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Katrina Burtt, a member of the Mississippi Nurses Association, is an organ recovery coordinator with the Mississippi Organ Recovery Agency.
The majority of money spent on nursing research comes in the form of grants, ranging in size from modest to millions. For years, the American Nurses Foundation (ANF), the National Institute for Nursing Research (NINR), and the Sigma Theta Tau Honor Society have helped nurses turn their research goals into reality. And as nurses build their reputation as excellent researchers, these groups are embracing more projects and increasing their research dollars.
In addition to these recognized organizations, a number of other institutions have opened their doors to nursing research. Barbara Rogers, PhD, RN, a professor of nursing at the University of Mississippi Medical Center, in Jackson, and a member of the Mississippi Nurses Association Board of Directors, maintains that the scope of grants available to nurses has widened since she got her first $2,500 award from Sigma Theta Tau in 1969 to conduct a sleep study. In fact, by actively seeking out a variety of funding sources, she was able to specialize in her life’s work—diabetic wound healing.
“Getting research money is a sales job, in some ways,” she says. “You must be absolutely truthful, but you have to sell them on the notion that nobody has looked at this question quite the same way you will.” And that’s not all, Rogers explains. You also have to broaden your search. “There is a large untapped reserve for nursing research, because people go back to the same source for funding again and again. The Internet is a great tool for finding money for research.”
One of the reasons nurses are successful in getting grants is that RNs offer a unique, patient-centered approach to research projects, Rogers explains. “When we do research, we bring a holistic perspective. For instance, when I work with tissue cultures, I know the impact my findings can have on real patients,” she says. “So, as nurses, with our background and experiences caring for patients, we have a different outlook than, say, a biochemist in the lab.”
Encouraging new nurse researchers has been a cornerstone of the ANF since its establishment over 40 years ago. According to Leo Schargorodski, ANF director, more than 200 beginning researchers have received a total of $2 million since ANF was founded. This year, the foundation will award $125,000 in grants to 25 beginning and advanced researchers. To publicize and administer grants, the foundation collaborates with external sources of research funding, such as specialty nursing organizations and pharmaceutical companies.
“The emphasis here is to promote beginning nurse researchers, so that they become established and they have a track record of going to organizations and companies that could provide them greater and greater dollars as well as to the federal government,” Schargorodski explains. The typical ANF grant is $3,500 for beginning researchers, but Schargorodski says 1999 should see that amount increase to $5,000, with an increase to $7,500 for advanced researchers.
“These small grants [that ANF, Sigma Theta Tau, specialty nursing organizations, and related interest groups provide] are a real godsend when you’re germinating an idea,” says Anna Alt-White, PhD, RN, the 1997 Eastern Nursing Research Society Scholar, and recipient of a grant to study the effects of research dilemmas on critical care nursing. “When you have a new idea, like ours—we found nothing in the literature that addressed it—you can’t go to the National Institute of Nursing Research.”
The grant gives Alt-White, associate chief of nursing service, research at the Veterans Affairs Medical Center in Washington, DC, and her research partner, Maryann Pranulis, DNSc, RN, of San Diego, the chance to first develop their theory, then to establish that further investigation is called for, and finally, to apply for larger grants with their preliminary results.
The larger grants to which Alt-White refers include, but aren’t limited to, federal grants from the NINR, as well as grants from the privately supported Robert Wood Johnson Foundation, which funds community-based research. The NINR estimates that it has granted $58 million for intramural and extramural research. Both groups generally award grants to seasoned nurse researchers who have proven they can conduct and administer large, complex projects.
Rogers acknowledges that the establishment of the NINR in the 1980s offered much-needed attention, credibility, and prestige to nursing research.
“It gives us status in the arena of research,” she says. “We’re the new kids on the block. Even though Florence Nightingale was grounded in scientific data collection, nursing veered away from being an academic tradition to becoming one of apprenticeship. It took us a bit longer to return to an academic foundation. Now we have predoctoral and postdoctoral research training grants.” Rogers emphasizes that the key is to have a faculty member who has done the particular type of research you’re hoping to do. That way, they’ll know you have a mentor.
