Roles and functions in clinical care for registered nurses with a PhD-A systematic literature review.

BACKGROUND: Nurses are responsible for nursing care and their expertise is crucial for quality of care. One factor important to successful delivery of evidence-based care is availability of staff with the expertise to support their colleagues in this endeavour. RN/PhDs versed in scientific research with a thorough knowledge of their disciplines have the potential to help narrow the gap between theory and practice. The roles and functions of RN/PhDs involved in clinical care have not yet been well defined. AIM: To explore publications concerning clinical contributions from registered nurses who hold a PhD (RN/PhDs) regarding impact on quality and improvement of care. METHOD: A systematic literature review was conducted and qualitative content analysis was applied to the data obtained from the included studies. FINDINGS: The leadership role is considered essential for RN/PhDs, where the focus is on the pursuit of evidence-based practice and the improvement of nursing practices. The opportunity to combine the clinical and academic aspects of nursing is considered crucial in order for RN/PhDs to influence and improve care, yet few such positions are currently available. RN/PhDs cited limited career opportunities as one important reason for not combining clinical and academic work. CONCLUSIONS: In order for nursing practice to reach full potential, clinical positions with clearly defined job descriptions for RN/PhDs are needed. To fully leverage their expertise, it is important to allocate sufficient time to conduct relevant research, as well as to support colleagues and students in the improvement of clinical practice.

Is It Possible for Registered Nurses and Physicians to Combine Research and Clinical Work to Facilitate Evidence-Based Practice?

BACKGROUND: Evidence-based patient care requires clinicians to make decisions based on the best available evidence and researchers to provide new scientific knowledge. Clinician-scientists (i.e., registered nurses [RNs] and physicians with a PhD) make important contributions to health care; yet, their roles are not fully understood, supported, or recognized by healthcare leaders. Only a few studies have addressed the factors that enable RNs and physicians to simultaneously pursue both clinical work and research after earning a PhD. AIM: To explore what factors have a bearing on the ability of RNs and physicians to pursue research and clinical work simultaneously after earning a PhD. METHODS: The study used a qualitative design based on open-ended, in-depth interviews. Data were analyzed using conventional content analysis. RESULTS: Analysis of the data yielded a broad range of factors that RNs and physicians perceived to either facilitate or hinder continued research while simultaneously undertaking clinical work. Most of the perceived barriers were due to factors external to the individual. Several factors applied to both professions yet differed in impact. Factors mentioned as fundamental to continued research were financial support and allocated time for research. Maintenance of a good relationship with academia and support from management were also considered to be important. In addition, personal factors, such as motivation to pursue a research career after obtaining a PhD, were influential. LINKING EVIDENCE TO ACTION: A supportive infrastructure is important for enabling clinician-scientists to pursue research after earning a PhD. Creating favorable conditions for RNs and physicians to combine research with clinical work can facilitate evidence-based practice. This information can be used for interventions aimed at improving the conditions for clinician-scientists.