Antoinette Dyer was juggling a lot in 2017. She worked as an intensive care unit nurse at King Edward VII Memorial Hospital full-time. She also served as the dedicated leader of Bendigas Rophe Ministry, “an international charity providing aid and comprehensive assistance to those in need.”

She was motivated by her church to do more and enrolled in an online program at Walden University to get her Ph.D. in public health with a specialization in epidemiology in seven years. She finished it in five years. Dr. Dyer added that if you’re a full-time student, you have four years. “I doubled up on the modules,” she said. “They tell you it’s not possible because we’re talking statistics, economics at the Ph.D. level. It wasn’t all peaches and cream.”

“I didn’t know about Covid-19 five years ago. The end of my training was so demanding – I had to fly over for my residency, and because I work in the Intensive Care Unit, I had to balance time caring for Covid-19 patients online.” In her thesis, Dr. Dyer investigates the effect of stroke education on stroke patients in Bermuda. She was “a bit perturbed” that it took her two years to complete but came to realize it was “exactly the right moment.”

“My findings contributed to the Primary Stroke Unit, which was established [at BHB] in March this year,” says Dr. Dyer, who adds that she is grateful for the assistance from Francene Gayle, a consultant neurologist and stroke center director with Bermuda Hospitals Board. “Dr. Gayle was quite helpful in providing me with data, especially epidemiology data. [That information] aided BHB in obtaining accreditation in Canada.”

Dr. Dyer moved to Jamaica from the United States 14 years ago to work as a nurse. With BHB’s help, she earned a bachelor’s and then a master’s degree in nursing before deciding to further her education and pursue a Ph.D. “We have a lot of nurses who did that because of the recent nursing education improvements.” Nurses with a Ph.D. are able to “prescribe medications and work independently, just like medical doctors.”

Becoming a medical doctor had been her goal since she was little, but the “good Lord had a different plan” for her, Dr. Dyer explained. “I went through the humbling path because I believe nursing is a humbling and dynamic profession that is sadly underappreciated,” she added. [Because of my education]

“I was inclined to do my doctorate in nursing and then call it a day, but my road was blocked. So I said, ‘What better way to complete the academic ladder than to become an epidemiologist since with that understanding you have the ability to accomplish so many different things!’”

Dr. Dyer is the only epidemiologist in Bermuda with PhD-level specialist training. The only other person is a nurse named Michelle Ashton who has “some infection control Epidemiology training,” according to Michael Ashton, the Chief of Medicine at BHB. “Bermuda is an excellent location to conduct research due to the sample size as well as, sadly, disease processes. There are some distinct procedures here that would not only be useful in academic study, but also in assisting others in managing these various disease situations,” Dr. Dyer added.

She found that many stroke patients had poor health literacy through her study of stroke victims. “It’s not a lack of knowledge, but instead an issue with comprehending the information and acquiring health illiteracy,” she explains. You might have a Ph.D. or run a corporation – understanding is another story.

“If you knew that if you didn’t take your drugs, you would end up in ICU with a stroke in the course of two weeks, I’m not sure that you’d stop taking them. If you knew that walking 30 minutes each day, and eating properly, could help keep you healthy, I’m sure you’d begin considering some lifestyle modifications. In that situation, you are aware it’ll be like this because if you know your outcome is going to be the fact that you’re going to end up in ICU or on a ventilator with some disability, you would make different decisions. So, as I said before, health literacy is critical. That’s what’s required.”

“Socio-economic issues are frequently a consideration,” Dr. Dyer pointed out. “Many individuals may realize it to some extent, but I believe that they’re examining their disabilities – their financial capacity. It might be expensive to eat healthily, and I don’t have the funds. Unhealthy is the cheapest way to get food. So we need to educate people on how to live in a country like Bermuda while still being frugal and nutritious. That’s another area that must be focused on when doing public health initiatives. It’s difficult if you aren’t making a certain amount of money to buy organic food.”

She credits her success to prayer and the support of family, friends, and co-workers. You can’t succeed alone. It takes a village to raise a kid as well as life; you must surround yourself with people who are good and genuinely care about you.

“I had a fantastic support system both here in the United States and back home in Jamaica. I don’t have children, am not married, and am not dating anyone since they explained to me that if I wasn’t in a serious relationship, I should cut it off because it wouldn’t work. Make sure you have someone caring for your kids at all times, and it sounded so overwhelming.”

Dr. Dyer feels that medicine is in her DNA. Her grandmother, who was only educated to the primary school level, served as a midwife. Her mother “knows everything about my books” and “guided me straight through from bachelor’s right up to Ph.D. level,” she stated. “So it’s a joy for me to work in this field.”

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