Nurses have long been an ideal pool of subjects for clinical research conducted by scientists and doctors. Nurses tend to be clustered in one area for ease of study and they know how to follow directions both in study activities and in reporting their experience.
But in the current quick-paced medical environment, where nurse roles are becoming more important and simultaneously more stretched, it's also time for nurses to take on more in terms of the research that impacts their field of practice. They should also be the ones conducting evidence-based research, gathering the data and drawing the conclusions before they go on to implement the findings.
There's the obvious reason nurses need to understand research: it helps them "determine effective best practices and improve patient care," according to Northeastern State University, which emphasizes research skills as part of its BSN programs. "The findings from peer-reviewed studies can correct old misunderstandings, pave the way for new treatment protocols and create new methodology, all of which improve patient outcomes. Research also helps nursing respond to changes in the healthcare environment, patient populations and government regulations."
Nursing PhD candidates already do a lot of valuable research as they analyze already published papers. Through academic "reviews of literature," they evaluate literally scores of other scientists' published studies and then use various research tools to analyze them and come up with fresh findings.
But The Conversation, a British academic-journalistic publication, is calling for more. "As nurses are at the front line of patient care, they are able to identify gaps in clinical practice and develop ideas and strategies for improving the healthcare needs of patients. So it is essential that nurses are encouraged to undertake nursing research to provide them with the opportunity to address the issues they see in clinical practice. By promoting evidence-based nursing care we can close the gaps between research and practice." Nurses can also combat the bias that occurs when research is designed by doctors and carried out by nurses. "Nurses need to carve out their own nursing-focused areas to research."
An example of such research already happening is the undergrad work of Emory University Nell Hodgson Woodruff School of Nursing student Pele Solell-Knepler. She conducted an online nationwide survey with ethical approval to get 78 correctional nurses to answer six questions on how they cared for incarcerated patients.
"I'm fascinated with the sociology of work so I wanted to see how nurses provide care in a constricting custodial and stringent environment," she says. "I think caring for patients as people first is the utmost important part of health care." She argued in the resulting paper that understanding authority structures within their realm of caregiving, in this case prisons, allows nurses to act as patient advocates and insure their professional and ethical obligations. The young researcher says this theme is reflected in other nursing careers, that many times nurses are "stakeholders in a system where care is not the shared goal."
Solell-Knepler will walk across the stage at graduation this spring with highest honors due to that study. But the reward to science and society when nurses themselves participate in hands-on research far exceeds one student's academic career, says her advisor, assistant professor Kylie M. Smith, Ph.D, Mellon Faculty Fellow for Nursing & the Humanities.
"As a historian of nursing, I pay close attention to the generations of nurses who have conducted research in the past, because without them we would not know what nursing is," she says. "Nursing practice - what nurses do, how they relate to patients, how they understand health and illness - has been shaped entirely by the research that nurses themselves have undertaken, even when no one thought that was the nurses' role."
Smith notes how nurses took responsibility for researching the best way to relate to patients over the course of mental health developments, for example. "They developed a body of knowledge and theory that now underpins the whole profession. Physicians are not concerned with how nurses do what they do, but they do know that without nurses patients suffer, and without particular types of nursing, patients suffer more. Only nurses can provide that knowledge and direction for the profession, and they do it through research."
Solell-Knepler is looking forward to getting her paper published, maybe as early as this summer. She hopes it will illuminate both the barriers certain nurses experience in care and what is the best care in corrections nursing. At the same time, she's glad her research included the nurses themselves. "As I saw in my research, nurses are not always invited to sit at the table, so we have to push for that."
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