Dr. Denise Poirier Maguire, B.S. ’76: Improving Outcomes in the NICU
November 2, 2017 by Lisa M. McMahon, MA'09
Dr. Denise Poirier Maguire, B.S. ’76, found her calling while touring a neonatal intensive care unit during her studies in Niagara University’s College of Nursing. She has dedicated her life ever since to making the lives of these littlest patients, and their families, a bit easier.
Denise first became interested in nursing as a career when she was a young teen, volunteering at a home that provided long-term care to terminal cancer patients. The nuns who ran the facility were also nurses, and Denise said they inspired her.
But when she began her studies at Niagara, she thought she might have made the wrong decision. She did not enjoy taking care of adults, which was the focus of the program at the time. A tour through the University at Buffalo’s NICU, however, reignited her passion and set her on a course to work with premature or ill infants, a fairly new specialty at that time.
After graduation, Denise worked as a staff nurse in the NICU at Strong Memorial Hospital in Rochester, N.Y., and, a few years later, at The Children’s Hospital in Boston, where she spent 13 years. The physicians she worked with were involved in research, and she soon realized that she wanted to learn more about this developing field. In 1984, she earned a master’s degree in parent child nursing, clinical nurse specialist, and says she “felt an obligation to teach others.” So she continued the research she started in grad school and began writing in professional journals and speaking at conferences, earning a national reputation as an expert in neonatal care.
In 1989, she took a position as clinical nurse manager in the NICU at Beth Israel Hospital in Boston, and then moved to St. Petersburg, Fla., to be the director of a larger NICU at All Children’s Hospital. She continued her research as she worked toward her Ph.D., which she earned in nursing sciences from the University of Florida in 2000. She held numerous faculty and research positions since then, and is currently an associate professor in the College of Nursing at the University of South Florida.
Denise’s early research focused both on neonatal care and on the role of the NICU nurse, because she saw how much influence a neonatal nurse had on the care of their infants, and that, even in the most tragic of circumstances, the way they approached the situation could help families cope.
She, herself, experienced this, and shared a story of a newborn girl who was brought to her NICU from a hospital hundreds of miles away. The infant was born without a windpipe. At that time, there was no surgical solution for this condition, and the only thing keeping the baby alive was a tube that connected her lungs to a ventilator.
But before the tube was removed, Denise and her staff were able to contact the baby’s father, who was on a fishing boat off shore (her mother was still recovering from a cesarean section and was unable to be with her child). He arrived at the hospital two days later to see his little girl for the first – and last – time. Denise stayed with him as he held his daughter, and remained with him when he was ready to let her go and have the breathing tube removed. Although the memory still brings tears to her eyes, Denise says it was “a wonderful experience,” as well as a teachable moment for the nurse she was working with at the time.
“I’d seen nurses put a baby in the father’s arms and then leave,” because they don’t want to deal with that kind of death, Denise explains. “The thing I was trying to teach them is that just being with the family, even if you don’t say anything, makes a big difference--their pain is yours, too.”
Denise’s research focus shifted slightly in 2007, when, as an assistant professor in the University of South Florida, Denise collaborated with another professor on a study of moral distress in the NICU. The study showed that taking care of infants with neonatal abstinence syndrome and their families was a primary source of moral distress for NICU nurses. With drug use increasing, and synthetic drugs making it more difficult to manage these infants’ withdrawal symptoms, Denise recognized that there was an opportunity to research this area more thoroughly.
“I thought there was a lot I could do here,” she says.
So she began to focus her research on infants with NAS. While it was common knowledge in the NICU that these babies were irritable and extremely difficult to feed, Denise’s studies were able to quantify this fact for the first time. In addition, this irritability often made mothers feel that they were not good parents and that they were not bonding with their child, so Denise has also looked at the interaction of drug-addicted mothers and their babies, even traveling to Panama to observe breastfeeding practices and drug use among new mothers there.
Denise has been a prolific author on this topic, and her work, much of which has been grant funded, has been published in numerous journals. She notes that her papers are some of the most downloaded among journal articles.
Her work has also earned her numerous honors, including a research grant award from the Southern Nurses Research Society, the University of Southern Florida College of Nursing’s Clinical/Teaching Article of the Year award, two Manuscript of Exceptional Merit recognitions from Neonatal Network and, most recently, fellowship in the American Academy of Nursing, something she never expected to achieve, she says.
“It’s been there as this stretch goal,” she says, adding that, at the ceremony, which was held in Washington, D.C., “I was very proud to be with those other people who are doing unbelievable things.”
Ultimately, Denise hopes that her research will enable her to find a way to help mothers successfully feed their infants with NAS, noting that currently, it is a “hit or miss thing.”
“My overall goal is to test a simple intervention that can be used in the NICU by nurses to help moms be more successful feeding their infants with NAS,” she says. “I did a study recently asking expert NICU nurses how they got these babies to feed successfully, and they had a lot of interesting tips that I had never heard of before. I’d like to put some of the tips in an intervention for moms so that NICU nurses all over the country can use that information.”