The mission for Kristen Fessele, PhD, RN, ANP-BC, AOCN, is personal.
Her mother had survived cancer. But Dr. Fessele, a nurse scientist at Memorial Sloan Kettering Cancer Center (MSK), wanted to see her more than just survive — she wanted to see her thrive again.
Dr. Fessele saw that movement has the potential to keep patients physically and mentally strong, so she decided to change her field of study from genetics to encouraging physical activity in older cancer survivors. It’s the perfect career for her skill set: As a nurse scientist, Dr. Fessele uses her experience caring for patients to solve the most urgent research questions. The goal is to help today’s patients as well as tomorrow’s.
Her passion has driven her to the top of her field. In 2022, she was one of just 12 nurse scientists nationwide selected for the Betty Irene Moore School of Nursing fellowship at UC Davis Health. It grants her $500,000 over three years to further her research.
What Does a Nurse Scientist Do?
Like all researchers, nurse scientists design studies, accumulate data, and publish their findings. Their concentration in nursing means that they’re focused on patient needs, perspectives, and outcomes. Whereas a medical doctor might study how a drug is working, a nurse scientist may take a more holistic view of how a treatment affects a patient’s and their family’s quality of life.
MSK has three full-time nurse scientists — Drs. Fessele; Margaret Barton-Burke, PhD, RN, FAAN; and Ann Marie Mazzella-Ebstein, PhD, RN — who collaborate in and out of the lab to ease the burdens of cancer and its treatment.
“We see a problem that patients are having, and we want to try to make things better,” says Dr. Fessele, who has been with MSK for five years. “I’ve been very fortunate to be with people through the months or years of their treatment, really walking hand in hand with them. As you see their obstacles and struggles, those are where our questions come from.”
Their studies help not only patients but MSK providers and researchers too. Nurse scientists are a bridge between patient care and scientific discovery, translating each group’s needs to the other.
“As a scientist who is also a nurse at MSK, I have the unique opportunity to explore my research goals, support novice nurses in their research, and be a clinical partner to other researchers,” says Dr. Mazzella-Ebstein, who studies emotional intelligence, stress, and burnout in nurses.
Nurse scientists are at the top of their professional game: They hold PhDs in nursing and are master multitaskers. On any given day, they might be designing their own study, crunching data with MSK’s biostatisticians, digging into a grant application, or poring over journals with MSK librarians. One study often leads to another.
Says Dr. Fessele: “You’re taking the data and saying, ‘What’s the next question?’ ”
Years of preliminary research may take place before an appropriate source of funding comes along to enable them to get answers to their questions. They must be persistent and resilient, says Dr. Barton-Burke, who studies racial disparities in treatment side effects.
“[MSK’s former President and CEO] Craig B. Thompson once told us, ‘Hey, we all get grants turned down,’ ” she says. “ ‘You just go back and start over.’ ”
How MSK Mentors Nurse Scientists
In addition to doing their own research, MSK’s nurse scientists guide bedside nurses who want to dive into topics of their own. At the first-ever Nursing Research Colloquium during Nurses Week in May 2022, MSK bedside nurses presented on a variety of topics, including patients’ coping strategies, nurses’ quality of life, challenges in hospice care, and more. There are plans to make the colloquium an annual event.
On a yearly basis, MSK’s nursing research fellowship gives 10 clinical nurses dedicated time away from the bedside to create their own study. Dr. Mazzella-Ebstein oversees each nurse’s development over the 18-month program. A former fellow herself, she loves working with the next generation.
“I understand their struggles,” Dr. Mazzella-Ebstein says. “It’s a joy to see them work through their questions.”
The expectations are high: Participants must present at MSK Nursing Grand Rounds as well as at professional forums, plus write a manuscript. The program has had 40 fellows since its start in 2016.
MSK clinical nurse specialist Mary Elizabeth Davis, DNP, RN, AOCNS, was a 2017 fellow. She studied whether a new way of giving chemotherapy to children with retinoblastoma, an eye cancer, caused hearing loss. Dr. Davis learned how to write a grant and raised enough money to cover the costs of hearing tests patients needed for the study, which boosted the participation rate.
Dr. Barton-Burke says the fellowship is about the research process as much as it is the project. “It’s putting all the pieces together: formulating the right question, working with the statisticians, finding funding,” she says. “We help them move through each step.”
Dr. Davis says it was an eye-opening experience. “What I really learned, that I didn’t have a full understanding or appreciation of, was the rigor that is involved in conducting research,” she says. “Even small things, like the best time to approach a patient, are written out step-by-step. This has carried over to evidence-based and quality-improvement projects that are now stronger and better designed.”
Two-Time Magnet Recognition
The strength of nursing science at MSK has been recognized twice by the American Nurses Credentialing Center’s Magnet Recognition Program® — MSK was awarded the Magnet credential in 2016 and 2020. It’s the highest honor for professional nursing practice and a distinction less than 10% of hospitals in the U.S. hold.
To achieve Magnet recognition, organizations must pass through a rigorous and lengthy process that takes research into account.
“The Magnet team knows that nurses need an evidence-based practice model,” says Dr. Barton-Burke. “And from that comes research projects.”
Turning ‘Research Into Reality’
Drs. Barton-Burke, Fessele, and Mazzella-Ebstein all agree that MSK is an ideal place to dig into their questions because of the institution’s joint focus on research and patient care.
With an eye on the future, Dr. Barton-Burke hopes to bring new voices into their fold. She says that support from MSK’s Chief Nursing Executive, Tracy Gosselin, PhD, RN, FAAN, is key: “Her vision is for MSK nurses to turn their research into reality.”
In the meantime, the busy team of three remains hard at work, asking the questions that lead to better patient care.
“We are a small but mighty team,” Dr. Fessele says. “We should get T-shirts that say that.”