its inaugural roster of FIERCE Award recipients, naming 10 transformative healthcare professionals and institutions who have driven change and positively impacted the lives of their patients with cancer. For her work as an oncology nurse navigator and her accomplishments in patient navigation, ONS member Cynthia Cantril, RN, OCN^®, CBCN^®, MPH, was named one of the BCI’s FIERCE Award recipients at the Biden Cancer Summit Welcome Reception in Washington, DC, on September 20, 2018.

Although care coordination and interdisciplinary collaboration are essential components of every oncology nurse’s role, oncology nurse navigators (ONNs) take that work even farther by helping patients and caregivers navigate a complex healthcare system and access much-needed resources. By ONS’s definition, ONNs are key in meeting patient and caregiver needs while providing evidence-based, cost-effective, and quality cancer care by eliminating barriers to timely care.

Oncology nurse navigators (ONNs) fill a critical, ever-growing role in cancer care settings across the country, providing patients with the resources, education, and care coordination they need to successfully navigate their cancer journey. By reducing barriers and burdens on patients and their caregivers, ONNs help lead patients from initial diagnosis, during treatment, into survivorship, and often through end-of-life care. 

Even for medical professionals working in health care every day, the U.S. healthcare system can be incredibly complex. Understanding where to obtain information and how to connect patients to resources can be difficult. For patients, navigating their treatment journey can be—at times—downright impossible. Coordinating care for patients with cancer is a crucial component to successful outcomes and quality cancer care.

When I worked in the clinical setting, like many of you, I guided patients through treatments, prepared them for managing their care at home, celebrated the completion of treatment, and grieved the deaths of many. I coordinated patients’ care. 

Well-coordinated care by knowledgeable healthcare providers improves patient-centered care, supports shared decision making, reduces fragmentation of care, and decreases readmissions and emergency room visits. However, patients with complex care needs are often lost in the very systems designed to support them.

The nursing profession has long been an incubator of innovation. Nurses are continually blazing new trails in clinical care, research, and administration, and the landscape is no different in the specialty of oncology. This article provides an overview of three non-traditional roles in oncology nursing: nurse navigation, nursing informatics, and research nursing.

As Oncology Nursing Month, May saw celebrations at the ONS 42nd Annual Congress and in our workplaces. Nurses on ONS staff enjoyed recognition and celebration of their commitment to our mission and you. They partner closely with members who volunteer their time and expertise in developing initiatives and priorities for ONS. I would like to describe a few of those initiatives and work groups that have met at the national office in the first six months of 2017.

Based on the results of the oncology nurse navigator (ONN) role delineation survey and feedback from ONS membership, ONS evaluated and updated its ONN Core Competencies. Several significant changes were made.