October 30, 2024

PhD pursuit a labour of love for nursing researcher Dr Catherine Stephen

Researcher on a mission to improve the lives of Aussies living with chronic health conditions through nurse-led intervention

Growing up in England with working-class parents, her mother a nurse and her father a builder, Dr Catherine Stephen never imagined career dedicated to improving the health of Australians was ever on the cards, let alone a doctorate. 

Dr Stephen yesterday (Tuesday 29 October) graduated with a Doctor of Philosophy (PhD) from the University of Wollongong’s (UOW) School of Nursing. 

Dr Stephen is the first in her family to go to university. At 18, she left her hometown of Coventry in England, completed an arts degree, and started a gap year, which ended up turning into an eight-year adventure travelling the world following her passion for snowboarding.  

When her dad was diagnosed with a chronic illness at the start of Dr Stephen’s gap year, she put her travels on hold and returned home for months at a time to care for him with the assistance of dedicated community nurses. He lost his battle with occupational lung disease and passed away when she was 22.  

Ten years later, Dr Stephen’s mother was diagnosed with breast cancer and she again found herself taking on a key role in caring for a parent in their childhood home, this time with her Australian-born husband Paul, who she met while travelling, and their young daughter by her side.  

“I was 10 years older, a bit more seasoned and grounded. I had the help of Macmillan nurses at the end, they would come and do the planning around the clock. Mum’s health deteriorated quite quickly.” 

With the unwavering support of the community nurses, they were able to keep her mother in her own home and out of the hospital. 

“They were really kind and giving with their time. They showed me aspects of care that I could take on as a non-nurse; engaged me in the care, inspired me, and gave me hope.  

“I knew Mum wasn't going to get better, but the privilege of participating in her care was incredibly special. When Mum eventually passed away, I thought ‘I think I could do this for someone else’.”  

Passion for Nursing 

Dr Stephen and her husband moved to Australia, to Wollongong, with their 1-year-old daughter Molly.  

“A new country, new home, and still in the grieving process I wondered what was next. I started to think that what gave me hope last time was the idea of making a difference thorough nursing. Throwing caution to the wind I applied to nursing school.”  

While working as a healthcare assistant at Port Kembla Hospital, without telling anyone she enrolled and was accepted to study a Bachelor of Nursing at UOW in 2011.  

“I didn’t know how I was going to afford it, but I just threw myself into it.” 

Dr Stephen was awarded the Winifred Smith Scholarship for Excellence in Nursing in her first year at UOW.  

“I was lucky to get that scholarship, that one decision that the panel made changed my path. I graduated on the Dean's Merit List, was offered honours and introduced to Professor Liz Halcomb. I started working as a lecturer. Professor Halcomb went from being my supervisor to my research collaborator still to this day.”  

Dr Stephen was also supervised by Professor Marijka Batterham at UOW and Professor Nick Zwar from Bond University.  

For each of these momentous occasions she has carried her mum’s National Health Service registered nurse’s medal tucked away in her pocket as her lucky charm, the medal her mum received after graduating from nursing school through the hospital system in 1964.  

^{Dr Catherine Stephen with her daughter Molly, Isla and husband Paul. Dr Stephen is proudly wearing her Coventry City football scarf}

Nurse-led intervention 

Dr Stephen’s thesis, Improving Blood Pressure Control in Primary Care: The ImPress Study, examined how nurse-led intervention can improve the lives of people living with chronic conditions and received the Examiners’ Commendation for Outstanding Thesis for the School of Nursing. 

“In 2019, we had the horrendous summers with bushfires, and I was doing a randomised, controlled trial around blood pressure in general practice in sites all the way down the South Coast that were affected. A trial for a PhD is quite precarious under normal conditions.  

“Data collection in fire-effected communities became impossible. The doctors and nurses who were part of the trial were showing me pictures of them hosing down the surgeries and their houses as fires approached. It was chaotic. Up until that point the trial had been going really well.  

“Then COVID happened, and most sites closed, only offering telehealth or strictly limited emergency consultations. 

“Everything just seemed like it was crumbling. It was hiccup after hiccup. You either give up or you just do something else, so I wrote about it. I wrote an article for Nurse Researcher, Research in a time of crisis: keeping my PhD on track, that was quite cathartic. 

“Thanks to the doctors and nurses, their tenacity and their pride in this work we ended up collecting all the data. It was incremental and slow, but we got those sites back on track and collected the data.” 

After the results came in, Dr Stephen admits she was “hooked” and knew her future was going to be focused on improving healthcare led by nurses throughout Australia. 

“Over 6 million Australians have hypertension. But of those, 4 million people have uncontrolled blood pressure, which means that despite it being treatable and preventable, people still struggle. This increases their risk of cardiovascular disease in a couple of years' time.” 

“We need to shift focus from reactionary, hospital-based care to primary health care where we have our services in the community and partner with people for better health outcomes.” 

Dr Stephen is a supporter of equitable, universal health care and believes nurses are part of the answer, particularly the next generation of nurses.  

As a lecturer in the School of Nursing, she has embedded hands-on learning from a student’s first year. The students work with patients to learn about their experience of living with hypertension, running pop-up blood pressure stalls at community events. The programs bring together dietetics, nursing, exercise and physiology students alongside professors and the community to inform a global data set that talks about prevalence.  

Her hope is that more nurses coming through UOW follow the research pathway to explore what research in nursing might look like. 

“If you can't see it, you can't be it. It's explaining to student nurses that there are opportunities beyond the hospital that primary healthcare nursing is growing.” 

Dr Stephen’s youngest daughter, Isla, was born as she started her honours. Juggling teaching, studying, honours and a PhD across the last ten years with her young family has been hard. At yesterday’s graduation ceremony Dr Stephen was able to celebrate with her family by her side.  

“I've had to miss out on a lot of the fun times, working after hours, when they're in bed, or particularly on the weekends.  

“When things are challenging it's often because they're worth doing. I hope I’ve been able to show my girls that with a bit of spirit, determination, and the support of others, you can achieve incredible things.”