College of Nursing researchers focus on human reaction to high-stress jobs

Closeup of Stephen James and Lois James
Stephen James and Lois James

Among the faculty at the WSU College of Nursing are two experts on police use of force, implicit bias, and the effect of fatigue and shift work on law enforcement officers.

Stephen James and Lois James have been interviewed about that work by the Washington Post, NPR, Al Jazeera America and CNN, among others.

So what’s the connection with nursing?

Like law enforcement and the military, nursing is an occupation “where stressors such as fatigue, shift work and fear affect job-task performance, and where the consequences for getting it wrong are high,” explained Stephen James.

He joined the College of Nursing this fall as an assistant professor after working as a researcher for the WSU Elson S. Floyd College of Medicine.

Lois James, also an assistant professor, has been on faculty at the College of Nursing since 2016.

“My draw to nursing is based on my interest in the treatment of the human response,” she said. “I am less interested in the specifics of any particular disease than I am in how patients respond and cope. I see a core component of the nursing profession being the treatment of that response, which directly aligns with all of my research goals.”

The married couple, both Irish, met at Trinity University in Dublin when they were on the boxing team. Stephen enlisted in the British Army at 17 and pursued an undergraduate degree a decade later so he could become an officer.

Lois, meanwhile, came to WSU in Pullman for her master’s degree in criminal justice in 2009. She worked there with Bryan Vila, director of the Simulated Hazardous Operational Tasks Laboratory, who persuaded her to stay on at WSU to get her PhD.

Stephen was in Afghanistan wrapping up his ninth combat tour. Vila offered him a spot at the lab, which is part of WSU’s Sleep and Performance Research Center.

“I wasn’t a traditional academic,” he said. “I back-doored into this. This is as far from what I thought I’d be doing with my life as you can get.”

They shared an interest in improving training and performance among people with high-stress, high-stakes jobs.

“Being able to measure performance in areas like nursing, like policing, can be difficult because some of it is ‘soft skills,’ the way a person interacts with others for better outcomes,” Stephen said.

He added, “Evidence-based practices are very familiar to nursing. We have a lot of evidence around medical interventions, so what we’re really trying to build is evidence around the human interactions people have.”

The James’ are testing and refining a process to measure physical stressors like fatigue and shift work and their relation to performance. Their research projects have included:

  • Influences on a police officer’s decision to use deadly force.
  • Social interactions between members of the military and local populations overseas.
  • Measuring performance among mental health professionals, law enforcement and emergency medical technicians in crisis interventions.

Other research projects under way include building metrics to measure leadership in public-safety occupations and measuring the effect of back-to-back work shifts by nurses on patient care and driving safety.

Most recently, they were awarded a grant with the Seattle Police Department to develop and implement a fatigue risk-management strategy to improve safety, performance and health among the department’s 1,500 officers.

“I am committed not just to understanding a problem such as shift work-related fatigue, but also finding and evaluating ways to alleviate the problem,” Lois James said. “For me, that’s the true purpose of research — to ultimately help the populations you are studying.”

Both Stephen James and Lois James consult on their subject matter, publish journal articles and are often called on to comment by the media.

A recent paper published in Policing: An International Journal titled, “How police officers perform in encounters with the public: measuring what matters at the individual level,” was named Outstanding Paper in the 2019 Emerald (Publishing) Literati Awards covering the company’s more than 300 journals. The awards committee called it “one of the most exceptional pieces of work the team has seen throughout 2018.”

Stephen James said he’s happy to be joining the College of Nursing, taking what he’s learned working with law enforcement and the military and applying it to the nursing profession.

“The goal is to study occupations where stressors occur and the consequence of getting it wrong is high. Sleep deprivation, shift work and fear appear in other occupations, but if people get it wrong nobody’s going to die. That’s not the case in nursing. And being a land-grant university, I’m 100 percent behind the mission of taking what we learn and doing good with it in the world,” he said.

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