Aspiring Nurse Researchers: Keep Asking Questions
I sat in the third row, staring blankly at the manuscript. My classmates and I carefully avoided eye contact with each other and the professor. Dr. K stood at the front of the room, arms folded, waiting for an answer to his simple question, “What does the table on page 8 mean?”
Panic crept in as we all stared at the hieroglyphs, which I thought used to be numbers. No one had a clue how to interpret the results, because none of us understood the statistical analysis that generated them. Suddenly confronted with academic work beyond my knowledge and experience, I felt defeated. Was I even cut out for graduate school?
Dr. K wasn’t trying to be cruel just for fun; he was proving a point. As researchers, my classmates and I would eventually find ourselves on a project or reviewing papers we couldn’t understand, but that doesn’t mean we should give up. We needed to learn to break the concepts into pieces we understood and figure out what they meant together.
Almost 10 years later, it is still one of the most important lessons I’ve ever learned: The best researchers aren’t the ones who know the most answers; they’re the ones who ask the best questions. I’ve also come to understand that my nursing career has taught me this lesson too.
Fostering Inquiry at the Bedside Is Key
My career began like many others: as a nursing assistant giving baths in a nursing home, then moving on to the local hospital. I asked lots of questions; many of them felt embarrassing, but I was lucky to have colleagues who encouraged my curiosity.
There was Dr. J, a hematologist, whose rounding put her in my sights right after I noticed one of my patient’s blood didn’t bead up when I pricked his finger to check his sugar. After I peppered her with questions, Dr. J spent 20 minutes downloading articles for me to read and explaining how shear forces between red blood cells help create viscosity in our blood. Then there was Paul, a physician’s assistant, who needed assistance with a lumbar puncture but ended up cornered until I was satisfied with his explanation of prion disease. In my defense, he mentioned Creutzfeldt-Jakob disease was part of his differential for the patient, and I had never heard of it before.
I worked my way through school and earned my practical nursing diploma, then my ADN at the local technical college. With each degree and each year of experience, I learned a little more and kept asking questions. I knew I wanted to be a scientist, but I had no idea how.
Finding a Research Mentor
I joined quality improvement projects and tried to start a journal club. I dreamed of a dramatic moment when an accomplished researcher would invite me to join their team. One day, after a particularly disappointing turnout at our campus’s nursing research committee, I sat in a small room with Sue, the system’s nursing research manager. I lamented to her, “I don’t get it. I’ve been trying, but no one seems to want to mentor me. I don’t know what I need to do.”
Sue tilted her head and raised her eyebrow, “I didn’t know you wanted a mentor. Who all have you asked?”
“I’m supposed to ask people?” I stared at her in disbelief.
It couldn’t possibly be that simple. But it was, and Sue became my first official research mentor. I started meeting with her regularly to set goals and evaluate my progress. She pushed me to complete my BSN, and when our hospital offered a free graduate certificate in clinical and translational science, we applied together.
The Question That Changed Everything
In 2019, I left the bedside. I had already moved from the emergency department (ED) to the float pool and cross-trained in the ICU to give me more flexibility to work on my master’s degree, but I decided I wanted a doctorate. I took a position launching and managing an ED-based HIV and HCV screening program. I spent my days building processes to help ED providers identify candidates for screening and writing code to make sure we gathered all the results directly from the electronic health record (EHR). My team contacted patients who tested positive and connected them with the infectious diseases department for treatment.
When COVID-19 emerged, I was auspiciously positioned at the intersection of critical care, informatics and infectious diseases. The health system asked me to develop and maintain a COVID-19 registry to support quality tracking, supply chain management and research. I was encouraged to leverage this local registry to join an international registry led by the Society of Critical Care Medicine. During one of the first meetings of the VIRUS COVID-19 Registry, I asked the group whether anyone was interested in automating extraction of the data from the EHR instead of abstracting it manually. I was rewarded for my curiosity with a committee to lead as chair, and I spent the next six months with a team of 30 health systems optimizing processes to pull the data we needed. My question turned into dozens of publications and a massive grant application (and award) with the U.S. Food and Drug Administration. I was offered my current job and lead of the project, as scientific director of an international research consortium where we advance tools for extracting EHR data.
