Advancing the Nursing Profession Through Science

Research is key to supporting evidence-based practice in all medical specialties and populations, ranging from anesthesiology to urology and pediatrics to geriatrics. It’s equally important in nursing.

“Nursing is more than just the tasks performed by clinical nurses,” says Cynthia Danford, PhD, CRNP, PPCNP-BC, CPNP-PC, FAAN, Nurse Scientist II in the Office of Nursing Research & Innovation at Cleveland Clinic. “There is a science behind it – evidence behind what we do, how we do it and how we make care decisions for our patients. Keeping research front and center helps us maintain that focus.”

Danford is one of six nurse scientists at Cleveland Clinic, including Nancy M. Albert, PhD, CCNS, CHFN, CCRN, NE-BC, FAHA, FCCM, FHFSA, FAAN, Executive Director, Associate Chief Nursing Officer of Nursing Research & Innovation. While many nursing professionals participate in research projects, the nursing scientist role is distinct.

“A nurse scientist is a PhD-prepared nurse whose focus is developing and contributing to the science of nursing through research,” says Nurse Scientist II Karen S. Distelhorst, PhD, APRN, GCNS-BC. “Scientist roles can vary across settings depending upon the type and needs of the site where someone is employed. At Cleveland Clinic, our role is multi-purpose. We develop our own program of nursing research, mentor health system nurses in developing, implementing, disseminating and translating research and assist nurses and teams in understanding evidence-based practice (EBP).”

Researchers and mentors

Nurse scientists often begin their careers in clinical settings before something drives them to pursue a research specialty. Distelhorst was a clinical nurse specialist at Cleveland Clinic South Pointe Hospital when the facility sought to earn Magnet® designation. She conducted a research project – a required component of the Magnet Recognition Program – and “caught the research bug.” After earning her PhD in 2020, Distelhorst became a nurse scientist at Cleveland Clinic.

Danford, who specializes in pediatric nursing and primary care, held a faculty position at the University of Pittsburgh School of Nursing prior to joining Cleveland Clinic’s Office of Nursing Research & Innovation more than three years ago. One of the courses she taught explored career options, including becoming a nurse scientist. She wanted to learn more about the role, so she reached out to Albert.

“After several conversations with Nancy, I realized this could be a really good opportunity for me,” recalls Danford. “I could blend my teaching experience with my research background and expand my abilities beyond my own methodologies.”

Nurse scientists at Cleveland Clinic divide their time between two primary areas – conducting research and mentoring nurses in research. Distelhorst studies social determinants of health and how they impact patient outcomes. Danford examines family-focused interventions for pediatric patients and their families to help establish healthier lifestyle behaviors.

Both nurse scientists mentor approximately 20 to 24 clinical nurses at any given time who are in various stages of research projects, from developing a research question and writing a protocol to getting approval from Cleveland Clinic’s Institutional Review Board (IRB), conducting the study and drafting the results for publication.

“Research isn’t the first job for most health system-based nurses. They take care of patients or have specialty roles, and patients or primary work expectations come first,” says Distelhorst. “Some projects take longer than others; some require multi-site or multidisciplinary collaboration, and others may be paused if other priorities emerge. We follow the lead of what nurses can handle and encourage and support them to move forward. It’s their research, not ours.”

Opportunities to grow and learn

In addition, nurse scientists have global leadership responsibilities. They prepare and present workshops for nurses and other Cleveland Clinic caregivers, serve as liaisons with hospital Shared Governance Research Councils, present research or clinical content at meetings for their respective professional organizations, help the healthcare system rigorously evaluate programs and practice decisions, and more.

“There is no typical day in the life of a nurse scientist, and that’s one of the things I like about it – the variety,” says Danford.

Another aspect of the job that she and Distelhorst appreciate is that they are continually learning. Although Danford specializes in pediatrics – and still consults with a child life center – she mentors nurses in neurology and other areas.

“It’s broadened my viewpoint. Even though we practice in different areas, nursing has fundamental principles that still apply,” says Danford. “Nurses have amazing ideas, and they are on the forefront of bringing those ideas forward. That’s exciting.”

Nurse scientists also continue to learn about research philosophies, approaches and methodologies.

“When you finish your PhD, you are a budding expert in one type of research related to your dissertation,” says Distelhorst. “As a nurse scientist, you have the opportunity to learn and apply many different types of research designs and methods, implement them along with the nurses you mentor and broaden your own understanding of research processes.”

The road to becoming a nurse scientist

Distelhorst and Danford encourage anyone who has a research idea to reach out to local internal or external nurse scientists.

“Research is open to any nurse, and we are here to help any nursing caregiver within our health system,” says Distelhorst.

In the course of serving as mentors, nurse scientists have identified caregivers who they believe are a good fit for a nurse scientist specialty. Danford is currently guiding one such nurse on the final steps of her research project – submitting the results for publication.

“She has embraced every step of the way and worked very hard. And there have been some bumps in the road that she’s handled beautifully,” says Danford. “I’ve encouraged her to consider going back for her PhD, and she’s thinking about it.”

So how do you know if earning a PhD and becoming a nurse scientist is right for you?

“Some nurses who go on for an advanced degree are focused on quality and EBP and want to make a difference in the hospitals where they work, so they pursue obtaining a Doctor of Nursing Practice degree,” says Distelhorst. “The nurses I encourage to pursue their PhD are conceptual thinkers – really big-picture thinkers – who have the ability to break down concepts and understand how they impact nursing care locally and globally.”

Distelhorst and Danford recommend that anyone considering the nurse scientist field:

• Learn more about nursing research. Nursing scientists are supported by several national organizations, including the National Institute of Nursing Research, the Council for the Advancement of Nursing Science and the Association for Leadership Science in Nursing.
• Get involved in research projects, not only as a principal investigator but also as a contributor.
• Join research committees at your hospital.
• Network with others internal and external to your worksite who are involved in research.

“Research is incredibly impactful. It leads to improvements in healthcare delivery and patient outcomes,” says Danford. “Cleveland Clinic is well known for our innovations and advancements, and research is integral to both.”