June 28, 2023
Nicole Bohr joined UChicago Medicine in 2017 as a nurse scientist. With a BSN from the University of Iowa, Bohr worked as an ICU nurse for several years before returning to the University of Iowa to pursue an MSN and PhD in nursing. In 2020, Bohr became a research associate in the Department of Surgery at UChicago Medicine, as well as the manager of nursing research in the Department of Nursing Research and Evidence-Based Practice, where she has been promoted to director of nursing research this year. A PITCH fellow since 2021 and currently the only nurse PI at the University of Chicago, Bohr not only directs all the hospital’s nursing-based research, she also trains other UChicago Medicine nurses interested in research through the Nurses Using Research to Support Excellence (NURSE) Fellowship program.
As the hospital’s only nurse scientist, Bohr draws on her experience as a nurse at the bedside of patients, which offers particular perspective and insights into medical problems and medical practice in the over 20 projects she is simultaneously heading. “Nurses are some of the earliest folks who are looking at things like shared decision making and health literacy because those are the kinds of things that impact our jobs on a day-to-day basis,” she notes. “Nurses are often managing symptoms at the hospital, so I focus on symptom science.” Bohr also studies practices and dynamics within the nursing workforce: “compassion fatigue, nurses during the pandemic and how we rolled out training”—pointing out that nurses and other workers often feel more at ease disclosing information to peers with shared experiences (“Nurses for a very long time have been asked to deal with impossible circumstances”).
Communications among patients and medical professionals have long been a focal point of Bohr’s work. Her first study, at the Iowa City VA hospital focused on discharge communications among rural veteran patients. “I was interviewing people as they were going home, and they’d say, ‘My nurse doesn’t know that.’ I’d be like, ‘That seems like pretty important information for your nurse to have,’” she says. “People would cry; they would say, ‘Can you stay in the room when the doctor comes in?’ They’d feel like, ‘You sat here and listened to me.’ If you’ve ever been in the hospital, you get this thick packet of discharge instructions. It is dense—it’s all the things we legally have to tell people after they’ve been in the hospital, but it’s really hard to read. [So] we helped them roll out health literacy screenings in the VA and establish a helpline. I realized this could be really powerful. I absolutely loved being a staff nurse—I miss it; I still wander up to the unit sometimes. But I knew I could maybe help more if I went this other route.”
Bohr is currently continuing this line of research in Clinician Awareness of Social Concerns and Discharge Effectiveness (CASCADE), which studies how communications within the care team about social determinants of health can impact patients being discharged home after a hospitalization. “If we don’t all have shared understanding of a patient’s home situation, patients tend to struggle,” she says. “It’s important for the nurse, the physician, and the patient to share the same set of knowledge of where a patient is going.”
Pain is another longstanding interest for Bohr. “Disparities in pain drive me to do what I do,” she says. “It really was working at bedside and having patients come in excited, saying, ‘I’m having this surgery—I’m not going to have pain anymore.’” Yet, for some, surgery did not correct or eliminate their pain. “Noticing that people were being treated differently—they would say they still have pain, but for some folks it wasn’t taken as seriously as for others—that really bothered me as an ICU nurse.” Now, Bohr focuses on the experience and management of pain for aortic dissection patients. “We’re digging into the psychological factors that influence pain, like catastrophizing: if I experience pain, where do my thoughts go? Am I thinking about it constantly? The brain can make it worse. We’re also interested in how people manage pain on their own. Surgery is not always the best way to go. We ask people if they are in pain before they have surgery. But I’m not sure that everybody is experiencing the same kind of pain. Are they having the kind of pain that will get better if they have surgery?”
In addition to directing all the current studies from a nursing perspective at UChicago Hospital, Bohr has led the NURSE Fellowship program since 2020. “We don’t have a college of nursing—I don’t have a student base or nursing faculty to draw from—so the fellowship program is for staff nurses,” she says. “The questions we ask tend to be a little different because we spend an intense amount of time at the bedside of the patients. A lot of nursing is dictated by policies, procedures, and physicians. Nurses are used to digging in and finding an answer, but usually if we’re digging into literature, it’s because of a particular patient: this person keeps breaking a fever, what’s going on?” Of the five nurses who have participated in the program so far, three have decided to continue research—“One is pursuing a PhD, one is pursuing a DNP, one is getting their MPH now. I feel it’s going somewhere!” she says. “My goal is eventually to do a T32 so I can have a program that’s similar to the PITCH fellowship.”
“We were thrilled to have the opportunity to work with the hospital’s first nurse scientist and mentor her as she began developing a fellowship program of her own,” says PITCH Director Neda Laiteerapong. “We are proud of Nicole’s work and excited to watch the nursing research program grow at the University of Chicago.”
As a PITCH fellow, Bohr cites community and mentorship as particularly valuable experiences. “I’m the only nurse scientist for the institution, so I don’t have other researchers in my department. So I’m an oddity,” she says. “The PITCH fellowship has allowed me to break down some the barriers and connect with other folks who do research. Neda and Elbert [Huang] have helped me hone in on my research story, figure out what I really want my career to be about, and prioritize my own work—it’s so easy to prioritize the needs of others, especially in healthcare professions. They helped me find my confidence in what I was doing. I really want what I do to improve health outcomes in meaningful ways for patients. I want to help patients use the information we have to improve shared decision making and help them be engaged in their own care. I want to make sure that our research gets back to the community we serve.”
Story and photo by Irene Hsiao