#MeetUsMonday - Meet Nurse Scientist, Heart Failure Expert, and Prof Windy Alonso
Meet Windy.
Runner. Reader. Sports fiend. Mom to three kids, a Rottweiler named Rubi, and daughter of a Vietnam veteran. Worked as her high school mascot, “the Carnivore.” Former NICU nurse who learned people skills during her first job as a Wal-Mart cashier and cared for rural heart failure patients as a nursing assistant. First-generation college attendee who grew up rural, and, as an NIH grantee, has earned more than $4M in funding to study ways to promote exercise for individuals with chronic illness across the lifespan. A new faculty member, Charlottesville resident, and chair of the Department of Nursing Research.
EARLY LIFE
“There are about 2,000 people in Curwensville, PA, the rural town where I grew up. My mom was an office manager, and my dad was a mechanic in a coal mine, and, later, worked at a Wal-Mart distribution center in our town. I was always really good at math and science and enjoyed them. I was also extremely competitive, even though I’m not super athletic. What I lack in athleticism I make up for in a fiercely competitive spirit! My very first job was as a cashier at Wal-Mart . . . I interacted with people from all different backgrounds in that role, and it really informed how I eventually interacted with people who I study, teach, and work with."
“Patients say, ‘Why would I stress my heart when I’ve been told it doesn’t work well? Why would I make myself extremely uncomfortable?' Getting them past that is important. It doesn’t take long before they see the benefits of exercise. Their symptoms improve. Having them in a supervised setting to get started, where a healthcare professional says, ‘OK, it’s normal to feel this way,' . . . it makes a huge difference."
PATH TO NURSING
“I got a bachelor’s degree in biology from a small liberal arts college in central Pennsylvania, but, because my parents hadn’t gone to college, they didn’t say, ‘Well, what are you going to do with that?’ After starting a PhD program in pathology, I had a hard time seeing how what I was doing in the lab would eventually apply to humans. It was too far removed from the human connection. That was a turning point for me. A postdoc I worked with taught chemistry to nursing students said to me one day, ‘Have you ever thought about nursing?’ I hadn’t. I didn’t realize then all the avenues nurses could take.
“Around that same time, I had some weird health issues and started to think, ‘Maybe I would like being a nurse. Caring for people, getting to spend time knowing them.’ I knew I wanted to feel the impact of my work.
“I got a job working as a nursing assistant at a hospital just to see if I even liked it. That was another turning point because I absolutely did. But I’d spent a ton of money going to college already and wasn’t in a position financially to roll into an accelerated BSN program. I discovered that the hospital where I was a CNA would support tuition for me to earn an associate’s degree in nursing, so that’s what I did. I worked full-time weekends and night shifts as a nursing assistant while I earned my degree, working on a step-down unit caring for patients with heart failure. I’ll tell you, as a small person, lifting the adults was really hard. It was the most physically demanding job I’d ever had, and I had a hard time imagining locking into that.
“Once I became an RN, I decided to become a NICU nurse, so my back didn’t hurt anymore! I worked in the NICU in full- and part-time roles for about seven years. I loved that work, had phenomenal colleagues, and a great work environment, and loved working with babies and families.”
PATH TO NURSING SCIENCE
“A little later I worked for a medical device company and realized how much I enjoyed educating people. I started an NP master’s program and paid for it with free credits because I agreed to teach a clinical course. It was slow going, but I enjoyed it. A few semesters in, my research professor said, ‘Are you sure you want to be an NP? I just noticed that you seem to really like science. Have you ever thought about getting a PhD?’
“‘A PhD in what?’ I asked her. She meant a PhD in nursing. I didn’t even know nurses had PhDs! Another turning point. She advised me to do some research and educate myself on the possibility. Once I began a PhD in nursing program, it felt like I was right where I was supposed to be: that perfect blend of the art of nursing and science.”
FINDING A SCIENTIFIC NICHE
“At Penn State, I was fortunate to be paired with [nurse scientists] Judy Hupcey and Lisa Kitko, who were a palliative care nurses with an R01 grant looking at palliative care and heart failure. I’d worked with heart failure patients before, and, at the time, it was absolutely not where I wanted to go, deciding instead to focus my study on pediatric palliative care in rural areas. I’d observed as a NICU nurse that a lot of families wanted to take their very sick babies home to spend their last days in the home they’d made, but they just couldn’t; there wasn’t enough support. I thought, ‘OK, I’m going to study terminally ill children and their families so we can learn how to help them in their communities.’
