EDITORIAL
Pushing the Envelope
Judith Effken
The American Academy of Colleges of Nursing (AACN) recently made several
recommendations, including encouraging “Fast Track” BS to PhD programs,
creating a new practice doctorate and creating a new role, that of clinical
leader. Why the changes and why now?
The fast track BS to PhD program may be the easiest to understand, for it
aims at more quickly filling our critical need for nurse scientists and
nurse educators. Traditionally, nursing has thought it necessary for nurses
to move in lock step through baccalaureate, masters, and doctoral
education. However, many are now questioning that logic, arguing that
clinical practice can be obtained at any point in the nurse’s career, in
conjunction with the advanced education. Further, why not help students who
are clearly focused on an academic or research career to move into that
career while they are young, enthusiastic and have many years of productive
time ahead of them?
The papers in this issue of JUNS provide excellent support for this
argument, I think. These authors represent the best and brightest of our
nursing students and demonstrate that undergraduates can indeed conduct
meaningful research. These are precisely the kinds of students that should
be encouraged to pursue doctoral education early in their careers, rather
than later.
The new practice doctorate has been proposed to increase the expertise of
nurse practitioners, putting them on a more even footing with physicians and
other health care professionals. It is difficult for nurses to collaborate
with colleagues when there are disparities in their education. This new
degree will serve to even the playing field.
The new clinical leader role also serves to even the playing field for
nurses, but at the same time provides them with additional education so that
they can act as case managers for groups of patients, facilitating their
care across the continuum. The additional year of education that is
proposed is clearly needed in the current health care climate in which
managing patient’s trajectories is so needed. I recently learned of a
doctoral student at the University of Washington who is studying the “work
of patients” who are undergoing chemotherapy for breast cancer. I await the
results of his study eagerly and applaud the insight he has shown in
exploring the topic. Any of us who have had to work our way through the
health care system lately will attest to the work of patients as they
navigate the system—and we are in the field! The clinical leader role is
one that can specifically assist patients to navigate the healthcare system
more efficiently and safely and perhaps reduce the burden of work they
currently must assume.
One might ask, why now? Why should we initiate new roles when we have an
acute nursing shortage? Certainly, nursing education will be challenged to
prepare nurses to take on these roles. But what better time can there be,
when the shortage of nurses makes the need so acute? In crises, there are
opportunities—and this shortage is of crisis proportions. But the result is
that nursing, because of its absence, has become much more visible—and
therefore fundable. Increasingly we are seeing new collaborations emerge
between schools and community agencies to support new educational programs
because both stand to gain.
If you are in a nursing program now, this is the time to think big! If you
have a question that you really want to answer through research, consider
getting a research doctorate (PhD)! If you anticipate working as a nurse
practitioner, consider a practice doctorate. Not only do these degrees
provide you with an incredible amount of additional knowledge and
experience, but they provide career opportunities that can only be imagined.
So, if advanced nursing education might be in your future, think about the
many new educational opportunities that are unfolding. One of them might be
just right for you!
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