Any other new grads considering a PhD?

Mission · Jan 19, 2010

I'm not at UCLA but I can tell you, in general, if you are going to do a PhD it should be at a program that fully funds you with a T32 or some other type of training grant. A PhD is a huge time investment, I can't imagine the costs if you also had to pay for it. Applying for funding is usually integrated into the application process. That's not to say that you can't apply for more funding for your research, but people generally do that once they've been enrolled. My schools policy is not to accept students unless there is funding for them, other schools may be different though.

The most important thing when picking a PhD program is finding an adviser who shares your research interests. Go on pubmed and look up research in your area of interest, see whose name pops up most often as an author and find out where that person teaches. Email them and find out if they're accepting pre-doctoral trainees. Give a general idea of your research interests and why you might be interested in working with them. Don't say something like "I'm interested in international health", because that just means you want to travel, say "I'm interested in disaster preparedness in low-resource settings" or something like that. Another good step is to attend an academic conference, find out where the presenters are from for the research that you found interesting. Conferences are great because you will find a lot of pre and post doc trainees presenting who can give you the ins-and-outs of a particular program or adviser. Again, I can't stress how important the right adviser is, they can really make or brake your entire career. Only about 1% of nurses have PhDs and everyone knows everyone in their particular sub-field.

RN-MPH · Jan 20, 2010

Mission thanks a lot for your input.

I really appreciate it

Moogie · Jan 20, 2010

I have a direct-entry MSN and have been doing med-surg for 4 months now at an understaffed inner-city hospital. As you might imagine, it's exhausting and a bit frustrating. Once I've been there a year I plan to go someplace else, before I get burned out.
I know that almost any other place is going to be an improvement, but I suspect that I'm never really going to be satisfied with bedside nursing (as several of my classmates predicted). Some of my instructors suggested trying a PhD program, which I've been going back and forth about for a while now. I've previously considered NP (the primary choice of my classmates), but I've never really gotten excited about the possibility.
I find that I like to have the opportunity to think about things, to imagine and explore possibilities, and to be creative. I don't get the opportunity to do that in my present position, and I doubt any subsequent beside positions will be much better in that regard. Just med passes, call lights, and lots of paperwork...
I've done some teaching as a teaching assistant in the past, and while it could be tedious it could also be fun, a way to be creative and expressive (I even considered being a high school teacher for a while). I also did some research as part of my MSN and while I also found some of it tedious, I did find other parts of it quite interesting and even exciting, something I might want to build on.
I've always been an idealist, someone who's lived a fairly spartan intellectual existence. I think an academia-oriented position might be a good match for me.

Joe, I know your current job situation is, well, less than optimal. It sounds hectic, stressful and frustrating for anyone, new grad or not.

I also think going on for more education is a great idea, particularly if you are interested in teaching.

Please don't take this as one of "those" posts from an experienced nurse who looks down on ambitious, well-educated new graduates---but I want to share a personal experience with you that has helped me in my own career.

I had several years of hospital experience in a variety of specialties and then got out of nursing for some time to raise my family. When I returned to nursing, I took an RN refresher course and additional education, worked in a non-clinical specialty for a while, then started in a MS program in nursing education. One of my professors told me that I needed to get some current clinical experience so that it would not only make my education more relevant and help me develop research interests but also help me regain some confidence and be more credible as an instructor.

For various reasons---personal and otherwise---I left that program. I taught as a clinical instructor for a while and enjoyed it but I often felt shaky and unsure about my own skills---and I'm sure that showed. So when we moved, I decided to return to a clinical area. It was a stressful position---more because of politics in the workplace than the actual patient care---and I found that I once again felt comfortable in my clinical, assessment and interpersonal skills. Another huge benefit of working in the clinical setting was that I was able to formulate research questions based on what I saw at the facility---I saw things done in practice that made me wonder if there was a better way---something out in the nursing literature or maybe something that hasn't yet been discovered through nursing research.

Now I'm back in a graduate program, enrolled in the MS program for now but considering transferring to the BSN to PhD program later this year. (My other option is to finish the MS and apply for the traditional PhD program next year.) I do feel that the time I spent in a clinical setting was worthwhile. It wasn't the optimal work environment for me but it was enough to help me feel I was up to speed in terms of performing as a registered nurse again. I notice that I have a lot more confidence and I know it will help me in the future, as a student and as an educator.

I do intend, as necessary, to return to clinical nursing when I need to so I can continue to feel current not only with my skills but with the realities of bedside nursing.

