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“Nurses are often the masterminds behind innovation in patient care,” shares Nicole Duffey, SVP & General Manager within PRA’s Strategic Solutions Division.

After 22 years in the clinical development industry, Nicole understands the unique role nurses play in healthcare innovation because she was one herself. Nurses have the most interaction with patients. They see firsthand how an illness or treatment affects a patient. They experience the hopes and fears of patients and their families as they navigate a difficult diagnosis. When it comes to improving the safety and quality of care for patients, nurses are on the frontlines leading the charge.

It was a group of nurses in San Francisco who pushed for community education and public awareness during the HIV/AIDS epidemic in the 1980s, ultimately leading to improved patient care. That course would repeat itself — patients receiving treatment then becoming ill — until finally, the patient may come in for end of life care.

And it was a nurse who transformed her own clinical experience into a 10-step process for promoting breastfeeding vulnerable infants in the neonatal intensive care unit (NICU)—a process that’s now successfully used in hospitals around the world.

Nurses are constantly finding creative solutions to clinical challenges, like elevating the head of a patient’s bed to reduce the incidence of ventilator-associated pneumonia or leveraging everyday toys and electronics to build low-cost medical devices in less-developed areas. These seemingly simple changes have broad and lasting impact on patient care.

“Nurses have historically had fantastic ideas around innovation,” Nicole explains. “Unfortunately, they’re often an untapped resource pool in clinical development and healthcare in general.”

Nicole always knew she wanted to go into healthcare, but she was drawn to nursing specifically after her niece was born with a rare disease.

“When I was a teenager, my niece was born with a rare genetic disease that impacts every aspect of her health and, in turn, her life. Basically, every cell in her body except for her red blood cells are impacted,” Nicole says. “Watching my niece and sister struggle with not only managing this rare disease, but simply trying to receive a diagnosis, was what inspired me to go into nursing.”

After graduating and passing her boards, Nicole started her career as an oncology nurse. It was both rewarding and emotionally draining. “We didn’t have the same type of outpatient settings that we do today,” she explains. Diagnosed patients would be admitted in-patient for their chemotherapy or other treatments. Then they’d come back again when they got sick because their immune systems were compromised from the chemotherapy. That course would repeat itself—patients receiving treatment and then becoming ill—until finally, the patient would come in for end of life care before going to hospice or passing away in the hospital.

“That really took a toll on me,” Nicole says. “It takes a special nurse who can work in oncology for their whole career, or even just a good part of it.” After several years in oncology, Nicole left the hospital and transitioned to a home care setting. There, she continued to hone her nursing skills and clinical background while delivering healthcare to people in their own homes. It was during that time that she received a call from a pharmaceutical company with an offer she couldn’t pass up.

“They were looking for nurses to review clinical trial data. I saw this role as an opportunity to utilize my clinical background but make a broader impact—I wouldn’t just be helping my patients and their families. I could potentially have a more extensive, more global impact.”

Transitioning from working directly with patients to working in clinical research wasn’t always easy. Even today, there are still some things Nicole misses about working as a nurse. However, she’s constantly reminded of the reason she chose this path—the broader impact she’s able to make in the work she does now.

“I still use the basic tenets of nursing in what I do today. Of course, there’s the skilled nursing care component and the technical side of being a nurse, but there’s also the human side centered around empathy and compassion,” says Nicole. “These characteristics tend to shine through in the application of whatever work nurses do.”

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Nicole also believes in treating everyone—colleagues, clients, patients—with dignity and respect, another characteristic she attributes to her time as a nurse. Empathy, compassion, and respect are integral to Nicole’s daily work, as well as in the patient-centered initiatives she helps lead at PRA. From partnering with clients to promoting disease awareness through programs that celebrate nurses and midwives, Nicole continues to support patients and amplify the voices of her nurse colleagues.

As part of the 2020 Year of the Nurse and Midwife, Nicole is encouraging employees to enter partner-led nurse innovation challenges that center around a variety of healthcare topics, including improvement of care in oncology, pediatrics, and mental health. These challenges aim to help nurses continue to drive innovation within healthcare, and winners can receive grants or funding for projects that correspond to their submissions.

“It’s inspiring for me to tap back into my nursing background,” Nicole says. “I love helping employees who come from that clinical background—from direct patient care—to stay connected and create community, which is especially important in a big company like PRA.”

Nicole’s work doesn’t end with care initiatives. She’s also devoted to helping others discover and excel in their careers—and women and those with a nursing background hold a special place in her mind.

“Nursing has long been a woman-led career. I’m interested in finding ways to help women, especially those in the beginning of their careers, understand that there are many pathways nurses can take into non-traditional areas, like clinical research,” she explains. “I want to provide an opportunity for nurses who’ve moved into clinical research to continue to thrive.”

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