'Without them we'd be lost': The vital role of Nurse Navigators

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Patient Romona Sands with Nurse Navigator Margie Allen.

Patient Romona Sands with Nurse Navigator Margie Allen.

Three years ago, struggling with ill health, Yarrabah resident Romona Sands said she no longer wanted to live.

‘I was in too much pain and spent too much time in and out of hospital,’ the Kuku Yalanji woman said.

At the time, Romona moved to Cairns with husband Vincent to better access health services.

But it was not an easy road and she faced multiple barriers, such as limited transport and difficulty navigating and understanding the health system.

A regular to Cairns Hospital with three or more chronic conditions, together with multiple ED presentations and admissions resulted in Romona eventually being referred to the Nurse Navigation service in 2019.

And that’s where things have turned around.

‘I didn’t have an understanding of what the doctors were saying to me,’ Romona said. ‘There were a lot of appointments I would miss because I would forget and with the nurse navigators they were there to help me with that. To make sure I had transport, that I would get to the doctors. They wouldn’t push things on me, they would suggest things.

‘I think for a lot of Indigenous patients, if we didn’t have nurse navigators we’d be lost.’

The Nurse Navigator program began in 2018 with eight nurses dedicated to specifically work with Aboriginal and Torres Strait Islander patients. As the title suggests, these specialists help patients to ‘navigate’ the health system, link patients with services and educate them about the importance of medication and health checks. The navigators are a vital conduit between the health service and the patient, also helping them to understand their health issues and a medical professional’s recommendations for treatment. The service has since opened to the wider community, but the majority of clients remain First Peoples.

Romona was paired with Nurse Navigator Margie Allen in 2019 and the two have since formed a close relationship.

‘Margie and I have become really good friends over the years,’ Romona said. ‘I would say ‘Margie what are they saying’. She would explain what medication they are going to put me on. They are lovely doctors, but they talk in their own lingo. Margie would break it down so I could understand.

‘Margie explained what dialysis is. I had no idea what it does for me or what it can do for my health.

‘Because I was so ill, I just couldn’t be bothered with my health, but it’s improved every day. I am not going to hospital on the regular basis that I used to. When I do go to hospital, Margie is there.’

Describing the nurse navigator role as ‘much more than a job’, Margie said a Nurse Navigator takes a holistic, patient-centred approach to care.

‘She gets the information in a way she can understand, then she makes the decision on what she wants to do,’ Margie said.

‘This last year when Ramona was very sick and quite low, she did say to me at that time she didn’t feel like she wanted to continue living, so we did have discussions around planning for end-of-life care. It’s a bit real. It’s a bit raw. Gently, gently over time and we’re still having those discussions. But now that she’s in a much better place it’s nicer to have that discussion again - what her wishes might be should things head downwards again.

‘We’ve formed a bit of a partnership over time. It’s lovely to have that partnership and respect.’

Romona said Nurse Navigators played a vital role for First Nations people.

‘One word I can use to describe nurse navigators is compassion. If she didn’t have compassion for me, I would be lost in the system. To me it’s much more than just a nurse navigator, it’s knowing that you are there for me all the time.’

Read more about Queensland Health Nurse Navigators.