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By Gail Hinchion Mancini
As a part-time pre-professional in South Bend Memorial Hospital's intensive cardiac care unit, Shelley Kruk would often see nurses conduct the rigorous process of removing a catheterization shunt using only their hands.
A mechanical shunt, called a C-clamp, might have spared these nurses the most difficult part of this process: holding pressure on a groin-area incision for as long as 25 minutes to staunch bleeding.
"I did it once," said Kruk, 22, who graduated from IUSB this past December and began full-time work at Memorial. "It hurts. After I held that pressure for 25 minutes, my whole back, shoulders and hands were shaking."
Kruk had the experience very much on her mind as she undertook an undergraduate nursing honors research project. Her work was supported by an IUSB SMART program grant, which allowed her to concentrate on the project last summer. She also earned three independent study nursing credits working with Marti Makielski, clinical assistant professor of nursing. These honors nursing credits allowed Kruk to leave as IUSB's first honors nursing graduate.
Sifting through 69 case studies Memorial had collected on manual versus mechanical procedures, and combining medical libraries for other studies, Kruk determined that patients experienced no health benefits from the traditional "hands-on" approach as compared to the mechanical procedure.
"The rate of complications was no different. The time of stasis--how soon the artery stopped bleeding--was no different," she said.
However, nurses remain more confident about the manual process and shun the clamp. And, it may not be possible to use on extremely large or small body types. (Identifying the best candidates strikes Kruk as a good next research project.) But when possible, Kruk plans to use the mechanical process. At the very least, it will free her hands to provide other nursing care, particularly in the case of an emergency.
By the time Kruk completed her project, the process had become about much more than C-clamps. Her description of the research process is interspersed with comments about the numerous professionals who helped her and have influenced her own future plans. Graduate school seems almost a certainty.
At Memorial Hospital, Kruk was championed by ICU/CCU supervisor Patricia Keresztes, herself a doctoral candidate who researched post-catheterization processes. At IUSB, Kruk worked with her honors program preceptor Makielski. Cyndi Sofhauser, assistant professor of nursing, pitched in to sharpen Kruk's research skills.
While she continues to refine a publishable form of "The Removal of Femoral Lines Using Manual versus Mechanical Pressure," Kruk has already presented a version at IU's Undergraduate Research Conference on the IUPUI campus this past fall.
Although Kruk admits it was difficult to face the audience, she accepted her mentors' advice that the exercise was good practice and an investment towards graduate school.
Kruk says she always has seen graduate school in her future and considered medical school as a possibility. Working with Makielski and Sofhauser, she sees the benefits of advanced nursing studies. For one thing, she loves nursing and the hands-on experience it allows with patients that physicians have less time to enjoy.
"And Marti and Cyndi are very influential, because they love what they do."