The challenges and benefits of undertaking a nursing PhD

Studying for a nursing PhD equips nurses as researchers to drive improvements in patient care. This article looks at what motivated two nurses to take the PhD route

The role of nurses as researchers is being pushed and supported nationally. Healthcare research is essential to providing high-quality, evidence-based treatment. Despite the fact that a nursing PhD can lead to new career opportunities, nurses who pursue it are underrepresented in comparison to other professional groups. In this article, two general nurses share their experiences pursuing a PhD, including their motivations, their paths, and advice for beginning.

Citation: Lees-Deutsch L, Stafford-Umughele A (2020) The challenges and benefits of undertaking a nursing PhD. Nursing Times [online]; 116: 3, 24-26.

Authors: Liz Lees-Deutsch is consultant nurse in acute medicine, University Hospitals Birmingham, Heartlands Hospital and lecturer, University of Birmingham; Augusta Stafford-Umughele is return to practice student, Swansea University.

• This article has been double-blind peer reviewed
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Introduction

The last 12 years has seen a drive by the National Institute for Health Research (NIHR) to develop the research skills of nurses and other health professionals to increase the body of healthcare knowledge and innovations that improve patient care. NIHR options for embarking on a clinical academic pathway include:

• Academic internships (including preclinical academic fellowships);
• Clinical doctoral research fellowships;
• Clinical lectureships;
• Senior clinical lectureships.

More recently, Health Education England laid out its vision for developing the NHS workforce that embraced five global drivers of change in delivering healthcare: demographics; technology; current and future service models; patient and staff expectations; and associated social, political and environmental factors (HEE, 2017). Specifically, in the area of research and practice, it highlighted the need to respond to “changing patterns of service and embrace research and innovation to enable it to adapt to the changing demands of public health, healthcare and care services”.

However, although research by nurses and other health professionals that supports innovative, high-quality and evidence-based patient care is being promoted and supported nationally, there are still fewer nurses taking NIHR-funded PhDs compared with other professionals (Council of Deans of Health, 2013). Nurses are by far the largest professional group in healthcare; the number of nurses on the Nursing and Midwifery Council register is greater than the combined registers of the General Medical Council and the Health and Care Professions Council, so it is clear that the profession is underrepresented.

This article describes the various routes to a PhD, what it involves and why nurses may choose to embark on this journey. It shares the experiences and insights of two general nurses who embarked on this journey.

Although we took different career routes and made different decisions at key points along the way, we both had similar motives for completing a PhD. By sharing our stories, we hope to encourage other nurses who are contemplating a research career to follow in our footsteps.

Funding routes

As well as the ongoing national drive by the NIHR, health and nursing charities advertise PhD studentships for themed research related to their cause. Universities also advertise PhD studentships for work on projects that already have funding. There may be ways to negotiate study leave and adjust your working hours to accommodate work and study. Another option is self-funding, which means you are not tied to research themes set by funders. Regardless of the route you take, your PhD will be closely governed by the university where you choose to study.

What does a PhD involve?

Nurses often consider a PhD if they want to challenge themselves and develop new skills; others may have a desire to ‘invent for the real world’ through a research career. Typically, a PhD requires you to:

• Produce a viable research proposal for the number of years you have allocated for your PhD;
• Conduct a literature review to identify the research gap;
• Work up your research proposal detailing your research methods;
• Conduct the research;
• Produce a thesis;
• Defend your thesis in an oral examination known as a viva.

Passing the viva by demonstrating your original contribution to knowledge is what distinguishes a PhD from any other degree, but each stage of a PhD brings its own challenges, because of the time required to complete the work.

Potential barriers

A PhD usually takes 3-5 years, depending on whether you choose full- or part-time study. Over this period, people’s life situations can change, it can require significant tenacity to balance PhD study with career, family and life events. It may take longer and changes are sometimes negotiated throughout the course of the PhD. Learning how to apportion your time is a crucial skill you will need to develop.

A PhD can also bring financial challenges, particularly if you are funding yourself, even if this is only a drop in salary during your period of study. Self-funding may also mean not having a base organisation where you can conduct your research. Securing the assistance of a gatekeeper, someone who is employed at the organisation where you wish to do the research is essential. Contact with researchers and clinical staff (as needed) at an early stage can save valuable time by helping with issues such as gaining access to the research site, and locating and introducing yourself in the area.

