This week is Nursing Week and is an opportunity to highlight the many accomplishments being made in the field-and the remarkable people making advances and changes in such a dynamic profession. Pauline Voon is one of those remarkables: she applies her breadth of education and experience in nursing to research. Her resume already includes a long list of titles. She is a Registered Nurse, Research Associate with the BC-CfE’s Urban Health Research Initiative (UHRI), an Addiction Nursing Fellow with the St. Paul’s Hospital Goldcorp Fellowship in Addiction Medicine, and a Doctoral Student in the School of Population and Public Health at the University of British Columbia (UBC).
To add to this, Voon received in May a Nursing Hero Award from Hospital News magazine and a 2016 Young Alumni Award from the UBC School of Nursing. She was also selected as one of 30 trainees across North America to take part in the inaugural North American Pain School in June, and one of 6 to be selected as a correspondent during the workshop to gain extra experience in knowledge translation and science communication.
Voon’s primary research interests include chronic pain among people who use illicit drugs, prescription opioid misuse, HIV and AIDS, and addiction treatment. Meanwhile, her nursing practice in hospital, community, global health and research settings focuses on health promotion among vulnerable populations with complex health issues, including HIV and addiction. The BC-CfE spoke with Voon about her work and advice for others looking to enter the research field.
BC-CfE: How or when did you first become interested in nursing?
Pauline Voon: Growing up, I always had the idea of working in the field of health care in the back of my mind. I wanted to be in a helping profession through which I could make a meaningful contribution to people’s lives. Nursing stood out to me as a compelling option to do just that. In high school, I had a job as a radiology clerk and volunteered at local clinics for cancer patients and veterans. I remembered seeing how nurses often spent the most time with patients, and I was inspired by the kindness, humility and compassion I saw in them. I also noticed the emerging role of nurses as leaders in diverse fields ranging from health care administration to policy, research, and education. So, it seemed like an attractive option to enter such a rapidly growing field with huge potential for impact in the community. Looking back, I think becoming a nurse was one of the best decisions I’ve ever made.
BC-CfE: When did that lead to an interest in addiction research?
PV: When deciding where I wanted to focus my nursing practice, I was drawn to the field of HIV/AIDS, as its social justice roots fascinated me. As a HIV nurse on the 10C Urban Health unit (formerly a specialized HIV/AIDS unit) at St. Paul’s Hospital and at the community-based Dr. Peter Centre, I worked with many people living with addiction. Injection drug use continues to be one of the major drivers of the global HIV pandemic, so there is often considerable overlap between populations with HIV and addiction. In instances and regions where people living with HIV can access treatment, it is now a largely manageable chronic condition. Therefore, much of the clinical care for people living with HIV now tends to focus on other complex health issues, such as untreated addiction.
I have also had a longstanding interest in researching vulnerable and marginalized populations to better understand barriers to health and inform health policy and care. Naturally, when I learned about the opportunity to work as a Clinical Research Associate with the BC-CfE, I was excited to apply my experience working with people with HIV and addiction in a research setting. That is when I really started to plunge into the world of addiction research.
BC-CfE: How does your background as a nurse shape your work as a researcher? Are there valuable crossovers between the two?
PV: Definitely. My research stems from questions and observations from my nursing practice and discussions with other clinicians. Having a clinical background and an appreciation for the pharmacological, physiological and systemic aspects of clinical care also helps to inform my research. At the same time, it is very rewarding to be able to interpret and translate my research findings and other scientific literature into everyday clinical care practices, education, and policies and guidelines.
The value of clinician researchers is being increasingly recognized. While clinician researchers have traditionally been physicians, I hope to be one of many future Nurse Scientists who can help bridge the gap between research and clinical care. I hope to help advocate for evidence-based health policies and practices. There is a shortage, alongside need, for Nurse Scientists in general. In particular, more Nurse Scientists are needed in the field of addiction. It is an exciting and rapidly evolving area for research and care.
BC-CfE: Tell me about the work you do at the BC-CfE. What does it focus on and what kind of impact do you think it has?
PV: My doctoral research aims to investigate the risk behaviours and public health concerns among people with a history of substance use or addiction. My research focuses on the impact of chronic pain on a population often burdened by a multitude of social, structural, economic and other barriers such as poverty, homelessness and complex physical and mental health concerns. Such factors may exacerbate chronic pain. Clinicians are challenged by a lack of evidence-based guidelines to treat pain in individuals with addiction or substance use issues and, as a result, often simply deny pain medication. Due to stigma and mistreatment, individuals with a history of substance use may simply avoid health care and self-manage their pain using drugs (such as heroin and prescription opioids). This can pose high risk for disease transmission, overdose or death.
Especially given the current public health crisis of opioid overdose deaths in North America, I hope my research will help fill the current void in evidence-based care and health policy related to concurrent pain and addiction. Moving forward, I hope my research will help inform policies and practices to foster appropriate chronic pain management, while mitigating harms among people with a history of substance use.
BC-CfE: Do you have any advice for someone who might be interested in entering the research field?
PV: Find supportive mentors and peers. The research field can be daunting at first so it can be helpful to talk to others who can help you navigate through challenges. I have been so fortunate to have a strong network of mentors and peers through the BC-CfE’s UHRI faculty and other trainees. My other piece of advice would be: do it! It is such interesting, meaningful and rewarding work. Especially in an area like addiction, there are so many exciting opportunities in health research. There are many people living with addiction for whom research could help better inform their care, and there remain many unanswered questions in this field.