Julianne Brewer is one of Breast Cancer Foundation NZ's specialist breast nurses - ensuring that people affected by breast cancer all around the country have the knowledge and support they need. We caught up with her with a Q&A about her role, what a day looks like for her, and why it's so important to have services like this available.
How many years have you been a nurse?
What is the most challenging part of the job?
Breast Cancer Foundation NZ Nurses provide care over the phone - this kind of telehealth is now very common across New Zealand. A challenge for me is to really establish a connection with someone that you cannot see physically or visually, you can only hear their voice.
Making a trusting connection over the phone with each woman can take a longer time period and requires intense listening to understand her situation as well as quick thinking to ensure as much information is gathered to enable a clear understanding of her situation, support and needs. Once we have had our initial contact with a patient, the challenge is to make sure that that person feels supported by BCFNZ over the length of their cancer treatment journey. By being able to schedule regular follow-up phone calls with them I hope that I am able to achieve this.
What kind of calls do you receive?
Every call I receive from a woman with breast cancer, or a concerning symptom, is personal and important. No two calls are the same and everyone deserves and requires our complete care and attention. It is not uncommon for a call to come in from a woman with a symptom of breast cancer and BCFNZ is the first point of contact. My role is to assess their symptoms and their situation carefully. I give clear information and advice, particularly on the importance of seeing a GP regarding their symptom, and I do this in a calm, reassuring and comforting way as women in this situation are very anxious.
People will also call us when newly diagnosed for advice and information about their breast cancer treatment, or the tests and investigations they need. Many people are well supported by their hospital treatment team but they know that the BCFNZ nurse has the time to listen to their concerns or questions and advise additional support if needed. People who have very early breast cancer may simply require surgery, but for many, breast cancer is a complex condition, including those with Advanced Breast Cancer who need support to improve symptoms in a variety of ways. Working with these patients can be incredibly rewarding when able to improve their quality of life. I enjoy the challenge of these calls in making a positive difference.
What’s your most memorable call?
There have been many and it is difficult to just pick one, however, the following stuck with me due to the many challenges. The husband of a lady called explaining that she was too anxious to speak, following finding a lump. They were terrified and didn’t know what to do having found a breast lump, at the time we were in a level 4 lockdown. She wasn’t able to get an immediate GP appointment either face to face or via telehealth. Following gaining a history of the concern I was able to liaise with both the Practice Nurse at the GP clinic as well as the local Breast Care Nurse to help navigate the complexities of lockdown to enable referrals for a mammogram and other diagnostic tests. During this time, I made regular follow-up phone calls to continue to provide ongoing support. Initially, these were with the husband but once she gained the confidence in my support she would start to talk on the phone as well. It was wonderful to be able to gain her trust to feel comfortable enough to talk to me and support both through this stressful time.
Why is this service so important?
If we are to achieve our mission of zero deaths from breast cancer every person in New Zealand needs to be able to access education and information about breast health, signs and symptoms of breast cancer and early diagnosis. It is also important for those with a diagnosed breast cancer who are having treatment to be able to access the best possible advice and support whenever they need it. As a specialised nurse at BCFNZ, this is what we do.
What makes a good nurse?
Here is a list of things that I consider important for nursing; caring, empathy, respect, excellent communicator, patient advocate, team player, organised, skilled in nursing assessment and treatment planning, competent, comfortable with change, always learning, supportive to others, etc. For me, one of the great things is that I am still learning from both my patients and the people I work with after my many years of nursing.