ADVANCE's 2008 LPN of the Year is a nurse by choice and an LPN through perseverance and dedication

By Joe Darrah

Sonia Sheehan, LPN, CRC, considered walking away quietly. She was ready to pack up and find another job when the inpatient infant/children's ward on which she'd worked for 10 years went to an all-RN staff.

Then she remembered how much she loved her job at Montefiore Medical Center, Bronx, NY, and how she had absolutely no desire to leave.

It was 2003, and Sheehan, 41, was at a crossroads that would lead her nursing career down a new path; she just hadn't realized it at the time.

Today, Sheehan is still part of the Montefiore staff, except now she's an accomplished research nurse in the newly built children's hospital. She's spearheading prestigious pediatric clinical trials, including those for childhood vaccinations being considered for FDA approval to treat rotavirus, meningitis and pneumococcal disease.

Her decision to remain at the facility has helped lead her to being named ADVANCE'S 2008 LPN of the Year.

"When I received the phone call [on winning the award,] I was stunned," said Sheehan. "My goal each day is to show respect and compassion to my patients and their families. I think this award shows I'm committed to my nursing career, and holds as an achievement to the work I do and the care I give to my patients. It truly is an honor."

But winning the award wasn't easy. This year, ADVANCE opened its contest to LPNs across the U.S. Sheehan's toughest competition came from four excellent practical nurses: Shirley Hedin, LPN, Bayada Nurses Home Care Specialists, Toms River, NJ; Bruce Schumer, LPN, ELNEC, Hospice by the Sea, Boca Raton, FL; April Brinson, LPN, Mary Washington Hospital, Fredericksburg, VA; and Tammi Howard, LPN, Hawthorne Ridge Alzheimer's Facility, East Greenbush, NY (see side bar).

But it was Sheehan's remarkable attributes as a clinical research nurse that gave her the edge. She attributes her success to her work ethic, and a supportive healthcare staff — most notably a physician she works alongside who saw too much potential in the Harlem native to allow her to move on.

A Difficult Decision, A Timely Opportunity

Sheehan, who earned her practical nursing education from New York's Mabel Dean Bacon Vocational High School in 1984, didn't have a ton of options when the nurse staffing change was implemented on all inpatient pediatric units at the facility.

However, as a nurse who had developed an unwavering passion for pediatrics since she began working in the field as a home care nurse 2 years into her career, Sheehan had acquired enough seniority at Montefiore to transfer to nearly any other unit staffed by LPNs.

So, despite her ego having been bruised by the unexpected staffing change, Sheehan took a position at Montefiore Medical Group, an offsite clinic for outpatients that had an opening in the pediatric department.

"It wasn't exactly what I wanted to do, but I was happy to still be caring for children in a facility I've always felt valued in," Sheehan says today. "Plus, I knew a staffing change like that could happen to any LPN anywhere."

The possibility of returning to school to earn her RN so she could remain on the inpatient unit also crossed her mind, but Sheehan said she simply felt too confident in her skills as a practical nurse to leave the clinical setting for an extended period.

So, when Montefiore physician Paul A. Shurin, MD, who had begun collaborating with Sheehan when she transferred to the clinic, approached her about a clinical research position in the children's hospital in November 2003, Sheehan jumped at the chance. She hoped the position would give her comparable nursing experiences and job satisfaction in a field where very few practical nurses are involved.

"I knew I would be entering an extremely challenging field," Sheehan said. "But Dr. Shurin told me he liked how well I interacted with the patients and wanted me for the position because it involved recruiting children to participate in our studies. I was willing to give it a shot."

Less than 5 months later, Sheehan had completed clinical research training (provided by facility researchers and nurse practitioners as well as through independent course study). She had also earned certification in the conduct of human research, in handling of investigational drugs and hazardous materials, and in management of the ethical and legal requirements of research.

Her "new" career had officially unfolded.

An All-Encompassing Nurse

In her role as clinical research nurse coordinator in the Vaccination and Prevention of Infectious Diseases Program, (the first LPN to be hired into the program), Sheehan is responsible for organizing, monitoring and managing pediatric clinical trials in which the children's hospital participates.

In this role, she maintains the recruitment end of things, which involves screening and interviewing potential patients. She's also tasked with providing hands-on, ongoing care, which includes evaluating each patient's vitals throughout treatment; conducting blood draws and collecting specimens for the lab as needed; and documenting results so patients can be evaluated by the program's nurse practitioners and physicians.

Upon a study's completion, Sheehan is also the one who conducts follow-up monitoring with each patient, which can last several years depending on what the studies require. In the last 5 years, she's enrolled more than 500 patients who've been involved in 19 clinical trials, five of which are still current. On average, each study lasts about 2 years.

