Many of the patients for whom Holli DeVon, PhD, RN, FAHA, FAAN, cared as a cardiovascular nurse knew what a heart attack should feel like or at least they thought they did.
Unfortunately, the classic Hollywood heart attack, with the severe, gripping chest pain, thats not the norm, DeVon said. Most patients we see in the emergency department have milder symptoms.
But that doesnt mean they dont do harm.
When DeVon left clinical care after decades at suburban Chicago hospitals for academia and a new career as a nurse researcher and, most recently, as associate professor at the College of Nursing at the University of Illinois at Chicago, she became determined to focus her work on uncovering the clues and spreading the knowledge to help nurses more quickly and properly diagnose those cardiac symptoms and then provide the care needed to minimize the damage.
In the years since, DeVons work, carried out as part of a team of nurse researchers from multiple institutions, has investigated the differences in cardiac symptoms among different demographic groups, and particularly among women knowledge that for some patients could be the difference between a mild, immediately treatable cardiac episode and one with much longer-lasting implications.
We know both men and women suffer the same symptoms during a heart attack, DeVon said. Chest pain, arm pain, nausea, fatigue. But what weve found is the differences lie in the proportions of the symptoms.
Later this year, DeVon and her colleagues will report further results related to patient demographics, as they wrap up a multi-site study involving more than 1,000 patients in Chicago, Tucson, Ariz., Sacramento, Calif., and Portland and Salem, Ore.
But that work represents just a sliver of the work, past and present, conducted by nurse researchers, the results of which have led to real improvements in the care of patients suffering from cardiovascular disease, or CVD. Across the country, nurse researchers some at universities and other schools of nursing, others still working in clinical practice have dedicated themselves to ferreting out through science the answers to vital questions on CVD. Recent research has focused on a variety of topics, as reflected in articles published in official journals, such as the Journal of Cardiovascular Nursing. Some nurses, for instance, have examined CVD among pregnant women. Others are looking at the effects of alcohol on the heart. For many nurses, however, the research consistently has returned to the core mission of nurses everywhere: To not only treat the patients disease, syndrome or symptoms, but also to help the patient gain the knowledge to understand what is happening and has happened, and then provide the treatments, technology and confidence to cope with the condition and yet live a full life of quality.
Patricia Davidson, PhD, MEd, RN, FAAN, has made that her goal since entering the research field. After two-and-a-half decades in clinical practice in Australia, Davidson eventually served as the director of the Centre for Cardiovascular and Chronic Care at the University of Technology in Sydney.
A year ago, Davidson came to the U.S., to take the position of dean of the Johns Hopkins University School of Nursing in Baltimore.
But through all of her work, whether as a clinician, researcher, teacher or administrator, Davidson said her focus has remained on improving support and palliative care for CVD patients, and particularly those who have suffered heart failure.
Were talking about a group of people who live with a very high symptom burden, Davidson said. And my biggest contribution, I think, has been to work to incorporate a palliative approach to care, to help patients and their families adjust to the reality of the condition.
At Emory Universitys Nell Hodgson Woodruff School of Nursing in Atlanta, Associate Dean Sandra Dunbar, PhD, RN, FAAN, FAHA, FPCNA, also has focused her research efforts on helping patients manage their treatment for cardiac problems, including those stemming from heart failure or serious arrhythmias. Through the years, her work has examined, among other aspects of care, how patients responded psychologically to the disease and the treatment, and how that affected their recovery. That, in turn, led to research into the role of family support in the patients psychological response and how the patient later cared for themselves after treatment.
Because nurses are so key in counseling and teaching patients and their families, I designed and tested nursing interventions to improve coping and psychological response to cardiac conditions, improve self-care and improve family support, Dunbar said.
Dunbars research findings also have been incorporated into patient teaching materials to help patients and their families talk about the condition and learn how to support each other as they cope and treat it with such technology as implanted defibrillators. Our families have told us we have given them new tools for simplifying and managing their cardiac conditions, Dunbar said.
Dunbar said she has now turned her attention to CVD patients who also suffer from diabetes, looking to uncover new ways to convey concepts of dealing with complex and competing diets, medications and symptom management.
Dunbar, Davidson and DeVon all said they believe nurse research on CVD has only scratched the surface, as nurses in the U.S. and around the world are just beginning to tap their potential to advance science and improve patient outcomes.
As an individual nurse, you can touch individual patients, Davidson said. And thats great.
But as a researcher, you have the capacity to affect the care of thousands or even millions of patients throughout the world.