As we celebrate Nurses Week, we honor our nursing staff at the CTRI Center for Clinical Research (CCR). Research nurses are active members of investigative studies. They interact with human subjects involved in clinical trials, administering injections and infusions, performing biopsies and lab work, measuring vitals, and observing. The CCR presently includes three Registered Nurses (RNs) and two Licensed Vocational Nurses (LVNs). They recently reflected on what it means to be a research nurse.
The CTRI nurses are (from left): Lee Vowinkel, Jessica Nasca, Patricia Moraes, Maeve Taaffe and Dennis Perpetua
Patricia Moraes, RN
A good ear and a soothing voice – and maybe a little interest in Star Wars video games – can go a long way quelling fears in clinical trial participants, especially if they are pediatric subjects.
“Many participants come to the clinic and are anxious,” said CTRI nurse Patty Moraes. “Some are children participating in pediatric studies. Children are afraid of needles, and I talk to them and try to make them feel brave.”
As a research nurse, she works with subjects enrolled in clinical trials and is involved in many phase I studies, which require an RN to be with the patient during infusion times. Moraes interacts with subjects, administers medications, draws blood, and answers questions. A major role is providing information and putting the subjects at ease. “For example, with young participants I ask what grade they are in. I might ask if they like video games. I try to get into their world,” said Moraes, the mother of a 9-year-old daughter and 4-year-old twin sons. She then explains that the needle poke will be quick and hurt less than a bee sting. And when the needle for a transfusion or blood draw has been inserted, she tells them how brave they are.
Since subjects come to the clinic on average once every two weeks, and studies can last for years, research nurses become well acquainted with their study participants. “As research nurses, we develop a relationship with the subjects,” Moraes said. It’s that interaction and ability to help them that Moraes finds most rewarding. She is also touched when subjects thank her for what she does.
With the rewards come challenges. Some diagnoses, she said, can be devastating, and in trials, some participants receive investigational medicine and others receive placebos. Her hope is that every participant can be helped.
Moraes has more than 10 years of experience as a nurse, with extensive experience in Intensive Care Units, including five years at UC San Diego Sulpizio Cardiovascular Center. She received RN training and a master’s degree in nursing in her native Brazil, where she worked in nursing for seven years before moving to the U.S.
“I always wanted to work in research and took an extension course at UC San Diego on clinical trials design and management,” Moraes said. “But I also wanted to continue working as a nurse. Clinical research at CTRI gave me the chance to do both.”
Jessica Nasca, LVN
For Jessica Nasca, joining the CTRI in 2010 as a research nurse made her dream a reality. Nasca conducts patient care at CTRI, performing tasks such as taking vital signs, monitoring a patient’s status, starting IVs, and drawing blood. Behind the scenes, she also processes and ships out specimens.
“When I was in nursing school, I remember thinking that working for UC San Diego would be a dream come true,” Nasca said. “Its reputation is stellar and jobs here are highly sought after by individuals.”
She especially prizes becoming part of the clinical research world at the CTRI. “I love how I get to interact with my patients, as well as my co-workers, and feel like I’m contributing to the future of healthcare,” Nasca said. “I’ve seen the CTRI grow in many ways over the years, and I’m excited to be a part of the next chapter when we move to our new home, the Altman CTRI building. It will be my third move here and it’s always fun to be hands-on in setting up a new clinic space.”
Her job has rich rewards and some challenges. “The most challenging aspect of my job is dealing with unpredictable outcomes,” she said. “For example, a subject with a certain disease or disorder might receive the study drug, but might receive a placebo. If the subject receives the drug, I’m always hopeful it will be helpful and not harmful. But that’s the nature of research, so you have to be ready for all possible outcomes. That’s where your keen observation skills as a nurse come in handy.”
The most rewarding aspect of her job is witnessing the benefits of a research drug or device. “Since I’ve been working here, I’ve seen the world of medicine change,” Nasca said. “There was once no cure for Hepatitis C and now there is one. The latest Autism study also produced promising, exciting results. We conducted Autism drug studies here, so it’s amazingly gratifying to see other people’s lives change with the help from our work.”
Nasca has been an LVN since June of 2010 after graduating from Grossmont Health Occupations Center in Santee, Calif. She is currently enrolled at San Diego City College’s LVN-to-RN program and plans to attend full time this fall. When not working, the born-and-raised San Diegan enjoys traveling, planning vacations with friends, and cooking. “If I hadn’t wanted to be a nurse, I would have gone to culinary school because I love to cook (and eat!),” she said.
