1. Pickler, Rita H.

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In a previous editorial, I addressed sustainable science from a variety of perspectives (Pickler, 2022). In particular, I noted that sustainability of a program of research or, specifically, a focus of scientific inquiry is important for scientific progress. In that editorial, I primarily focused on the individual scientist and the challenges associated with sustaining an established, productive research program during scientific shifts. However, there are additional challenges to the broader sustainability of nursing science, influenced by the "supply chain" of people and ideas necessary to meet the health needs of those who look to us for guidance, aid, and support.


Briefly, a supply chain includes all the resources needed to obtain, produce, and deliver goods from start to finish (Chopra & Meindl, 2010). A critical element of an effective supply chain is a design that avoids gaps in resources and production (Sukati et al., 2012). Unfortunately, nursing has not always been as deliberate in designing its scientific supply chain. Thus, although there are plenty of health problems that need attention from nurse scientists, as a discipline, nursing has let demands get ahead of our capabilities. In particular, we have failed to keep up with the human resources needed to conduct nursing science, and importantly, we remain unclear about our scientific purpose.


In nursing science, our supply chain starts with nurse scientists who identify gaps in knowledge about health and well-being and who study ways to eliminate those gaps in order to help individuals achieve health goals. Much has been written about the diminished numbers of persons completing PhD programs in nursing (Smiley et al., 2018), generally the first step in becoming a nurse scientist with the associated knowledge and skills necessary to solve disciplinary problems. Many individuals and organizations have offered suggestions for increasing enrollments in PhD programs (Ayoola et al., 2021). Unfortunately, despite significant efforts, the number of nursing PhD students training to become nurse scientists has increased only slightly. Moreover, projected retirements of many seasoned nurse scientists contribute to concerns about the nursing science supply chain; these experienced scientists are needed to guide the education of clinically focused nurses while also engaging nursing students in active, important programs of research (Fang & Kesten, 2017). Indeed, the "aging" of nurse faculty and nurse scientists is a concern because of the potential drain of talent of the most experienced of our scientists. Many thought the recent COVID-19 pandemic would accelerate the departure of aging scientists. However, this observer has noted that a number of high-profile scientists have continued working and plan to do so for some time, with a particular focus on supply chain issues. Anecdotally, it is noted that some senior scientists have stepped out of administrative positions in order to devote more time and effort to bringing their own scientific efforts to closure while at the same time increasing their efforts to mentor emerging scientists, thus building sustainable teams for the future. These actions enable continuation of important scientific work to improve health outcomes in which much time, thought, and money have been invested. I am personally and professionally grateful for the continued wisdom provided by these leaders of science.


One recent phenomenon that may enhance the supply chain for nursing science is the increased interest of young people in nursing as a profession (American Association of Colleges of Nursing, 2022). Although many schools of nursing have reported for some years that they received many more applications than they could accept, the recent increase in applications for baccalaureate programs is exciting. Equally encouraging is the increase in funding and support for baccalaureate nursing education, particularly through state initiatives. In addition, schools of nursing have been adapting strategies to enable individuals to gain baccalaureate degrees more quickly while still maintaining rigorous social and biological science foundations. Most of these "fast-track" programs are not new or innovative. Nonetheless, the growth of these programs is important to increase the number of nurses, some of whom will be future scientists. In addition, schools and professional organizations have increased recognition for the need to more fully diversify the profession (Redeker et al., 2021). Greater appreciation of the importance of diversity as well as the efforts needed to make diversity happen have led to small but important increases in nurses and nurse scientists from diverse backgrounds.


To sustain our supply chain for nursing science, we also need to continue to strengthen scientific thought and focus. It is important for nursing science to continue to build upon the important scientific advances made over the last 30 years, particularly in the areas of symptom science, self-management, and health promotion. At the same time, nursing scientists need to thoughtfully consider-discuss, debate, affirm, and disconfirm-the gaps in our current knowledge and address those gaps systematically. This could start in our PhD programs, although many PhD programs do not identify specific areas of focused substance within their training plans (Dobrowolska et al., 2021). That is, many nursing PhD programs do not have an identified focus on the substance of scientific problems important to the discipline. Rather, many PhD programs are largely about methods-how to do science rather than the study of the scientific focus. This creates a serious gap in our thought supply chain that possibly limits scientific advancement and attainment of scientific and professional goals. It also makes our science susceptible to disorder and interference from sources both within and outside the discipline.


Although there is evidence of serious discussion about the nature of nursing science (Tobbell, 2018), there remains little evidence of coalescence on the critical substance of our discipline. It is perhaps time for a more unified approach to our work; it is perhaps time for thought leaders within the discipline to gather for serious discussion about the focus for nursing science. This could logically begin in schools and colleges of nursing, whose resident scientists are busy at the work of doing nursing science. It will, however, take more than local conversation if we want to clearly explicate the purpose of our science in order to design a more stable and consistent supply chain.




Rita H. Pickler




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