“Once I decided that, my advisors sent me to a pediatric end-of-life (ELNEC) course to learn more. I should mention that, at the time, I had two small children: two-years-old and nine months old. The experience made me realize that subject was not for me. I told my advisors, ‘I appreciate that you made me do this. I couldn’t stop crying. I’m just not equipped.’ It was another turning point.
“So, I dug in with their research team. They were doing qualitative interviews with caregivers and patients with advanced heart failure. These were people who were expected to die from their condition, and it was through getting to know these patients and families, I fell back in love with heart failure and the population. Working with these patients whose families are just watching them from the passenger seat . . . it moved me. Some had these ventricular assist devices, many got heart transplants, but it was still a struggle for them day-to-day.”
HER INFLUENCES
“I am privileged to have worked with outstanding faculty mentors throughout my career. I initially studied the outcomes of patients in rural areas with LVADs (left ventricular assistive devices), which led me to University of Nebraska Medical Center, because I wanted to continue working with rural patients. My dissertation and training taught me that while we could ask these patients all these things, and ask caregivers what they needed, and what the experience was like, we needed interventions to help them. I wanted to learn how to do that.
“That quest led me to postdoctoral training in Nebraska with Bunny Pozehl, who had a lot of experience with intervention development. She studied exercise. It hadn’t been my plan, but there was an opportunity to submit a pilot grant to look at exercise and rural dwellers, and we got funded.
“Exercise is something I believe in personally. I’ve always been active and know how much better I feel when I’m moving. It wasn’t long before I started to recognize how important it was for patients with heart failure to exercise and observed how afraid they were. I talked to patients and heard what they wanted, asking, ‘How can we make this intervention more accessible, so we aren’t requiring that people come to the medical center to do it?’
“I wanted to develop something that would allow the patients to come to us virtually. That’s where I started to build my niche in developing home-based programs for patients with heart failure. It’s taken on a life of its own now.”
RESEARCH ON EXERCISE INTERVENTIONS FOR HEART FAILURE PATIENTS
“Heart failure patients are unique. You’re stressing your heart when you exercise. Patients say, ‘Why would I stress my heart when I’ve been told it doesn’t work well?’ They also have a lot of exercise intolerance; exercise is extremely uncomfortable. They say, ‘Why would I make myself extremely uncomfortable? And am I hurting myself on top of that?’
“Getting them past that is important. It doesn’t take long before they see the benefits of exercise. Their symptoms improve. Having them in a supervised setting to get started, where a healthcare professional says, ‘OK, it’s normal to feel this way,’ or, on the flip side, someone who’s there to tell them to slow down: it makes a huge difference.
“One particular memory I have is my mentor telling us that a participant had approached her in the community and said, , ‘You changed my life.’ Exercise was something I knew was powerful but, in this population, it is particularly so.
“Home-based exercise is available to patients wherever they are. For patients who live far away from a hospital, and don’t think they can get this kind of support, it’s so important because it allows them to have someone and something and they don’t have to commit to coming in.
“Simply, I promote exercise for individual with chronic illness across the lifespan. I don’t love going to a gym either, which is another reason that home-based exercise speaks to me.”
WHY WINDY?
"Windy is not short for anything but it is inspired by a song from the 60s."
UVA SCHOOL OF NURSING IN A WORD?
“WELCOMING. I say this not just because everyone here has been fantastic in helping me get my legs under me, and answering my 10,000 questions, but really because, when I came here to interview, I noticed the basic assumption on the sim lab’s wall, and it really spoke to me. I even took a picture of it. What an amazing welcoming and inclusive environment in which to learn and grow as a nurse. In my own personal experience here, I can see how that value is lived in the people here.”
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Position the School as a leader in nursing science, from discovery to translation
The School’s researchers seek to address some of the most pressing health inequities of our time by leading groundbreaking investigations, disseminating findings in ways that impact our local and global communities, and by recruiting and supporting nurse scientists at all career stages. The benefits of nursing science engage all our faculty and learners, supporting diverse scholarly and dissemination efforts. Our undergraduate and graduate curricula require students to engage in research and other scholarly endeavors and by offering opportunities for them to collaborate with mentors and peers to disseminate their work.