At work, one of the highlights is being part of the staff in the CTRI clinic. “My amazing co-workers make my job rewarding every day. Their support and friendship make all the difference,” Nasca said.
Dennis Perpetua, LVN
The diversity and multitude of studies – and the varied responsibilities at the CTRI clinic – are what captures the devotion of Dennis Perpetua.
“One day you might be working with a PI studying children with autism or how chocolates may help prevent hypertension,” said Perpetua, who joined the CTRI staff in January of 2011. “What makes my job very special is working with these investigators and knowing I am part of a team that is creating a brighter future for everyone.”
Perpetua’s scope of work as a nurse includes taking vital signs, drawing blood, performing EKGs, inserting IVs, and administering injections. The broad range of studies at the CTRI means exposure to a variety of research nursing duties.
“The day may start with a phlebotomy and progress to processing and shipping samples to various laboratories all over the country,” he said. “We always strive to give our best to provide the utmost care and professionalism to everyone who comes into the clinic. Each is an integral part of the science that may be the start of a future breakthrough.”
Perpetua, who enjoys photography and the outdoors, has been in the nursing field for 12 years. He also has a degree in architecture, which, he said, helps him to be creative “when stuck with a problem.” He embraces the challenges of clinical research, always on the lookout for novel resolutions.
“It is really a rewarding experience when you overcome challenges, especially when you can see that the small steps we are taking with each protocol or study may change someone’s life in the future,” Perpetua said.
Lee Vowinkel, RN
For Lee Vowinkel, rewards come from hearing five words: I feel so much better.
“My favorite part of the job is dealing with people who have tried other medications, approaches, techniques, and treatment plans and gotten nowhere, and then they come to us and get relief,” said Vowinkel, who works with human subjects involved in clinical trials at UC San Diego Clinical and Translational Research Institute (CTRI).
She joined the CTRI staff in 2013 after working as a nurse for 10 years at several medical facilities, including UC San Diego’s Thornton Pavilion and Sulpizio Cardiovascular Center. Her duties at CTRI’s Center for Clinical Research (CCR) include interacting with the subjects in the research studies, administering injections and infusions, and performing biopsies, phlebotomies, lab work, and lab processing. “I do whatever duties the study requires an RN to perform for the various protocols. I meet with the subjects, measure their vitals, administer the required medication, and observe the subjects,” Vowinkel said. All the while, she is guided by two principles – ensuring the safety of the subject and the progression of research.
She has been involved in studies testing experimental therapies for ulcerative colitis and Crohn’s disease, as well as a novel treatment for macular degeneration that involves injecting an experimental drug directly into the eyeball, among many studies. In the gastrointestinal studies, she was responsible for administering the drug and observation; in the macular degeneration study, the drug was administered at Shiley Eye Institute and the subjects came to the CCR for follow-up lab work. “We did the blood work, EKG, and urine samples,” she said. “We processed those and shipped them out to the sponsor.”
The medical field has captivated Vowinkel since she was a child. “I’ve always been drawn to healthcare and fascinated by anything medical. I was the kid who liked to go to the doctor,” she said. She received bachelor’s degrees in biological anthropology and biological psychology from UC Davis in 1997, worked as a lab assistant for three years, and decided to pursue a nursing degree, which she received from Maric College in 2004. In 2014, she received a master’s of science and nursing from Point Loma Nazarene University.
She sees her work as having a direct link to the CTRI vision of translating scientific discoveries into improved health. “The research we do and my nursing work help make experimental therapies a reality for patients who are sick or in need,” Vowinkel said. “I’ve heard so many subjects say that because of these medications they feel so much better and their quality of life is improved. That’s really rewarding."
About UC San Diego Altman Clinical and Translational Research Institute:
UC San Diego Altman Clinical and Translational Research Institute (ACTRI) is part of a national Clinical and Translational Science Award consortium, led by the National Institutes of Health National Center for Advancing Translational Science. Established in 2010, ACTRI provides infrastructure and support for basic, translational and clinical research throughout the San Diego region to bring discoveries from the laboratory to the bedside, and facilitates training and education of the next generation of researchers. ACTRI carries out its activities in collaboration with institutional and corporate partners and currently has more than 1,500 members.