As we begin a new decade, the World Health Organization (WHO) has deemed 2020 Year of the Nurse and Midwife - a global message is advanced for all to listen to – nurses, healthcare team members and collaborators, friends of nursing, and varied community groups who engage with nursing.
As nurses, we have an opportunity to advance nursing’s message of importance and worth in helping to promote, maintain and restore health. Through continuous messaging and education to all of our friends - healthcare professionals, legislators, and the public, - advocacy for the work we do can continue to advance as we begin a new decade of progress.
Continuing knowledge development and its integration in clinical care is essential to the work of nursing everywhere. Nurses who are engaged in research in whatever setting - universities, healthcare organizations, and clinical practice- participate in building knowledge for the benefit of varied populations world-wide.
Investment in knowledge-building through research promotes greater understanding of clinical excellence and the advancement of nursing science. Whether research is conducted by nursing or in collaboration with other health professionals, its importance is demonstrated through acquisition of new knowledge that can be translated and shared about our patients, the nursing workforce, and healthcare work processes.
Recognition of best practices in clinical care, as it is identified and translated, facilitates care knowledge in health promotion, maintenance or restoration of health. To advance nursing and healthcare research, continuing resources are needed to build increased nursing research momentum.
More nurses are needed worldwide at all levels of education
Data collected internationally (2007-2016) describe 87 countries of the world having less than 3 nurses and/or midwife capacity per one thousand persons; more than fifty percent of healthcare is provided by nurses (1). The World Health Organization estimates by 2030, nine million nurses will be needed worldwide to meet the global needs of healthcare.
In the United States, 3.2 million nurses are employed, and similar to other countries, nurses provide more than 50 percent of needed healthcare (2). In the next ten years, 1.2 million more nurses will be needed as nurses retire from the workforce and the number of persons with chronic illness increases (3).
The largest percent of working nurses today have a bachelor degree (63.9 %), 17.5% have a master’s degree and 1.9 % have attained a doctoral degree (4). Clinicians, educators and researchers are needed to support and build research momentum. Nurses working with patients at the bedside, in communities, those working as educators to prepare the next generation of caregivers, and/or those who are prepared at the doctoral level to advance science - knowledge-building or translation - are all important in advocacy for increasing nursing research momentum.
More dollars are needed for nursing research
The National Institutes of Health (NIH) is a major funder of grants in support of medical and nursing research in the United States. In particular the National Institute for Nursing Research (NINR) provides grant money for nursing research through a competitive review process. In September of 2018, legislation passed entitled, Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act, 2019’ appropriated funding for the 27 Institutes within the National Institutes of Health.
In the legislation, the amount of money funded specifically to the NINR was less than to any other Institute and equaled only $162,9 million dollars (5). Dollars awarded through NINR support, include research aims that address health promotion, symptom science and individual health self-management (6). More money is needed to support these aims and other nursing inquiry leading to the advancement in our understanding of nursing, patients, nursing care and the environment in which care takes place.
Other organizations offering research support include other Institutes of the NIH, the Agency for Health Research and Quality (AHRQ), American Nurses Foundation (ANF), the National League for Nurses (NLN), Sigma, American Association of Colleges of Nursing (AACN), the Robert Woods Johnson Foundation (RWJ) and varied other nurse specialty organizations. Additional funding for nursing research can provide doctoral-prepared nurses increasing opportunity to advance knowledge and build evidence for all to better understand health promotion and human response to illness.
Of interest, the Bureau of Labor Statistics projects the job market for medical scientists or those persons, "conducting research aimed at improving overall human health" and who "typically have a PhD, usually in biology or a related life science or health related occupations" (7). Statistics indicate a blossoming job market through 2028 for medical scientists, typically who are non-nurse scientists.
In 2018 medical scientists occupied 130,700 jobs. Most medical scientists work in offices (34 %), colleges and universities (24 %), and in hospitals (18%) (7). By comparison, demographics of nurse scientists whose primary focus is conducting research is not as available. Statistics regarding the annual number of nurses who enroll and graduate from PhD nursing programs indicate approximately 800 nurses graduate with a PhD in Nursing each year (8). Limited information is available as to how many of these nurses are actively engaged in nursing research in schools or in healthcare organizations.
Many more nurses enter educational programs leading to a Doctor of Nursing Practice (DNP) – a degree focus that directs and supports translational nursing research. Among PhD-prepared nurses, many work in educational settings and combine faculty responsibilities, both in nursing education and research. Statistics specifically regarding the number of faculty conducting research are not readily available.
More nurses are needed in all settings to serve as leaders and mentors
New nurses need the opportunity to connect nursing research to day-to-day practice. As new graduates and early career nurses of any educational level enter the workforce, guidance and support is needed in putting it all together - understanding the relevance of nursing theory, in research collaboration and in directed new learning and decision-making- for enhanced patient outcomes to occur.
Faculty are needed in schools and clinicians and nurse researchers are needed in varied work settings to educate, encourage, support and lead the way for generations coming after us. Employment opportunity in service settings that include nurses with research knowledge as Nurse Scientists are needed more than are available; in schools of nursing, support is needed to encourage and provide time for seasoned faculty to mentor new faculty that includes building scholarship through nursing research.
Building nursing research momentum is multi-faceted. More data is needed regarding the status of nursing research resources today. To advance development of nursing science, nurses need to work together regardless of background or orientation, - each perspective is important in advancing momentum in nursing and healthcare research.
Planned Action Needed
A new way of thinking is needed among nurses – one that focuses on what can be rather than what is. Organizations need to support the professional nurse in whatever capacity to effectively have time to think, act and incorporate new learning through research engagement that ultimately serves the public good.
As 2020 The Year of the Nurse and Midwife is beginning, let each of us ‘seize the moment’ to identify and engage in knowledge-building and translation through research, thus advancing momentum to build our capacity for the advancement of nursing science.
References
(1). World Health Organization (Jan 9, 2020). Nursing and midwifery Retrieved at https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery
(2). American Association of Colleges of Nursing (AACN), (2019). Nursing Fact Sheet. Retrieved at https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Fact-Sheet
(3). Buerhaus, PI, Skinner, LE, Auerbach, DI & Staiger, DO (2017). Four challenges facing the nursing workforce in the United States. Journal of Nursing Regulation. 8(2): 40-46. Retrieved at http://healthworkforcestudies.com/images/JNR0717_40-46_Buerhaus.pdf
(4). U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. 2019. Brief Summary Results from the 2018 National Sample Survey of Registered Nurses, Rockville, Maryland. Retrieved at https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/nssrn-summary-report.pdf
(5). US Government Printing Office (September 28, 2018) Public Law 115-245 115th Congress Retrieved at https://www.congress.gov/115/plaws/publ245/PLAW-115publ245.pdf
(6). Department of Health and Human Services, National Institutes of Health: National Institute of Nursing Research (NINR). FY 2020 Budget. Retrieved at https://www.ninr.nih.gov/sites/files/docs/NINR-Budget-FY-2020-508c.pdf.
(7). Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Medical Scientists, Retrieved at https://www.bls.gov/ooh/life-physical-and-social-science/medical-scientists.htm .
(8). American Association of Colleges of Nursing (AACN), (2019). The PhD in Nursing. Retrieved at https://www.aacnnursing.org/News-Information/Research-Data-Center/PhD