Chapter 14: Research Nurses at MD Anderson
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Description
Dr. Buzdar begins this chapter by noting how important transparency is when asking a patient to participate in clinical trials. He then discusses a new, four-month training program for research nurses that was launched eight months previously (the first structured program for training research nurses). He explains the special features of training for research nurses and their role in educating patients about clinical trials. He sketches the history of research nurses at MD Anderson and notes that the new training program was created on the recommendation of a group of investigators.
Identifier
BuzdarA_02_20170216_C14
Publication Date
2-16-2017
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Topics Covered
The University of Texas MD Anderson Cancer Center - Building the Institution; Discovery and Success; Building the Institution; MD Anderson History; Research; Education; On Education
Transcript
Tacey A. Rosolowski, PhD:
Well, I had wanted to know more about kind of the general environment for clinical research at the institution, not necessarily from the regulatory perspective. The institution has grown, it's changed, they're shifting emphases. I'm wondering how, if things change, do people need to be trained differently, do they need to think differently?
Aman Buzdar, MD:
Oh yeah, that is a very important area, because the thing is, it has evolved that there are rules and regulations. So the persons who are interacting with the patients, who police that point of view, they have to understand that when you approach a patient, patients have to understand that this is research. We talked about it briefly before. You are participating as a volunteer on the cutting edge of the technology. It is now required that all the people who are interacting with the patient or patient material, they have to understand what are the rules and regulations. Every faculty member, every research nurse, all the data coordinators, we train them, so that they understand that what are the requirements. They have to follow the rules and regulations. That is a must. And the same way, what we have started actually, about now less than -- about eight months ago. The research nurses play a very pivotal role with the physicians, it's a team approach. So the nurses, it used to be you asked a nurse, Can you work with me and we will support your salary, and they will help you to carry out the research. But now, that thing has evolved. We have a totally structured, research nurse training program, first in the country, at MD Anderson. It just stated about six months ago. The first batch of nurses will come out in the next few months, in about a few months they will graduate. Before, it was just you did education and made a bare effort, what are the minimum rules and regulations which were mandatory. We did that, but now we have made it a very formal structured educational program.
Tacey A. Rosolowski, PhD:
And how is research nurse training different than regular nurse training, or oncology nurse training?
Aman Buzdar, MD:
The regular nurses are providing support and nursing care, whereas research nurses have to understand the research aspect of it; how to obtain a consent. As I explained to you, they have to tell the patient what are the risks, what are the benefits, and you are being asked to participate, and you have to volunteer. Do you want to be in the standard treatment? Even though it is a responsibility of the physicians, the physicians explain to them in the beginning, but a lot of times nurses sit down: patients have sometimes, concerns. They may visit with the research nurse once, twice, or three times, and in the end, the patient may say, No, I don't want to be part of this, I want to take the standard treatment. Then the physician has responsibility to communicate. But research nurse id also responsible. If the patient is under treatment, I see the patient. Let's say if the patient --I put the patient on the research treatment. I see the patient but also, the research nurse sees the patient. So, I collect the safety information and also, the research nurse collects the safety information. Did you have nausea, did you have vomiting, did you lose your hair, did you have any diarrhea? All the side effects, they are required to be captured and arrayed, because when you're carrying out arrays, it's a very structured thing. There is actually --all these things are required according to what we call the CTCAE, which is actually NCI-mandated classification of all the adverse events, from your hair loss, from your nail changes, to fever, to cough, everything.
Tacey A. Rosolowski, PhD:
Now, and is there the double collecting, the kind of provided checks and balances?
Aman Buzdar, MD:
Most of the time, because the thing is, physicians will look at it maybe from the efficacy point of view on a lot of things, whereas a nurse has a little more time. They will sit down, and at times, it is human nature. When I work as -- even the patient may be in a difficult situation, you ask the patient how are you doing? I'm doing great. But if a nurse goes, they will say, Oh, my hip hurts and my neck, this and that. It's human nature, to put the best front in front of the doctor. So when the research nurses sit and go in a lot more depth, to collect that information.
Tacey A. Rosolowski, PhD:
Interesting. Now you said that this is the first training program of its kind in the nation. When was the idea for this program first floated at MD Anderson? How long had it been in planning?
Aman Buzdar, MD:
Research nurses have been around at MD Anderson, I would say that maybe since the research became far more structured, in the late '70s, early '80s. At the present time, we have close to maybe 400 research nurses at MD Anderson, and we have over a thousand plus nurses. Thirteen hundred nurses who are providing nursing care. But the research nurses provide support to the investigator and interacts with only those patients who are on research studies.
Tacey A. Rosolowski, PhD:
When was the idea that there should be a formal training program, though?
Aman Buzdar, MD:
The idea was actually when Dr. DePinho came. At that point a subgroup of investigators met with Dr. Ki Hong, who was the Division Head of Cancer Medicine. He was appointed as a vice provost. He set up an advisory committee and one of the recommendations was that it was a difficult and constant challenge, to find nurses who can work as a research nurse. It was recommended to the institution, to initiate a research training program and it took us until the middle of last year, that we started it. Now every four months, we have a new batch, and it is a one-year structured program.
Tacey A. Rosolowski, PhD:
Now, what was your involvement in this, Dr. Buzdar?
Aman Buzdar, MD:
I played a very pivotal role working with Dr. Wilding and with Dr. Ki Hong. My office actually coordinates most of this work with our vice president of nursing. Before, we were talking with Barbara Summers, who was here, in fact when we were still in the process of developing it. Now, it is fully structured and it is ongoing, and our Division of Nursing plays a very pivotal role, because we have our education system over here which did train oncology nurses. When a nurse becomes a registered nurse, then there is an oncology training, but this is on top of it.
Tacey A. Rosolowski, PhD:
Who is in charge of the nursing program, the research nurse program?
Aman Buzdar, MD:
Her name is Debbie Klein, who is in the Division of Nursing. The person who, in my office, her name is Jan Yungglas, Y-U-N-G-G-L-A-S. She's the Director of Clinical Support Services, so she plays a pivotal role in that.
Tacey A. Rosolowski, PhD:
Okay, cool. I hadn't heard about that, that's really interesting. I spoke with, interviewed Barbara Summers, and such a good focus on research, and so I'm not surprised that this emerged out of -- you know, she was part of this conversation. "ƒ
Recommended Citation
Buzdar, Aman U. MD and Rosolowski, Tacey A. PhD, "Chapter 14: Research Nurses at MD Anderson" (2017). Interview Chapters. 575.
https://openworks.mdanderson.org/mchv_interviewchapters/575
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