You’re Never Alone When Facing Lung Cancer Thanks to Nurse Navigators

If you are at risk for lung cancer, have wisely received a computed tomography (CT) scan and the scan detected a suspicious lung nodule, it’s understandable you’d be nervous. You may feel confused and not sure what to do next. At Lehigh Valley Health Network (LVHN), we know this and have planned for it. 

“Patients with a suspicious CT scan or X-ray will meet with an interventional clinician first,” says Brian Civic, MD, Chief, Pulmonary Medicine. “If a biopsy is needed, our nurse navigators walk the patient through the steps to diagnosis.”

Amanda Velez, BSN, RN, and Jena Wolfe, RN, will set up the bronchoscopy appointment and answer any questions. If the patient hesitates or cancels the appointment, Velez and Wolfe will contact the patient and urge them to come in. “The last thing we want is for a patient to go without a workup for a year or so, and then come in with later stage cancer,” Dr. Civic says.

If there is a diagnosis of cancer, there is a “warm” introduction to nurse navigators Alyssa Pauls, BSN, RN, and Kristin Murphy, BSN, RN, who compassionately take the patient through the rest of the treatment plan. With direction from advanced practice clinician Andrea Dally, CRNP, MSN, who oversees the Lung Nodule Program, patients understand where they are in the process and what they need to do next.

Time is of the essence with suspicious lung nodules. So much so, LVHN has invested in an advanced robotic bronchoscopy system called Ion, allowing the team to biopsy a suspicious lung nodule and also determine the cancer stage at the same time, in the same procedure. Previously this required two separate procedures. This advancement saves time to diagnosis and stages the tumor right away, since the cancer stage is important in determining treatment. The urgency with lung nodules is also why the nurse navigator team is so efficient and proactive.

“We’re great at communicating with each other, and we expedite appointments for these patients,” Velez says. She and Wolfe do everything they can to speed up scheduling a positron emission tomography (PET) scan, which detects early signs of cancer, or another biopsy.

If a patient receives a diagnosis of cancer, Pauls and Murphy step in and make sure the patient is seen by the oncology team. “They will communicate with the proper departments, let them know what appointments they need and why – and even speak with the department manager if necessary – to get the patient seen sooner,” Velez says.

Velez adds that the team also accommodates patients according to where they live. “If a patient lives closer to Lehigh Valley Hospital–Pocono than LVH–Cedar Crest, we’ll get on the phone and see how fast we can schedule them at their most convenient location,” she says.

According to the American Cancer Society, smoking is by far the leading risk factor for lung cancer with about 80 percent of lung cancer deaths attributed to it. For that reason, and to familiarize people with CT scans of the lungs, the pulmonary nurse navigators do a lot of community outreach.

It starts with coordinating with primary care clinicians to spread the word about screenings. The nurse navigators also set up educational tables at malls, senior centers and festivals. “We talk with people about what the screening is and what it’s like to get one,” Velez says. “We also help people understand that it’s best to stop smoking, because if they continue, their lung health will progressively get worse.”

“The nurse navigator team is active across the whole spectrum of interventional pulmonology,” says Dr. Civic. “They provide a point of contact for patients on questions or concerns, they work to ensure seamless care through the entire process of diagnosis and treatment, and they help educate the community. They’re invaluable.”