Much like Florence Nightingale, the founder of modern nursing, U.S. Army Lt. Col. Pauline Swiger, a nurse scientist and deputy chief of the Center for Nursing Science and Clinical Inquiry at Landstuhl Regional Medical Center, is no stranger to asking questions to improve patient outcomes.
Swiger was recently recognized for her career-long contributions to the field of nursing and patient care delivery as one of two active-duty Army nurses receiving a military nursing practice award for 2019.
"I've always asked a lot of questions," said Swiger, a native of Bedford, New Hampshire. "What's awesome about research is it's your job to ask 'why?' or 'how can we do it better?' and to challenge the status quo."
Being curious is far from the only characteristic which earned Swiger the recognition, as she has been part of numerous studies, authored various professional publications and mentored several junior Army Nurse Corps officers in their pursuit to improve patient outcomes.
"(Swiger's) dedication, enthusiasm, and commitment to her profession and to her peers are unparalleled," said Dr. Patricia Patrician, who nominated Swiger for the award. "She is always eager to jump in and help struggling colleagues and mentees, leading the way with kindness, tact, and a genuine passion to see others succeed."
The award is presented to active-duty Army Nurse Corps officers in the ranks of major or lieutenant colonel who have made a noteworthy mark on military nursing and patient care delivery. In addition to the research Swiger has contributed to the nursing field, she's also initiated a joint-service research interest group with Navy and Air Force counterparts to promote, assist and guide less experienced military nurses toward collaboration and research of their own.
The Centers for Nursing Science and Clinical Inquiry focuses not only on nursing research, but also applying evidence-based best practices to improve LRMC operations and deliver unsurpassed health care to beneficiaries.
"We have a threefold mission: to conduct original research, improve clinical care by implementing evidence, and provide decision support to the hospital," said Swiger.
Still, corroborations formed through the research and study at LRMC goes beyond the European theatre.
After a tour as a medical-surgical inpatient nurse and head nurse for cadets at the U.S. Military Academy, Swiger deployed with a combat casualty care research team to Baghdad, Iraq, to conduct research focused on mass blood transfusions, analyzing most effective tourniquets for casualties and documenting patient outcomes. Although deployed in the role of a research assistant, Swiger's dedication to nursing and patient care pushed her to aid when she could.
"What was really awesome about my job was I got to be right there and help them. If there was (a casualty influx) going on, I was a nurse. But when we had enough staff, I was an observer that was gathering information to make important decisions for what we were going to do next, when the next person came in," said Swiger. "You don't get enough information or data from civilian institutions to make changes when it comes to trauma. When you're in theater, there was so much trauma coming through the door."
Swiger's deployment drew her interest toward conducting research in efforts to improve military medicine and patient outcomes, leading to a Master's degree and eventual Ph.D. in health services research.
"I kind of held on to that experience as a silver lining of all that tragedy. For me, it was like saying, 'Okay, that stuff is happening. We're doing the very best we can and we're working hard to get better' and I loved that," said Swiger. "I saw the power of research. The power of thinking in a systems sort of way, using the robust information that was out there to make clinical decisions, and put it together."
Additionally, Swiger supports overall Army Nurse Corps functions through her work with the Patient CaringTouch System, a patient-centric framework for healthcare delivery designed to reduce nursing care variation and improve patient and nurse outcomes across the enterprise.
Swiger's interest in progressing nursing practices and mentoring junior Soldiers has led to numerous accolades from colleagues, mentors and mentees.
"Since (earning her doctorate degree) she has had several funded grants and is mentoring junior investigators in their research projects," said Patrician, a retired Army Nurse Corps officer who advised Swiger during her Ph.D. "Swiger is the type of professional who will continue to make contributions to the nursing profession, long after she retires from the military."
Others in the hospital share the same sentiment as Patrician.
"She's been an awesome mentor so far," said U.S. Army 1st Lt. Shelby Müller, staff nurse and assistant officer in charge of LRMC's Same Day Surgery Clinic. "Having her there has been fantastic. She always thinks of things that I wouldn't have thought of."
As part of the Clinical Nurse Transition Program, Müller and her peers presented an evidenced-based research project, as required for all nurses in the course, which led the team to conduct further research and analyze effects of Human-Centric Lighting in the inpatient setting. Müller's curiosity led to her involvement in a larger project to further research, fund, and implement her research at LRMC with the help of Swiger's guidance.
"We went from a simple end-of-training requirement to actually going on and (implementing the research)," said Müller, a native of Paducah, Kentucky. "If you're sleep deprived, research shows you can have more pain and increased wound healing time. So we're trying to make an overall better experience for the patients."
Müller's project, one of many in which Swiger has been an essential part, will soon be implemented at LRMC's inpatient ward, providing patients an evidence-based environment which stimulates their healing.
Swiger continues a path toward higher learning, currently attending the Department of Defense's highest level of officer professional military education, Senior Service College. Swiger hopes to ultimately contribute to improving the quality of care and processes across the DOD. For now, Swiger is enjoying her role in the Army Nurse Corps and mentoring junior Soldiers, which she considers the greatest asset to military medicine.
"Don't ever stop asking why, it's so important. When you're just not sure about something, when it doesn't feel like you have a good justification for what you're doing, it's such an important time to look at (the process) and ask, 'What does the evidence say? Is this the right thing for our patients?'" said Swiger. "(Junior Soldiers) are at the point of care day in and day out. I don't ever want them to think that they are insignificant. When we talk about being a highly reliable organization, where we defer to expertise, the (junior Soldiers) are (those) experts."