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CONCERNS ABOUT THE SCHOLARLY DEVELOPMENT OF THE NURSING PROFESSION AND THE ACADEMIC NURSING PIPELINE

HIGHLIGHTS

  1. 1. Preparing the future nursing workforce.

  2. 2. Shortage of future faculty to prepare future nurses.

  3. 3. Need for high-level clinical strategies for academic nurse line planning and nursing faculty.

HIGHLIGHTS

  1. 1. Preparing the future nursing workforce.

  2. 2. Shortage of future faculty to prepare future nurses.

  3. 3. Need for high-level clinical strategies for academic nurse line planning and nursing faculty.

While concerns abound globally with regard to the preparation of the future nursing workforce, in relation to issues such as safe staffing, workplace wellbeing and pay and conditions, one additional concern for us is the lack of strategic planning for higher-level development within the profession. Indeed, this prompted us to recently write about this issue, suggesting a “call to action” in order to spearhead a critical discussion on the scholarly development of nursing11 Ryder M, Connolly M, Kitson AL, Thompson DR, Timmins F. A critical discussion regarding the scholarly development of the nursing profession: a call to action. Nurse Educ. Today [Internet]. 2022 [cited in 2023 Feb. 05];110:105249. Available in: https://doi.org/10.1016/j.nedt.2021.105249.
https://doi.org/10.1016/j.nedt.2021.1052...
.

Termed the “clinical-academic divide” by authors22 Darbyshire P, Hungerford C, Thompson DR, Lauder WJ. Nursing, leadership and academia: passing the baton. Nurse Educ. Today [Internet]. 2020 [cited in 2023 Feb. 05];89: 104400. Available in: https://doi.org/10.1016/j.nedt.2020.104400.
https://doi.org/10.1016/j.nedt.2020.1044...
there is now an urgent shortage of future faculty to prepare nurses of the future and limited scholarly development within the discipline. This is now at crisis point and urgent action needs to be taken. These challenges are faced by nurses globally. There are also some examples of proactive steps to address this, with countries such as Spain, where in the early 2000, a career framework was created that facilitated increasing the number of Masters’ prepared nurses as part of the workforce as well as investing in PhD preparation and training. At the same time, investment in education of nurses to Masters’ and PhD level also has to make economic and clinical sense.

It is our view that while there have been great strides in the development of the profession globally, especially with regard to the continued and ongoing connection between nursing and university-based education in most countries, this development seems to have reached its pinnacle in many areas. It appears that rather than continued advancement of the discipline through research and PhD study, postgraduate specialisation appears to be the accepted conclusion of the vigorous professional development that has occurred across Europe and the UK in the last two decades: “We now have a complete apprentice pathway from entry level to postgraduate advanced clinical practice in nursing, providing a high-quality route into the profession” (Nursing degree apprenticeships: in poor health 2019:194)33 Nursing degree apprenticeships: in poor health? The Government’s response to the House of Commons Education Committee. Br. J. Health Assistants [Internet]. 2019 [cited in 2023 Feb. 06];13(4):194-199. Available in: https://doi.org/10.12968/bjha.2019.13.4.194.
https://doi.org/10.12968/bjha.2019.13.4....
.

Whilst globally there has been an increasing emphasis on advancing nursing practice, both academically, but also within clinical practice, the manifestation of nursing as a research led and informed profession is not borne out in practice. For example, the research activity required of many advanced nurse practitioners (ANPs) is often not prioritised or supported in practice44 Ryder M, Jacob E, Hendricks J. An inductive qualitative approach to explore nurse practitioners views on leadership and research: an international perspective. J Clin Nurs [Internet]. 2019 [cited in 2023 Feb. 05];28(13-14):2644-2658. Available in: http://dx.doi.org/10.1111/jocn.14853.
http://dx.doi.org/10.1111/jocn.14853...
. Indeed the advancement of nursing as a scientific discipline is faltering in many European countries as few nurses are advancing to PhD level, and are rather, understandably opting for a clinical career pathway.