"This program would not be possible without her," said Shurin, who has worked in clinical research the better part of 30 years and nominated Sheehan for the 2008 award along with Cathy Cahill, RN, associate director, pediatric ambulatory subspecialty service. "As a doctor, there's no point to accepting a research grant without a reliable research nurse. The paperwork has to be perfect, and the patient care to those who participate in the research has to be more than perfect. She just has tremendous commitment. It's so difficult to take on the roles that she does, but Sonia does it effortlessly."

From Start To Finish

As easy as it may seem to the observer, Sheehan puts a lot of effort into the initial recruitment interviews with potential patients, who can be as young as infants or as old as young adults.

"Participating in research is not for everybody," she said. "It takes a special patient to participate because there's a lot of involvement on their part and there's a lot of information we're seeking from them in terms of their health, their responses to treatment, and their time commitment. But it's also a great way for them to give back to the public, and that's what I try to stress to them and their families."

To make the invitations she extends more comfortable to accept, Sheehan performs face-to-face interviews with her prospects (who are referred by primary doctors and nurses) at their family physician's offices or one of the hospital's offsite clinics.

"This is not something you want to try getting people to agree to over the phone," she said. "You want to be there to answer their questions, walk them through the consent forms and allow them time to discuss everything with their physician before making a decision."

Once that decision is made, Sheehan's role with the patient intensifies. In working with children living with chronic conditions for which treatment protocols haven't been standardized to those who are relatively healthy and are receiving treatments that could one day serve as vaccinations, Sheehan's involvement with each may be as routine as daily vital screens to as comprehensive as providing education, counseling and overall emotional support.

Maintaining that patient connection is what satisfies her most, she said.

"I do miss caring for patients by the bedside, but I've ended up with a great opportunity here," Sheehan said. "It's just been so fruitful because our children, like all pediatric patients, are so receptive to their nurses. I also enjoy the interaction I have with the families — I'm the first person they come to when they need to change an appointment or if they need help with a sick child. They have also come to me with personal issues, and I welcome that."

Like Mother, Like Daughter

In nominating Sheehan for the award, Shurin praised her compassionate nature with all her patients — a trait Sheehan said she gets from her mother, Felicita, who has been very active in her church, providing community services such as working in a local soup kitchen, since Sonia was a youth. In particular, Shurin spoke glowingly of Sheehan's commitment to a teen who had been enrolled in a study last year and had later left her home as a runaway.

"She had disappeared on the streets, but Sonia was somehow able to track her down, speak with her and reunite her with her family," he related.

More recently, Sheehan came to the aid of two children (a 4-year-old and 1-year-old) who were discovered to have been left home alone when the nurse called the house to speak to the children's parents who were involved in a study.

"She stayed on the phone with the older child, talking with him, keeping him busy until the police arrived," Shurin said. "Her involvement with her patients is limitless. A lot of people just follow protocol. Not Sonia."

Gwendolyn Moore can attest to that. The Bronx woman met Sheehan when her daughter Jasmine was recruited for a clinical trial to test a possible rotovirus vaccine more than 3 years ago. Coincidentally, the young girl developed a neuroblastoma and died after her participation, but Sheehan remained in contact with the family during this trying time.

"Sonia has touched my life through my children in a way that's unexplainable," said Moore, who attended Sheehan's award presentation by ADVANCE along with her eldest daughter Jelissa, who also recently participated in a study testing a potential herpes vaccine. "She has been a blessing to me, and I can only thank God for allowing her to come into my life."

In The Now

Clinically, Sheehan said she's most proud of her work in ongoing trials testing the validity of Gardasil in adolescents and a CDC-funded study on the potential development of a protocol for pertussis diagnosis.

In the Gardasil study, she administered 3 doses of the HPV drug over a 6-month period among young boys and girls. Today, Sheehan assists in drawing blood work, conducting pap smears and assessing for signs of HPV. For the pertussis project, she's collecting nasal, blood and oral fluids presented by toddlers and adults who experience coughs lasting 5 days or more and writing recommendations that will eventually be considered by CDC officials.

Fully content with her LPN career, Sheehan doesn't plan to become an RN anyime soon.

"I intend to remain an LPN for now," she said. "My role requires a lot of education. I have to be up to date on newly approved medications, existing medications and how each medication works when administered — but that's all information I can get by completing CEs. That's not to say the door to an advanced degree is closed for me entirely, but it's not something I consider as a part of my immediate future."

Joe Darrah is associate editor at ADVANCE.