My advice to you is---I KNOW your job is frustrating. I would not want to work there, either. But do what you can to work in a different environment. Remember, nursing is not only an academic discipline; it's a practice discipline as well. It behooves nurse educators at whatever level to remain as current as possible.

Besides, there is the credibility issue. When I was a student in my baccalaureate program, we had an instructor who had gone straight from her BSN to an MSN and into teaching, without having any clinical experience whatsoever. My class was comprised of RNs who were going for their BSNs and this instructor, who had less experience than any of us, had absolutely NO credibility. I even recall someone in class challenging her because the student had years of experience and the instructor only had "book knowledge".

The other thing is, when you get your PhD you will be required to articulate your research interests. You discover your research interests through working in different nursing environments. My passion---and my main research interest---is gerontology. Did NOT anticipate that when I started my initial master's program. I wouldn't have discovered that had I not worked in gero. On the other hand, I have always been interested in obstetrics but have had precious little time in that specialty. It would be illogical---and extremely difficult---to decide to do research in maternal-child nursing without having experience in that specialty.

I hope I am making some sense here. At the time, I wasn't happy with the professor who told me to get out there into a clinical setting but now I consider hers to be the best advice I have ever received in my nursing career.

Good luck to you in whatever you decide!

BTW, if changing jobs is not an option, can you maybe reframe some of the challenges you face in issues that could be relevant for nursing research? I'm thinking of staffing levels and patient outcomes, income/race/age disparities in health care and outcomes, or post-surgical outcomes?

again, I wish you the best!

RN-MPH · Jan 20, 2010

Hello Moogie,

Your point is valid, actually our professors in nursing school had obligatory clinical working hours they needed to do per year. They needed to go and work as RNs on the floor. And this was implemented after they taught our class. I know how students can act, and i know how they can intimidate the instructor and challenge her/his capabilities, specially if they are doing the RN-BSN program.

lifeistweet · Jan 21, 2010

I'd go to med school before all that ed for no $$ in nursing.

aura_of_laura · Jan 21, 2010

Finishing up my BSN this semester, and I'm starting on my applications for a PhD program as of yesterday. While I enjoy nursing, my heart belongs to academia! I'm skipping the MS route, as I have no desire to be a nurse practitioner or "clinical leader." This way I can get started in research a few years earlier...

Best of luck!

Joe NightingMale, MSN, RN · Jan 21, 2010

My advice to you is---I KNOW your job is frustrating. I would not want to work there, either. But do what you can to work in a different environment. Remember, nursing is not only an academic discipline; it's a practice discipline as well. It behooves nurse educators at whatever level to remain as current as possible.

Don't worry, I'm not going to go running out of the hospital just yet. I'm going to complete a year here at my present hospital, and another year or so at some other place that's better than my present one.

As I have my MSN, I've already done research and have a good idea where my research interests lie, so I'm pretty well set there. I just have to focus it a bit more and I'll be there.

And I don't think I'll every completely leave the bedside. I'll likely do something that I might enjoy, like hospice, part-time in addition to my academic career.

Mission · Jan 21, 2010

I'd go to med school before all that ed for no $$ in nursing.

If someone is interested in NURSING research or academic nursing why go to med school? If it's just about money, again, why go to med school when you can make more money in less time with an MBA and you don't have to worry about malpractice suits? Nursing faculty, at least the ones I know, make six figures, and the benefits at an academic institution are pretty great IMHO.

aura_of_laura · Jan 21, 2010

Six figures? Where do they teach?

Moogie · Jan 21, 2010

One question:

The point of nursing research is not to do research just for its own sake; the point is to impact upon the practice of nursing. How can anyone with minimal or no experience in the practice of nursing expect to do research that will be clinically relevant and able to bridge the theory-practice gap?

If nursing research is not applicable in real-world clinical settings, of what value is it? (Okay, that's two questions, but I digress...)

Joe NightingMale, MSN, RN · Jan 21, 2010

Nursing isn't a completely separate field from everything else, it's knowledge overlaps with that of other fields. So even research that's grounded in fields other than nursing can provide valuable information for nursing.

There's also the question of what is relevant. I suspect that you're thinking of research related directly to bedside nursing...ie infection control or diabetes education. I'm thinking more in broad terms...ie how patients experience illness, or how nurses see their profession.

I think we have a disagreement not only in terms of what we regard as relevant, but how we see nursing.

I guess I'm a bit of a rebel, which is another reason academia is attractive to me...

