Dr. Bice's Personal History

 

I can’t remember a time in my life when I wasn’t preoccupied with the desire to comfort others. As a child I would think about the comfort of adults, other children, animals, and even trees and flowers growing in the Earth. Although I didn’t know the tenets of comfort theory or understand comfort contexts when I was young, I still desired for others to feel the comfort needs they experienced in a holistic way. I transitioned into adulthood with that same burning desire to comfort others. Thus, I integrated my love of comforting others and my calling to be a healer and made the decision to commit my life to nursing. I began my nursing education at the University of Central Florida where I graduated with a thesis project focused on pediatric pain recognition and treatment in 2004. As an experienced RN in pediatrics, I became a master skills nurse- holding the position of float or resource staff and performing numerous uncomfortable interventions on infants, children, and adolescents such as: intravenous (IV) cannulation, medication/vaccine injections, venipuncture blood sampling, urinary catheterization, and various other invasive procedures. These procedures are commonplace in pediatric health care. Although I was a “master” at successfully completing nursing skills, I learned quickly that I was also seen by children as the “needle lady” and prophylactic or acute procedural pain and comfort treatments were subpar. Thus, my work in the area of procedural pain management began.

 

As a master’s pediatric nurse practitioner student, I completed many projects focused on procedural pain and comfort nursing protocols. I became involved in evidence-based practice for pediatric pain and comfort enhancement at the hospital I worked for and I assisted in writing and revising various pain management policies and procedures. I graduated with my MSN from the Volunteer state at the University of Tennessee in 2011. I continued my education immediately in a PhD program for nursing and adult education. As a doctoral student, my focus remained on pediatric procedural pain and comfort management. However, as my work unfolded, so did the phenomenon of interest. I progressed my focus to procedural holistic comfort (more than just pain management or the absence of pain) because caring for the whole child appeared in the literature as an ongoing need with little to no research. It was during this time that my connection to and desire to explore and integrate Kolcaba’s Comfort Theory was born. I was so intrigued and so determined to learn more in fact, that I drove from Knoxville, TN to meet with Dr. Kolcaba in Oberlin, Ohio where I interviewed her prior to defending my dissertation at the University of Tennessee: “Exploring holistic comfort among children receiving a clinical venipuncture procedure.”

 

In the qualitative dissertation work described above, I interviewed child and caregiver dyads. Four themes of procedural holistic comfort were interpreted from child and caregiver descriptions: body comfort, comfort in the procedure surroundings, cognitive and emotional comfort, and comfort play. It is from these four themes that the Pediatric Procedural Holistic Comfort Assessment (PPHCA) instrument was created. Items on the PPHCA came directly from the words of children and caregivers, contributing preliminarily to its face validity. The first step in assessing the function of the PPHCA included the need to evaluate feasibility. Qualitative Findings of the PPHCA feasibility study and cognitive interviewing indicated nurses think the PPHCA is: useful, time and length appropriate, and allows children to express holistic comfort. Children found the tool to be relatable, comprehensible, and artistically pleasing with appreciation of the colors, drawings, and being able to mark the boxes themselves. Furthermore, child perspectives on feasibility did not depend significantly on age, race, gender, or type of procedure completed, showing evidence of appropriateness for a diverse group of participants. This feasibility study was disseminated and a psychometric study is in preparation. My work has also expanded into exploring holistic comfort care in pediatric populations with diverse backgrounds as evidenced by my current funded research in progress: Exploring Holistic Comfort Care Needs Among Sexual and Gender Minority Adolescents. My continued focus on holistic comfort enhancement is evidenced by various publications and presentations at the local, regional, national, and international level. Since that original meeting in Oberlin, Ohio, I have remained close to my mentor, Katharine Kolcaba, who has inspired the majority of the work I have completed surrounding pediatric holistic comfort enhancement.

 

Currently, I am an Assistant Professor and Certified Pediatric Nurse Practitioner at the University of North Carolina Wilmington. My teaching is focused on advanced primary care of infants, children, and adolescents, advanced health assessment, as well as professional nursing and nursing research. My nursing experience includes caring for hospitalized and outpatient children in the areas of hematology/oncology, surgery, emergency care, neonatal and pediatric intensive care, primary care, and care at the end-of-life. I am also currently still in practice part-time as a pediatric nurse practitioner in a Federally Qualified Health Center. My service, teaching, and scholarship is coupled with publication contributions to science, including: a literature review centered on increasing nursing treatment for procedural pain, a concept clarification on cognitive dissonance related to nursing treatment of procedural pain, a policy analysis focused on the underutilization of procedural pain treatments in the ED, a systematic review of procedural comfort interventions in children, and a qualitative research report focused on child and caregiver descriptions of procedural holistic comfort, a feasibility study for the Pediatric Procedural Holistic Comfort Assessment, a position paper related to teaching from a holistic comfort perspective, and book chapter authorships on Kolcaba’s Holistic Comfort Theory.

 

On a personal note, I am the mother of three beautiful children: a 20-year-old daughter who found her calling as a cosmetologist and identical twin boys, Elijah (the feeler) and Preston (the thinker), age 5. I enjoy cooking with my children. We try a new recipe weekly although sometimes it is a miserable fail so the experience ends in a lot of laughter. I also enjoy bird-watching (Elijah’s favorite bird is the mourning dove and he tells everyone this). I also love gardening with my children and teaching them about plant life- although I am not very good at it sometimes, we all get a good laugh out of this as well. I also have an amazing life partner, Robert: an industrial electrician, the best planner of North Carolina day trips, and a man with the widest vocabulary of anyone I have ever known. I downloaded a good dictionary when I met him. An interesting fact about me is that I collect tea pots (I have over 100 boasting on a wall in my dining room) but I don’t drink tea- I drink coffee.

 

After a long-standing professional relationship between Dr. Kolcaba and I, the pioneer on comfort herself, my mentor, asked me to serve as an additional consultant for Comfort Theory. I graciously accepted. As Kolcaba so eloquently puts it, comfort is germane to the discipline of nursing. But, in truth, it is germane to all walks of life. When will you ever meet someone who does not have the desire for comfort needs to be met? Never. I will continue to offer support for all individuals wishing to learn more about integrating comfort theory as a lens for inductive or deductive work. I am dedicated to the dissemination of holistic comfort science because I believe in the basic human right to have relief, ease, and transcendence.  

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Dr. Bice's Research Team