Nursing

Hello.

Welcome to Mayo Clinic Nursing Research.

I am Dr. Linda Chlan. I have the honor and privilege of serving as the first associate dean for nursing research at Mayo Clinic. My role is to lead and advance Mayo Nursing Research across all of our Mayo Clinic sites, including the Destination Medical Center campuses of Rochester, Jacksonville, and Arizona, as well as the Mayo Clinic Health System.

Nursing research at Mayo Clinic generates science to address unmet needs of patients with complex health care conditions. Specifically, our nurse scientists seek solutions to the myriad, complex health care needs through the conduct of independent programs of research in the broad areas of symptom science, self-management science, and caregiving science, encompassing both lay family as well as professional caregivers.

I would like to take this opportunity to introduce you to our nurse scientists in the Division of Nursing Research. We have four nurse scientists on the Mayo Clinic Rochester campus.

Dr. Sherry Chesak's program of research is centered on caregiver science. She investigates mindfulness-based interventions aimed at decreasing stress and promoting resilience among caregivers of patients with complex health care needs. She also studies burnout and how to mitigate burnout syndrome among clinicians.

Dr. Heidi Lindroth's program of research focuses on innovative, scalable and sustainable solutions to individualize care and mitigate the symptoms and severity of delirium, a form of acute brain dysfunction among hospitalized patients, including vulnerability to delirium, identifying at-risk individuals, and predicting delirium.

Dr. Samantha Conley studies self-management science among persons with chronic health conditions, specifically inflammatory bowel disease. IBD has periods of disease activity and inactivity that significantly impact sleep and the well-being of adults in their prime.

Dr. Elizabeth Umberfield is the newest addition to the Rochester nurse scientists. Dr. Umberfield's program of research is focused on informatics and health technology to benefit patients and getting technology solutions to patients in a seamless manner. She is interested in standardized language among systems in order to facilitate sharing of health information.

In Florida, Dr. Cindy Tofthagen's program of research is focused on management of cancer treatment- related symptoms. Chemotherapy, radiation therapy, targeted therapies, and immunotherapies have numerous side effects that create significant physical, emotional, and financial burdens for patients and their families. The goal of this research is to find effective ways to prevent or treat these side effects, as well as to help patients better self-manage symptoms and side effects at home.

In Arizona, Dr. Komal Singh's research program is focused on symptom science to evaluate underlying biological mechanisms associated with symptom occurrence and severity so that targeted interventions can be designed to help alleviate symptom burden in patients with cancer.

Dr. Stacy Al-Saleh is a postdoctoral nursing research scholar supported by a gift from the late King Hussein of Jordan in recognition of the nursing care received at Mayo Clinic. Dr. Al-Saleh is focused on the unmet needs for self-management among persons who have undergone organ transplantation, as well as the numerous needs in this population for symptom self-management due to numerous therapies and medications necessary to maintain the viability of the transplanted organ.

Thank you for taking the time to view this video. I invite you to take a closer look at Mayo Clinic Nursing Research and consider growing your program of scientific inquiry in one of our open positions.

Best wishes for good health.

Hello, I'm Dr. Linda Chlan, the associate dean for nursing research and professor of nursing at Mayo Clinic. In addition to my administrative leadership responsibilities as the Mayo-wide associate dean for nursing research, I maintain my own independent program of extramurally funded research.

My clinical nursing experiences caring for critically ill patients receiving mechanical ventilatory support in the intensive care unit, continue to inform my program of research today. A majority of my research career over the past 15 years has been focused on testing music listening. Music can be a very powerful anxiety- reducing intervention when applied correctly with preferred, familiar, relaxing music for critically ill patients.

The other focus of my research is testing innovative interventions that appropriately empower critically ill, mechanically ventilated patients, to self-administer their own sedative therapy based on their individual needs. Patient-controlled sedation, mirrors patient-controlled analgesia, which has been used for 40 years in clinical practice to effectively manage pain with high patient satisfaction ratings.

Currently, I am leading two ongoing multidisciplinary teams in the conduct of clinical trials in the setting of the ICU. The first study is testing patient self-administration of sedative therapy with dexmedetomidine to promote self-management of anxiety, a common distressful symptom among critically ill, mechanically ventilated patients.

