“People don’t often discover the course until they are older,” she says. “I had no idea what nursing research was like, but I wanted to dip my toes in it. I really discovered I liked working with kids and I learned how to better communicate with them.”

Vilda was part of a group that used data analysis to determine whether asthma education helps elementary-aged children better manage their health. Their findings were presented during Binghamton Research Days. She completed training in working with human subjects, became a facilitator through the American Lung Association’s Open Airways for Schools program, and then went to a local elementary school and taught children with asthma how to detect the warning signs of asthma, avoid their triggers and make decisions about their health.

That research experience, along with a three-month student nursing externship in the pediatric intensive care unit at NYU Langone Medical Center, helped influence her career aspirations: Vilda hopes to work in a pediatric emergency department after graduation.

“I just really love that population and the diversity of cases you see. You have to think on your feet and really use your critical thinking skills,” she says. “And I love treating the person rather than the idea that you’re treating a patient with a medical diagnosis. It’s why I chose the profession in the first place. You’re treating the mind, body and spirit, and I try to focus on that every time I have a patient interaction.”

The New Windsor resident knew nursing was her calling by the time she was in high school.

Binghamton University was the first school out of the 30 that she visited. “It was the gold standard for all of the other visits going forward,” she says. “I fell in love with the campus and the welcome I got from the nursing program advisors. Without a doubt, I know I made the right decision. It’s one of the best in the state and as a New York resident, it’s a great value.”

When Vilda graduates from the Decker School of Nursing this spring, she will also leave behind a legacy of mentorship, professional development and networking that will help future students pursue healthcare careers.

The Nursing Student Association, like so many organizations on campus, had to limit traditional social gatherings this school year due to the COVID-19 pandemic. However, Vilda saw it as an opportunity to encourage her peers to develop relationships with older classmates and alumni so they might feel better prepared applying for externships or future jobs.

As the outgoing president of the NSA, Vilda oversaw the creation of a professional development chair position. She also designed a series of networking and mentoring events, including a collaboration with the Fleishman Center for Career and Professional Development for nursing-specific workshops on resume-writing and LinkedIn. There was also a summer job/externship event where seniors shared their experiences with younger students and an alumni week that featured a virtual panel discussion.

“Alyssa takes pride in serving as a role model to current and future nursing students, and her leadership is valued and respected,” says Sara Wozniak, senior assistant dean for the Decker College of Nursing and Health Sciences. “She is passionate, outgoing, reliable and has an amazing ability to bring people together.”

“I’ve had some what I call ‘Aha!’ moments in my career,” says Sutherland, a professor of nursing at Binghamton University. “I have an umbrella of research, which focuses on interpersonal violence and sexual health. I’ve looked at reproductive coercion, pregnancy risk and choices around birth control. I’ve had other studies that have focused on healthcare providers. Part of that is me thinking as a nurse practitioner, ‘What do I do? What is the role of the nurse practitioner?’”

Sutherland’s research focuses on interpersonal violence, its impact on young women and factors that perpetuate intimate partner violence. She has studied reproductive coercion — when a partner impairs a woman’s ability to access contraceptives or make reproductive decisions — and how it impacts college-age women. Her most recent and ongoing studies center on college health and screening.

A recent study reviewed how and when healthcare professionals documented experiences of violence. Often, the problem remained unaddressed, the experience remained undocumented and the victim was not pointed toward possible resources.

Sutherland, who began her studies at Cornell University, graduated with a bachelor’s degree in rural sociology before pursuing a second accelerated bachelor’s and then a master’s degree in nursing at Binghamton. She earned a doctorate in nursing from the University of Virginia in 2008.

Sutherland is also certified as a community health nurse practitioner. She has practiced in Binghamton and in Boston, Massachusetts, during her tenure at Boston College’s Connell School of Nursing.

As a Fulbright Fellow in the spring of 2017, Sutherland taught, worked and mentored faculty in the development of a nurse practitioner program at the Pontificia Universidad Cátolica de Chile in Santiago, Chile.

She is also a 2018 Fellow in the American Academy of Nursing and the director of Binghamton’s Kresge Center for Nursing Research, where she continues her research and mentoring. Both the American Nurses Foundation and the National Institutes of Health have funded her research.

“I think nursing is really unique, compared to some other disciplines, where we are also practice-focused,” Sutherland says. “It’s often a balance to figure out how you’re going to integrate practice into other roles that you’re focused on. Every day is trying to just figure out what’s going to work for today.”

Some ongoing studies have concentrated on how to address gaps in healthcare communication to help victims of sexual assault. Much of the work on reproductive coercion, for example, is being examined through different ethnic and racial populations. The next step of Sutherland’s work is to develop an intervention method that addresses and reduces barriers to screening.

Gale Spencer, an associate dean, distinguished teaching professor, community health nursing coordinator and the Decker chair in community health nursing, first met Sutherland as a student. She has only grown in her dedication to research and patients in the years since, Spencer says.

