The nurse navigator: Broker, boundary spanner and problem solver

Abstract Background The Queensland Health nurse navigator service is an innovative model that has recently emerged as a way of bridging gaps in care and supporting care coordination for patients with highly complex care needs. The translation of key principles into practice, and how nurse navigators operationalise their role in the care of individual patients in a highly complex health system while engaging a diverse team of health care providers, requires further understanding. Aim To explore how nurse navigators in Queensland operationalise their novel roles. Methods This was a qualitative study involving in-depth interviews with three nurse navigators. To explore interprofessional relationships and modes of operation, an exploratory multiple-case study design was used to produce illustrative case examples of practice. Findings Three main modes of operation were identified and illustrated: the boundary spanner, the problem solver, and the broker. These modes of operation offer important insight into the practices and experiences of nurse navigators. Discussion The ‘problem solver' demonstrates capacity to instigate system improvements, using patient advocacy as a mechanism for broader systems initiatives. The ‘boundary spanner' exemplifies how nurse navigators can transcend traditional health system boundaries and build networks across nonhealth settings. The ‘broker' illustrates the nurse navigator's relational role in forging partnerships with patients, across stakeholders in patient care, and across settings (and beyond the health sector). Conclusion These case examples are demonstrative of how nurse navigators operate across a continuum, delivering holistic and individualised care.