The second clinical trial, funded by the NIH music and health initiative, is testing a seven-day, slow-tempo music listening intervention as a complex, cognitive stimulus to activate brain regions in order to reduce the burden of delirium, a common brain dysfunction syndrome among critically ill hospitalized patients.

I received my Bachelor of Arts degree in nursing from the College of St. Scholastica in Duluth, Minnesota. My master's and Ph.D. degrees in nursing, are from the University of Minnesota. I received postdoctoral research training at the University of Iowa College of Nursing, specifically in the area of nursing interventions and outcomes.

My program of research has always been patient-centered. I derive great satisfaction in improving patient outcomes and providing comfort to critically ill patients at a very distressful time in their lives. I hope you will take a closer look at our cutting-edge science at Mayo Clinic.

Robert R. Bennett, Nurse Scientist: Hello, my name is Dr. Robert Bennett and I'm a Nurse Scientist at Mayo Clinic in Arizona. I specialize in adolescent and young adult, or AYA Oncology and Palliative Care Research.

My years of clinical practice taught me that casual conversations with my patients are opportunities for us to form a connection. These discussions with my AYA patients revealed important personal information which helped me understand their priorities and created valuable segways into goals of care conversations.

Through these exchanges, I developed an interest in psychosocial outcomes in the AYA population. Receiving a cancer diagnosis and cancer treatment are traumatic events, especially during developmental stages like adolescence and young adulthood, a time associated with previously imagined paths and possibilities.

Cancer frequently disrupts these plans and steps towards independence, such as pursuing higher education, socializing, dating, and working. Depression and anxiety commonly occur in AYAs during cancer treatment and survivorship. If untreated, these can become chronic problems which ultimately impact the rest of their adult lives.

What I've learned from my experience working with AYAs is that each of them has a unique story to share. However, some parts of their stories can be triggering or too upsetting to discuss because traumatic events are mentally stored as images. Creative art provides a non-threatening way for AYAs to process their experiences with cancer, and shape these into understandable forms.

The focus of my research at Mayo Clinic is to develop digital media interventions to help AYA cancer survivors successfully process their experiences. Through resolving their underlying trauma we can begin to improve AYA cancer survivors mental health outcomes and work towards improving the quality of their cancer survivorship.

I received my PH.D. from the University of Colorado Denver and completed my Postdoctoral Fellowship in Palliative Care and Aging Research at the University of Colorado School of Medicine. As both a nurse scientist and pediatric nurse practitioner, my ultimate goal is to help patients live with the best quality of life possible and with the greatest amount of purpose.

It's truly a privilege to perform this work, and I'm grateful to do so at Mayo Clinic.

Hi, I'm Sherry Chesak, a nurse scientist at Mayo Clinic, and my program of research has centered on care for the caregiver. I study the measurement of stress among family and professional caregivers and primarily focus on the investigation of mindfulness-based interventions, which have been well-documented to lead to decreases in stress and improvements in resilience.

Family caregivers, including relatives, friends, and partners, take on major responsibilities in the care of those who are facing complex health conditions. So they are very important members of the health care team. They are often thrust into the role unexpectedly and are responsible for supporting the patient, not just physically, but also psychologically, spiritually, and emotionally.

The weight of these responsibilities can lead to many negative physical and emotional symptoms. And research has shown that when caregivers take good care of themselves, they tend to provide a higher quality of care to the care recipient. So I aim to identify best practices for promoting self-care and resilience among caregivers that will assist them in managing their stress and promoting their ability to provide optimal, compassionate care.

I am also concerned about the well-documented all-time high levels of burnout among clinicians. This burnout has consequences at both the professional and personal levels. On the professional front, it leads to decreases in quality of care, productivity, and patient satisfaction and increases in medical errors and a tendency for clinicians to leave their job, which also negatively impacts patient care. And on the personal level, it affects their personal relationships and often leads to alcohol and substance use, depression, and even suicide. Therefore, it is of the utmost importance that we identify the most effective measures to prevent burnout and build resilient individuals, teams, and organizations within health care.

