Why combining nurse perspective with scientific approach improves care

A nurse-scientist at Palo Alto, Calif.-based Lucile Packard Children's Hospital Stanford is using her experience as a pediatric oncology nurse to examine how teens and young adults with cancer make decisions.

With more than 30 years of experience as a pediatric oncology nurse, Kimberly Pyke-Grimm recently earned a PhD in nursing. She is one of two nurse-scientists working at Lucile Packard Children's.

Dr. Pyke-Grimm's work is part of a larger trend in which nurses are bringing their perspective from clinical care to conduct research. She devotes 40 percent of her time to research at Packard Children's and 60 percent to patient care as a clinical nurse specialist.

She identifies good research questions, seeks funding, conducts and studies through the lens of a nurse.

For example, Dr. Pyke-Grimm published studies during the 1990s that uncovered different preferences for how parents wished to collaborate with their child's oncologists. The findings can help providers tailor medical discussions to families' needs when making decisions about their child's treatment.

"Nurses think about the human response to things because we spend so much time with patients in very desperate and stressful situations," Dr. Pyke-Grimm said. "Almost every day that I work as a clinical nurse specialist, I think 'We should study that!' or 'Why is it we're doing it this way?'"

After starting work at Stanford in 2011, Dr. Pyke-Grimm continued to study decision-making and focused her PhD dissertation on teens and young adults with cancer. These patients face a unique set of challenges, including medication adherence challenges, maintaining friendships and managing changes to their bodies.

"We hope that if we work on decision-making, communication and self-management, there will be opportunities to increase their adherence to treatment, and maybe even increase enrollment in clinical trials and improve survival rates," Dr. Pyke-Grimm said.

Dr. Pyke-Grimm's most recent work, which has revealed information about what types of decisions teens want to be involved in, is now being submitted for publication.

Next, she aims to test decision-making interventions based on what she has learned to see if they improve patient outcomes.

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