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10 Steps to Becoming a Nurse Navigator

nurse navigator walking with patient

Nurse Navigator Career Snapshot

Where you’ll work: Hospitals, specialty care centers, hospices, patient advocacy organizations and hospice agencies.

What you’ll do: Act as a liaison between patients and healthcare providers by making sure patients can navigate the healthcare system and are being successfully cared for.

Minimum degree required: ADN or BSN. Although it is common for many employers to prefer or require nurses to have a BSN, nurse navigator positions may value experience over education.

Who it’s a good fit for: Strong communication skills are key for nurse navigators. As a bridge between patients and the healthcare system, they must be creative and resourceful to make sure patients have the knowledge to make informed decisions about their care.

Job perks: Since the role is not as focused on direct patient care, nurse navigators tend to have a less fast-paced, high intensity position. Instead, they get to have a direct impact on patients’ outcomes by helping reduce or eliminate bureaucratic barriers to high quality care.

Opportunities if you pursue a higher degree or certification: Although there is no professional certification available for nurse navigators, there is a certification for nurse navigators who work specifically with cancer patients. Pursuing a certification or advancing your education to become an APRN could lead to more job opportunities and a higher salary.

Median annual salary: $81,220

What Is a Nurse Navigator?

Nurse navigators are registered nurses with at least a two-year nursing degree who advocate for patients, communicate their needs to healthcare professionals, and manage their care. The role was originally created to help oncology patients and their families navigate the complexities of cancer treatment. Today, nurse navigators work to ensure patients with a wide variety of conditions have the support they need.

Steps to Become a Nurse Navigator

Find a nursing program and school that fit your goals.

nurse working on computer

You can find nursing programs online, on campus, or as a hybrid that combines both on-campus and remote learning. You can attend a full-time program that will take four years to complete, or you can choose a part-time accelerated program and earn a degree in about two years. The right nursing program for you is one that aligns with your career goals and fits your budget and lifestyle. It’s also important to look for a program that offers services that meet your specific academic and career needs. For instance, some programs offer career placement assistance or career counseling services to students.

No matter what school or program you choose, accreditation matters. Accreditation means that your nursing program has proven it will deliver a quality education that meets the requirements of your state’s board of nursing. Accreditation is also important if you plan to apply for loans or grants to help pay for school because only students enrolled in accredited programs are eligible for federal student aid. Plus, accreditation will allow you to transfer your credits to other colleges or universities. This can save you time and money if you want to transfer schools or if you want to pursue an advanced degree later.

Decide on a degree that will allow you to be licensed as an RN.

two nurses talking together in medical facility

There are two degree options for aspiring RNs. You can earn either an Associate Degree in Nursing (ADN) or a Bachelor of  Science in Nursing (BSN). Either degree will allow you to earn licensure in any state.

BSN degrees are more advanced than ADNs, and some employers prefer or even require BSNs. They are offered by colleges and universities and generally take four years. Although students with either degree will be eligible for RN licensure, BSN degrees may open the doors for higher-level RN positions and potentially higher salaries.

Your experience will likely play a bigger role than your degree when it comes to nurse navigator roles. Betty Long, RN, MHA, the founder, president, and CEO of Guardian Nurses Healthcare Advocates, says considerable nursing experience is paramount.

“While many on our team do have BSNs, we do not require a BSN at Guardian Nurses,” says Long, whose company is a national patient advocacy organization that employs a team of nurse navigators to help patients get the care they need. “We want to see two letters after someone’s name: ‘RN.’ We require at least 10 years of clinical experience.”

Apply to a school.

closeup of woman working at laptop computer

Each school and program will have its own admissions requirements and steps. Often, nursing programs have admissions requirements that are separate from the requirements designated by the school as a whole. You might need to take additional steps after you’re admitted to the school before you can begin the nursing program.

In general, you can count on needing your high school diploma or GED before your admission to any nursing program. GPA requirements will vary, but many schools will pay close attention to your grades in math and science courses. If your grades in these classes were low, or if you did not take many of them, you’ll likely need to take a few to get up to speed. In addition to your grades, many programs will ask for your scores on the SAT, ACT, or an admissions exam that is specific to your school. You might also need to send in an admissions essay or letters of recommendation as part of your application process.

