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November 2004 Issue

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UC Nurse Scientists Boost Development of Quality Care

Published November 2004

From their early days as "handmaidens" to a then patriarchal medical profession, nurses have long since assumed significant, decision-making roles on what is now a multidisciplinary health care delivery team.

In the past 15 to 20 years, however, nursing has evolved even further. Nurses are moving from the bedside to the research bench in a growing trend to nursing-oriented science.

Nurses are not only in the forefront of delivering quality health care. They're also playing an increasingly important part in developing it.

A measure of how important their role is viewed by health care governance in the U.S. is that fact that nurses now have their own National Institute of Nursing Research at the National Institutes of Health (NIH).

Where once any nurse "doing research" was at best a project director implementing someone else's protocol, today's nurse scientist is very likely to be the funded principal investigator directing a team of physicians or PhDs.

"In some areas nurses are now the senior, mentoring scientist, and that's a real switch," says Marilyn (Lynn) Sommers, PhD, RN, associate dean of research at UC College of Nursing and head of the school's Institute for Nursing Research.

Dr. Sommers, herself heading two major studies funded by the Centers for Disease Control and Prevention (CDC) and the NIH, says training doctoral-level nurses in investigative techniques not only advances patient care and professional education—their research also generates hotly contended external funding.

And it's this "grantsmanship" that wins respect and acceptance in the highly competitive, cash-conscious milieu of growing academic health centers like UC.

In the 1980s, says Dr. Sommers, academic nursing saw the value in graduating more scientists as well as doctoral-level educators. But, she says, "there was ambivalence then about their role."

Critics questioned whether nurses could in fact do "rigorous" science, and many nursing schools had trouble getting accredited to grant the PhD degree. From a handful 20 years ago, however, there are now 90 nursing schools in the U.S. granting PhD and DNSc degrees.

"Opponents thought the money could be better used," Dr. Sommers says. "We had to make a strong argument about what nurses have to contribute to research. Demonstrating a body of knowledge took 10 to 15 years.

"Since then nurses have gone head-to-head with scientists in other disciplines and shown their science can hold its own."

For example, the College of Nursing has increased its research funding from $420,000 in 1991_92 to $1.8 million in 2004, much of it from the CDC, the National Institute for Occupational Safety and Health, the National Institute on Alcohol Abuse and Alcoholism and the National Institute of Nursing Research.

But what do nurse researchers do to justify funding that others say could be "better used" elsewhere?

It's a familiar question to Dr. Sommers.

"The main difference," she says,"is that the physician scientist generally studies interventions conducive to cure. The nurse is more concerned with prevention, and what works best to help patients live with their disease. Timewise, in fact, patients come to the hospital more for nursing than for physician care.

"For example, the cancer specialist studies whether radiation, chemother-apy or surgery is the best approach. The nurse sees a cancer patient as a person who will suffer from profound fatigue and asks what the interventions should be.

"Both views are equally important," says Dr. Sommers. "One seeks the best cure. The other studies the best way for patients to live and cope with the diagnosis and manage their symptoms. Whether it's diabetes or heart failure or even nausea in pregnancy, they want a better quality of life, and nurses are in the best position to find ways to achieve that.

"Of course we need to continue to spend money on finding cures, and physicians are the best people to do that," Dr. Sommers says. "But we must also find new ways to prevent disease, and help people live to their fullest when they become ill.

"I believe people very much want to live better with their diseases. If that's the case, then the argument for nurses in research is won.

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