For Carolina nurse, big ideas bring big results

From the time she was small, Debra J. Barksdale thought big. At the age of 9, she was inspired by the television show Julia, starring Diahann Carroll as a black American nurse. “Everything I did from that point on was so that I could be a nurse,” she says.

She was determined to be the first in her family to acquire a four-year degree, and she went on to be a nurse practitioner and to attain a Ph.D. in Nursing Research from the University of Michigan.

Today, as an associate professor at UNC-Chapel Hill’s School of Nursing, she juggles teaching, research, mentoring, volunteering and providing leadership within and outside the school. In fall 2010, she was the only nurse appointed to the Board of Governors for the new Patient-Centered Outcomes Research Institute. The national institute was established under the Patient Protection and Affordable Care Act, part of federal health-care reform legislation. The institute will carry out research projects to help patients, clinicians, consumers and policymakers make informed health decisions.

“There are some major needs regarding health and health care in our country, and I hope to be able to make a difference,” Barksdale says. “I will also be an advocate for the disadvantaged, underserved and underrepresented in regard to issues of health and research.”

Barksdale’s unique research involves studying hypertension in black Americans. “Hypertension is a huge problem in our community. I have seen it in my family and my patients,” she says. “I started out thinking about the relationship between stress and hypertension and have gradually gotten more sophisticated in my study of these phenomena.”

With a grant from the National Institute of Nursing Research, she is studying cardiovascular and neuroendocrine responses during sleep. The responses indicate a person’s physiological costs of chronic exposure to stress, which is known as allostatic load. Her work is so unique that instruments did not exist for necessary 24-hour ambulatory monitoring. With support from the school’s Biobehavioral Laboratory, Barksdale worked with a company to adapt equipment for her research.

With doctoral students Jeongok Logan and Carolyn Lekavich and post-doctoral fellow Minhee Suh, Barksdale is studying the effects of the body’s release of cortisol shortly after awakening from a night’s sleep. They will study this cortisol awakening response in black Americans while recording ambulatory blood pressure and how the heart is working for 24 hours. Studying blood pressure and heart function throughout the day and during sleep might shed light on a mystery that vexes clinicians and researchers alike: Why do so many heart attacks and strokes occur in early morning?

Barksdale’s volunteer service includes working several times each month as the primary health care provider at the Robert Nixon Clinics for the Homeless in Chapel Hill.

She involves students in the clinics and community agencies as much possible, which has allowed her to mentor nursing practitioner and pharmacy students as well as students interested in nursing and medicine. The experiences enable students to serve while meeting academic requirements such as research for a master’s paper.

“I believe in giving back,” she says. “It is a win-win because I provide a service and get to help people while satisfying my clinical practice requirements.”