Lucy Marion, PhD, RN, FAAN, department head of public health, mental health, and administrative nursing at the University of Illinois at Chicago (UIC), was recently named one of the first Robert Wood Johnson Executive Nurse Fellows, and received a $30,000 matching fund grant.
In her position at UIC, Marion directs her own research and facilitates the work of several researchers within her department. Some of the projects are funded by the NINR, the National Institute for Mental Health, and other sources. One study examines a walking program for sedentary, mid-life women. Two others look at sexual behavior and reducing the risk of sexually transmitted diseases (STDs) in Latino adolescents.
“All of these are big, fully funded grants, and are practice-based,” she says. “Everything we learn from our research can be applied directly to clinical practice. From these studies, we have developed instruments that clinicians can use. The walking program is highly successful in terms of generating knowledge about exercise in mid-life women who didn’t exercise previously. It includes physiologic measures—body composition, blood measures, stress tests—before and after. It has been on national TV and been published many places. So, we’re generating new knowledge; the women are getting healthier, and they’re also asking us as nurses, ‘Where can I go for better health care?’ It’s an integration—not just being a researcher is important, but being a nurse and a researcher at the same time is key.”
Currently, Marion is writing a grant application for $3 million to the NINR. The project aims to reduce by 40% the STD reinfection rate among young, low-income, African American women who live on Chicago’s West Side. Marion has brought together several local entities and the university to address the project. The study will provide a comprehensive case-managed package of care, and will be administered by advanced practice registered nurses.
“Everything that’s in the literature we’ve put together. Most of the studies do one or the other, and they haven’t made a package that might be able to work in a managed care environment,” Marion says. “It wouldn’t cost this much if we were just providing the services, but we are doing all of the research that goes with it—all of the measures, all of the rigor that goes into a true story—to get clear, well-documented outcomes. This is as good as it gets.”
The type of study Marion describes can have dramatic impact on public health by improving the health of Chicago residents and reducing the amount of money spent on treating STD reinfections.
Other research projects, such as the one undertaken by Elizabeth Capezuti, PhD, RN, may radically change the way bedside nurses provide care in nursing homes and hospitals, and will offer new safeguards for elderly patients. Capezuti was named the Virginia Stone, RN Scholar when she received an ANF grant this year. She will use the grant, along with others, to further her research into side rail use in nursing homes. She says the money is essential in collecting data on an adequate number of patients, and that it is the product of a decade of work.
“I’m part of a team at the University of Pennsylvania [that includes nurse researchers, geriatricians, an internist-epidemiologist, and a biostatistician] that has been working for the last 10 years on reducing restraint use,” she says. “The kind of work I’m doing is to improve the care of frail nursing home residents. Right now, I’m focusing on interventions to prevent falls from bed. Side rails are an intervention that nurses often employ to reduce falls, but they’ve been associated with an incidence of greater injury. So I’m testing new interventions—low beds, different types of short side rails, cushions that define the borders of beds, and so on.” Capezuti says the results of her research will benefit patients by offering new solutions for nurses providing their care.
“We’re trying to change our practice from what we assumed works to what is based on scientific evidence,” she says. “Ultimately, we are trying to help staff nurses by giving them a new repertoire of interventions that we think will work better.”
The collaboration of her team members, Capezuti believes, has shaped and directed the research project. “Being part of a team really makes it happen,” she says. “Those different perspectives represented by the variety of people sitting at that table really enhance your ability to ask new and more meaningful questions.” Alt-White echoes that sentiment: “Working in collaboration with your peers, no matter what your experience or expertise, enriches you.”
Marion, who notes that the merger of her department (public health, mental health, and administrative nursing) created a “fertile environment for research,” predicts the future looks promising for nurses engaging in research. She has been asked to create a degree for nursing for those interested in directing research studies.
“This is good for nurses, because we are out there with people,” she explains. “Nurses are excellent project directors. When you look in the newspaper, you see ads asking for nurse managers for major research projects. That’s who they want. Everybody knows a nurse is the best project manager you can get. We’ll find the best way to address that, whether it’s through a new master’s degree, or a postgraduate certificate.”