Complete your coursework and graduate.

nurses listening to instructor in training class

The exact courses you take will depend on whether you pursue a BSN or an ADN. Your school may also have certain classes it requires aspiring nurses to take. However, since all nursing programs will lead to RN licensure, the core of your nursing education will be similar at all schools. You can count on courses that cover:

• Patient assessment
• Nursing practice
• Nursing ethics
• Pharmacology
• Anatomy and physiology
• Behavioral health
• Population health

You’ll also need to complete clinical hours as part of any nursing program. Clinical hours will be done onsite at local hospitals or other medical facilities and will give you the chance to gain supervised nursing experience. The exact number of hours will depend on your program and state, but most programs require 700 to 800.

Take and pass the NCLEX.

nurse navigator student taking nclex exam

The National Council Licensure Examination (NCLEX-RN) is a national exam that you’ll need to pass before you can work as a nurse in any state. The exam is administered by the National Council of State Boards of Nursing (NCSBN). The NCLEX-RN is designed to ensure you’ve mastered the essential knowledge you’ll need to be a successful RN. The exam is computer-based and takes about five hours to complete. Your results will be sent to your state board of nursing. You’ll be able to receive your RN license and work as a nurse if you pass the NCLEX-RN. You can retake the exam if you don’t pass on your first try.

Earn your RN license.

two nurses looking at medical charts together in medical facility

RN licenses are overseen by each state’s board of nursing. You’ll need to send proof of your completed education, along with any other documentation required by your state board of nursing, to apply for licensure. Your state might ask for:

• Proof you’ve completed supervised clinical hours
• Transcripts from your nursing program
• A criminal background check and FBI fingerprinting
• A current CPR certification
• A recent photograph
• A letter of recommendation from a professor or employer

Proof you’ve met the requirements to resolve any negative marks on your criminal record. For example, you might need to include proof you’ve completed community service, attended a required driving course, paid court fines, or paid past-due child support.

Gain experience.

three nurses walking together in medical facility

Healthcare can be confusing and overwhelming for patients and their families. They often don’t know who to call or where to turn for care. They might not know what healthcare professionals or facilities are best for their situation. As a nurse navigator, one of your primary responsibilities is helping patients understand the healthcare system so they can get the care they need. To be successful, you’ll need an in-depth understanding of how healthcare works. To gain that understanding, you’ll need experience.

“Nurses with less than five years’ (nursing) experience do not, in my opinion, know enough about being a nurse or know enough about navigating the healthcare system themselves” to work as a nurse navigator, Long says.

You can gain nursing experience by working in entry-level RN roles. Hospital units such as critical care and medical-surgical can be great places to start your nursing career. You’ll see a variety of patients and sharpen your nursing skills. You could also take on a geriatric nursing role in a skilled nursing facility to get experience providing long-term care and education to patients and their families. No matter what, you’ll be gaining skills that will build the foundation for a nurse navigator career.

Consider certification.

nursing student raising her hand in classroom

There are no nationally required certifications or certifying bodies for nurse navigators. In fact, there is currently no certification at all for general-practice nurse navigators. However, there is a specialty certification for nurse navigators who work with cancer patients. The Academy of Oncology Nurse and Patient Navigators (AONN) offers the Oncology Nurse Navigator–Certified Generalist certification. You’ll need an RN license in good standing and at least three years of experience as an oncology nurse navigator to qualify.

Keep your credentials current.

nurse instructor conducting class with nursing students

You’ll need to keep your RN license active and in good standing to work as a nurse navigator. Every state board of nursing has its own requirements for RN license renewal. Generally, a license will be up for renewal every two or three years. You’ll need to send your state board of nursing a renewal fee along with proof that you’ve completed a set number of continuing education hours and have worked a set number of hours. If you hold a certification, that needs to be kept current as well. Nurse navigators with AONN certification will need to complete 45 hours of continuing education every three years to keep their certification current.

Level up!

nurses in training class

After you get experience in an entry-level role and move into nurse navigation, there’s still room to advance.

You can take on leadership roles, expand your responsibilities, and potentially increase your salary as a nurse navigator by becoming an advanced practice registered nurse (APRN). There are four types of nurses that fall under the APRN umbrella, but those most applicable to a nurse navigator career would be clinical nurse specialist (CNS) or nurse practitioner (NP).

Both of these advanced nursing roles could allow you to lead a team of nurse navigators, clinically assess and diagnose patients, and provide safer and more effective care.

You’ll need to earn either a Master of Nursing Science (MSN) or Doctor of Nursing Practice (DNP) degree to take on either role. Bridge programs are available to help current RNs at any degree level earn advanced degrees and become APRNs.

Can I Specialize in Nurse Navigation During My Nursing Program?

No. You can’t specialize during any ADN or BSN program. ADN and BSN degrees are focused on general nursing. You’ll be able to specialize by gaining nursing experience after you graduate.