Although you will probably meet like-minded students on courses you choose to take, you will also need to be self-motivated to study alone for at least some of the time. Some people are put off taking a PhD because they fear it will be a long and lonely journey, but seeking support from supervisors, colleagues and former PhD students can help negate this.

Lack of a clear job plan/career prospects after completing a PhD can be an issue for some, but having a realistic idea of where you would like to be working or what you would like to do after your PhD can help with early preparation to steer you towards your goals. For example, training in additional skills, presenting at conferences and networking over the duration of the PhD will enhance your prospects of paid employment afterwards. Your PhD will also give you an in-depth understanding of your topic, and on-going research interests and methodological preferences, to take you forward.

The following case studies describe our experiences of embarking on a PhD, including our careers leading up to it and the different routes we took. They also describe the lessons we learned along the way, including our tips (Box 1 and Box 2) to ensure success.

Box 1. Tips from Liz Lees-Deutsch

• Be honest with yourself why you want to do a PhD
• Seek support early on from research and development, other academics and your local university
• Ask yourself whether you are self-motivated to study
• Choose a topic that holds your interest and that you would like to continue with in your career
• Think what you will do when you have finished the PhD
• Talk to others who have gained national funding
• Look up authors of key works in your chosen area of study to find a PhD supervisor

Box 2. Tips from Augusta Stafford-Umughele

• Apply for PhD funding if you can, as it can be hard covering fees and additional expenses as a self-funded student
• Select a topic that interests you and that you can build on in the future
• Choose your supervisor carefully – research the lecturers, their experience and special interests, their work with PhD students and their publications
• If you choose to study part time, allocate a couple of days a week to your PhD study
• Build a support network – studying for a PhD can be a lonely road at times

Case study 1: Liz Lees-Deutsch

I qualified as a general nurse in 1991. In the following eight years I gained a variety of nursing experience, including working in older persons’ care, acute surgery and medical admissions. I then moved to the US for a year on a Florence Nightingale Scholarship to study intermediate care delivery.

Following my return, I managed a community hospital in Birmingham. After a year, I moved to a community role as lead nurse in a rapid response nursing team before moving back into acute hospital care to take on the role of consultant nurse, where my main interest has been service improvement.

My journey into my current area of expertise, patient discharge, began when a former clinical director dared to suggest ‘nurses simply followed doctors’ discharge orders’.

Once I had managed to get work published, my mission was to share what I was doing through robust data collection and a systematic approach to writing, as I never saw the point of doing work unless it could be shared. At the back of my mind, I also had the idea of studying for a PhD to delve deeper into the theory and social science underpinning patient discharge.

As a consultant nurse, I took three secondments; in older persons care, at a faculty of education and my current secondment (one day a week) at the University of Birmingham. I also took a BSc degree in nursing, a master’s degree and a health service management diploma.

In 2013, while on secondment at the faculty of education, I was encouraged by the head of education to apply for a PhD fellowship. Although this seemed a natural next step for me, I was unsure what further study would add and was worried about leaving clinical practice behind. However, I felt a PhD could break the glass ceiling that I felt at times had held me back from academic career progression.

The research career pathways the NIHR provided were new to me, and the process of applying for a PhD felt like scaling a mountain without any equipment, putting me on a huge and rapid learning curve. When considering an application for national funding, the NIHR panels judge the merits of the applicant and the employing organisation, as well as the applicant’s research proposal and intended career pathway (Association of UK University Hospitals, 2016).

I wanted to create a risk assessment for discharge for patients admitted to hospital and my intended career pathway was to become a clinical academic nurse. My line manager provided guidance and a supporting statement. The proposal also required a full literature review to ensure the research gap I envisaged was real. I chose the University of Manchester as my place of study as I had studied there before, and was required to submit my research proposal and key milestones for three years of study.

Despite preparations over 12 months, my first application to the NIHR was unsuccessful. At interview, the panel felt I had the right attributes, but had insufficient support from my organisation. An onward career pathway is a critical aspect of gaining any research funding and they felt my organisation lacked the vision to find me suitable employment on completion. Undeterred, I reapplied a year later following a clear strategy (see tips in Box 1). In 2014 was offered full funding, along with three years’ salary and training costs.