“I think her love of research and her high standard of practice and scholarship are what I really admire in her,” Spencer says. “I see that strength — she’s innovative, she’s excited about things, and she gets things done. I have seen that strength in her, intellectually, just continue to grow and grow. Now, I see her as an equal colleague.”

Delirium is “an acute change in mental status characterized by inattention and fluctuating mental status,” Flanagan says. No one is really sure what causes it, but delirium can occur in 25-80 percent of hospitalized older adults and can lead to increase in morbidity and mortality. It can also lead to other serious health issues, including dementia.

That’s why she has examined the correlation between two different tools to measure delirium: the Confusion Assessment Method (CAM) and the Confusion Assessment Method-Family Assessment Method (FAM-CAM). The CAM, she says, is the “gold standard,” but it’s limited to the observations of geriatric patients by healthcare professionals. The FAM-CAM is aimed at getting families involved in assessing whether a patient has delirium. “My study was one of the first that looked at the comparison of the family members and the provider,” she says.

In the end, Flanagan, a nurse practitioner for more than 25 years, found a strong correlation between the CAM and the FAM-CAM, meaning that family members can play a role in catching delirium early. She published her findings in two nursing journals in 2015.

It’s important for healthcare providers and family members alike to recognize delirium so they can figure out what’s causing it, she said, and what can be done to try to limit its duration.

“The longer they stay delirious, the more likely they are to develop dementia,” Flanagan says. “In older adults, they have a 12½-fold more likelihood of developing dementia.”

What she found while researching her dissertation was that family members will notice subtle things not known or noticed by healthcare professionals. “You really have to rely on the family members or caregiver to give you the picture of what this person is like,” she says. “You know, pre-hospital or pre-rehab. What were they like at home? How are they managing?”

The impact of Flanagan’s research is that the FAM-CAM can be a starting point in getting a clearer picture of what’s happening with the patient. It’s also, she says, a way to introduce the topic of delirium and get family members to understand it.

“I think that’s probably the biggest impact, opening a window to some education about what delirium is and how it happens,” she says. “You know, as a team, the family and the provider and the patient can all work together to try to make things better. So it’s really about that collaboration between the family and nurse.”

“Dealing with PTSD is like riding a rollercoaster, ” said Muscari, an associate professor in the Decker School of Nursing at Binghamton University. “The swing of emotions can have a huge impact on relationships, work environment and social activities. And in addition to disrupting the lives of the victims, PTSD often has a ripple effect, throwing relationships with family members, friends and colleagues into complete turmoil. But help is out there, and this book offers individuals with PTSD and their families the tools to recognize the problem and know how and where to get assistance.”

Muscari said the key is to get treatment as soon as possible after PTSD symptoms develop so that it doesn’t become a long-term condition.

“Treatments for PTSD can involve psychotherapy or medications, or a combination of both,” Muscari said. “It’s all about support, dialogue and education. But because everyone is different, there is no substitute for treatment provided by a mental health professional experienced in treating PTSD — someone who is trained to figure out what’s going to work best. And while my book cannot replace therapy, it can be a valuable resource for sufferers and family.”

In addition to covering current treatment options, What Nurses Know….PTSD goes to the root of the condition, examining the causes and the disorder’s impact on victims and their families. It also looks at associated problems such as substance abuse and offers tips for managing stress. For instance, Muscari urges PTSD sufferers to use time-management techniques such as learning how to say “no” and delegation as ways to manage everyday stresses.

Muscari also examines PTSD in children and adolescents, focusing on what makes this disorder so challenging in young sufferers. “Kids with PTSD may experience many of the same symptoms as adults,” Muscari said. “But they often have greater difficulty talking about their thoughts and feelings. Children and teens also tend to have different types of recollection experiences than adults. We’re talking frightening dreams and even behavioral problems. If not treated properly, a child’s sense of security can be severely impacted, which in turn influences brain function and development.”

Muscari said the goal of What Nurses Know….PTSD is to show victims and their friends and families that they are not alone in their struggle.

“PTSD sufferers have a real illness, one that is as real as high blood pressure or diabetes,” Muscari said. “But it can also be seen as merely a barrier in our life’s journey.”

But chest pain can signal a heart attack in a woman. Women also may experience a range of other symptoms, not all of them easy for the typical sufferer to identify.

“We believe that heart attacks in women go unrecognized 30 to 55 percent of the time,” says Stewart Fahs, professor and Decker Chair in Rural Nursing at Binghamton University’s Decker School of Nursing. Women who miss the warning signs fail to get help, or they head for the hospital only when the problem grows acute, increasing the risk that they will die or be gravely disabled.

In hopes of shortening women’s time to treatment, Stewart Fahs is collaborating with Melanie Kalman, associate professor and director of research in the College of Nursing at SUNY Upstate Medical University, on a project called  “Matters of  Your Heart.” The goal is to develop an effective program to educate women about heart attack symptoms and also to teach about the early warning signs that a heart attack might be on the way.

Heart disease is the No. 1 killer of women. In fact, 1 in 4 women in the United States dies from heart disease, according to the National Institutes of Health. The most recent national study on the subject, however, found that 49 percent of women don’t realize that they need to be concerned about heart disease, Stewart Fahs says.