Fostering Inquiry Is Key
As my career has evolved into leadership roles, I realize the importance of having a team that shares my passion for asking questions and driving innovation. Building a culture of curiosity, psychological safety and belonging in the team has been instrumental in our success. We constantly challenge each other’s assumptions, critique each other’s work, and remove the boundaries of what’s possible in our research.
I frequently travel to conferences and meetings with different members of the team. Typically, the team includes at least one postdoctoral fellow and Pam, the senior project manager. Pam is sharp, accomplished and the kind of organizational powerhouse that you want keeping the team focused and on time, yet she doesn’t have a scientific background.
At a recent conference, we were listening to Eric, a young postdoc, present a poster on his work exploring how digital health technologies (e.g., movement data from a smartwatch) could be used to identify patients at risk for postpartum depression. Pam listened carefully, then asked, “Did you check whether the patients had depression before the pregnancy?” Eric and I shared a glance. I was thrilled! Pam identified an essential consideration for the type of research Eric was presenting. In response to Pam’s question, Eric shared that he had considered it and planned to explore the potential limitation in future research.
Your Greatest Asset Is Your Team
Pam’s ability to ask such relevant questions keeps me on my toes. With postdoctoral fellows and even other scientists, it can be all too easy to hide behind jargon or simply share a publication. When Pam asks a question, I must stop and think about how to answer her. By taking her questions seriously, I can also signal to other team members how much I value curiosity. In business, this is called a growth mindset, an essential strategy to promote collaboration and success.
By investing in the team’s growth and fostering an environment where everyone feels empowered to ask questions and explore new ideas, we’ve tackled complex challenges and achieved remarkable outcomes. Each member brings their unique perspective and expertise to the table, enhancing our collective ability to make meaningful contributions in our field.
Whether you’re starting your research career or already in a leadership position, your team is your greatest asset. Cultivate a culture of curiosity, recruit diverse team members, provide opportunities for professional development, and encourage open communication and collaboration. A broad range of perspectives helps a team approach problems holistically and minimizes the influences of each individual’s cognitive and social biases (we all have them). Together, we can achieve remarkable advancements in science and improve patient care worldwide.
How to Get Started as a Nurse Scientist
If you’re intrigued by the idea of delving into research as a nurse, please take the first step. Here are a few actions to get started:
- Find a mentor you trust and engage them. (Ask!) Here’s a great article on how to work with a mentor.
- Ask for feedback and listen to it. “Radical Candor,” by Kim Scott, includes tips on how to give and receive feedback effectively.
- Join a professional organization, if you haven’t already. Like many other professional organizations, AACN offers opportunities to engage with your peers and seasoned colleagues.
- Join your hospital’s quality improvement or research committee. It will be your best opportunity to dip your toes into some projects and get your first experiences with research.
Nurses Are Natural Researchers
As nurses, we are natural problem solvers and advocates for our patients’ well-being. My research journey has taught me that curiosity and persistence are essential traits for success in this field. From my beginnings as a nursing assistant to leading critical projects at the intersection of healthcare and science, I’ve learned that the path to becoming a nurse researcher is not always straightforward. It requires dedication, mentorship and a willingness to ask the right questions.
Let’s continue pushing the boundaries of nursing knowledge and driving positive change in healthcare through research. Your unique perspective and passion for improving patient care can make a difference. Embrace the journey, keep asking questions, and never underestimate the influence you can have as a nurse researcher.
Reflect on a time when you had a question about a process in your department or an aspect of a patient’s plan of care. How did your question help you gain new knowledge? Did anything change in how your department works or how the team cared for the patient?
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