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Marti Buffum, APRN, at the San Francisco Veterans Affairs Medical Center, with a presentation on nursing research.

Jane Morse, RN, is living proof that you don’t have to have a graduate degree to work in nursing and medical research. Morse, a nurse at the Iowa City Veterans Affairs Medical Center is participating in her third research project.

She joined the research world in 1999 when a nurse who was working on a study on atrial fibrillation had to leave her job. Morse, whose nursing background included stints in cardiology and a cardiac catheterization lab, was asked to step in because she had experience reading telemetry strips.

“It sounded really interesting and at that point I thought it would be nice to do something because it was a national study and we 85 were able to do something for more than one patient at a time,” she says.

Morse now is participating in two research studies. One involves educating patients on blood thinners to monitor their health at home and to do so more frequently than they would if they had to go to a physician’s office for testing. The second study involves assessments of congestive heart failure patients by telephone or videophone. That study is supervised by Bonnie Wakefield, RN, PhD, associate chief of nursing research at the Iowa City VA hospital. Wakefield, who has been a nurse for 28 years, began conducting research in 1997 after earning her doctorate. She credits an enthusiastic college nursing professor with inspiring her to go into research.

“Her knowledge and enthusiasm for the effect that nursing research could have on patient care just motivated me,” she says. “I decided that’s the role I wanted to have.”

Patricia Grady, RN, PhD, FAAN, director of the National Institute of Nursing Research (NINR), says the NINR, a division of the National Institutes of Health, encourages nurses to become researchers to help develop a body of knowledge in the areas in which they are interested.

The NINR supports clinical and basic research to establish a scientific basis for care for everything from management of patients during illness and recovery to the reduction of risks for disease and disability. Nursing research also promotes healthy lifestyles, quality of life in those with chronic illness, and care for people who are dying.

“What we are doing is research to improve patient care,” says Grady, an internationally recognized stroke researcher. “Our research mostly looks at patient symptom management and involves behavior intervention. It also has a very large focus on prevention and health promotion as opposed to the medical model, which is the treatment/testing research model.”

Grady says one example of how nursing research can improve patient care is a study in California to help Hispanic adults with arthritis. Researchers came up with a program delivered in Spanish to arthritis sufferers that resulted in decreased reporting of pain and an increase in activity and exercise. The program has been adopted by the Arthritis Foundation in California, she says, and may be adopted nationwide.

Marti Buffum, APRN, DNSc, CS, associate chief of nursing service for research at the San Francisco Veterans Affairs Medical Center, has worked with both physician and nurse researchers. She says nurses and physicians generally have different approaches when it comes to conducting research. Physicians, she says, tend to focus on things like preventing diseases or which drugs work best. Nurses, on the other hand, generally don’t study drug treatments because they don’t prescribe medicine.

“What a nurse researcher delves into more is symptom management,” says Buffum, whose research has focused on dementia and pain management. Nurse research, for example, might look into how to help patients manage their illness, medication, or the aftereffects of a medical procedure. It also might involve helping a patient cope with mental illness or providing family members with the education they need to help a sick relative.

“Sometimes, pain treatments involve medication and so I usually will include a physician on my team as a coinvestigator,” says Buffum, who became a nurse in 1969 and earned her doctorate in 1992. “I look at MD researchers and nurse researchers as different but complementary, and I like it when they work together because I think they [each] bring a different skill set.”

Nurse researchers and physician researchers generally answer different questions, she says, but there is room for both types of research and they sometimes dovetail into one another or even cover the same territory.

“It depends on the nurse and the physician and their area of inquiry,” Buffum says. “It could be a nurse is asking a medical question or a physician is asking a question that overlaps nursing care.”

Familiar ground

Colleen Goode, RN, PhD, FAAN, vice president of patient services and chief nursing officer at the University of Colorado Hospital, often works in an area in which physicians would have little or no interest or expertise: nursing administration research. Goode has conducted research on nurse manager interventions that provide recognition to staff, how staff nurses participate in decision-making, and case management in acute care hospital settings, among others.

She also is known for her practice-changing research on vein irrigation comparing the use of heparin and saline. Her analysis of existing research showed that saline worked just as well as heparin and was both safer for the patient and less expensive. That research study is a good example of an area in which nurses would be much more interested than physicians, she says.

“Nurses are the ones that irrigate IVs and I was interested in it because it was a nursing intervention, whereas [physicians] would be interested in a medical intervention,” Goode says.

Morse, like Goode, has worked with both nurses with doctorate degrees and physician researchers and she, too, notices differences in the way they do their jobs.