The Institute of Medicine's (2010)The Future of Nursing report acknowledges the growing expertise of nurses and promotes their leadership of "nurse-led initiatives" to improve patient care. The growth of doctorally prepared nurses actively involved in the conduct of research offers an opportunity to acknowledge the challenges and potential that can be realized within clinical practice environments as well as possibilities to achieve this goal. Although the title assigned to nurse researchers varies from site to site (e.g., nurse researcher, nurse scientist, or senior nurse scientist), this emerging role is frequently accompanied by a well-defined job description that delineates clear research and often clinical responsibilities within the organization.
Unlike their academic partners, nurse researchers in practice settings often lack the protected time needed to actively participate in funded research investigations. Added challenges include securing needed support to "buy out" time to complete their organizational roles and related responsibilities. Accessing comparable leaders to replace these nurse scientists within the structure of a demanding clinical environment is often difficult. Creative models that actualize the role of the nurse researcher in a practice environment have begun to emerge. Recently, the Eastern Nursing Research Society has developed a research interest group to address the barriers and facilitators that impact full actualization of the nurse researcher role in practice.
The visibility of the doctorally prepared nurses in clinical settings can influence another IOM (2010) recommendation linked to increasing the number of nurses with doctoral preparation by 20%. The presence of nurse researchers on patient units and in the community, along with the inclusion of staff involved in research mentored by doctorally prepared nurses, often creates the needed stimulus for nurses to seek advanced education.
Centers like the Yvonne L. Munn Center for Nursing Research at The Massachusetts General Hospital in Boston have proven to be an important innovation to help nurses overcome barriers linked to advancing a research agenda in clinical practice. This environment provides both the infrastructure and support needed to integrate nursing research into the fabric of patient care delivery. The center has helped to accelerate external grant funding and foundational philanthropic resources essential to increasing research productivity. Emerging areas of research concentration including symptom management (e.g., chronic pain management), care of the older adult and palliative care, workforce evaluation, and interventional and educational evaluation are evolving areas of research concentration. Traditional methodological approaches, multisite investigations, and an emerging focus on comparative effectiveness studies are essential to address nursing leadership in improving patient care outcomes.
The growth of academic partnership across academic and clinical settings is an example of how the clinical laboratory is creating an opportunity to enhance research for students, staff, and faculty. These collaborations are helping to foster research, promote mentoring, and advance research and educational opportunities for inquiry within and across disciplines. As nursing knowledge continues to grow, nurse-led interdisciplinary research investigations can be realized, which will advance patient-centered, cost-effective, safe patient/family care.
Dorothy Jones, EdD, RNC, FAAN
Professor, Boston College
Director, Y. L. Munn Center for Nursing Research
Massachusetts General Hospital