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Advancing the Nation’s Health Needs
Together, influencing, redesigning, and shaping the environment for patients, families, and communities is another major area of study in nursing. For example, over 80 studies have shown the influence of nursing surveillance and presence on positive patient outcomes.5 The shortage of nurses, a critical factor, in a health care environment has been demonstrated to increase patient mortality and morbidity.6 Other studies show the benefit of home visits by nurses in improving the health and quality of life of low-income mothers and children.7
Research in nursing is often referred to as “nursing science” or “nursing research,” which has led some to confuse it with the nursing profession. This terminology exists at the National Institutes of Health (NIH) in the name of the National Institute for Nursing Research (NINR); however, the funding from NINR supports scientific research relevant to the science of nursing, and the investigators may be nurses or nonnurses. Nursing science is a knowledge structure that is separate from the profession and clinical practice of nursing.8 Furthermore, the term “nurse-scientist” is not reserved for graduates of Ph.D. programs in nursing; it refers to any scientist conducting research in the disciplinary field of nursing. For example, highly trained nurses under the supervision of a principal investigator could conduct the bulk of the work in a clinical trial.
Research training for nurses, as for other biomedical and behavioral researchers, needs to occur within strong research-intensive universities and schools of nursing. Important characteristics of these training environments include an interdisciplinary cadre of researchers and a strong group of nursing research colleagues who are senior scientists in the sense of consistent extramural review and funding of their investigative programs and obvious productivity in terms of publications and presentations. These elements are essential to the environment required for excellence in research training.
The NINR has traditionally placed a greater emphasis on research training in relationship to the relative size of the institute’s budget than is evident with NIH in general. This is due to the current stage of development of nursing research and the need for greater numbers both as investigators and academic faculty. At least 8 percent of NINR funds go to research training, which is roughly twice the percentage invested by other institutes.9 This commitment has been consistent for a number of years. This committee’s Nursing Research Panel members commend the wisdom of this tradition and encourage its continuation.
This chapter focuses on the following two areas that are of major concern to the discipline: (1) changing the career trajectory of research training for nurse-scientists to include earlier and more rapid progression through the educational programs to and through doctoral and postdoctoral study as well as increasing the number of individuals seeking doctoral education and faculty roles, and (2) enhancing postdoctoral and career development opportunities in creative ways.
CHANGING THE CAREER TRAJECTORY FOR NURSE-SCIENTISTS
The following three major factors motivate the critical need to change the career trajectory for nurse-researchers: (1) enhancing the productivity of nurse-researchers to build strong, sustained research programs generating knowledge for nursing and health practice as well as shaping health policy; (2) responding to the shortage of nursing faculty and the advancing age of current nurse-investigators, and (3) emphasizing the need for strong research training of nurse-investigators in research-extensive and research-intensive universities with equally strong interdisciplinary research opportunities.
ENHANCING SUSTAINED PRODUCTIVITY FOR NURSE-SCIENTISTS
Nurse-scientists play a critical role in the conduct of research and the generation of new knowledge that can serve as the evidence base for practice and improvement of patient health outcomes. However, nurses delay entering Ph.D. programs. There is particular concern because of inherent limitations in the number of years of potential scientific productivity. Starting assistant professors in other scientific fields typically have a research career trajectory of 30 to 40 years in duration. The average age of an assistant professor in nursing is 50.2 years. Hinshaw reasons that for a faculty member who enters the nursing academic workforce at the age of 50 and retires at 65, this productive period will be only 15 years for developing research programs and contributing to science for nursing and health practice in general.10 Thus, nurse-investigators tend to have a short career span. This limitation severely constrains the growth of nursing research and thus knowledge for nursing practice.
The median time elapsed between entry into a master’s program to completion of a doctorate in nursing is approximately 15.9 years compared to 8.5 years in other disciplines.11 In addition to having a long period of graduate training, the time has increased by 3 years since 1990, and there are no signs of the trend being reversed. Because there are many factors that reinforce the late entry of nurses into Ph.D. programs, there is a need to create incentives to change the career path. The challenge of promoting earlier entry into
Aiken, L. H., et al. 2002.
National Institute of Nursing Research. 2003. op. cit.