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September 26, 2022
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Research nurse supports women with bladder cancer in new care coordinator position

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As a nurse, Brianne “Bree” Duncan, RN, BSN, has always had the goal to help and make a difference in her patients’ lives.

Duncan plans to continue this mindset with her new position as the Gail Kraemer Care Coordinator for Female Bladder Cancer Patients at Vanderbilt University Medical Center.

“At the end of the day, it’s about making a difference in someone's life, and I want to be able to do that however I can.” Brianne “Bree” Duncan, RN, BSN
Source: Healio Interviews

Duncan is the first recipient of this position — created based on a gift from patient and donor, Gail Kraemer — which is designed to aid this group of patients in education, clinical decision-making, surveillance, support and screening, according to a Vanderbilt-issued press release.

She has spent 8 years at Vanderbilt, starting as a clinic lead nurse and then becoming a research nurse. Before both positions, Duncan helped urology and transplant patients as a pediatric nurse, according to the release.

“Throughout my time as a research nurse, I have seen how important it's been to women with bladder cancer to have someone with them throughout the entire process,” Duncan told Healio. “I start with them at the beginning, and sometimes I'm working with them for years. I have seen how much having that support means to them and improves their experience going through a bladder cancer diagnosis. Being able to take a lot of that and apply it toward this new position has helped me see what's important to them and how I can help.”

Female patient advocacy

With a focus specifically on the female bladder cancer patient population, this position is the first of its kind, and Duncan and Sam S. Chang, MD, MBA, chief surgical officer for Vanderbilt-Ingram Cancer Center, told Healio it will help these patients overcome the challenges they commonly face.

Sam S. Chang, MD, MBA
Sam S. Chang

“Every screening, educational and therapeutic effort tends to be male oriented or male centric,” Chang said. “One of the big concerns for women is that many of them go undiagnosed or have a delayed diagnosis because there's just an assumption that they may have a bladder infection. As a result, it's a big challenge for them to initially get diagnosed and then treated.”

As a woman, Duncan is hopeful that she will easily connect with the patients she is working with and create a space where they feel comfortable enough to speak about their concerns.

“I can't relate on the cancer aspect, but I think as a woman, it makes it easier to talk to them and then have them open up to me about their concerns and questions that would potentially go unasked,” Duncan said. “They might not feel comfortable asking their male doctors about some of their sexual function, but I think it's a conversation that we can have together. From there, I can hopefully get them plugged in with the appropriate support and education.”

‘Learning as we go’

When asked about how this program will act as a model for other institutions going forward, Chang said Duncan is taking plenty of notes.

“Every program will have a difficult time following Bree because there's nobody that can match her,” Chang told Healio. “It's a program that's evolving, so we're outlining every positive step and every misstep that we've taken to serve as a model for others.”

With an abundance of different services offered at Vanderbilt, Duncan said she is looking toward all of them to learn how to best serve her patient population.

“I’ve met with many different departments and people already, and I’m trying to put it all together to see how this will best work for the patients,” Duncan said. “At the end of the day, I’m also letting the patients drive this by tracking all the questions I get asked. My goal would be to address those questions before they even have to be asked by gathering as much information as I can right now.”

Chang also said they are tracking patient satisfaction through surveys to document how they’ve made a difference.

“It's definitely something that we're learning as we go,” Chang said.

In the future, Chang and Duncan both hope to share what they found at meetings and inspire others to think about additional underserved groups.

“Women aren't the only underserved population. There are so many groups that are not necessarily marginalized but don't get the attention they deserve, so we really look forward to seeing how this program goes,” Chang said.

“We're starting with this one because of Gail's wishes, but I definitely see it being something that serves as a model across diagnoses,” Duncan added.

Goals, advice

With her vast amount of experience as a nurse, Duncan is prepared to develop long-term relationships with her patients, which will be a new experience for her.

“Having a background as a nurse, I typically have short-term relationships with the patient who is in front of me or who is at the bedside. Learning to care for these women long term along this path is new,” Duncan said. “It’s different to think about how I'm going to care for someone for the next 5 years or longer, so one of my goals is to figure out how I can best do that for these patients.”

In this position, Duncan will also continue to aspire to reach her goal that she has had ever since she started as a nurse.

“Ultimately, I want to make a difference in my patients’ lives. That's always my number one goal,” she said. “For each specific patient, that’s going to be different. It is my priority to make it easier for them when receiving this diagnosis, going through all the different treatments or potentially losing their bladder.”

When asked about advice, Duncan said she is still new to the position but highlighted the importance of learning and devoting time to patients.

“Getting as much knowledge as you can and focusing on the patient is going to help drive the care coordinator position,” Duncan said. “At the end of the day, it’s about making a difference in someone's life, and I want to be able to do that however I can. I work with a great group of people who also want the same thing, so working with Dr. Chang for this new position has made it easy on me.”

Chang added that it takes a “very special” person like Duncan to fill this role.

“In this position, to have someone like Bree who is caring and has a high sense of empathy for every individual really makes a huge difference,” Chang said. “Not everyone should be attaining this type of position because they may not have the mindset or the ability to do it. How do you get to this position? You have to be very special, committed and willing to learn.”

For more information:

Brianne Duncan, RN, BSN, can be reached at brianne.duncan@vumc.org.

Sam S. Chang, MD, MBA, can be reached at sam.chang@vumc.org.

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