The Role of the Oncology Pivot Nurse: The Care Relationship and Responsibilities Across the Patient Care Pathway

Abstract

Introduction. The complexity of oncology care pathways requires specialized professionals capable of coordinating care and supporting patients throughout the therapeutic process. One such professional is the oncology pivot nurse, whose role is to ensure continuity of care, improve communication between patients and clinical teams, and increase patient satisfaction. However, important gaps remain in understanding the actual impact of this role compared with traditional care models. This review aimed to analyze the role and responsibilities of the oncology pivot nurse and assess its impact on quality of care, patient satisfaction, and continuity of care.

Methods. A review of the scientific literature was conducted in PubMed between July and September 2025. Articles published from 2015 to 2025 in English or Italian were considered. Quantitative and qualitative studies and systematic reviews examining care provided by pivot nurses or nurse navigators in hospital and community oncology settings were included. The reviewed articles addressed care pathways for patients with different types of cancer, including breast, lung, and colorectal cancer.

Results. The evidence indicated that the involvement of a pivot nurse was associated with improvements in the care experience, treatment adherence, timely initiation of therapy, and continuity of care. The reviewed studies reported reductions in stress from 5.1% to 2.7%, anxiety from 7.8% to 5.1%, and depression from 4.4% to 2.2%. Patient satisfaction reached approximately 97%, while the time from diagnosis to treatment decreased from 42.93 to 15.15 days. Pivot nurses also provided necessary information, coordinated care among healthcare professionals, and offered emotional support. Informational support represented 44% of the reported interventions, while care coordination accounted for 35%.

Discussion. The findings suggest that the oncology pivot nurse may improve patient satisfaction, communication among healthcare professionals, and the overall efficiency of the care pathway.