ICN 2026: APP Leadership, Cancer Pain Care, and Nurse-Led Rapid Care Models

At the International Council of Nurses and Nurse Practitioner Association for Continuing Education (ICN-NPAPN) 2026 Conference at Vanderbilt University in Nashville, advanced practice oncology nursing leaders gathered to address critical challenges in cancer pain management, rapid care access, and health system workforce sustainability.

In an interview with Oncology Nursing News, featured speakers Heather J. Jackson, PhD, APRN, FNP-BC, NEA-BC, FAANP, Director of Advanced Practice at Vanderbilt University Medical Center, and Ashley Johnson, DNP, APRN, AOCNP, Advanced Practice Manager at Vanderbilt-Ingram Cancer Center, outlined strategic care innovations for advanced practice providers (APPs) across diverse clinical settings.

Jackson and Johnson presented distinct practice innovations demonstrating the expanding impact of APP leadership: "Global Perspectives in Pain Management: Elevating Nursing Practice Through Comprehensive Care" and "BRAVE: An Advanced Practice-Led Approach for Breast Rapid Access Visits and Education.”

Key Takeaways for Advanced Practice Oncology Nursing

• Addressing Global Pain Training Gaps: Cancer pain management requires structured post-graduate clinical training and standardized assessment tools to overcome prescribing hesitation and improper opioid utilization.
• Fostering Rapport for Opioid Stewardship: Open communication regarding personal health history and trauma enables individualized pain control while mitigating substance misuse risks.
• Streamlining Access via the BRAVE Model: Nurse practitioner-led models offer 60-minute consultation visits, clinical templates, and structured scheduling pathways, significantly reducing time to evaluation after a breast cancer diagnosis.
• Demonstrating Value Through Metrics: Tracking key indicators, including time from biopsy to APP consultation and Press Ganey satisfaction scores, validates APP contributions to health systems.
• Mitigating Clinician Burnout: Empowering APPs to practice at top-of-scope, defining role boundaries, and securing executive nursing leadership seats are critical to workforce retention.

Overcoming Global Barriers in Cancer Pain Management

Addressing cancer pain management globally reveals persistent educational and systemic hurdles. According to Jackson, the primary barrier facing APPs in diverse clinical environments is a lack of specialized pain curriculum during formal nursing education.

"The predominant global barriers are training, really," Jackson stated. "There's not a lot of specialty pain development and curriculums. We don't get a lot of that exposure when we're in our schools. So really it's dependent on learning it when we get out of school and then it's on the job a lot of times.”

This educational gap often fosters clinical uncertainty surrounding prescribing practices and opioid stewardship. To optimize pain mitigation, Jackson emphasized utilizing evidence-based assessment algorithms and cultivating strong patient rapport.

"I think it starts with the assessment and really honestly the core is developing a great patient relationship," Jackson explained. "Making sure that you have developed that rapport with the patient so that they can be honest and transparent with you about the pain they're experiencing, what they think's been helpful, and then even traumatic events that may have occurred in their life that might be contributing to some substance misuse.”

The BRAVE Model: Rapid Access and Anxiety Reduction in Breast Care

Navigating a new breast cancer or atypia diagnosis presents psychological distress and information overload for patients. To address delayed surgical access, Johnson co-developed the Breast Rapid Access Visits and Education (BRAVE) model, an APP-led intervention providing rapid clinical evaluation within days of biopsy.

"The BRAVE model utilized a really coordinated framework," Johnson noted. "We established that the APPs would have 60-minute visits to allow them time to spend with each patient and to be really prepared for the visit. We also developed some templates that we utilized for patient education as well as for our office visit documentation.”

Through expedited consultations, APPs conduct physical examinations, review pathology, order staging workups such as breast MRI or genetic testing, and deliver tailored education before physician consultations.

"Having the really early access is what was so key to reduce patient anxiety and uncertainty," Johnson emphasized. "They were already engaged in their care and eager to come back to meet with the surgeon and the medical oncologist because they knew a little bit more about what to expect.”

The BRAVE model demonstrated strong operational success, maintaining high patient satisfaction scores during periods of limited surgeon availability.

APP Scope Expansion, Executive Leadership, and Burnout Prevention

As oncology care increases in complexity, both leaders stressed the imperative for APPs to serve as active operational decision-makers rather than passive providers.

"It was also really exciting to hear ways that APPs are involved in new roles, access to care, improving quality, patient satisfaction," Johnson shared. "I love being able to be part of a solution to a problem.”

To prevent widespread burnout, Jackson and Johnson advocated for top-of-scope practice, clear job definitions, and executive advanced practice leadership.