Bevin Cohen, PhD, MS, MPH, RN

Nurses represent the largest and most trusted segment of the health care workforce. The reasons are not surprising: nurses command expert clinical knowledge, interact with virtually every member of the care team, and are the providers closest to patients and family members, the ones who know them best.

Less well known is that nurses are also leaders in clinical and public health research, working to improve health care delivery and health outcomes across the globe. Mount Sinai’s Center for Nursing Research and Innovation (CNRI) is home to a cadre of such nurse-researchers who work across a range of specialty areas and earn competitive grant funding from the National Institutes of Health, foundations, and industry partners.

The Center was founded at The Mount Sinai Hospital in 2014, and in 2020, Beth Oliver, DNP, RN, FAAN, Senior Vice President, Cardiac Services, and Chief Nurse Executive at Mount Sinai Health System, expanded its scope to serve as a resource to nurses throughout the Health System. Bevin Cohen, PhD, MS, MPH, RN, is the Center’s Director.

The CNRI, one of only a few of its kind in the country, supports continuous improvement of nursing care through rigorous implementation, adaptation, and evaluation of new practices. The Center’s staff of full-time researchers approach this in two ways.

The first is traditional and fosters interdisciplinary collaboration. As members of the Icahn School of Medicine at Mount Sinai faculty, CNRI researchers lead and partner on large-scale studies within well-developed programs of scholarship. For example, they may focus on identifying biomarkers to detect subclinical heart disease with point-of-care testing in patients who visit the Emergency Department, streamlining communication about patients’ care preferences when they are unable to speak for themselves, or advancing equity in postpartum cardiometabolic outcomes.

The second way is unique and characterizes the ethos at the core of the Center.

Mount Sinai nurses are widely recognized clinical experts with innovative ideas and first-hand knowledge of how to improve care. As scientists embedded in clinical practice, CNRI researchers partner with clinical nurses who have practice innovations they wish to adopt, adapt, or test in their clinical specialty. The training and mentorship the researchers provide can help clinical nurses formally study and share their observations, ideas, and innovations.

“We’re here to guide and mentor nurses at each step as they plan, design, and execute a nursing research project, and then analyze and disseminate their findings,” says Dr. Cohen. “Who better to study the impact of nursing on care delivery than nurses themselves?”

Examples of this research include measuring the impact of repositioning on healing pressure injuries for patients using air fluidized therapy support surfaces or using video visits to enhance telephone triage for homebound patients. “Ultimately, our focus is on improving patient outcomes,” says Dr. Cohen.

Paving the Way for More Clinical Nurse-Led Research

“Clinical nurses are innovative and have great ideas about improving care delivery,” says Dr. Cohen. “But embarking on a research study to test those ideas can be pretty daunting, particularly to someone just starting out. Our goal is to demystify the process, eliminate roadblocks, and provide guidance at every step.” The vast amount of nursing knowledge that resides at the point of care is immense, and one of the Center’s goals is to help bring that forward.

With this in mind, the CNRI team developed a dedicated nursing page on the Icahn Mount Sinai “Research Roadmap,” an online reference tool designed to help nurses interested in conducting evidence-based practice, quality improvement, and research projects. This resource offers practical information about key topics, including writing an abstract, performing a literature search, crafting a meaningful research question, selecting an appropriate design, and navigating the Institutional Review Board. The team is also broadcasting detailed guidance through its dedicated playlist on Mount Sinai’s YouTube Channel.

“One area that we are most proud of is our journal, Practical Implementation of Nursing Science (PINS), which we launched in partnership with Icahn Mount Sinai’s Levy Library Press in 2021,” says Dr. Cohen. “There are so many barriers to publishing, which limits the spread of important clinical knowledge, as well as the visibility of clinical nurses’ contributions to improving patient outcomes. PINS is an open access, peer-reviewed journal that we designed for nurses to more quickly and easily disseminate results of practice-based interventions, whether on a large or small scale.”

Through partnerships with the schools of medicine and nursing at Mount Sinai, the CNRI is also dedicated to educating those new to the profession and new to research. An Evidence-Based Practice Fellowship guides undergraduate students through the process of conducting an evidence-based practice project on a clinical unit. An eight-week Interdisciplinary Collaborative Research Training Program provides hands-on and classroom research training for undergraduate, post-baccalaureate, and graduate students in nursing, medicine, and the allied health professions.

“We are also focused on building a more active and cohesive nursing research community within the Health System,” says Dr. Cohen. The Nursing Research Council provides a monthly opportunity for clinical nurses, nurse leaders, and nurse researchers to share updates on new and ongoing research initiatives. A Nursing Research Day Planning Committee is instrumental in selecting topics, themes, speakers, and abstracts for each year’s event, a forum designed for sharing research findings on critical or emerging topics. A Nursing Project Approval Council ensures that all nurse-led evidence-based practice and quality improvement projects are compliant with local and federal regulations governing data privacy and advises nurses on institutional review board requirements for research with human subjects.

Pathway to Leadership

Dr. Cohen has been interested in health care and research from an early age: “I started college as a pre-med student but quickly felt that wasn’t for me. There was a heavy focus on basic science, and less about our systems and policies, which were more of my interests.” A course in epidemiology and biostatistics taught by a great professor inspired her to switch to a public health track.

“I learned two things in that course,” she says. “One was that epidemiological thinking is applicable to every clinical, public health, or policy question one could wish to study. The other was that nurses are incredibly creative and resourceful. This class had one nurse enrolled who was getting her master’s degree, and she sat in front of me for the whole semester. For our final exam, the professor said we could bring one sheet of paper with notes and formulas. The whole class was in awe when the nurse arrived on testing day and pulled out a three-foot-long sheet of paper. She followed the rules, but she thought outside the box. That was the moment I decided I wanted to be both an epidemiologist and a nurse.”