What You’ll Do

The role of nurse navigator was originally developed in the 1990s to shorten the timeline between the diagnosis of cancer and the start of treatment for patients in underserved populations, especially patients without insurance. Today, cancer is just one of a wide range of both chronic and acute conditions that nurse navigators help patients manage.

Nurse navigators make sure that patients and their families get the healthcare they need. They act as a bridge between patients and healthcare professionals; educate patients to help them understand their conditions, their treatment plans, and their options; and communicate with healthcare professionals to make sure each patient’s needs are being met.

The nurse navigator role has expanded in recent years to support a wide range of nursing specialties beyond oncology.

“While we do not provide any direct care, we have the responsibility of shepherding a patient and family through difficult diagnoses, treatments, and critical conversations,” says Long.

Nurse navigators help patients by:

  • Identifying the need for a second opinion
  • Accompanying them to a physician’s visit
  • Visiting them in the hospital and ensuring that care is appropriate
  • Educating and empowering patients
  • Helping them understand the workings of insurance companies, including claim denials and copays

The Importance of Nurse Navigators: One Patient’s Story

Having a nurse navigator take on the often overwhelming number of tasks that come with a serious health diagnosis can provide more than stress relief, education, support, and comfort to patients and families. It can save lives.

“In a recent case, a 48-year-old patient was three days post appendectomy and was complaining of abdominal pain,” says Long. “The patient told us, ‘No one is listening to me. I think they think I just want the pain medicine.’ “Our nurse advocate visited the patient in the hospital, assessed her abdomen, and noted it to be distended and sore to the touch.”

Long says that’s when the nurse navigator took action. She called the assigned nurse into the patient’s room and together they reviewed the patient’s symptoms and treatment plan.

“Our nurse encouraged the staff nurse to call the physician, report the patient’s symptoms, and ask the physician to order additional testing,” says Long. “It turned out that the patient’s bowel had been nicked during surgery and was leaking into her abdomen. This is one example of an experienced nurse’s assessment skills helping a (less experienced) nurse get her patient timely care.”

Where You’ll Work

Nurse navigators can work anywhere patients might need help managing their care. “I’ve seen nurse navigators work effectively in complex clinical settings like oncology, neurology, cardiology,” Long says.

Employers for nurse navigators include:

  • Hospitals
  • Mental health hospitals
  • Health systems
  • Long-term care facilities
  • Rehabilitation facilities
  • Oncology and other specialty care centers
  • Hospice agencies
  • Home health care agencies
  • Patient advocacy organizations

What’s the Difference Between a Nurse Navigator and a Patient Navigator?

It’s easy to confuse the roles of a nurse navigator and a patient navigator. There is significant overlap between the roles and many people even use the titles interchangeably.

However, a nurse navigator is always a nurse. That means they always bring their nursing education, skills, and background to their work as nurse navigators. The job description and duties of a nurse navigator will be fairly consistent at any facility, organization, or agency. 

Nurse navigators always have a nursing background. A patient navigator’s educational background is often in social work.

Patient navigators come from a variety of backgrounds. Their education and experience can vary widely depending on the hospital or healthcare system. One hospital might use the title of patient navigator to refer to a social worker with a master’s degree, while another hospital might use the title to refer to a healthcare provider with a high school diploma and on-the-job training.

This means that a patient navigator’s job description and duties can vary from one facility to another. All patient navigators help patients connect to needed services, but a social worker under the title of patient navigator can do a lot more than someone without a degree. 

Salary and Job Outlook

The U.S. Bureau of Labor Statistics (BLS) doesn’t track data for nursing specialty roles such as nurse navigator, but they do provide salary figures for RNs. You can find median annual RN salary data for your state here:

Registered Nurses

National data

Median Salary: $81,220

Projected job growth: 5.6%

10th Percentile: $61,250

25th Percentile: $66,680

75th Percentile: $101,100

90th Percentile: $129,400

Projected job growth: 5.6%

State data

State Median Salary Bottom 10% Top 10%
Alabama $63,090 $48,820 $82,760
Alaska $102,260 $80,950 $127,280
Arizona $82,330 $66,040 $105,520
Arkansas $64,130 $37,630 $83,700
California $132,660 $84,700 $177,670
Colorado $82,430 $66,130 $107,260
Connecticut $95,210 $71,050 $119,600
Delaware $82,230 $64,100 $101,110
District of Columbia $98,970 $66,260 $135,260
Florida $77,710 $61,190 $100,060
Georgia $79,440 $60,400 $118,270
Hawaii $120,100 $76,640 $137,710
Idaho $77,940 $61,530 $100,440
Illinois $78,980 $62,180 $102,080
Indiana $73,290 $55,200 $95,600
Iowa $65,000 $56,330 $83,360
Kansas $66,460 $52,010 $93,120
Kentucky $75,800 $56,120 $98,540
Louisiana $73,180 $57,500 $95,540
Maine $77,340 $61,170 $100,910
Maryland $83,850 $64,680 $106,910
Massachusetts $98,520 $67,480 $154,160
Michigan $79,180 $64,270 $100,920
Minnesota $84,060 $65,500 $107,960
Mississippi $63,330 $49,980 $84,030
Missouri $71,460 $51,440 $94,340
Montana $76,550 $62,930 $98,970
Nebraska $74,990 $58,900 $93,230
Nevada $94,930 $74,200 $130,200
New Hampshire $80,550 $62,790 $104,270
New Jersey $98,090 $76,650 $118,150
New Mexico $81,990 $64,510 $106,300
New York $100,370 $64,840 $132,950
North Carolina $76,430 $59,580 $100,430
North Dakota $69,640 $60,780 $91,150
Ohio $76,810 $61,860 $98,380
Oklahoma $74,520 $53,560 $97,520
Oregon $106,680 $81,470 $131,210
Pennsylvania $78,740 $61,450 $101,450
Rhode Island $85,960 $65,260 $104,790
South Carolina $75,610 $52,620 $93,190
South Dakota $62,920 $51,240 $80,860
Tennessee $65,800 $51,270 $95,490
Texas $79,830 $61,950 $105,270
Utah $77,240 $61,850 $98,000
Vermont $77,230 $60,900 $101,570
Virginia $79,700 $61,970 $104,410
Washington $101,230 $77,460 $131,230
West Virginia $74,160 $47,640 $96,470
Wisconsin $79,750 $65,110 $100,820
Wyoming $77,730 $60,910 $102,010

Source: U.S. Bureau of Labor Statistics (BLS) 2022 median salary; projected job growth through 2032. Actual salaries vary depending on location, level of education, years of experience, work environment, and other factors. Salaries may differ even more for those who are self-employed or work part time.

The BLS also uses data to predict job growth by decade. Currently, the BLS is projecting 5.6% growth in RN roles through 2032.

Some RN specialties will likely grow much faster and see greater demand than others.  Nurse navigation is a relatively new nursing specialty, but it is becoming increasingly popular. Long believes that this trend will continue and that nurse navigators will see substantial growth in the next several years.

“There absolutely is demand,” Long says. Patients can quickly become overwhelmed by the gravity of their diagnosis and can benefit greatly from a composed, informed nurse navigator to help guide them through the system. The healthcare system is made up of “multiple levels of individual departments, possibly multiple facilities, who do not have the time to really, truly focus on patients,” Long says. “Helping that patient get the care and the attention will always be needed.”

Is this Job Right for You?

Nurse navigation is a complex nursing role. You won’t be providing direct patient care, but you will need to be able to assess and educate patients. Your daily tasks might look very different from those of a nurse working on a hospital unit, but nurse navigators rely on their nursing skills every day. In fact, Long says that some nurse navigators feel this role allows them to use their nursing skills and education more than ever before.

“Just in the last two days, I have heard, ‘I finally feel like I get to be a nurse!’ and ‘I feel empowered to help my patients and encouraged to use my years of nursing experience to improve their healthcare journey,'” says Long. “One of my colleagues said to me years ago, ‘This is why I went to nursing school!’ It is the independence, the ability to make a direct impact on someone’s journey, the satisfaction of being creative to minimize a crushing bureaucracy. All those things and more that are unique to our role.”

“One of my colleagues said to me years ago, ‘This is why I went to nursing school!'”

If that sounds ideal to you, nurse navigation might be the right choice. So what skill will you need to succeed if you pursue this role? Long has 17 years of experience finding the best nurse navigators. In her experience you’ll be a good fit if you’re:

  • Experienced
  • Resourceful
  • Energetic
  • Independent
  • Easily engaged
  • Creative problem solver
  • Skilled in verbal and written communication

Beyond those skills, a passion for the role and a real desire for helping patients is vital. Nurse navigation is an advocacy role that requires empathy and compassion for every patient.

Written and reported by:

Stephanie Behring

Contributing Writer

betty long

With professional insight from:

Betty Long, RN, MHA

Founder, President, and CEO, Guardian Nurses Healthcare Advocates