In October I went to Washington, DC, to cover the Third National Congress on the State of the Science in Nursing Research (see AJN Reports, page 28). I have to confess, I was not looking forward to it all that much. Don't get me wrong: I enjoy meeting new people and learning what nurses are up to. But three days of listening to presentations on nursing research?
I am aware of the wonderful clinical work nurse researchers are doing; AJN has had the honor of publishing the work of several of them. But I feared that most presenters would report on their validation of measurement scales or testing of theoretical constructs for educational models. Important work to be sure, but not of interest to this former emergency nurse.
Well, I was knocked out. Most of the 300 papers presented focused on clinical issues of importance to nurses. Most exciting to me were the nurses working in clinical settings who were also conducting research. For example, Paulette Gallant, BSN, RNC, a weekend night nurse at Maine Medical Center in Portland, was the principal investigator in a study evaluating the effectiveness of using an assessment scale, rather than the standard "dwell time," when determining when an IV should be removed. Other nurses at the medical center are studying pressure ulcers and evaluating the effect of various analgesics on postoperative nausea.
Nurse researchers know that what nurses do-provide high-quality care while keeping costs contained-has a significant impact on clinical outcomes. That information is crucial to proving nurses' worth. But outcomes don't tell the whole story, so nurses also are researching how to promote wellness in ways that honor patients values. A great example of this is Cookin' Up Health, an "interactive nutrition" program designed by nurses at West Virginia University to reduce the risk of cardiovascular disease in Appalachian women. The program uses a cooking-show theme to show users how to cook more healthful variations of favorite dishes, like fried chicken and dumplings.
Why, then, don't more people, including many RNs, think of nurses as scientists conducting important clinical research?
One reason may be that nursing research got a late start. Most nurses were trained at hospital schools until the 1960s. (In 1965 the ANA proposed the baccalaureate as the basic degree for an RN, resulting in more collegiate nursing programs.) For the first two-thirds of the 20th century, most nursing students were isolated from academia. Scientific inquiry just wasn't a part of nurses' training; nurses were taught to follow a hospital's policies and procedures. Also, nursing students were subjected to strict discipline-an atmosphere that discouraged independent thinking.
When nursing's first research journal, Nursing Research, debuted in 1953, much of the research it published focused on nursing education. Few nurses in clinical practice, let alone the public, paid much attention. And although federal funding for nursing research became available in the 1950s, the field really got its jump start in 1985 with the creation of the National Center for Nursing Research, a part of the National Institutes of Health (NIH). In 1993 the center was designated an institute, finally putting nursing research on equal footing with other sciences in the NIH. Now nursing research is catching up, and perhaps the word is finally getting out that nurses are scientists, too.
But how many staff nurses read research journals, nursing or otherwise? I was glad to hear Loretta Sweet Jemmott, PhD, RN, FAAN, from the University of Pennsylvania, remind researchers that they need to publish not only in journals read by their research peers but also in the journals read by nurses in practice settings.
This is especially important. As Lauren Aaronson, PhD, RN, FAAN, chairperson of the steering committee for the Council for the Advancement of Nursing Science, the congress's sponsor, said in the press briefing, "It's the nurse at the bedside who raises the critical questions we should be researching." The challenge now will be to build on the momentum that nurses have created, despite a worsening nurse shortage and uncertain federal funding for research.