1. Please provide a brief description of your STEP Signature Project.
For my STEP Undergraduate Research Project, I participated in a study seeking to understand the effects of Reiki therapy on mechanically ventilated older adults in the Intensive Care Unit (ICU). Through the College of Nursing Honors Program, I have seen this study develop, garner IRB approval, and begin recruiting patients. My role this summer mainly consisted of being a sham-Reiki interventionist (the study’s ‘placebo’). I also developed my research skills by starting a separate systematic review on the barriers and facilitators of ABCDEF bundle implementation with my mentor. I enhanced my understanding of inpatient nursing by working part-time as a Patient Care Assistant (PCA) at Nationwide Children’s Hospital.
2. What about your understanding of yourself, your assumptions, or your view of the world changed/transformed while completing your STEP Signature Project?
Before beginning to work on this project, my understanding of research was very much associated with science fair experiences of my youth. The experiments I conducted in that setting helped me develop a passion for science and nurtured my interest in the scientific process. In my undergraduate nursing curriculum, we are immersed in the cutting-edge world of evidence-based practice (EBP). Learning the nurse’s role in integrating the highest levels of evidence to enhance patient care led me to take part in the College of Nursing’s research-focused Honors program and eventually take part in this study.
In the time I’ve worked with the RISE-ICU study, I have grown to learn that in order to produce high quality evidence we can safely translate to practice, the research process must be rigorous and thorough. I also learned of the great number of parties involved in a successful study – Principal Investigators, Clinical Research Coordinators, statisticians, the Institutional Review Board, and the patient’s care team (RNs, RTs, PCAs) in the hospital, to name a few. I now have a more realistic understanding of the amount of time and effort which is needed to produce a high quality study. Additionally, I understand more clearly the roles of a nurse scientist and a bedside nurse in research.
3. What events, interactions, relationships, or activities during your STEP Signature Project led to the change/transformation that you discussed in #2, and how did those affect you?
My relationship with my mentor, Dr. Michele Balas, has helped shape me as a student, researcher, and healthcare provider. She has taught me the importance of being self-motivated in each of these three roles. Dr. Balas grants me autonomy in my work while simultaneously being an accessible resource to support me in my learning experience. Particularly through the addition of a systematic review to my project, Dr. Balas has taught me how to develop a relevant research question and review the literature existing on the topic. She has also helped me grow in resilience and taught me the benefits of a curious mind. I am grateful for the ways she has shown me how to advocate for myself, for my patients, and for my work.
Having had the opportunity to work with the study since its beginnings in Autumn of 2017, I have grown in patience and in my understanding of the research process. Completing the sham-Reiki intervention in the inpatient setting provided me with the challenge of coordinating with the care team, especially the patient’s nurse, when I could complete the intervention. This will influence my future practice as a bedside nurse, as I have an increased appreciation for promoting the research process, or as a nurse scientist, understanding the barriers that come with implementing a study to patient care.
An interesting intersection of my research experience and my part-time job as a PCA in the hospital occurred in the times I worked in the ICUs, which was also the setting of the RISE-ICU study and the typical environment in which the ABCDEF bundle is implemented. There were several instances where I used light-touch therapy and massage therapy techniques to calm patients who were experiencing agitation and allow them to sleep. The knowledge of how to do this and of the evidence suggesting its benefits came from my involvement in the RISE-ICU study. I am grateful to Dr. Susan Thrane, co-PI of the study, for her mentorship and guidance on how to incorporate these complementary therapies into practice.
Additionally, the hospital uses an early mobility (the “E” of the ABCDEF bundle) program; this allowed me to see first-hand the barriers and facilitators to its implementation which I was learning about as I reviewed the literature for my systematic review. I engaged in conversation with the hospital’s physical and occupational therapists, their main champions of the early mobility protocol, and was able to understand their perspective on the program. It was a fruitful opportunity for me to see the implementation of an evidence-based intervention in practice as it reminded me of the improvement to patient care that will hopefully come from our research.
4. Why is this change/transformation significant or valuable for your life?
The transformation I’ve experienced through my STEP Signature Project is significant in my life because it has helped me understand the career potential of a nurse involved in research. This experience, in tandem with my clinical experiences through the nursing program, has allowed me to make an educated decision on my future career plans. I hope to become a Nurse Practitioner and will have an even greater responsibility to incorporate evidence into practice to provide my patients with the best outcomes. Working on this project has given me a greater appreciation for the evidence we use to guide our decision-making in healthcare. Additionally, my new familiarity with the process of conducting a high-quality RCT will help me to decipher the evidence presented by studies I will read in the future and enhance my ability to choose what to incorporate into practice. I am grateful for the learning opportunities the STEP Transformational project has allowed me.
Here is a link to a YouTube video of Dr. Susan Thrane, one of the study’s co-PIs, discussing her research: https://www.youtube.com/watch?v=3hBJiZIkxKU. The images within the video show the intervention I was delivering as a sham-Reiki therapist.