Moogie · Jan 22, 2010

Nursing isn't a completely separate field from everything else, it's knowledge overlaps with that of other fields. So even research that's grounded in fields other than nursing can provide valuable information for nursing.
There's also the question of what is relevant. I suspect that you're thinking of research related directly to bedside nursing...ie infection control or diabetes education. I'm thinking more in broad terms...ie how patients experience illness, or how nurses see their profession.
I think we have a disagreement not only in terms of what we regard as relevant, but how we see nursing.
I guess I'm a bit of a rebel, which is another reason academia is attractive to me...

Joe, I am right with you in being a rebel and idealistic. (Are we related?) Now maybe my bias comes from the experiences I have had with graduate programs but every program I've checked into (as well as the program I was in prior to this one) has emphasized clinical research rather than research into, say, nursing education, professional communication or perceptions of the profession. The thing is, there's a difference between nursing research and research done ABOUT nursing. Research done about nursing can be done by behavioral scientists and the findings can be extrapolated to other professions. Nursing research is specific to nursing and, while it can be extrapolated to other specialties, much of it is pretty specific to nursing.

This is not to say that nursing cannot benefit from research done in other disciplines. I'm currently taking a course with a group of physical therapy students and find that many of the topics for research are much the same in both disciplines. However, the physical therapists are going to approach the problem in one way in their practice; nurses will approach the same problem in a different way. I can read all about the efficacy of group exercise classes vs. individualized therapy for increasing post-TKA mobility but as a nurse, that study means something very different to me than it does to the physical therapist who is reading that study and making treatment and practice decisions based on that study. The study would mean something completely different if I happened to be, say, the DON of a SNF that offered rehabilitation services. And it would have different implications if I was working home health and there was no physical therapist available to perform certain therapies.

I guess what I'm also trying to say to you is that you do run a very real risk of getting yourself pigeonholed into a specialty that might not suit you if you jump too soon to further your education. Getting a PhD is like committing to a spouse or partner; you want to choose your specialty carefully because you're going to be living with it for the rest of your career. For example, I am a parish nurse. I enjoy parish nursing and have always been interested in exploring spirituality in nursing. However, as much as I enjoy parish nursing, I don't want to limit myself to conducting research solely in that specialty. (One of my problems with my previous program, in fact, was that the faculty kept urging me to "research what I knew" which meant I felt pigeonholed into parish nursing----an interest, most certainly, but not something that is in enough demand or a strong enough interest to warrant my devoting the rest of my career to it.) What could happen to the nurse who jumps into research without having experience in a practice area is that the nurse could end up specializing in something, say, gerontology, and then end up realizing, once he/she has finished the PhD, that he/she HATES gero and would rather have explored other specialties like pediatrics, wound care, mental health or community nursing.

Now, of course, if I were doing gerontology research, I could certainly address issues such as wound care, mental health or community nursing (peds would be a stretch...) But when you get a doctorate, you are considered to be an expert in your field. If I were an expert in gero, I might be technically capable of doing research in peds, but would I have credibility?

Credibility might not seem like a big issue when one is starting out but when it comes time to write research grants, publish findings, lecture on one's findings---it is a big issue. Frankly, how much stock would you put into, say, a workshop on dementia if you discovered that the keynote speaker had never worked a day in dementia care and had only read about it in a textbook or the professional literature? How would you react if you were a peer reviewer for a nursing journal and a research article was submitted by someone who had a freshly minted PhD but absolutely no practical experience in the topic that was researched? And if you were a nurse practicing direct patient care, would you take very seriously practice recommendations from someone who had no experience at the bedside?

Please keep in mind that my comments are not intended to be the ranting and raving of some geezer nurse who thinks everyone should "pay their dues". It isn't a matter of "paying dues" because, if we're only looking at experience, NO ONE can have "enough" experience. Research and teaching require a balance of academic knowledge, scholarly ability and clinical knowledge. If you have one or two without the rest, you have a mediocre researcher/educator. BTW, yes, I have had professors who were incredible clinicians and completely unable to teach. I've also seen research papers done by well-educated post-docs that have left me scratching my head wondering on what planet the researchers lived because their recommendations were completely irrelevant and useless to actual nursing practice.

Forgive me but I am a mom and I hate to see other people fall into some of the same traps in which I've been ensnared. (I do this to my kids all the time.) When I was in my previous MSN program and my prof told me that if I didn't want to research parish nursing the rest of my career that I'd have to return to the bedside for a while, I was offended. (I also have physical limitations due to a chronic pain condition so returning to the bedside was very challenging for me.) But having taken her advice, I realize how wise it truly was. (And yes, this is the professor who rolled her eyes when I said initially that I wanted to do a thesis on the experience of stress in nursing students.)

Not wanting to debate anyone here, just offering a little food for thought.