Behind All Great Cancer Care Is a Great Oncology Nurse: Jeannine Brant, PhD, APRN, AOCN®, FAAN

Oncology Data Advisor: Welcome to Oncology Data Advisor. I'm Keira Smith. Today I'm here at the ASCO Annual Meeting in Chicago, speaking with Jeannine Brant, who is the Executive Director of Clinical Science and Innovation at City of Hope and the President of the Oncology Nursing Society. Thank you so much for being here with us today.

Jeannine Brant, PhD, APRN, AOCN^®, FAAN: Great, thank you so much for inviting me.

Oncology Data Advisor: Absolutely. So, there are obviously a lot of nurses attending ASCO and presenting research here. What would you say is the importance of nurses being visible here at ASCO?

Dr. Brant: I think it's so important that we are collaborative team players with physicians, and physicians really rely on nurses to deliver frontline care, provide patient education, and staff infusion areas. I have a fun story from when I was on my way here in the cab. I was with a medical oncologist from Nebraska, and I told him that I was the President of ONS. We were talking about our roles. He said that in his office, he has a sign saying, "Behind every good oncologist is a great oncology nurse."

Oncology Data Advisor: I love that.

Dr. Brant: I think that says it all about how oncology nurses play such a key role in quality cancer care across the country. We are part of the team, so to be visibly here and partnering with physicians is very important.

Oncology Data Advisor: Absolutely. What would you say are some of the most exciting abstracts or studies that nurses are presenting here at ASCO?

Dr. Brant: I think the most exciting ones are in terms of health care delivery research. So, what are some of the ways that we can deliver care better? There are new models for clinical trials, and there are new models for apps, like for gathering patient-reported outcomes, getting patients involved, and getting patients to have a voice in their cancer care. Technology is really driving a lot of this. I think those are some of the important messages to take home.

Then, there's research on how to engage the whole health care team to provide team care. We look at models of health care, such as navigation, telephone triage, gathering patient-reported outcomes, all of those things. Then you think about other ways nurses play an important role in cancer care, and that's through clinical trials. Of course, the advancement of cancer research and the contribution to new knowledge is all about new discoveries. Yet, if you think about how clinical trials are delivered across the country, it's oftentimes the nurses who are recruiting for the trials. They're consenting patients and identifying which patients might be most eligible for clinical trials. So, nurses are really foundational to the entire infrastructure of clinical trial development.

I think the other thing is how we have nurse scientists here, and nurse scientists are also at the table with new discoveries—new discoveries on symptom science, new discoveries on care delivery, and new discoveries on technology. These nurses are sharing some of their advances in research and in health care, as well.

Oncology Data Advisor: That's wonderful. You also mentioned some of the challenges in recruiting staff now. What are some of the challenges in recruiting more advanced practice providers at this time?

Dr. Brant: I've had some conversations, especially with some of my Montana colleagues. I'm at City of Hope in Duarte, California, a National Cancer Institute (NCI)–designated cancer center. But most of my career has been in Montana at Billings Clinic and St. Vincent Healthcare, so I really understand the challenges of rural health care settings and the community cancer centers. One of the biggest challenges is trying to find medical oncologists to really come to those rural settings for the delivery of cancer care.

Some of the conversations today have focuses on how there are no oncologists out there. Really, we are relying heavily on nurse practitioners (NPs) and advanced practice providers (APPs) to help deliver that care. This also is true in some of the big NCI-designated cancer centers, in the sense that it takes more than the physicians. It really takes a team for us to be able to all practice to our maximum skill set. Oftentimes it's the medical oncologist that diagnoses and sets the treatment plans up for patients, but then APPs and nurse practitioners can order consecutive chemotherapy, provide symptom management, and triage patients.

Now in Montana, it's interesting because we are the fourth largest state, yet we have only a million people, and we have fewer medical oncologists per population than most places across the entire US. If you heard President Vokes' talk in the opening ceremonies yesterday at ASCO, he talked about some of the rural disparities. Rural patients have worse outcomes in terms of morbidity and mortality for cancer. A lot of times, it's because the experts don't exist in those remote rural areas. That's where nurse practitioners in oncology really come into play, because they're well equipped. They have knowledge and symptom science. They have knowledge on how to provide care to patients right at home. For us to be able to increase that capacity is important.

Now, along with that, though, comes some legislation that has to happen. During the pandemic, there were waivers where NPs could have adequate reimbursement for telehealth, for example. Since the end of the pandemic, some of those waivers have been taken away. We really need to reclaim that, because APPs and nurse practitioners really are able to practice at that scope of full delivery of care in those rural areas, and the pandemic showed that. We just need to continue that momentum and really have a voice out there for our nurse practitioners.

Oncology Data Advisor: Thank you so much for talking about all this with us. This has been really wonderful.

Dr. Brant: Great, thanks so much. It's fun to be here. The buzz is here. It's exciting, and I encourage more nurses to come to ASCO in the future.

Thank you for listening to this podcast recorded live at the 2022 ASCO Annual Meeting by Oncology Data Advisor and ConveyMed. For more expert perspectives on the latest in cancer research and treatment, be sure to subscribe to the podcast at conveymed.io and oncdata.com. Don't forget to follow us on social media for news, exclusive interviews, and more!

About Dr. Brant

Jeannine Brant, PhD, APRN, AOCN^®, FAAN, is the Executive Director of Clinical Science and Innovation at City of Hope in Duarte, California, and the 2022-2023 President of the Oncology Nursing Society. As a member of ONS for over 35 years, she has previously served on their Clinical Practice Committee, the Clinical Journal of Oncology Nursing editorial board, and the Putting Evidence Into Practice committee for pain management guidelines and resources. In addition, Dr. Brant has served on the Clinical Trials Workgroup of the Joe Biden Moonshot Panel, the Topical Analgesic Panel of the National Academy of Medicine & Sciences, and the Palliative Care Steering Panel of the American Nurses Association. She has authored over 150 publications and has spoken at more than 300 national and international events.

For More Information

President's message (2022). Oncology Nursing Society. Available at: https://www.ons.org/about-ons/presidents-message

Vokes EE (2022). President's address: ASCO Annual Meeting. Available at: https://meetings.asco.org/2022-asco-annual-meeting/14329?presentation=206995#206995

Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.