Hand-in-hand with the work I do on building resilient teams, is my additional focus on identifying best practices for engendering a sense of belonging among health care workers in diverse settings. A sense of inclusion and belonging in the workplace has been positively associated with work engagement, job satisfaction, and teamwork. Therefore, this is a key factor to promote resilient teams and organizations.

I received a Ph.D. in nursing from the University of Wisconsin, Milwaukee, with a focus on resilience training for nurses. And I feel honored to be able to continue this work in my nurse scientist role at Mayo Clinic.

Hi, my name is Samantha Connolly and I'm a Nurse Scientist at Mayo Clinic. I completed my master's degree in nursing at the University of Michigan and my Ph.D. and postdoctoral training in nursing at Yale University with a focus on self and family management. My research focuses on the self-management of symptoms in people with chronic conditions. I am particularly interested in young adults with inflammatory bowel disease.

Inflammatory bowel disease includes Crohn's disease and ulcerative colitis and is a chronic inflammatory disease of the gastrointestinal track. Most people with inflammatory bowel disease experience many symptoms, even during periods of inactive disease, including pain, fatigue, depression, anxiety and sleep disturbance. However, these symptoms do not occur in isolation, and most people with IBD experience at least two of these symptoms at once. These outcomes are especially alarming, as half of people with inflammatory bowel disease are diagnosed before the age of 30, and IBD can disrupt education, career plans, and family rearing.

The goal of my research is to help people with inflammatory bowel disease better manage their symptoms, to improve their well-being and daily functioning.

My research has two main focuses. First, I aim to better understand what causes symptoms in people with IBD. One key area that I research is sleep, because sleep is a restorative process that is essential for everyone's well-being. Poor sleep is common in people with IBD, and they experience both short and disrupted sleep. I am interested in how sleep health impacts symptoms in people with IBD, so we can determine the type and timing of sleep interventions needed to improve their symptom burden.

My second focus is on the development and testing of precision symptom management interventions. Better understanding the right intervention, for the right person, at the right time will help us to know how and when to offer symptom management interventions. My research team hopes to offer evidence-based interventions to people with inflammatory bowel disease that they can integrate into their daily lives to improve their symptoms and promote their well-being.

Thank you.

Hi, my name is Heidi Lindroth. I am a nurse scientist and practicing critical care nurse at Mayo Clinic.

My vision is a world without delirium. Delirium is a type of an acute brain failure that people experience after an acute event like a surgery, an infection or a traumatic event like a car accident.

Imagine, if your loved one went into the hospital for an elective surgery and while the surgery itself went well, they experienced delirium after surgery and their lives were forever changed. Delirium independently increases the risk of death, both in the hospital and after discharge.

People who experience delirium are more likely to need an institutional facility after discharge from the hospital instead of returning home. They are also more likely to experience declines in both their thinking (or cognition) and function.

In addition to all of this, it is a terrifying experience. A quote from one of my colleagues and a delirium survivor, Mark Hudson, illustrates his experience with delirium well. He says, "Words can't do justice to the horror, terror and fear I experienced while suffering from delirium."

Now my goal is to stop this from happening: to prevent delirium. I am collaborating with an amazing international team of scientists and clinicians, at Mayo Clinic and beyond, to reach this goal. My program of research focuses on anything that will move the needle toward that goal.

This includes the vulnerability to delirium, identifying at-risk individuals and predicting delirium. Building on all available evidence we strive to prevent delirium by finding innovative, scalable, and sustainable solutions to individualize care and mitigate the symptoms and severity of delirium. In other words, identifying things that all of us can do and things that will work.

The patient is central to everything I do. I believe clinical care and research go together. We make our best advancements when we work as part of a team and that is why I am a team research scientist.

I received my Ph.D. from University of Wisconsin-Madison with a focus in neuroscience. My postdoctoral fellowship was at Indiana University where I trained in agile methodologies. And I am honored to be a part of Mayo Clinic. Thank you for listening.

Natalie S. McAndrew, Ph.D., R.N., ACNS-BC, CCRN-K, Nurse Scientist, Mayo Clinic: Hi there, I'm Natalie McAndrew, a nurse scientist at Mayo Clinic. My research is all about supporting patients and their families through serious illness. But, before we dive into my research, I want to talk about the many years I spent in clinical practice as an ICU nurse and a clinical nurse specialist.

