Understanding pain to help patients

By Daniel Punch

Sheila O’Keefe-McCarthy’s earliest nursing lessons came from the first person she ever met.

A nurse and midwife who emigrated from Ireland, O’Keefe-McCarthy’s mother earned a reputation as a respected clinician, and was the “go-to person” when the family’s Lindsay, Ontario neighbours needed health advice or a vitamin B shot. She also taught her daughter about the sacred bond between nurse and patient.

“(My mother) instilled in me the privilege and honour of being in someone’s life at a vulnerable time,” O’Keefe-McCarthy says. “It’s a gift.”

But it wasn’t until she volunteered as a 17-year-old candy striper at Lindsay’s Ross Memorial Hospital that she fully appreciated her mother’s lessons, and began to see nursing as an alternative to her dreams of a career in show business. She remembers entering a room in the hospital’s ward for persons with dementia to find an older woman distraught and yelling. Instinctively, she took the woman by the hand, looked into her vibrant blue eyes, and hummed an old Irish lullaby. The woman calmed down. “We connected on a higher level,” O’Keefe-McCarthy recalls.

She went home that night and told her mother she wanted to go into nursing. “She nearly fell off her chair,” she remembers. Thus began a highly decorated career that has already spanned more than three decades.

O’Keefe-McCarthy graduated from George Brown College in 1982 and spent her early career in various roles at Toronto General Hospital (now part of UHN). She learned the value of mentorship right from the start, receiving guidance from veteran nurses, and serving as preceptor to others just beginning their careers. “I’ve not gotten anywhere without the help of others,” she says. “So I love to share the wealth.”

In 1989, she was hired in the intensive care unit at Ross Memorial, where she still practises to this day. The majority of her patients over that time have suffered from cardiovascular ailments, and she found nearly all of them had one thing in common: pain.

“I don’t like to see patients suffer with pain,” she says. “(It) really drives me out of my mind.”

Despite its prevalence, O’Keefe-McCarthy found pain is largely misunderstood by health-care professionals, and she yearned to do more for her patients. She knew pursuing higher education was the best path toward that goal. She completed her nursing degree in Ryerson University’s post diploma program in 2004, then earned her master of nursing at the University of Toronto (U of T) in 2007. Inspired by her clinical practice, her doctoral research for U of T – completed in 2013 – evaluated health professionals’ knowledge and attitudes around cardiovascular pain management. This research, conducted at Ross Memorial, was the first study to examine cardiac pain and associated anxiety in the first hours of an emergency hospital admission for chest pain. From this research, she found a correlation between pain and anxiety – when anxiety increases, pain often does the same. “That was a very important thing,” she says. “It’s a major opportunity for clinical education.”

O’Keefe-McCarthy’s findings earned her the Award of Merit for Outstanding PhD Thesis from Sigma Theta Tau International in 2014.

Now an assistant professor at Brock University in St. Catharines, her research delves even deeper into cardiovascular pain and symptom management. She is also developing an iPhone app for patients and health professionals to monitor heart pain and anxiety. In the classroom, she teaches students that nursing requires both academic and emotional intelligence – just as her mother imparted to her many years ago. “Giving (students) the knowledge, skills and abilities to be the best they can be is really thrilling,” she says.

While her CV is filled with accolades, including two RNAO Recognitions Awards, O’Keefe-McCarthy says her goals have always been simple: to improve clinical practice for the sake of patients. “Am I going to change the world? Probably not. But I may help at least one person have a better experience… And that’s what motivates me.”

Daniel Punch is staff writer for RNAO, the professional association representing registered nurses, nurse practitioners, and nursing students in Ontario. This article was originally published in the January/February issue of Registered Nurse Journal, the bi-monthly publication of the Registered Nurses’ Association of Ontario (RNAO).