Nurse Navigator; A consultant and supporting friend for the cancer patients

August 02, 2019
 “Being diagnosed with cancer is a heavy and sinking experience for patients. It is our duty to provide something for them to hold onto and get above the water.”
K. Nattha Suktua (Mam), on the vital role of a Nurse Navigator at Bumrungrad Hospital’s
Horizon Cancer Center in Bangkok


     Challenging and heart-quenching situations are the words that describe a regular day for Nurse Navigator. Being a Nurse Navigator means to meet variety of cancer cases each day. With 13 years of experience in Nurse Navigator role, K. Mam was able to coordinate various department and deliver the best and encompassing treatment for patient – “When I wake up, I start my day by reinforcing myself that I will perform my best despite what hardship and complicated case may bring. I am happy every time that the patient receives fast and correct care. The result of the patient is what drives me every day.”

Nurse Navigator’s Main Role
     The role of Nurse Navigator like K. Mam may seem simple at first glance – general coordination work relies mostly on communication. In reality, it is one of Horizon Cancer Center’s most vital roles for providing holistic care. Patients, whose cases were delivered to Horizon Cancer Center, are in a state of depression and hopeless about their condition. They are being swelled with anxiety of uncertainty. K. Mam’s role is to take care of this: “More than 60% of cancer patients who had been diagnosed for cancer experience a ‘mental pain’ to some extent and are usually uncertain of how to approach next. When we take over the case, it is my duty to ensure that the patient receive the best care and attention physically and mentally.” K. Mam said. “In every case, we place importance in patient’s benefit first and foremost. The care that the patient receive must be holistic, encompassing care for the physical side, mental side, and spiritual side. Physically, we need to do our best in coordinating fast and clear, such as when a patient requires chemotherapy, we need to contact the department, or when a patient is unable to take certain food, we need to contact nutrition to ask for their advice and coordination. It is vital that we must identify which party to contact that will help provide the best, most effective, and quickest solution”.

     “Mental part is also no less important. For patients to recover, emotion and attitude are crucial. It is my role to create a good relationship and provide consultation to help patient feel relaxed and supported. Lastly, the spiritual side. This is also very important such as when patients are devout Muslim and partake in daily prayer each day. We need to respect their routine and understand each patient’s needs.”

Patient Management for Optimal Treatment
     Another important role of Nurse Navigator is the coordination between hospital’s internal departments and communicate with related foreign organizations. This includes coordination with participants of the Multidisciplinary Tumor Board that is held every Wednesday where doctor share their cases to help devise solutions. The Multidisciplinary Tumor Board team consists of almost 30 experts in various field such as Diagnostic Radiologists, Nurses, and others. In the case that requires biopsy from Lab Molecular in Singapore or USA, it is K. Mam responsibility to coordinate the key contacts at each organization to participate in the particular case meeting.

Team work and solving immediate problems
     “If I am asked which role is the most important in Horizon Cancer Center, my answer would be that every role is equally important. At Horizon, the patient comes first. Here, we work as a single team that seamlessly integrated. For example, there was a case where the patient is a foreigner. In such cases, we involve a translator to help in term of communication. When the assigned doctor looked at the film, we decided to contact the chemotherapist for further consultation right away. When chemotherapist came in, they agree that the patient required radiation treatment. So, we invited the radiologist to join in on the case immediately. Lastly, the case appeared to require the involvement of surgical doctor, we talked to the surgeon immediately right then and there. I think that this shows a very fast team work coordination which is very rare in regular hospital environment.”

Commitment and happiness in work even on holiday
     With her “Patient First” mind set, K. Mam believes that her work is a ‘One Stop Service’ even on holiday. She always cleared her schedule on holiday in case there was an emergency: “Oftentimes there were cases that was call-in for me to decide on my holiday. I was happy to facilitate and coordinate for those cases. There was one case where the patient was excreting and vomiting blood. The on-duty nurse evaluated the situation and saw that the symptoms were bad and decided to call me. I called the assigned doctor and facilitate the emergency room to prepare for immediate treatment as there is high risk of patient shocking and leading to death. The patient received immediate attention and was treated in time and recovered. This made me very happy to have contributed to the saving of patient’s life. Tiredness is not the matter when our effort yields good news.”

Attention to details is the key
     “Occasionally, some patients may opt for alternate medicine and other superstition method of treatment which are often done in private without the treatment team knowing. When we see the result, we can say with high level of certainty that the expected result from correct treatment should not look like the actual result outcome. Most of the time, patients would not say it directly and so it is very important to build a strong relationship with patients for their own sake. It is important that we are the most trusted by the patient to take care of their condition as they may reveal their hardship and obstacles they face. Sometimes, they take uncertified herb and other supplements which unwittingly decreased their white blood cell count and damage their liver. Some patients deliberately took cannabis oil without proper knowledge of consequence. However, once we get the full picture of the situation, the team can devise a proper solution for the patient”.

     “We believe that patients are a member of our family. When they became unwell, they will feel anxiety and will look for someone to depend on during the critical time. So, we must perform our duty to the best of our capability, coordinate with every related party for the most precise and timely treatment.” K. Mam said.

Work ethic that is the pillar for Nurse Navigator
     “Every day when I wake up, I think off a new day challenge. I look toward what case may present for our team to solve. At the end of the day, I review every event that happened and think of how things can be improved or done better. Honestly, if you ask me whether taking the role of Nurse Navigator is exhausting, I would not deny it, but when I look back and see how our team’s effort had improved patient’s condition and saving life in time, my exhaustion all disperse.”


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