Clockwise from top left: DNP candidates Sherri St. Pierre, Donna Cullinan, Beth McNutt-Clarke, Jacqueline Sly, Maureen Connolly, Allan Thomas, Nanci Haze, and Catherine Conahan.

Nurses like Jacqueline Sly vividly recall the early days of the COVID-19 pandemic, when little was known about the seemingly relentless infection, testing was limited, and shortages of personal protective equipment (PPE) made caregiving both fraught and frightening.

Witnessing their patients鈥� fear and suffering, nurses worried in particular about being forced to reuse equipment like N95 respirators鈥攖he highly sensitive filtering masks normally discarded after each patient encounter. What鈥檚 more, information and guidance on how to handle the equipment safely was scant.

鈥淚t was really distressing when I had to take on and off my mask [between patients],鈥� recalls Sly, a certified family nurse practitioner who provides same-day urgent care as part of a family practice. 鈥淚 was concerned about getting COVID myself and bringing it home to my family.鈥�

But now, thanks to Sly and a small, stand-out team of innovator nurses in the Connell School鈥檚 new Doctor of Nursing Practice (DNP) program, educational materials are available to teach clinicians and caregivers how best to conserve previously worn, contaminated N95 masks.

鈥淭hat鈥檚 what we know about nurses. Give us a problem, and we鈥檒l fix it,鈥� says Connell School Associate Dean for Graduate Programs Susan Kelly-Weeder.

Jacqueline Sly

Jacqueline Sly

Nanci Haze

Nanci Haze

Allan Thomas

Allan Thomas

Beth McNutt-Clarke

Beth McNutt-Clarke

Advancing nursing practice

Sly is one of eight students in the DNP program鈥檚 inaugural cohort, all of them advanced practice nurses who are pursuing a rigorous degree program that aims to improve individual patient practice and advance the field of clinical nursing. The students, all of whom teach at CSON, will graduate in December 2020. At that point, they will become certified Doctors of Nursing Practice, the highest advanced practice nursing degree recognized in the U.S.

Candidates for the DNP, one of two doctoral programs Connell offers, are expected to develop both clinical expertise and a comprehensive understanding of epidemiology, organizational leadership, and health care systems.

Rather than writing a dissertation that generates new research鈥攁 Ph.D. requirement at the Connell School and in most other nursing programs鈥攕tudents in the DNP program apply existing research findings, along with their clinical and classroom experience, to an evidence-based 鈥減ractice change project鈥� dedicated to improving health care outcomes for a particular patient population.

Because Connell鈥檚 DNP program launched only in fall 2019, these are the first students who have undertaken these projects. At the turn of 2020, a small group was working with Hebrew SeniorLife (which provides care, housing, research, and teaching) on projects involving music and memory and person-centered care. But as the number of COVID-19 cases rose in Massachusetts in mid-March, the students鈥� in-person clinical visits to health facilities were suspended.

So, the DNP cohort regrouped and picked practice change topics they could study remotely.

New ways of nursing

Working from home, CSON鈥檚 first DNP candidates communicated using Zoom, email, texts, and phone calls. They learned to use statistics software programs and other tools and went through the rigorous process of obtaining approval to conduct their research from 乱伦小可爱鈥檚 Institutional Review Board. While juggling the demands of work, school, and family responsibilities, the colleagues also enjoyed collaborating.

鈥淚t was a lot of work,鈥� says Allan Thomas, a certified registered nurse anesthetist on the N95 respirator project team. 鈥淏ut there was a lot of laughter and learning and feeling really good about making a difference.鈥�

The challenges of self-monitoring

Clinical placements鈥攖he hospitals, clinics, and other health care settings in which students acquire firsthand experience in their fields鈥攁re a critical part of nursing education. To safely enter these sites and avoid spreading the coronavirus, Connell students must check themselves for COVID-19 symptoms.

鈥淵ou have to be able to demonstrate that you鈥檙e monitoring for symptoms and are symptom-free before you can go in [to clinical settings],鈥� says DNP candidate Maureen Connolly, a certified adult nurse practitioner. 鈥淣ursing is unique in that we鈥檙e so physically close to our patients. We鈥檝e got to figure out a way to do this.鈥�

So, when choosing a topic for a practice improvement project to pursue for the rest of the semester, Connolly鈥檚 DNP team of four decided to explore whether a group of nursing students could regularly check themselves for COVID-19 symptoms twice a day.

With help from the University鈥檚 Research Services staff, they created a symptom self-monitoring tool and then recruited student participants from Connell鈥檚 Direct Entry Master鈥檚 program. The 16 who volunteered received an email twice a day (at 7 a.m. and 7 p.m.) with a link to an anonymous survey that asked respondents to document whether they were experiencing any COVID-19 symptoms, such as feeling feverish or experiencing a headache, shortness of breath, or new loss of smell. (The team used a secure web platform to record its responses.) Participants could fill out the assessment by smartphone or computer; it took only a few minutes. Anyone who felt unwell was advised to seek medical help.

To the surprise of the DNP candidates, only half of the 16 participant volunteers fully completed the symptom-tracking survey during the 10-day study period. The other eight missed one or more of their symptom checks.

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