The next stage was quite daunting, as I had to leave my full-time post, become a student and learn completely new skills. I met my supervisors every month; one supervisor gained a promotion and left soon after I started, but the other saw me through to the finish. I completed my PhD in 2018 and then had a post-doctoral fellowship funded by Health Education England and hosted through the University of Birmingham. This gave me time to complete further publications arising from my PhD, progress research work, consider funding streams and complete further research methods training. I got funding from the Burdett Trust for Nursing for evaluation work of an education programme in acute medicine (Lees-Deutsch et al, 2019).

I also got a place on the NIHR 70@70 national nurse and midwife leadership programme, giving me three years of part-time funding. As a result, my role is now much more collaborative with researchers, lecturers and clinicians, with the aim of securing further funding this year to continue my patient discharge research.

Case study 2: Augusta Stafford-Umughele

Having trained at the North Middlesex Hospital, I enjoyed working as part of a team helping patients move from an ill and helpless state to full recovery and discharge home.

I decided to study for a master’s degree in human resource management at Middlesex University Business School. Fundamental to this decision was my interest in staff behaviour across the team and my intention was to gain a management qualification I could combine with nursing. Throughout this time I worked as a staff nurse and then as a sister in a London nursing home.

As part of my master’s degree, I completed a placement in a personnel department at the hospital where I trained as a nurse and was asked by my mentor to evaluate the advanced nursing skills course for post-registration nurses. My findings showed nurses were not being given the opportunity to perform advanced skills and lacked confidence because they were not using the skills frequently enough. After completing my course, I worked in nurse recruitment, where I further developed my interest in advanced nursing roles.

In 2001, I decided to leave my job in nurse recruitment to look after my four young daughters. It was not until 2010 that I planned my return back to work. Having been out of work and education for nearly 10 years, and with a young family to support, the idea of resuming work or study was daunting, and I decided to search for courses that were more compatible with family life.

In January 2012, my New Year’s resolution was to take a PhD in nursing, which I had wanted to do for many years. I planned to explore advanced nursing roles, potentially building on elements from my master’s degree. My aim was to increase understanding of how advanced practice had developed and the benefits of having experienced highly skilled nurses in these roles. In particular, the shortage of doctors across the UK meant the topic and the timing felt right.

I looked into the distance learning PhD programme at the University of Manchester’s School of Nursing. Distance learning enabled me to be based at home in Wales and travel only occasionally to Manchester, access learning modules from home and attend courses as needed around the UK. I felt satisfied that advanced practice was worth exploring further and contacted two senior lecturers with an interest in nursing roles and patient care quality to see if they would be interested in supervising my research. I received a positive reply.

My PhD was self-funded. I chose this route as I was not employed so did not have an employing organisation to support my application. The online application process was straightforward; the only challenge was professional references, as I had been out of work and education for 10 years and had to establish my ability to study at PhD level. I was advised to do another master’s degree, which I was not keen to do. Then the university offered me the opportunity to take individual modules from its master of research programme as a route onto the PhD nursing programme. Having completed these, I was admitted onto the PhD nursing full-time programme in September 2013.

The programme involved me attending a couple of 3-4-day workshops in the first year and completing other elements via Blackboard, an online learning system provided by the university. I went to seminars and presentations and had supervision once a fortnight via Skype with my three supervisors, as well as arranging to see them whenever I was at the university.

Following my viva, my final submission was in March 2018 and, since then, I have provided qualitative analysis and a report for an educational research project, and I am gradually publishing aspects of my thesis. I am now taking a return to practice course to update and participate in clinical practice, with a view to working in nursing research, as opportunities arise.

Conclusion

Despite the inevitable hard work undertaking a PhD has been, we both thoroughly recommend PhD study to nurses. We have gained invaluable skills in research methods, ethics, theory and writing (to name a few) and these will help us to progress to the next stages of our career. Reflecting back, we are both approaching the last 10 years of our careers, ideally, the decision to undertake a PhD should be supported at a reasonably early career stage to build your research skills over your employment lifetime.

