Livia Vargas is an Oncology Nurse Navigator at San Antonio Regional Hospital’s Women’s Breast & Imaging Center in Upland, California. She is passionate about improving patient access to care, as well as supporting her patients emotionally and through education. For Livia, giving back through her work as a nurse navigator is an incredible privilege.
“Just by listening, you’re giving that patient so much you don’t even realize,” said Livia. “Providing support is the ultimate gift. Being a successful navigator and the go-to person for patients is incredibly rewarding because they’re choosing to come back to you for support time and time again.”
As a nurse navigator, Livia guides and directs patients across the continuum of care, serving as a liaison between the patient and her physician with the understanding that a cancer diagnosis can be frightening and distressing. She offers emotional support and education about the disease process and treatment plan. “As best I can, I help bridge the gap between informational and supportive needs,” said Livia. She is a resource, educator, and supporter for any questions or concerns patients may have.
Livia also navigates women in the Women Caring for Women (WCW) program, designed to provide free diagnostic services for uninsured and underinsured women who are under 40. She helps identify barriers to the services needed, such as financial and language barriers as well as healthcare illiteracy.
The Center where Livia works has a soothing and supportive environment, where patients find both comfort and confidence. The atmosphere helps patients relax while waiting for appointments and procedures. “It’s a very beautiful facility that was created for women by women. In fact, most women say that they do not feel like they’re waiting to have a mammogram.”
We spoke to Livia about the importance of early access to care and tips for patients and their caregivers as they prepare for each step of treatment.
Why is early intervention and timely access to healthcare services of special interest to your work with breast cancer?
Early intervention and timely access to health care services is more than an interest, it is a necessity for quality breast cancer care. Navigators can assist patients with identifying barriers to healthcare that may place them at risk of “falling through the cracks.” Making sure that patients have been scheduled in a timely manner for their initial consultations with their oncology team is paramount. I help facilitate the connection between the patient and their health care provider by scheduling appointments and arranging for the transfer of records, to improve the flow and timeliness of care.
Education is an important intervention that I provide to our lovely women. After a woman is told that she has breast cancer she always wants to know what is next – what can I expect? Providing that one-on-one education is a perfect opportunity to educate her on disease-specific information, potential treatment options, what to expect from the surgical consultation as well as self-care and coping.
Navigating the complexity of the health care system for some patients can be overwhelming. I understand that patients may fail to comply with the treatment plan or to understand the need for self-advocacy to expedite care when there is malignant diagnosis. Early interventions and timely access to health care services overall improves outcomes and survival.
How do you work with women who are newly diagnosed with breast cancer?
When a woman is told she has breast cancer, there are so many emotions going through her such as disbelief, fear, and sometimes anger. Although these feelings are normal, initially it can make it more difficult for her to absorb and understand all of the information that is provided to her.
The patient and her family are provided with emotional support, anticipatory guidance, coping strategies, potential treatment plan and reassurance that the Navigator will remain available to her throughout her journey.
The educational intervention we provide has been well received. Surgeons in the area have mentioned to me that they notice when a patient has visited with me first because they are more prepared for their consultation and most of their basic questions have been answered (for example, the difference between an oncologist and a surgeon). Meeting with patients beforehand enables them to make the most out of their initial consultations.
As a navigator, I can be a lifeline for women facing breast cancer and a safety net for her loved ones. My overall goal is to promote patient preparedness, ongoing support and guidance throughout their cancer continuum.
What advice do you have for a patient’s loved ones to help make sure newly diagnosed women are feeling supported through their experience with breast cancer?
- Lend a Hand With Research, Resources & Communication: Patients have a lot on their minds, and others can take on some of the work of researching more information about options and treatment, or take on the role of updating others on a patient’s status. Caregivers should educate themselves about the diagnosis by going to research-based and evidence-based organizations. If the patient has not been connected with a nurse navigator, making this connection can be a helpful step.
- Accompany the Patient to Appointments: If they can help it, patients should not go on visits to the doctor alone. They should have a reliable family member, friend or navigator with them. A great way for those accompanying patients to help is by assisting with preparing a list of questions or taking notes throughout the appointment.
- Suggest Support Groups: The best thing that friends or family members can do is listen and gently guide patients to resources such as support groups where they can be connected with others who are facing a similar experience. For many, support groups are the place where feelings can truly be confronted, acknowledged, validated, and affirmed.
- Avoid “Cheerleader” Statements: Patients want to be listened to, without judgment. Avoid “cheerleader” statements such as, “Don’t worry, you’ll be fine” or, “You’ve been through worse.”
- Avoid Personal Anecdotes and Unsolicited Advice: Often times people feel as though they are being supportive by sharing “things they’ve heard” about a disease when they have not been personally affected by it, and it usually is not very helpful. Avoid discussing negative outcomes of other breast cancer patients, which can be very distressing, especially to newly diagnosed patients.
- Don’t Overwhelm the Patient With Questions: Keep in mind that newly diagnosed women do not always have enough information to answer all the questions that may come up from family members and friends. While people are often trying to show support by asking questions or offering opinions, it can often overwhelm the patient and cause more stress.
To learn more about patient navigation, check out the rest of our Heroes in Pink!