Bridging Nursing Practice and Research
Innovative Role Connects Children's Hospital and School of Nursing:
Last May, the University of Wisconsin-Madison School of Nursing and American Family Children's Hospital ventured into uncharted territory by jointly hiring the very first pediatric nurse scholar, a position that reports to both organizations with the goal of accelerating the translation of nursing research into clinical practice.
After an extensive search, Anne Ersig, PhD, RN, was selected as the best person to help both organizations innovate through the typically lengthy process of identifying practice challenges and implementing evidence-based solutions.
Fortunately, the children's hospital and nursing school are not new to collaboration. Over the years, many nursing students, preceptors, nurses, researchers and administrators have worked together to mutual benefit. These successes led to an academic practice partnership, signed by the dean of the School of Nursing and chief nurse executive at UW Health in 2016, to formalize the collaboration and generate new opportunities to improve nursing education, facilitate research and advance nursing practice.
The pediatric nurse scholar position is a key part of that strategy, intended to leverage and align the vast clinical and research leadership that exists across both organizations.
From the beginning, Ersig has seen her role as one that spans the two nursing worlds so that information and insights can flow back and forth, experiences in practice can raise research questions, and research findings can inform and improve practice.
"I don't need to be involved in everything, but my goal is to facilitate these types of things," she says.
Ersig came to Madison from Pennsylvania, where she served as a nurse researcher at the Children's Hospital of Philadelphia and as an assistant professor at the University of Iowa-College of Nursing, where she earned her PhD and pursued research on the genomics of chronic stress and anxiety.
As the pediatric nurse scholar, Ersig splits her time between her clinical colleagues and her research peers and students.
Q. What appealed to you about the pediatric nurse scholar position?
A. I missed the academic environment and I wanted time to pursue my own research. Yet I also love nursing practice. This is an opportunity to connect the two. I can help build a culture of scholarship and inquiry on the clinical side and advance science and nursing research on the academic side.
Q. This is a new position. How did you spend your first few months here?
A. I scheduled "meet and greets" with clinical nurse specialists, nurse managers, nurse educators, administrators, leaders and teams comprised of nurses, physicians, social workers and therapists, to learn more about their respective areas and identify shared priorities and interests across the hospital to help form the basis for organization-wide projects and studies, and provide opportunities for connecting nursing faculty, researchers and students from the School of Nursing with projects and teams at the hospital.
I also took the time to work on my own line of research by meeting with multiple groups and individuals across campus whose expertise and interests align with mine. I view this as my first "pass through the buffet." I sampled everything, and now I'm developing a list of priority projects.
Q. What are those priority projects?
A. I've identified three priority topics at Children's Hospital that cross over unit and specialty boundaries. The first is transitions of care. The second is teamwork, collaboration, and interprofessional communication, education, and practice. The third is stress, burnout and resilience - in all groups, including staff, patients and families. The priority projects are those that involve one or more of these topics.
Q. Can you point to any specific projects within those topics that presented themselves as good opportunities for collaboration?
A. There are several. One physician mentioned an interest in using mindfulness to develop resilience on her team. I also heard from a nurse manager who saw her staff struggle with stress and burnout, and she, too, wanted to find ways to build resilience. The exact language was different from unit to unit, but the desire to develop resilience was a consistent theme across the organization.
We are moving forward with creating a work group to identify and evaluate evidence-based strategies that could work for the different groups. One of our DNP students, who is also a practicing RN at the hospital, will be joining that work group to represent nursing and, perhaps, to determine whether it could develop into a scholarly project, which is a requirement of the DNP program. Also, my own research deals with chronic stress and anxiety and I am exploring whether there may be some opportunity for me as well.
Another physician expressed an interest in interprofessional education, which we embrace and promote at the School of Nursing. That led directly to an opportunity for four undergraduate nursing students to shadow the interprofessional team in the Diagnostic and Therapy Center (DTC) while their assigned preceptor was on leave. This gave them the opportunity to observe care in a less well-known clinical area; their feedback on the shadowing sessions also highlighted the interprofessional collaborations among team members in the DTC and how essential those are to providing excellent care.
Q. Barb Byrne, vice president of clinical operations at American Family Children's Hospital, has said that one of the goals of this position is to facilitate the dissemination of findings. In other words, she wants nurses to recognize they can drive change, find ways to do it, and then share what they learn so they can improve nursing practice and all of healthcare across the country and even around the world. This seems like a tall order. What do you think?
A. I agree with Dr. Byrne. If we find a way to improve care, we need to share it and share it widely. It shows commitment to all pediatric patients and their families, and it shows leadership in nursing and healthcare. But I believe it is also a fundamental aspect of nursing. Ultimately, the goal is to improve child and family health and wellbeing. One of the ways nurses do that is through direct patient care, patient-by-patient, family-by-family.
Another way is by disseminating our discoveries so that other health systems can learn from our findings and adopt evidence-based methods that work. The School of Nursing knows how to do that, and that is one of the things we bring to the partnership.
Q. Dean Linda D. Scott has described this position as innovative and forward-thinking. What do you think she means by that, and do you agree?
A. The position - and the partnership that created it - aligns with the National Institute of Nursing Research's vision for the future of science that encourages more partnership between those who are experts in generating nursing knowledge and those who are experts in translating and applying it. This is where nursing - and all of healthcare - is headed.
Of course, translating research into practice is already happening, but it takes, on average (nationally), 17 years. That's way too long!
While American Family Children's Hospital and the School of Nursing may not be the largest clinical and academic institutions, they are just the right size to identify innovative research findings, implement and test them in practice, and then share what we find with others. This is how we're going to advance health care in this country - through key alliances and partnerships between the clinical and academic setting.
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