Translation of EBP: Why creating nurse scientists is the way to improve patient outcomes.
Brief Overview: You can read the below verbal explosion or you can know this… I basically say what is contained in the bullets below then provide links.
- Research is sometimes far removed from bedside nurses
- Research is COOL!
- Research is about PATIENTS and not fame/fortune of researcher
- Research is critical to practice and there are big gaps that nurses need to fill
- Bedside nurses may be the most crucial link in research ideas, translation, and practice.
Creating nurse scientists has been somewhat difficult for the profession of nursing. I can only guess as to why this has been, but unlike other fields of biology, chemistry, and the like, where employment is often found in seeking answers, solving mysteries, and in effect being ‘scientists’, nursing has traditionally and rightfully been a ‘hands on’ profession of action for patients to produce desired outcomes. (Forgive the brevity of the definition of nursing, it is quite complex, but one gets the idea.)
Often nurses are too busy keeping patients alive, preventing complications, and working over time to consider solving the larger problems of their patients or their profession. However, nothing could be more critical. I believe that the hard-working, nose to the grindstone, mentality has kept nurses from exploring the science of their practice and answering important patient/practice questions. Likewise, many nurses may not be empowered enough at the bedside, another post entirely, to solve problems, lacking support from administration. There is also some distant mystery in the idea of being a nurse scientist. Personally, I used to believe that I could never be a nurse scientist. They were the rock-star like icons I only read about, but were not present in my health care institution, my local universities, and certainly, I believed, not pushing medications with me at the bedside. (I still would love to get several autographs – so nurse scientists out there, send them in with your photos. Linda Aiken, Robin Newhouse, Bernadette Melnyk , etc.)
The Need for More Evidence:
Evidenced Based Practice (EBP) is more than the latest buzzword for the vernacular of health care facilities and nursing schools. It IS health care, and yet it is still emerging. For nurses, there are so many practice areas where we have not verified with research what we do. I recently worked with a group of RN-BSN students on identifying a problem within their working units that they would like to change and I am always encouraged by their resounding frustration at not being able to find any ‘research’ on the area they want to change. Topics like decreasing cost of medical care waste, pain medication dosage/timing in post-operative patients, non-pharmacological practices for comfort measures at the bedside, nurse managed out-patient protocols for stomatitis in oncology patients, direct admission of septic oncology patients from out-patient/office triage, music as an anxiety reliever in pediatric emergency room waiting, use of certain products as bedside cleansers in ICU patients, and so forth … pepper their projects but baffle their attempts to find printed, peer-reviewed, research. The students are thinking and ready, but it is important for them to find nothing on their topics. They must be aware that THEY must be the catalyst for evidence and change, and that interdisciplinary evidence, and pilot projects are needed to test their theories. Science is a mystery that continues to change and nurses are the critical detectives, the Perry Masons of health care and patients, with their outcomes at the center of the mystery.
Research is Personal
As much as science provides statistics and evidence, it also has unseen faces, lives, and effects. Numerous unidentifiable persons participate in research in hopes of improving their own lives or to help improve the lives of others. They believe in health care scientists and our ability to move health forward. Beyond the research awards, publications, funding, and all of the rest, they are central. They are the purpose, the catalyst, and the mechanism through which we will discover answers. This was never more clear to me than when I completed a recent study and saw first hand the hope and desire for improved health of participants. For the researcher, who remains professionally detached, we learn that research is about people. Who better than nurses, who know people/patients well, to seek answers to the most pressing questions our patients face? Often, nurses see the bigger gravity in what are considered ‘minor’ issues by others in health care and how they affect patients. Patients need evidence and nurses can help them get it.
Nurse researchers really were at the bedside with me, guiding theory, practice, and nursing. They were the ones who pushed for things like Primary Care nursing, improving patient relationships through listening and communication, and the like. The need for evidence is no less pressing and is indeed growing. Pulling in nurses at all levels of health care to help discover and translate evidence is needed. Building consortiums of nurse researchers to bring nursing out to smaller health centers and hospitals as the ANA is doing, or building hospitals that function with bringing nurses into evidenced based practice at every level, and actually empowering them to act/translate/search/implement as Johns Hopkins is doing are models that should be echoed throughout health care agencies.
Nursing Research Matters to Everyone
With the increase in age of patients, nurses, nursing faculty, the pending large influx of patients into the U.S. health care system, and the push to a preventive-team approach to health instead of acute care-reactionary medicine, the time is now to create more nurse scientists. Below are some links of importance to nursing science and highlights of nursing research being done.
Nursing science and EBP matter, for our patients.
- The NINR
- Nurse Researcher Hall of Fame at STTI
- Massage for blood pressure control (recent nursing research in the news)
- In home therapy improves disabled elder’s health outcomes (recent nursing research in the news)
- Vitamin C helps heart failure patients (recent nursing research in the news)