That number is lower than in past years, and the medical community has gotten out the word that women’s heart attack symptoms may differ from men’s. However, as the story of the woman on the floor points out, there’s still room to improve education about women’s cardiovascular disease.

Intense pain might be the first obvious sign of an impending heart attack, Stewart Fahs says. But many women who look back on the period before an attack report that they first felt pressure or discomfort. “Some women will say, ‘It’s like I had a big knot up here,’” she explains, pointing to her upper chest. “‘Like I swallowed an orange whole.’” Overwhelming fatigue or pain that radiates into one or both arms or the neck or jaw are other common warning signs.

Kalman and Stewart Fahs conducted the first phase of their project under an intramural research grant from SUNY Upstate. Their first task was to develop a questionnaire to measure a woman’s knowledge of heart attack symptoms and warning signs. They then created a pilot version of an educational presentation.

Working with 141 post-menopausal women, Stewart Fahs and Kalman held small-group sessions to administer the questionnaire, present the program and then give the questionnaire again. “We did find that the educational program increased knowledge,” Stewart Fahs says.

The researchers based the presentation in part on a program that Stewart Fahs developed several years ago to teach rural residents about symptoms of a stroke. That program employed an acronym created by the American Heart Association — FAST, for Face, Arm, Speech and Time.

The new program uses a similar mnemonic device, and Stewart Fahs says the method has proven effective, especially when women practice putting it to use. “We have periods in the presentation when they work in groups of two to four and come up with different symptoms for heart attacks and the female warning signs,” she says. Members take turns naming the symptoms.

As a specialist in rural nursing, Stewart Fahs gave the questionnaire and program to women in rural areas, while Kalman concentrated on urban Syracuse. The population they have studied so far is too small to reveal whether the program works better for one demographic or the other, Stewart Fahs says.

In a second phase of their research, Kalman and Stewart Fahs plan to give the presentation to many more women over a broader geographical area. Eventually, they hope to do a longitudinal study to discover whether their program improves the way women respond when they experience signs of a possible heart attack. “Having knowledge doesn’t necessarily change your behavior,” Stewart Fahs says. “But if you don’t have the knowledge, you’re unlikely to change.”

Once they’ve perfected the program, the researchers will share it with hospitals, community health agencies and other healthcare organizations. Besides offering the PowerPoint slides for classroom use, they might someday use communication technologies to give the presentation a broader reach, Stewart Fahs says. “There should be a way, through cell phone apps or some kind of Internet application, to get this message out to women once it’s fully developed and tested.”

While looking for new ways to educate women about heart attacks, Stewart Fahs also continues helping to advance the discipline of rural nursing. In May, she became editor of the Online Journal of Rural Nursing and Health Care. She also serves as an external advisor to the Interdisciplinary Healthy Heart Center: Linking Rural Populations by Technology at the University of Nebraska Medical Center.

Her combined expertise in rural nursing and cardiovascular issues makes Stewart Fahs especially valuable as an advisor to the Healthy Heart Center, says Professor Carol Pullen, principal investigator on the project. One striking aspect of Stewart Fahs’ work is that, along with publishing articles on cardiac risk among rural women for academic journals, she also writes for media that reach a wider audience, Pullen says. “I think it’s important not only to get your work in scientific journals, but also to get it out to lay publications for everybody to enjoy the results of your research.”

Stewart Fahs hopes that the results of her latest research will include better outcomes for more female victims of heart attack. “The more aware you are of the signs and symptoms,” she says, “and the more aware you are of the risk of heart disease for women, the better able you are to take a proactive stance.”

Olympia Berger is a family nurse practitioner at the Greater Binghamton Health Center, where she cares for patients with severe mental illness.

“Some of my geriatric patients wander,”  Berger says.  “I noticed that as their blood pressure dropped, I saw some cognitive changes.”

That led her to studying the effects of hypotension (for these purposes, a systolic reading of 140 or lower) on cognitive function, and to a theory that low blood pressure may trigger wandering. Decrease in regional cerebral blood flow is common in individuals with Alzheimer’s. In fact, patients who wander may have more advanced pathology and a more pronounced decrease in cerebral blood flow.  “No one has looked at changes in blood pressure before, during and after an episode of wandering,”  Berger says.  “Is that the body’s mechanism to increase cerebral blood flow?”

Berger notes that not all Alzheimer’s patients wander. Those who do — more often men than women — aren’t looking to go anywhere; they just seem to need to move. She has seen patients get up and walk when they’re in pain, even soon after having surgery.

Working with her advisor, Carolyn Pierce, an assistant professor of nursing and of bioengineering, Berger is following a small group of patients using an ambulatory blood pressure monitoring device. They hope to identify peak times for wandering to see if there are connections to mealtimes or blood pressure.

One idea they’re exploring is that senior citizens may need a higher blood pressure than younger people. If that’s true, it may suggest changes in blood-pressure medication and diet for this population.

For Berger, there’s no question that psychiatric and medical issues are related.  “You need,”  she says,  “to look at the whole person.”