PhD Graduate’s Work Could Alter Stroke Treatment Paradigm

Nicole Schumacher began working at 14, when she started helping her dad with his eBay side business of selling electronic components from their garage. At 18, the California native worked for Best Buy and had no plans for college.

Today, Dr. Schumacher is doing research on glucose levels in stroke patients, especially in the very early stage of the stroke called the hyperacute phase, and how that affects their post-treatment outcomes. This research has the potential to make a significant impact in the care of these patients, said her research advisor, Professor Anne Alexandrov, PhD, AGACNP-BC, CNS, NVRN-BC, ANVP-BC, ASC-BC, CCRN, FAAN.

"The previous research completed on control of blood glucose in acute stroke patients never focused on gaining control in the early minutes after arrival to the emergency department, yet clinicians know the blood glucose level within the first five to 10 minutes after patients come through the emergency department door," Dr. Alexandrov said. "Dr. Schumacher's pivotal work demonstrates that emergency practitioners and acute stroke health care providers have not considered this paradigm shift, largely because the focus of our work is on ensuring rapid delivery of reperfusion treatment."

Finding Her Sweet Spot in Research

Dr. Schumacher's research also shows that acute stroke providers believe it would be feasible to incorporate ultra-early glucose control. "Overall, her work allows us to begin exploration of feasibility, safety, and outcomes associated with ultra-early glucose control in patients treated with reperfusion therapies," Dr. Alexandrov said.

For Dr. Schumacher, the most exciting aspect of her work is "that I am hopefully uncovering actionable insights that could potentially change practice and improve outcomes in stroke."

She initially felt drawn to the nursing profession after hearing another student at the community college mention becoming a nurse practitioner. "It's the caring aspect. I always felt that I was an empath. I'm a middle child," she said. When a professor at the same college urged her to earn her bachelor's degree in biology, her studies in that area confirmed her interest in research.

A first-generation college graduate, Dr. Schumacher jokes that her family likes to tease her about constantly being in school. But it was her pursuit of advanced training as a neurovascular practitioner that led her to Dr. Alexandrov, who established the NET SMART (Neurovascular Education & Training Acute Stroke Management & Reperfusion Therapies) post-graduate fellowship training program for advanced practice nurses in acute stroke.

When Dr. Schumacher took the course, she realized how much she could learn from Dr. Alexandrov, who is considered the leading international nursing expert in acute stroke management. "She is the godmother of the field," Dr. Schumacher said.

She applied to the PhD in nursing science at UT Health Sciences, where she completed the program in three years while working full-time.

"Nicole makes things happen," said Program Director Carolyn Graff, PhD, RN, FAAIDD. "Her commitment to learning, developing her research knowledge and skills, and supporting her peers is exemplary."

Dr. Schumacher also balanced work and school with her life as a wife and mother of two young children and a stepson. She said time management was key. "When deadlines start to get close, I typically change up my schedule to wake up earlier to get a few hours of productivity before work," she said. "This obviously wasn't always possible, but I think I was able to keep up a pretty good routine where my time with my kids wasn't too affected." She also credited her husband's support in keeping the household running smoothly.

Her next goal is to establish a clinical trial or pilot study on glucose levels in the hyperacute stage of stroke. But she is also hard at work on a post-MSN certificate in acute care as a nurse practitioner, saying it will help her in her job as a nurse practitioner at a comprehensive stroke center.

"I really like school," she said. "I'm glad I got into it."