Nurse describes care coordination role for female patients with bladder cancer


"My goal is to always meet them there in clinic, and then just start that relationship, in a sense of, I'm there for whatever they need," says Bree Duncan, RN, BSN.

In this video, Bree Duncan, RN, BSN, describes her role as the Gail Kraemer Care Coordinator for Female Bladder Cancer Patients at Vanderbilt University Medical Center in Nashville, Tennessee.


Please describe how your role was created.

It was started by a patient of Dr. Chang's. She had been his patient for a while. I actually worked with her closely as well on a clinical trial, so the 3 of us had a long-standing relationship during her cancer journey. And through that journey, she saw some needs and resources we had for her, and so along that way, she worked with Dr. Chang, and they developed this position to see how they could help other patients as well [who were] going through the same thing she was going through. So it started, and it still is specific, for women with bladder cancer, trying to be another resource to them.

What are the responsibilities your position entails?

What I'm doing is identifying women with bladder cancer; we really started with a focus on women who are getting their bladders out because of bladder cancer. That's been the primary focus as we've started this. That seemed like the patient population that had the greatest need, where I could be of most use to them. I start by identifying those women. The goal is always to meet them when they're in the clinic, when they're maybe first meeting the providers or first talking about the fact that they may be getting their bladders out. My goal is to always meet them there in clinic, and then just start that relationship, in a sense of, I'm there for whatever they need. At the current moment, we don't have necessarily set things that we do with every single patient just yet; it really is patient specific. A lot of patients will reach out to me after that meeting because typically during those meetings, it can be really overwhelming when someone's going over a surgery when they're going to remove your bladder. And so it's nice to sometimes after you get out of there be like, "Oh, my gosh, I have all these other questions." I'm a resource to them. And I work with all the nurses and all the providers in the clinic. So even though I'm doing this separate role, I still work really closely with everyone. These patients are given my direct contact information here at work, so they get my email, they get my direct office number. And so when they have those questions, whether it's something big or small, they feel like I'm easy access to get those questions answered quickly, vs maybe calling the clinic and you might have to wait maybe a couple of days to get a response back. I've walked with these women along that whole path with them, from meeting the providers to the surgery to postoperatively. The goal is to not only be a resource for their questions, but then also, hopefully attend a lot of their appointments with them, potentially pre op and post op, because you meet a lot of people along that pathway. There are a lot of providers beforehand, and a lot of them after, because we are such a big institution and we offer so many services, which is great, but it can be really overwhelming for a patient. My goal is to be that person they can look to to help clarify things for them or help make sure things are getting done as they should. And then, like I said, I'll follow up with them afterwards. I visit them when they're in the hospital for their surgery. So sometimes again, it's nice to just continue that relationship. I'm not there to do anything except just be of support to them when they're in the hospital unless they need something from me, of course, but sometimes it's nice to just have a familiar face come and see you that's not there for anything else other than to support. So that's where we're at with the role at the current moment. I see it continuing to grow even more, especially into the rest of women with bladder cancer. But the women who are getting their bladders out is where we've started because it seems to be [where] I can make the most difference.

This transcription was edited for clarity.

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