Interview with Paige Gehrke, Research Coordinator at FLOURISH (D’Souza Lab)

We spoke with Paige Gehrke, a research coordinator at FLOURISH (D’Souza Lab), about her career in nursing and health research. In the interview below, Paige discusses her role in the CanOSS project, her previous research experience, which includes her thesis work recently published in the Journal of Advanced Nursing, and her advice she for aspiring health researchers.

What inspired you to pursue nursing?

I got into nursing after I graduated high school, out of my interest in science. I didn’t know anyone who worked in healthcare, so I had no idea what nursing was really like. Once I started, I discovered that I liked the intersection between science and supporting individuals during their health journey. I did my Bachelor of Science in Nursing at Western University and I also have a Critical Care Nursing certificate from Niagara College.

I started at an outpatient and in-patient dialysis clinic at a community hospital and worked concurrently on an in-patient nephrology unit. As a dialysis nurse, I also provided dialysis for individuals admitted in the intensive care unit (ICU). I then worked in the ICU and I completed my critical nursing certificate. I also spent some time working in labor and delivery. I enjoyed applying what I learned from the ICU in a different context, while also developing a whole new spectrum of skills and knowledge.

What were some of your major takeaways from your experiences in nursing?

Something I enjoyed about intensive care nursing was the autonomy that you have as a nurse in that setting and providing one-to-one patient care. It’s a very detail-oriented type of nursing. I also loved collaborating with interdisciplinary teams. I enjoyed supporting families and patients during difficult times, whether it be critical illness or end of life. Labor and delivery then allowed me to support individuals in a different way. There was a lot of beautiful moments that I was able to be there for and some difficult times too. I felt like my experiences in nursing gave me an opportunity to deliver a wide range of support to individuals and develop a diverse set of skills that I’ll be able to draw from throughout my career.

You recently graduated with a MSc from McMaster. Congratulations! Why did you decide to pursue your Master’s? What did your research focus on?

I always knew I wanted to pursue a graduate degree, but I received some advice from a mentor that really helped me to decide when to make the decision. They said that it’s helpful if you have a particular career goal or research question that drives you during your degree; don’t pursue a Master’s degree ‘just because’.

I graduated from my nursing program in 2014 and didn’t start my Master’s until 2019. During that time, I took opportunities to network and work on different projects to figure out what I liked. In the ICU, I ended up helping with a lot of research projects. I was inspired by the topic of nurses’ responses to occupational stress and work environment, like burnout and moral distress, which was a common thread throughout my nursing experiences and my education. For example, I had studied compassion fatigue in my undergrad for a final project and then once I started practicing, I observed many different outcomes nurses experienced in response to their clinical work. I was interested in exploring these topics and decided to focus on moral distress during my Master’s.

You recently conducted a study focused on Canadian ICU nurses’ responses to moral distress during the COVID-19 pandemic. What is moral distress?

Moral distress is a response to an ethical event in which an individual recognizes or partakes in an action that does not align with their values. Moral distress tends to negatively affect nurses’ health and well-being. It can cause nurses to consider leaving their practice, which leads to increased turnover. It can also impact the quality of care that nurses provide. Ultimately, moral distress impacts the entire health system.

It’s clear from existing literature that we know that moral distress significantly impacts nurses. But there’s a big gap in the literature when it comes to mitigative interventions – things we can do to prevent or mitigate moral distress. And we don’t know what moral distress looks like in the context of global health emergencies, like the COVID-19 pandemic, nor do we know what nurses are looking for in terms of interventions and support. My study focused on understanding ICU nurses’ experiences of moral distress during the pandemic and gathering their recommendations for interventions.

Tell us about some of the major findings of your study.

I interviewed 40 ICU nurses from across Canada working in different types of hospitals and levels of ICU care. Many nurses confirmed that they were experiencing moral distress and shared valuable insights on the contributing factors. We found that nurses experienced moral distress when their voices weren’t heard in their efforts to optimize patient care, and when patients received care that was not patient-centered, pain-free or aligned with practice standards.

We also learned that nurses engage in a variety of coping strategies to deal with moral distress, such as passive acceptance, avoidance, and action. And we learned about their recommendations for organizational interventions. We found that their recommendations speak to their desire to be heard at every level of the health care organization – a desire which often goes unmet.

Your article was published in the Journal of Advanced Nursing. Why is it important for researchers to have their work published in academic journals?

Publishing is super important; it gets your work in front of a global audience and supports existing and future research. Moral distress is a globally documented phenomenon, so I’m hoping that our study can have a broad reach and help inform the development of moral distress mitigation strategies that meet nurses’ needs.

In addition to academic journals, it’s important that we disseminate our work in ways that are accessible to different audiences. We’ve also developed an infographic based on our study, which is a great way to offer a quick look at our overall findings. I’m excited to distribute that; I hope it can reach an even broader audience than the article, including nurses and leaders in healthcare organizations.

Learn more about Paige’s study and check out the infographic here.

Tell us about your work at FLOURISH (D’Souza Lab).

I’m working with Dr. Rohan D’Souza and the lab team on the Canadian Obstetric Surveillance System (CanOSS) project. The project is a combination of several things that I really enjoy, like qualitative methodology and maternal health research that focuses on creating change at a systems level.

An obstetric surveillance system is a method of collecting confidential information about maternal health events, which can then be analyzed to inform recommendations for best practices. We’re specifically looking at analyzing severe maternal morbidity (SMM) events and developing recommendations to prevent these serious pregnancy complications.

My work will focus on growing the CanOSS program in collaboration with individuals who are involved in SMM case review in Southwestern Ontario. We’re working to pilot an obstetric surveillance system in that region, with the goal of expanding it to the rest of Ontario. We’ll be working directly with health care units to develop and pilot the program. I think this grassroots approach is a great way to ensure the program is designed based on the needs of who will be using it.

What advice would you give to those interested in pursuing an education and/or career in health research?  

First, I would suggest pursuing a research field that you’re interested in; it makes things easier when you’re passionate about the work that you’re doing. At the same time, it’s important not to pigeonhole yourself too early in your career. Remember to explore different opportunities. This can help you develop a broad range of skills and allow you to see if there are other things that you might enjoy, while eliminating options that don’t work for you.

But by far the most important thing in pursuing a career in health research is building relationships. Mentorships and connections have been so important to me in my career growth, not only for skill and knowledge development, but also in feeling supported. Research is collaborative, and so is healthcare, but the nature of research can be very isolating. Building relationships and finding that community of people that understand what you’re going through is really important. And when you’re seeking professional opportunities, consider if the team’s values and goals align with yours – that’s what makes work more enjoyable at the end of the day.