Nurses as Scribes: A Tool for the Oncology Nurse Navigator

Background Adequate preparation for an experience such as cancer empowers the patient and improves self-management and quality of life. The first visit with the oncologist can be extremely overwhelming and anxiety producing. Oncology nurse navigators (ONNs) need an effective way to communicate the information discussed during the initial oncology physician consultation to patients with newly diagnosed cancer and their families. A documentation template was developed so the oncology nurse navigators could take notes while accompanying patients and families during the initial visit with the oncologist.

Objectives To help patients and families better understand all the information that is presented in the initial consult with the medical oncologist.

Methods A one-page form was developed that included the following headings: type of cancer, stage of cancer, details of cancer, test results, medications prescribed, chemotherapy/biotherapy planned; names of chemotherapy/biotherapy and how often it will be given; radiation therapy planned; and an area on the form labeled What’s Next? to aid the patient in understanding the next steps to take in the cancer care process.

Separate documentation templates were developed for medical oncology and radiation oncology consults. The nurse acts as scribe for the patient and families ensuring that all the pertinent information discussed at the visit is recorded. The forms can also be used as a teaching tool to summarize the important information covered in the visit using the teach-back method before the patient leaves.

Results The oncology nurse navigators now consistently use the Summary of Visit form to provide a written summary of everything discussed with patients during their initial oncology consultation, and a copy is given to the patient before he or she leaves the clinic.

Conclusions Patients and families said that having access to the information from the initial consult with the oncologist enhanced comprehension and supported communication regarding disease stage, treatment plan, and referral information. They also commented that they were better able to focus on details of the oncologists’ interactions knowing they did not need to take notes themselves. Use of the Summary of Visit form has enhanced the readiness of patients for treatment and improved communication between the patient and the oncology team members.

Next steps include creating an electronic version of the templates that can be entered directly into the electronic medical record at the time of the visit, which allows other practitioners access to the information; incorporating the Summary of Visit note into OSF myHealth functionality, which allows the patient online access to some of their medical record information.