These experiences taught me a lot about the challenges of serious illness. It's tough on patients, their families and on healthcare teams. We know that palliative care can ease the physical, psychological, social, spiritual and existential suffering of patients and their families, improving their quality of life.

Unfortunately, many patients and their families don't get enough palliative care, leading to more suffering, increased emergency department visits and added challenges for their health care professionals. But there is hope. We can involve families as critical partners in care, not just visitors. By recognizing their expertise and providing them with the tools they need, we can empower them to help navigate serious illness.

Delivering palliative-informed care to better address the physical, emotional, social and spiritual needs of patients and their families is the focus of my research. My expertise lies in finding ways to engage, empower and support families in managing these difficult, serious illness situations.

I develop interventions to help patients and their families stay connected to what matters most to them. I've identified a universal need to increase family engagement and improve palliative-informed, supportive care across neo-natal, pediatric and adult practice settings.

I work with families across various populations and diagnoses to improve family-engaged, palliative-informed care, ensuring that they get the support they need throughout their illness journey. When patients and their caregivers create and maintain a sense of meaning and connection, they do better physically, emotionally and spiritually.

I've led studies on meaning-focused interventions for highly burdened family caregivers, like those supporting stem cell transplant recipients or individuals with ALS, also known as Lou Gehrig's Disease. Meaning-focused interventions not only benefit patients directly, but they also help caregivers fulfill their roles while maintaining their personal well-being, which is extremely valuable for both the patient and the healthcare system.

So, I focus on improving access to this type of support for patients and their families. One way to address the needs of the family, is through dyadic approaches and experience-based co-design, which gives more voice to patients and their families throughout the research process. This can increase knowledge about family strengths and improve family outcomes with solutions that will work in the real world.

My goal is to build compassionate, family-inclusive healthcare models and integrate palliative-informed interventions into everyday care. From hospitals to homes, to community-based settings. By partnering with families, clinicians and healthcare leaders, I'm working towards a future where every patient and caregiver feels seen, valued, empowered and supported.

Hello, my name is Komal Singh. I'm a nurse scientist at Mayo Clinic, Arizona. My research focus in symptom science is to evaluate underlying biological mechanisms associated with symptom occurrence and severity so that targeted interventions can be designed to help alleviate symptom burden in patients with cancer.

Currently, I'm evaluating associations between chemotherapy-induced nausea and changes in the gut microbiome. The goal is to develop and test individualized interventions to alleviate unrelieved nausea and other co-occurring symptoms in oncology patients.

Oncology patients can experience several neuropsychological symptoms and gastrointestinal symptoms as a consequence of their treatment, along with variability in the occurrence and severity of the symptoms.

For example, upwards of 60% of patients who experience chemotherapy-induced nausea are highly likely to report bothersome symptoms of vomiting, dry mouth, diarrhea, lack of appetite, mouth sores, weight loss, a change in the way food tastes, fatigue, sleep disturbance, depression, and cognitive decline. We hypothesize that chemotherapy-induced changes in the gut microbiome alter functions in the gut-brain axis, leading to these burdensome, co-occurring symptoms.

The goal of my research is to improve patient quality of life after cancer treatment. Emerging scientific evidence supports associations between patients' symptoms, including nausea, and changes in the gut microbial ecology. The precise changes that occur in the gut microbiome composition and function are not known. I plan to use a multiomics approach to evaluate the changes in the various processes regulated by the gut microbiome before and after chemotherapy treatment.

This multiomics approach, specifically metagenomics and metabolomics, will provide a deeper understanding of associations between chemotherapy-induced nausea and changes in levels of metabolites as well as microbiome functions. If we can tailor interventions to keep the microbiome as diverse and abundant as it was before chemotherapy treatment, patients may not experience as many adverse events after chemotherapy.

My current research has evolved from my doctoral and postdoctoral work at University of California, San Francisco, where I received my Ph.D. in physiological nursing and I did my postdoctoral training in omics research. I'm working with a transdisciplinary team of scientists at Mayo Clinic and at Arizona State University to achieve my goal of improving oncology patients' treatment outcomes.

I'm honored to be part of Mayo Clinic, where I am receiving my mentoring and training to be an independent investigator in symptom science and symptom management.