There is a serious need to develop a clinical academic career pathway, not only to inform and advance clinical practice, as research activity and where clinical research careers are embedded there are better patient outcomes55 Kitson AL, Harvey G, Gifford W, Hunter SC, Kelly J, Cummings GG, et al. How nursing leaders promote evidence-based practice implementation at point-of-care: a four-country exploratory study. J. Adv. Nurs. [Internet]. 2021 [cited in 2023 Feb. 05];77(5):2447-2457. Available in: https://doi.org/10.1111/jan.14773.
https://doi.org/10.1111/jan.14773...
-66 Newington L, Wells M, Adonis A, Bolton L, Saghdaoui LB, Coffey M, et al. A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine. BMC Health Serv. Res [Internet]. 2021 [cited in 2023 Feb. 06];21(1):400. Available in: https://doi.org/10.1186/s12913-021-06354-y.
https://doi.org/10.1186/s12913-021-06354...
, but to ensure that there are enough PhD prepared faculty to educate the nurses of the future. Indeed there is existent concern about the lack of strategic planning for the future “pipeline”: “Nursing faces a crisis because there exists a dearth of qualified nurse academicians and administrators willing to step up to high-level leadership positions such as deanships and chief nursing positions” 77 Branden PS, Sharts-Hopko NC. Growing clinical and academic nursing leaders: building the pipeline. Nurs. Adm. Q [Internet]. 2017 [cited in 2023 Feb. 06];41(3):258-265. Available in: https://doi.org/10.1097/NAQ.0000000000000239.
https://doi.org/10.1097/NAQ.000000000000...
:258.

This situation has arisen due to a lack of infrastructural support, including opportunity for research advancement and limited funding opportunities for nursing research, the authors88 Goodwin M, Fingerhood M, Slade E, Davidson P. Development of an innovative curriculum-to-career transition program for nurse practitioners in primary care. Nurs. Outlook [Internet]. 2021 [cited in 2023 Feb. 06];69(3)425-434 [cited in 2023 Feb. 06]. Available in: https://doi.org/10.1016/j.outlook.2020.11.012.
https://doi.org/10.1016/j.outlook.2020.1...
something which resonates strongly with us as a team. However the nursing profession needs to begin to influence strategic planning for this aspect of nursing, including advancing the nursing research agenda. What is needed is: “a well-prepared, diverse, well-funded and steady supply of nurse scientists from those in the educational pipeline through early stage, mid-career and senior careers”99 Redeker NS. (2021). Fortifying the pipeline of nurse scientists to assure the nation’s health: a “career-span” approach. Nurs. Outlook [Internet]. 2021 [cited in 2023 Feb. 05]; 69(2):246-248. Available in: https://doi.org/10.1016/j.outlook.2021.02.005.
https://doi.org/10.1016/j.outlook.2021.0...
:246.

High level clinical strategic partnerships are urgently needed to plan for the nursing scholar and nursing faculty pipeline. This may include targeting and nurturing current undergraduate students but also providing financial and infrastructural support necessary to support PhD and postdoctoral career development. Clinical research units need to be embedded in healthcare sights, in partnership with the universities, led by the nursing professoriate. There is an urgent need for both global and national nursing research strategy. There is also a need for conversations about developing clinical academic career pathways to enable succession planning of expert clinicians to guide nurse education for the future. We concur with Watson1010 Watson R, Hayter M, Jackson D. (2021). Is the PhD well for nursing faculty running dry? J. Nurs. Manag [Internet]. 2021[cited in 2023 Feb. 05]; 29(6). Available in: https://doi.org/10.1111/jonm.13308.
https://doi.org/10.1111/jonm.13308...
who suggest that:

If we do not address the apparent shortage of doctorally prepared nurses, especially in clinical practice, then this will have an adverse effect on the pipeline into academia. Consequently, this will have an adverse effect on our ability to teach future generations of nursing students and it will also threaten our place in universities. Watson et al1010 Watson R, Hayter M, Jackson D. (2021). Is the PhD well for nursing faculty running dry? J. Nurs. Manag [Internet]. 2021[cited in 2023 Feb. 05]; 29(6). Available in: https://doi.org/10.1111/jonm.13308.
https://doi.org/10.1111/jonm.13308...
.

There are other issues to consider. Professional doctorates, which are useful for practicing nurses, are not consistently thought to provide the research training required for the discipline. In the US for example, some nurses have not had their doctorates recognised for research credibility and have had to ‘convert’ to a PhD, usually self-financed. At the same time, senior management in the health care setting have been very reluctant (for a whole host of reasons) to support, let alone invest, in nursing research, academia and leadership for nursing research, some of which we have witnessed first-hand. However, it is still incumbent on us to attempt to persuade others/society to invest in nursing research, and advance the research aspect of our profession, through PhD prepared nurses and adequate numbers of professors. We really need to make sure the leaders of our profession are on board - and that is a challenge.

