As the world grapples with the two-year anniversary of the COVID-19 pandemic, the stories of nurses who are leaving the profession due to burnout and exhaustion are common. Despite the challenges, however, an incredible number of nurses have stepped up and dedicated themselves to caring for high-risk patients. Jennifer Lynch, a Doctor of Nursing Practice (DNP) student at UConn School of Nursing, is one of them.
Lynch worked as a nurse practitioner in a neonatal intensive care unit (NICU) in New York City during the spring of 2020, when COVID-19 first reached the U.S.
“It was both professionally and personally challenging,” Lynch says.
With two young boys and her 85-year-old grandmother at home, Lynch says the fear of exposing her family to the virus was ever-present. The hospital that Lynch worked for was struggling, as health care workers were constantly exposed to COVID-19 by patients, including women who were having babies. In an effort to optimize effectiveness and reduce exposures in the delivery room, the NICU restructured roles so that the nurse practitioners, who normally only cover the delivery room on nights and weekends, would cover the role 24/7.
“For COVID-positive deliveries there was a multidisciplinary team in place, but a nurse practitioner and a registered nurse were the front-line providers in the room in case the infant needed to be resuscitated,” Lynch says. “I was one of the members of my team who volunteered to cover this role and, while I realized the potential risk, I felt proud of my contribution.”
Lynch’s team was present for every COVID-positive delivery at their hospital and, additionally, was responsible for all of the infants of COVID-positive mothers who required admission to the NICU.
In the summer of 2020, Lynch was asked by her institution to provide a presentation on NICU nurse practitioner role adaptations due to the pandemic. While preparing, Lynch inquired about data regarding COVID-19 deliveries and NICU admissions. She was informed, however, that the data was not yet published.
That news took Lynch by surprise, encouraging her to reflect on the nursing experience during COVID-19.
“Why hadn’t we kept track of the number of deliveries we had attended and infants that had been admitted?” Lynch says. “After all, we were at every delivery. We admitted every baby. It occurred to me that, as nurses, we are always clinically driven, not academically driven. We aren’t included in the collection and publishing of data, even when we are the most involved group in the activity of data being collected.”
These considerations inspired Lynch to challenge this norm and seek her doctorate.
“As nurse practitioners, we have the unique perspective of being the only member of the medical team who has been both at the side of the bed and the head of the bed,” Lynch says. “We have much to contribute both clinically and academically.”
In the fall of 2021, Lynch applied to the DNP program at UConn School of Nursing. Her scholarship focus is dedicated to improving preterm infant outcomes in the NICU.
Many of the diagnostic and therapeutic procedures that are used to save preterm babies have consequences, Lynch says.
“My project specifically seeks to reduce the frequency of peripherally inserted central catheter (PICC) dressing changes for preterm infants,” Lynch says.
“[Nurse practitioners] have the unique perspective of being the only member of the medical team who has been both at the side of the bed and the head of the bed.” — Jennifer Lynch
A PICC is inserted through an extremity into a vein near the heart and carries nutrients and medicines into an infant’s body. The dressing, which is a specific type of bandage that keeps the catheter site dry and free of germs, must be changed regularly to maintain the line. There are very few evaluations of dressing-change practices in neonates, Lynch says.
Her hospital adheres to a weekly dressing change policy in order to prevent central line blood stream infections, despite a lack of evidence showing reductions in infections as a result. In the field, there is no consensus regarding dressing-change frequencies.
“What we do know is that frequent dressing changes cause distress to these infants, which is associated with poor neurodevelopmental outcomes, threatens skin integrity, and sometimes results in line dislodgement,” Lynch says. “I’m hoping my work can effect positive change for my patients and also provide insight on this knowledge gap for other NICU clinicians.”
The DNP program will provide Lynch with the necessary analytical skills to address these gaps as she encounters them, and she credits the pandemic with inspiring her to lean into the nursing profession.
“The pandemic has shown me what I am capable of both personally and professionally,” Lynch says. “Nurse practitioners have so much to contribute, and I look forward to the possibilities the DNP degree will afford me in the academic side of my profession.”
The UConn School of Nursing DNP Program is accepting applications. Learn more and apply at dnp.nursing.uconn.edu.