Thank you.

Hi, my name's Dr. Cindy Tofthagen. I'm a Nurse Scientist here at Mayo Clinic Florida, and I conduct research on management of cancer-related symptoms. Cancer treatments have side effects that create a significant physical, emotional and financial burden for patients, as well as their families. The goal of my research is to find effective ways to prevent or treat these side effects and help patients better manage side effects at home.

The focus of my research is really in three main areas:

The first is chemotherapy-induced peripheral neuropathy. My research tests interventions to improve balance, reduce falls and control symptoms of this long-term side effect of many common chemotherapy drugs.

Psychologic distress associated with cancer. A cancer diagnosis is associated with uncertainty, anxiety, depression and other negative emotions that negatively influence health.

Pain. Cancer treatment-related pain, like muscle or joint pain caused by drugs used in cancer treatment, are difficult to control and increase suffering. My background as an oncology nurse guides my research, which focuses on two priorities. First of all, areas of high concern to patients, and second, symptoms for which effective treatments are needed.

By focusing on these areas where there is great need, my research team and I hope to offer effective solutions to important clinical problems that trouble patients.

Melissa A. Wilson, Ph.D., APRN, CCNS, FAAN, Nurse Scientist, Mayo Clinic: Hello, my name is Dr. Melissa Wilson and I'm a Nurse Scientist at Mayo Clinic. I want to share with you two critial areas in health care that are research topics in which I hope to make an impact.

The first area, is management of acute pain. Effective, accute, pain management is crucial to prevent long-term complications, such as; chronic pain, opioid and alcohol abuse, anxiety and other issues. I believe that with the right, individualized approach these chronic complications are mostly preventable, while managing well the acute pain experience.

The second area, which is very close to my heart, is moral distress and moral injury in health care professionals. These occur when health care providers know the right thing to do but are prevented from doing so due to internal or external barriers. Moral distress and moral injury were thrust into the spotlight during the Covid-19 pandemic. Health care professionals face situations where they had to make life-saving decisions with limited resources, leading to significant emotional and psychological strain.

I have studied these topics in both military and civilian health care settings long before the global pandemic brought these health care situations into the spotlight. It's my theory that because health care professionals care deeply, they suffer when they cannot provide the care they know is needed.

My research aims to keep health care providers connected, whole, and as caring professionals despite the challenges they face. My team is committed to finding solutions so we can make sure to prepare, mitigate and treat moral distress for the common health care encounters we know our providers will experience, regardless of the setting in which they practice.

Even though moral distress manifests within the provider, it impacts patient outcomes, the team, the organization and health care as a whole.

Thank you for taking the time to hear about my research programs.

Hi, my name is Stacy Al-Saleh. I'm a postdoctoral scholar in the King Hussein Nursing Research Scholars program in the Division of Nursing Research. I received my Ph.D. in nursing from the University of Arizona, where I focused on health disparities and illness self-management. I've also worked as a transplant nurse coordinator at Mayo Clinic for over seven years.

My goal is to promote the highest level of health and well-being for all organ transplant recipients. Organ transplantation is a valuable treatment option that can improve longevity of life for people with end-stage organ failure.

However, people that have received organ transplants are tasked with managing very complex medical regimens. Additionally, transplant recipients experience many co-occurring symptoms, including sleep difficulties, fatigue, depression, and memory problems, which can negatively impact their lives.

My previous research indicates that memory processes and cognitive impairment may be especially important to consider in transplant populations, as these processes are related to medication adherence, which is essential for the prevention of organ rejection after transplantation.

My current research expands on this work by examining relationships between symptoms including fatigue and cognitive problems, sleep characteristics and disability after transplantation. Disability describes the impairments, activity limitations and participation restrictions that occur because of the interaction between an individual's health condition and the individual's context.

Understanding how symptoms and sleep characteristics may be contributing to disability after transplant is very important as we consider interventions to support this population. This research is relevant to nursing practice because nurses are responsible for much of the education and care coordination of transplant recipients, both in inpatient and ambulatory settings.

Building upon this evidence will allow us to better identify patient needs and match interventions to those needs so that we can optimize the health and well-being of transplant recipients.

Thank you.