Key points

• There is a national drive to encourage more nurses into research
• Studying for a PhD equips nurses as researchers to increase knowledge and drive improvements in patient care
• As the largest professional group in healthcare, nurses taking PhDs are under-represented compared with other groups
• Nursing PhD programmes require commitment, but can offer flexibility, so you can pursue them at your own pace
• When applying to study for a PhD, it helps to learn from others who have already been down that route

References

Association of UK University Hospitals (Clinical Academic Roles Development Group) (2016) Transforming Healthcare Through Clinical Academic Roles in Nursing, Midwifery and Allied Health Professions: a practical resource for healthcare provider organisations.

Council of Deans of Health (2013) Clinical Academic Careers for Nursing, Midwifery and the Allied Health Professionals: Council of Deans of Health Position Statement

Health Education England (2017) Framework 15: Health Education England Strategic Framework: 2014-2029.

Top Reasons and Advantages of Pursuing PhD in Nursing Online 

Besides being the highest educational qualification, pursuing a PhD in nursing online will help you obtain the highest roles in the nursing field. Anyone with a master’s degree in nursing can take up the course. If you are looking for an advancement in your career, obtaining a PhD degree will do. This degree adds professional value to their careers. The benefits of studying nursing are plenty. Let’s explore what you can do with a PhD in nursing education.

Nursing: An Overview

Nursing is a highly demanding profession in the medical sphere. Its primary objective is to take care of the well-being of the general population. While providing patient care, nurses may have to educate patients and their family members about preventive healthcare and wellness practices. Although nursing practitioners can have their own independent regulatory body, they are assigned to serve in specific regions or communities.

As a researcher or an educator, the nurse can have an opportunity to influence society positively. It will take their careers to the next level. The primary role of a nurse is to organize and implement proper and prescribed care for patients. Nurses must be highly focused and are required to work collectively with their other medical counterparts. It includes doctors, therapists, and surgeons. They may also have to interact with non-medical personnel like the patient’s family members or peers.

The nursing professionals must be ready to deal with any type of disease, patient situation, or medical emergency. The nurse must also be prepared to face any situation and handle patients who are suffering from critical illnesses. Besides readiness, the nurses have to stay updated on the prevailing illnesses and advancements in the industry to treat patients without delay. 

People in several developing countries in Africa and South Asia suffer from a variety of fatal disorders. It is an alarming situation for the health professionals to save lives. These areas require region-specific nursing practitioners to fight against diseases and medical challenges. The intense need for well-qualified nursing professionals makes nursing a good career opportunity in the above-said regions. Nurses can get opportunities and take up various roles such as researchers, educators, practitioners, and so on.

Growth and Demand for Nursing Professionals (Senior Level)

Demand for nurses is across the globe. Without nurse, medical profession is not possible. Rural areas in African countries face various healthcare challenges. To address such fatality and help people to live a disease-free life, it is key to take your nursing career to the next level with a doctorate degree in nursing.  A PhD in nursing education is an attractive career-oriented doctoral degree.

There are many opportunities, dynamic growth, and demand for nursing professionals, especially in regions like Africa and South Asia. Occupational growth data also ranked this as a growing profession where the demand rose to 16% in the developing countries.

Nurse educators are in high demand due to a lack of proper guidance and strategies to generate future nurses. On the other hand, nurse practitioners are needed by various organizations to provide valuable service and care to the patients. By being a chief nurse in hospitals, one can supplement quality protection to patients.

The nursing researchers can also give their valuable contribution to their scientific thinking. They can broaden their research areas to treat various diseases in time. One can also take up a role as a nursing manager who will be expected to do the managerial roles. The number of patients is growing at a faster pace due to various environmental reasons and health conditions. It gradually increases the demand for health professionals. In this ever-growing sector, higher educational qualifications will enhance your quality and boost your career growth. With a doctorate degree in nursing, nurses can achieve excellence in their profession and become experts in their field. While being knowledgeable, they can perform their duties with exceptional qualities. It will help them take the necessary decisions in critical situations or involve themselves in finding new solutions for health issues.

What Does a Nurse with PhD in Nursing Do?

