Christi Deaton, RN, PhD

wouldn't want to be anywhere else," says Christi Deaton, assistant professor of nursing at Emory. "It's a tremendous time for the school, with multiple opportunities for the kind of research that can make a difference in the lives of patients and their families." Deaton has, more than most, taken full advantage of those opportunities and has done so across the full spectrum of Emory's Woodruff Health Sciences Center. A seasoned cardiovascular nurse, she is at home in a hospital coronary care or telemetry unit. An accomplished teacher and researcher, she is adept at working with nursing students and faculty, discussing outcomes research with clinicians at the Emory Heart Center, and collaborating with health services researchers at the Emory Center for Clinical Evaluation Sciences. When not engaged in those activities, Deaton also coordinates the nursing school's adult/gerontology advanced practice nursing program and writes and publishes regularly in the profession's leading scholarly journals. It is a daunting load that Deaton appears to shoulder easily. This professional dexterity, and immense promise to accomplish even more, has earned her one of the School of Nursing's two Faculty Scientist Awards for 1998-1999 (see related article).

fter finishing Columbus College's associate degree nursing program in 1977, Deaton began work in a rural 50-bed hospital in Baxley, Georgia. Those were the days, she says, before hospitals used thrombolytic drugs to dissolve clots, and she became accustomed to seeing patients being admitted for myocardial infarctions (MIs) with few treatment options. "I went through tremendous MIs with people who would come in and out of the hospital for treatment," she says. "I would see their left ventricular function deteriorate - and the impact this would have on their daily lives." Living in the same small town as her patients meant encountering them in the grocery store or on the street. Deaton's postman, for instance, who was being treated for MI complications, would drop by with the mail and with questions about his latest symptoms and medicines. Deaton's search for answers to these kind of questions eventually led her to Atlanta where, in 1984, she secured a position in Crawford Long Hospital's coronary care unit. While there, she earned her BSN at Georgia State University and her MSN at Emory, in 1988. During that time, Deaton recalls, she was one of the staff nurses who came in early for the evening shift to attend a weekly conference conducted for cardiology fellows by legendary Emory heart specialist Bruce Logue. "Dr. Logue would always remind us," she says, "that in addition to using the information provided by invasive monitoring and sophisticated tests, we should remember to ask ourselves, 'How does the patient look? How does he or she sound?' This emphasis on the importance of patient assessment was a lesson I never forgot."

ogue's lessons, together with her observations back in rural Georgia, combined to propel Deaton into the arena of nursing research - specifically, research into how nurses can improve the outcomes of patients with heart disease. In one early study of how nurses might ease the stress of cardiac catheterization, she and her Crawford Long colleagues randomly assigned consenting patients to either an experimental group who were taught a relaxation exercise or a control group who received usual care. They found that the patients who were taught the relaxation exercise required less Valium during catheterization and theorized that less sedation could decrease recovery time and diminish the risk of drug complications. In 1995, upon completing a doctoral program at Georgia State, Deaton began work as coordinator of outcomes research for the Emory Heart Center and found a mentor in Dr. William S. Weintraub, who directs cardiovascular epidemiology at the Emory Center for Outcomes Research and manages Emory's Cardiac Databank. This databank contains information on patients who have undergone cardiac procedures at Emory during the past 20 years and is a fertile source of data for the kinds of questions Christi Deaton was asking. In 1997 she and Weintraub, working with four Emory physicians affiliated with the Heart Center, used data from this source to evaluate patient outcomes from coronary artery bypass grafts performed between 1981 and 1995. Earlier this year Deaton, in collaboration with nursing and medical colleagues, again used data from the Cardiac Databank, combined with additional information from patient and family questionnaires, to do a pilot study of patient outcomes, including health status and rehospitalization within three months of having cardiac surgery. Findings were published from both studies. A current project finds Deaton collaborating with nursing colleagues at Henry Medical Center in suburban Atlanta. The hospital's perioperative manager is co-investigator in the study, which follows patients who have undergone cardiac catheterization and who have been treated either medically or referred to Emory for revascularization procedures. "Previously, each of us had incomplete data on a portion of our patients," Deaton says about the Henry County project. "Each of us had unique information, so it just made sense for us to share that, for the benefit of the patients." Deaton, along with Emory cardiovascular nursing researchers Drs. Sandra Dunbar and Laura Kimble, will also take part this fall in a major North American multicenter study of outcomes from optimal medical therapy versus angioplasty. Called COURAGE, the study will look at Veterans Affairs patients as well as non-VA groups in the United States and Canada. Weintraub will be principal investigator of Emory's part of the study, while Deaton and the other researchers will focus on such quality-of-life issues as symptoms and functional status.

tudents entering the nursing school's new doctoral program will be able to walk through the multidisciplinary doors opened by nurse researchers like Christi Deaton. Faculty currently interface with hospital staff nurses and nurse managers, and with physicians, economists, and health policy researchers from the schools of medicine and public health. The situation varies from nursing school to nursing school, but, Deaton points out, "We at Emory are lucky to have strong interdisciplinary relations with our hospital nursing leaders and physicians, as well as ties to national institutions based near Emory, such as the Centers for Disease Control and Prevention and the American Cancer Society. There is a lot of work that allows us to share our vision of academics and practice." The addition of bright, motivated doctoral students to the mix, she says, holds immense promise and excitement for the future.