Paper short abstract:

This paper presents an ethnography of nurse navigators in a public hospital in Chile, and discusses how this model may improve productivity in other low income areas, as these oncological nurses help their patients deal with both medical and bureaucratical complexities of their treatment.

Paper long abstract:

With the aim of highlighting mediators' role in healthcare environments, this paper presents an ethnography of nurse navigators in a public hospital in Chile. The navigator nurses work as mediators between oncological patients and the medical and bureaucratical system of a public hospital in a low-income area. Cancer treatments mean two complexities for the patient: the medical complexity of the treatment and the bureaucracy of the public health system. Given the high number of patients, oncologists do not have the time to explain all the details of the treatment. The nurses working at the chemotherapy room face the same problem, as they try to fit in as many patients on a day as possible. The nurse navigators then, fill in this gap by educating the patient on the details of the disease and its treatment and mediate between the patient and the complex bureaucratical system of public healthcare in Chile. These dedicated nurses constitute a human factor in healthcare that no app can replace. The nurse navigators, however, do use an app that is the most commonly used messaging app amongst patients: WhatsApp. We will explore the uses of WhatsApp by nurses and patients and the protocols that have evolved in the usage of this app. With the aim of building a model scalable to other low-income hospitals in Chile, we will explore the perspective of patients on this nurse model of healthcare and the advantages of using a messaging app already adopted by the target population.