There are various roles that a nurse with PhD in nursing can take up. They are as follows:

• A nurse can look after the healthcare policies and practices in the country or region.
• Nurse researchers can help in improving care practices in hospitals by analyzing data around the globe.
• A doctorate nurse can take the role of an administrator and can be a role model for other nurses.
• They can evaluate and participate actively in the growth of various medical professional programs.
• By being highly qualified, they can lead healthcare organizations with various roles and responsibilities.
• A nurse with a PhD in nursing education can add various aspects of education in universities/colleges/hospitals of available nursing organizations.
• They can mentor/monitor and teach upcoming nurses at colleges, hospitals, or universities.
• They can have an opportunity to put their efforts into positive thinking. They can also provide high-quality patient care with utmost satisfaction.

Career Options for Nurses with Doctorate Degree in Nursing

• Patient care delivery – Nurses are the ones who influence the future of the medical profession.
• They can evaluate the scientific changes through their intense research. They can also improve the precautions and prevention chances of diseases.
• The nursing managers can play the roles of supervisors and directors. However, the quality of patient care would be the primary focus.
• The chief nurses can share their knowledge with other nurses and guide them for the sake of patients.
• The nurse educators can educate the new entrants about the importance of the profession. They should plan a curriculum that can help learners gain theoretical and practical knowledge.

Nurses can aim toward a scientific approach and play significant roles in shaping healthcare policies. 

Highly qualified nurses can write protocols for upcoming research and get funding from research organizations for the growth of the sector. Likewise, it could be beneficial for the survivors.

Advantages of Pursuing a PhD in Nursing Education

• Become Industry Expert
  Nurses with a PhD in nursing will be acknowledged as experts. They will be positioned alongside doctors and practice nursing with ease.
• Have an Influence on Healthcare Policies and Practices
  They get a great chance to have a better influence on healthcare policy and practice. The nursing professional should participate in making policies and setting rules and responsibilities of the concerned authority. They can gather data and conduct scientific research for the betterment of the healthcare industry and the practitioners.
• Become Educators
  A PhD in nursing allows nurses to practice as educators. Therefore, the shortage of nursing educators will be reduced tremendously. Moreover, nursing students can get proper guidance to do their duty with perfection. The PhD holders can be a good educator, guide, mentor, or faculty with the real value of this invaluable profession.
• Take up Administrative Roles
  Nurses with a doctoral degree are in high demand. Being an expert with greater knowledge, a nurse can take up the roles of administrative duties. 
• Practice on Their Own
  By getting a doctorate, nurses can have their own center to provide health facilities. However, the gained knowledge and expertise must be implemented to help people medically. Besides, nurses may have to use their potential to the fullest to achieve medical excellence.

Salary of a Nurse with a PhD in Nursing

The salary of a PhD in nursing largely depends on the career they have chosen. Moreover, it also depends upon knowledge, skills, communications, leadership quality, experience gained in the respective fields, and country/region you choose. A nurse researcher in South Africa can earn an average salary of around R277,843, whereas it will differ for other countries in the African continent.

Growing medical complexities open better opportunities for health professionals to seek a career in the sector. There is a shortage of health professionals in various countries. It can be a greater implication if anyone thinks of seeking a career in nursing. In the present scenario, there is a rapid increase in vacancies in this profession. Therefore, by pursuing a doctorate, one can increase their chances of getting a job at a good pay scale.

Best Way to Pursue a PhD in Nursing

Pursuing a doctorate degree in nursing in a regular program take a lot of time. When you are in a medical profession, leaving your practice and studying a degree is not feasible. The best for nurses to pursue a doctorate degree in nursing is to take it up online.

Universities like Texila American University (TAU) offers PhD in nursing online is a renowned university. You can pursue your PhD in nursing online without leaving your practice.

TAU is a highly acclaimed university. Since its inception, TAU is engaged in providing the best knowledge to its students and healthcare practitioners to the societies. In association with the University of Central Nicaragua, TAU also offers best-in-class online PhD programs. It directs students to achieve professional excellence and become high-quality healthcare professionals. It is intended to provide society with the best nursing researchers, educators, administrators, and practitioners.

TAU follows a tailored curriculum of international curriculum. It consists of basic to broad aspects of knowledge to gain prerequisite information in the area of interest. Those who want to have a career as a health professional can register for the PhD in nursing online. Students can check their eligibility and register for the course online. This program will give valuable mold to the career of nursing professionals.

If you aspire to move to the next step in your nursing career, pursue a PhD in nursing online and explore better opportunities in the nursing sector.

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