Nurses have always been the backbone of patient care in hospitals, a fundamental truth highlighted repeatedly during the endlessly punishing demands of caring for the profoundly ill during the COVID-19 pandemic.

What most of us don’t realize — including professionals inside health care — is that nurses are quietly working to make care even stronger by helping run clinical research efforts that look for new ways to ease pain and speed recovery.

Gloria Walters.

After all, they spend their work lives at the bedside of patients. Who better to pioneer new ways for improved care?

Gloria Walters, Ph.D., nurse scientist at Novant Health, said that in addition to the health care system’s ongoing involvement in hundreds of device and drug-related clinical trials each year, nurses are empowered to propose and lead clinical studies of their own.

“Our nurses have great ideas when it comes to research,” said Walters. “Each year, they inspire and help lead dozens of clinical studies across multiple disciplines including orthopedics, diversity and inclusion and oncology.”

A heart for service

Nurse Bonnie Koski always knew that she wanted to be a nurse with a special interest in orthopedics.

“I liked the idea of being able to help someone in pain walk out of surgery pain-free,” she said. “My parents thought it was a good fit, and my grandmother actually used to send me newspaper clippings about nurses as a way to encourage me while I was in school.”

Koski ultimately chose to work at Novant Health Charlotte Orthopedic Hospital because of its excellence in nursing and Magnet recognition, which requires nurse-led clinical research.

“The Magnet distinction was incredibly important to me,” she said. “It means nurses have a seat at the table, and we get to not only provide care at the bedside, but also help to drive best practices for our patients.”

Since joining Novant Health in 2012, Koski has always been involved in meaningful work. Outside of her normal duties as the hospital’s clinical quality management coordinator, she recently served as the principle investigator in a nurse-led clinical trial. The research, inspired by a bedside nurse’s idea, set out to determine if reflexology, a form of post-surgery massage therapy, would reduce pain and anxiety after total joint replacement. The results were significant and driven by a team of front-line and passionate nurses.

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Making a difference

While Koski didn’t come up with the original idea of the orthopedic reflexology study, she was happy to essentially serve as overseer of the trial. In that capacity, she worked with an interdisciplinary team, which included Walters and Julie Jerman, an operational improvement advisor, to flesh out the idea and get it approved by the internal nursing research council and the institutional review board (IRB).

Bonnie Koski
Nurse Bonnie Koski holds up a thank you card she received for being a health care hero during the COVID-19 pandemic.

“If it sounds like a lot of work, that’s because it is,” said Walters. “On top of their day jobs, these nurses help drive their ideas forward by researching the topic and getting buy-in from the necessary review boards before they can proceed. In this case, the trial was well written and given the green light.”

The study launched at the end of 2019 and included 100 participants. Half the group received massage therapy, while the other half did not. When the trial concluded in summer 2020, patients who had received massage therapy averaged a 3.36 on a 0-10 pain scale. Those who did not averaged 5.2. Anxiety results were similar.

“We had a feeling that when we brought on a massage therapist that it would make a big impact,” said Walters. “But we wanted to be able to prove it with science. Now other departments are thinking about adding massage therapy for their patients.”

As the principle investigator, Koski is currently in the final write-up phase of the clinical trial. Once complete, the team’s research will be published and help inspire best practices for the next generation.

“It’s always nice when you see the results you want to see,” said Koski. “But more importantly, I think we’re only starting to realize the important role that nurses play in health care. We’re not just here to provide comfort, we have our own knowledge base and expertise, and we’re always looking to find new ways to contribute.”

Top photo: Bonnie Koski and Julie Jerman discuss clinical research at Novant Health Charlotte Orthopedic Hospital.