In 2000, world leaders and preeminent scientists gathered at the White House to celebrate the completion of the first survey of the entire human genome—an accomplishment that President Clinton hailed as the “most important, most wondrous map ever produced by human kind.”
From that year on, Ann Cashion, PhD, RN, FAAN, then a nurse and nurse educator, was hooked on the promise and potential of genetics and genomics in nursing.
A professor of nursing at the University of Tennessee Health Science Center (UTHSC), Cashion had heard about a new research training program in genetics and genomics, the Summer Genetics Institute at the National Institute of Nursing Research (NINR), which is part of the National Institutes of Health (NIH) in Bethesda, Md. She applied and was selected to participate in the program’s inaugural cohort—an experience that introduced her to the field and changed the trajectory of her entire career.
“I came here in 2000 and I was just in awe,” she says. “Now, 14 years later, it’s where I work. I wouldn’t be here now if I had not had that positive experience all those years ago.”
As NINR’s newly appointed scientific director, Cashion oversees research that is conducted by nurse scientists at the NIH Bethesda campus. This kind of “intramural research” comprises about 5 percent of the NINR’s appropriated funding and usually involves the study of biological and behavioral data, such as measures of genomics, depression, past traumatic events, physical activity, and diet. “Because we’re nurses, we’re very aware of the environmental and clinical factors that affect our patients,” she says.
“Despite our best efforts, the intramural program is one of the best-kept secrets in nursing research,” Cashion says. “One of my goals is to open up more to the nursing community and provide opportunities for nurse scientists to come to NINR for short periods of time.”
Cashion expects that there will be a redesigned nursing curriculum to incorporate genetic and genomic content so future nurses can incorporate the subject into research and practice. A mentor to doctoral students, she also puts a premium on training the next generation of nurse scientists. “I try to provide intramural researchers with what they need to move the science forward,” Cashion says. Overall, “my vision is to build an intramural program that is dedicated to discovering and implementing ways to alleviate symptoms and disease.”
Cashion’s new position comes naturally. Between 2012 and 2013, she served as NINR’s acting scientific director, which paved the way to her current position. A previous NIH-funded researcher herself, she can also relate to the nurse scientists who work under her.
An Interest in Organ Transplants
Since 2000, Cashion’s research interests have focused on the link between genetics, genomics, and the environment among organ transplant recipients. In her most recent NIH-funded study, she combined emerging technologies and behavioral questionnaires to investigate the role of genes and environmental factors in patients who gained unhealthy weights after kidney transplants. Last year, she published the findings of her research, which showed that six genes, as well as certain environmental factors, increased the risk that kidney transplant recipients would become obese in the first year after transplantation.
Cashion plans to follow up on the study during her tenure at NINR. She is also interested in supporting research into emerging technologies such as the microbiome, which looks at the influence of bacteria inhabiting the body on health and disease, and epigenetics, the influence of such things as food and stress on gene activity. “It’s fun. It’s all a puzzle. The more you learn, the more you realize you don’t know. And that curiosity is what drives all scientists,” she says.
Prior to her work as a nurse scientist, Cashion practiced as a critical care nurse for nearly two decades in Little Rock, Ark. In 1995 she decided to pursue her doctorate, and enrolled in the UTHSC program, even though it was more than 100 miles from her home. She commuted for several years while also raising three young boys and studying heart rate variability among transplant recipients.
After earning her doctorate, she joined the UTHSC faculty and became professor and chair of the department of acute and chronic care in the College of Nursing. While there, she also researched early biomarkers of acute rejection in recipients of pancreas transplantations.
In 2005, Cashion was selected to participate in the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program, which she says helped her decide to leave academia, at least temporarily, and move to the nation’s capital to take on a new role at NINR.
“It encouraged me to think bigger, and differently, and outside of my own discipline. I learned that my goals did not have to stay within nursing. The program helped me take what I thought was my highest goal and ambition in life—becoming a dean at a nursing school—and reframe it so I could see other ways to reach my goals.”