Martha Mackay is originally from Toronto, which is where her passion for nursing arose. Like many before her, the road to nursing began as a patient. As a teenager, she developed appendicitis, and become quite sick after her operation. She was taken aback by the nurses and the scope of nursing care. “It blew me away how important they were” she says.
In Toronto, Martha completed her basic nurse training (which in those days was a diploma) at George Brown College in 1978. “It’s been a steady path toward more advanced education” she says, referring to the fact that since then, she hasn’t gone more than eight consecutive years without returning to school.
Throughout her master’s degree, she was keen to improve her research skills and during that time began collaborating with several UBC School of Nursing faculty members on research projects related to cardiac patients and behaviour change. “It was very rewarding” she says, “and I occasionally applied for funding to do small-scale studies on my own, but was never successful because I didn’t have a PhD.”
This passion for research is what eventually led Martha back to UBC to complete her PhD. However, while her desire to be an independent researcher has played an important role in her career choices, she also acknowledges a commitment to clinical work and aims to combine the two. “I think that combination is important, but not common in nursing. It has the potential to make the research more relevant and allow a quicker transition into clinical practice.” She hopes to create a balance of time with 70% devoted to research and 30% devoted to clinical practice at St. Paul’s Hospital, where she works in the Heart Centre.
For her dissertation research Martha looked at sex differences in symptoms of myocardial ischemia. The study was presented at the Canadian Cardiovascular Conference in 2009, which Martha describes as “the ‘big’ cardiac meeting in Canada”, and profiled by the Heart and Stroke Foundation. As a co-sponsor of the conference, Heart and Stroke chooses several of the abstracts that they think will be of public interest and creates press releases based on their content. “The picked ours up and did a press release” says Martha. “And it just caught fire!”
She attributes the large scope of attention in part to the internet and syndicated press services. Canwest (now Postmedia Network Inc.), one of Canada’s largest international media companies picked up the story and it was circulated through numerous Canadian newspapers as well as being featured on nearly 150 websites internationally including in both Thailand and India. “But I was really only interviewed two or three times!” she marvels. One of the sites she was interviewed by was “the heart.org”, the English-speaking cardiology community’s main site for news and high quality information. “It’s both research and clinical content” she says, “but filtered down like newspaper headlines. The piece about our study was on their front page.”
“The reason [our research] caught on is because it’s about patients and symptoms, not some esoteric concept” says Martha. “It’s about what people feel when they have a heart attack. There has been quite a lot of research into whether or not men and women experience heart attack symptoms differently. Some studies show that women have less-common symptoms and some have shown that women don’t have as much chest pain for example, which is one of the cardinal symptoms that people recognize.”
But Martha didn’t have full faith in that research and recognized that it had flaws. She saw that the public was eager for information and were readily accepting the information given to them by the media. “There has been an almost exaggerated response, such that there is now a conception that women don’t have heart attack symptoms that are anything like men’s. In my opinion, that’s simply not true – and our study bore that out.”
She notes that on Oprah Winfrey’s website, for example, it states that “many of the symptoms of heart disease are often ignored, unrecognized or misdiagnosed, because women’s symptoms are completely different than men’s” (www.oprah.com/health/Facts-About-Heart-Disease-for-Women). “That is almost dangerous I think because it’s misinformation” says Martha. “It’s been a women’s issue many are aware of but are confused about, which I think largely contributed to the appeal of our research.” There is more and more research evidence accumulating that implies that women are in fact more similar to men in regard to symptoms of heart attack, explains Martha. “There are some differences, but women do indeed experience chest pain, and as often as men.”
The scope of her research has led her toward a number of accomplishments. “I was fortunate enough to receive the clinical research fellowship award from CIHR that supported me while I did my doctoral work.” She won the student essay prize award at the 2009 IPONS (International Philosophy of Nursing Society) Conference. And in 2010 was appointed by the UBC School of Nursing as a clinical assistant professor, a new category of adjunct that is specifically aimed at people like Martha, who hold positions where a combined research and clinical focus is integral to their work.
“It’s all a bit new” says Martha (referring to her position), “and there isn’t much president for it in BC or in Canada, so what it looks like and how it will unfold is still a bit uncertain. In terms of research, I intend to continue looking at people’s behaviours around experiencing heart attacks and other behaviours related to cardiac risk factors.”