REFERÊNCIAS

  • 1
    Ryder M, Connolly M, Kitson AL, Thompson DR, Timmins F. A critical discussion regarding the scholarly development of the nursing profession: a call to action. Nurse Educ. Today [Internet]. 2022 [cited in 2023 Feb. 05];110:105249. Available in: https://doi.org/10.1016/j.nedt.2021.105249
    » https://doi.org/10.1016/j.nedt.2021.105249
  • 2
    Darbyshire P, Hungerford C, Thompson DR, Lauder WJ. Nursing, leadership and academia: passing the baton. Nurse Educ. Today [Internet]. 2020 [cited in 2023 Feb. 05];89: 104400. Available in: https://doi.org/10.1016/j.nedt.2020.104400
    » https://doi.org/10.1016/j.nedt.2020.104400
  • 3
    Nursing degree apprenticeships: in poor health? The Government’s response to the House of Commons Education Committee. Br. J. Health Assistants [Internet]. 2019 [cited in 2023 Feb. 06];13(4):194-199. Available in: https://doi.org/10.12968/bjha.2019.13.4.194
    » https://doi.org/10.12968/bjha.2019.13.4.194
  • 4
    Ryder M, Jacob E, Hendricks J. An inductive qualitative approach to explore nurse practitioners views on leadership and research: an international perspective. J Clin Nurs [Internet]. 2019 [cited in 2023 Feb. 05];28(13-14):2644-2658. Available in: http://dx.doi.org/10.1111/jocn.14853
    » http://dx.doi.org/10.1111/jocn.14853
  • 5
    Kitson AL, Harvey G, Gifford W, Hunter SC, Kelly J, Cummings GG, et al How nursing leaders promote evidence-based practice implementation at point-of-care: a four-country exploratory study. J. Adv. Nurs. [Internet]. 2021 [cited in 2023 Feb. 05];77(5):2447-2457. Available in: https://doi.org/10.1111/jan.14773
    » https://doi.org/10.1111/jan.14773
  • 6
    Newington L, Wells M, Adonis A, Bolton L, Saghdaoui LB, Coffey M, et al A qualitative systematic review and thematic synthesis exploring the impacts of clinical academic activity by healthcare professionals outside medicine. BMC Health Serv. Res [Internet]. 2021 [cited in 2023 Feb. 06];21(1):400. Available in: https://doi.org/10.1186/s12913-021-06354-y
    » https://doi.org/10.1186/s12913-021-06354-y
  • 7
    Branden PS, Sharts-Hopko NC. Growing clinical and academic nursing leaders: building the pipeline. Nurs. Adm. Q [Internet]. 2017 [cited in 2023 Feb. 06];41(3):258-265. Available in: https://doi.org/10.1097/NAQ.0000000000000239
    » https://doi.org/10.1097/NAQ.0000000000000239
  • 8
    Goodwin M, Fingerhood M, Slade E, Davidson P. Development of an innovative curriculum-to-career transition program for nurse practitioners in primary care. Nurs. Outlook [Internet]. 2021 [cited in 2023 Feb. 06];69(3)425-434 [cited in 2023 Feb. 06]. Available in: https://doi.org/10.1016/j.outlook.2020.11.012
    » https://doi.org/10.1016/j.outlook.2020.11.012
  • 9
    Redeker NS. (2021). Fortifying the pipeline of nurse scientists to assure the nation’s health: a “career-span” approach. Nurs. Outlook [Internet]. 2021 [cited in 2023 Feb. 05]; 69(2):246-248. Available in: https://doi.org/10.1016/j.outlook.2021.02.005
    » https://doi.org/10.1016/j.outlook.2021.02.005
  • 10
    Watson R, Hayter M, Jackson D. (2021). Is the PhD well for nursing faculty running dry? J. Nurs. Manag [Internet]. 2021[cited in 2023 Feb. 05]; 29(6). Available in: https://doi.org/10.1111/jonm.13308
    » https://doi.org/10.1111/jonm.13308

Edited by

Associate editor: Editora associada: Dra. Luciana Kalinke

Publication Dates

  • Publication in this collection
    05 June 2023
  • Date of issue
    2023

History

  • Received
    24 Feb 2023
  • Accepted
    24 Feb 2023
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