Dr. Cohen received her Bachelor of Arts degree with an individually designed major in Public Health and minor in Statistics from the University of Vermont. She went on to earn her Master of Public Health and Doctor of Philosophy degrees, both in Epidemiology, from the Columbia University Mailman School of Public Health and her Master of Science in Nursing from the Columbia University School of Nursing.

While at Columbia, Dr. Cohen began working as a project coordinator for a preeminent researcher in nursing and epidemiology, who became a lifelong mentor. “Having a mentor who is principled, practical, ethical, and able to lead by example was tremendously impactful. My goal is for the CNRI to center these values along with research training as we educate the next generation of nurse researchers.”

Initially joining The Mount Sinai Hospital as Director of Research and Evidence-Based Practice, Dr. Cohen today serves as the Director of the Center for Nursing Research and Innovation for Mount Sinai Health System, and as an Associate Professor of Geriatrics and Palliative Medicine at Icahn Mount Sinai. Dr. Cohen is also dedicated to bringing research methods to life in the classroom and maintains teaching faculty roles in Columbia School of Nursing’s Doctor of Nursing Practice program and in the public health track of Bard College’s Bard Prison Initiative.

Myra Escudero, MSN, RN

J. Thomas, MD, received a diagnosis of multiple myeloma at a particularly stressful time in his life. He had recently lost a sibling with whom he was very close, and, as a consequence, had just became the primary caregiver for his elderly parents. Returning to the New York area after many years overseas, specifically to assist in his parents’ care, he was very busy readjusting to life back in the United States and a new and intense job in medical research. “It was not an easy time for me,” he says.

A little anxious for his first outpatient chemotherapy session in fall 2019, Dr. Thomas still remembers when Myra Escudero, MSN, RN, a nurse at the Ruttenberg Treatment Center of The Tisch Cancer Institute, entered the room, smiled, and introduced herself as his oncology nurse for the day. “I knew that I was only one of her many patients, but she made me feel as though I had her full attention and care. Thanks to her kind demeanor and calming voice, I was suddenly able to turn off my computer, my phone and, most importantly, all of the stressful thoughts that were spinning around in my head and was able to focus on the moment,” he recounts. “She took the time to learn about me, my background and concerns. She patiently explained the procedure for the day. Working in the medical field, I have seen many nurses in action, but Myra was particularly outstanding. One moment, she was very professionally following a meticulous medications preparation protocol, the next moment she was focused on putting me at ease, and not just this one time. Every time I came for therapy, even when other oncology nurses were assigned to me, she would check in with me and make sure that I was doing OK. Myra was my guardian angel.”

Myra is considered an outstanding nurse by her colleagues as well as her patients. “Myra is a superb model of compassionate care. We are so proud that she was recognized at the 2023 Oncology Nursing Society Congress as an Extraordinary Healer nominee,” says Miwa Saito, MSN, RN, OCN, Director of Nursing for Outpatient Oncology Infusion Services and Therapeutic Infusion at The Mount Sinai Hospital and Mount Sinai Queens.

Myra does not see oncology nursing as a job, but as a service to which she is dedicated. “In my role, it is so important for me to give my patients support and information about the treatment they will receive throughout their protocol. Most of my patients appreciate having someone to listen to their concerns; a cancer diagnosis and subsequent treatment is tough. Dr. Thomas became a friend, as do all the patients that I care for. It means a lot to me to help someone during a difficult time of their life.”

The Department of Radiation Oncology at The Mount Sinai Hospital is celebrating Irene Braccia, BSN, nurse manager, and Mariam Rahyab, LMSW, social worker, for their thoughtfulness and compassion. Their story was recounted by Marysabel Vargas Guzman, administrative coordinator for the department:

Irene Braccia, BSN, left, and Mariam Rahyab, LMSW

“The majority of our patients in Radiation Oncology are adults; pediatric cancer patients are not as common. For obvious reasons, these cases tend to take a toll on our team. Recently, a very ill pediatric patient was to undergo treatment on their birthday. Irene and Mariam coordinated to ensure a special birthday celebration. Mariam had found out that the patient liked Super Mario and Mickey Mouse, reached out to the team, and suggested the room be decorated accordingly. Mariam also designed a jumbo card with all of the patient’s favorite Super Mario characters for the treatment team to sign. Irene got the decorations, cake, and turned an exam room into a party hub. During the celebration, the patient kept asking for their favorite food, ‘doughnuts and chicken nuggets.’ Unfortunately, neither was on hand. Mariam excused herself, and a little while after came back with doughnuts and chicken nuggets. The patient’s face lit up with excitement. The patient’s mom was also happy and comforted in the midst of a heartbreaking situation. Irene and Mariam turned a very difficult moment into a memorable experience for this patient, and importantly, for the patient’s mom.”

Mariam and Irene are both inspired by their patients.

“I was so honored to watch the joy on the faces of this patient and their mom,” Mariam says. “Working in oncology, we experience our patients’ pain and trauma, but we also get to see all their hope and resilience. I try to go above and beyond in a patient’s care; as a social worker especially, I see the patient as a whole person in their environment. A patient’s story doesn’t stop when we say goodbye at the end of their appointment. I hope this story will provide some comfort to future families and patients who are feeling hesitant and worried about being valued and supported at Mount Sinai.” Irene says, “Oncology nursing is challenging, but I have met the most extraordinary people over the course of my career. This particular pediatric patient had a grim prognosis, and the entire Radiation Oncology staff wanted to ensure that both the child and his family would be cared for in a meaningful way. The patient’s smile was the best thank you ever! I cannot be more proud of the Radiation Oncology team for their professionalism and for their caring spirit.”