Nurses and PhDs – a new trend

Only a few decennia ago, no one could have imagined nurses obtaining a PhD degree. However, it now seems that a trend for nurses to do a PhD has emerged. What motivates them to participate in a PhD programme? What are their goals, and what do they want to contribute with their PhD degree? When talking with those who chose to pursue a PhD degree, it becomes clear that the nurses’ motives are different. 

Florence Nightingale (1820-1910) was the one who showed the path of research to nurses. She was a pioneer in the field of statistics. For instance, after the Crimean War, she carried out statistical research on the causes of a  high mortality rate among British soldiers in India. The powerful Royal Commission on the Health of the Army applied her research, and, thanks to her recommendations, the mortality rate was reduced. Data collection of hospitalized patients to carry out clinical studies, classification of diseases; both owe their use to her. Plus, she was behind the idea of the education of nurses by expert nurses. The path Nightingale chose was not easy, and we cannot say it became easier for nurses to carry out research over the decennia that followed. In the USA, PhD programmes for nurses came up in the 1970s1; the evolution of such programmes went even more slowly in Europe. Since the early 2000s, nurses from all over Europa started to get their PhDs.

Why nurses pursue a PhD degree
Besides the increased opportunities, nursing care has become more complex and multidisciplinary. The increased demand for more quality and proven effectiveness (through nursing research) has resulted in nurses who want to develop advanced skills in carrying out research. For the most part, nurses do a PhD to gain more experience in research projects and to develop a methodical understanding of qualitative and/or quantitative research — leading to the acquisition of more knowledge for the benefit of every patient. Of course, they could have conducted research without pursuing a PhD, but such a degree also brings them in a new dimension where their work and leadership are recognised, which also provides a motive. Another reason for taking a PhD is to become a locomotive for other nurses. PhD-holding nurses pull the nursing care toward a higher evidence-based level, thereby taking all the other nurses with them.

It is not easy to embark on a PhD programme. Therefore, the nurse needs the support of the entire team, above all from a supervisor who will guide the nurse all along the path to the thesis. The supervisor/ promotor could be a nurse, a doctor or anyone else such as a psychologist, an epidemiologist, and there are many differences between European countries. For the nurse her/himself, it is important to find a suitable topic and to put together a committee that is familiar with this topic and the necessary methodical procedure. The committee should impart knowledge, coaching in challenging situations, and support for the advancement of the project.

Florence Nightingale would have been proud
There are many nurses to be inspired by. In 2014, former EAUN chair Dr. Bente Thoft Jensen (DK) defended her PhD thesis about the efficacy of multimodal rehabilitation in radical cystectomy. She has presented the results  of her work all around the world and gained the respect of many urologists. Another past chair of the EAUN, Dr. Stefano Terzoni (IT), obtained his PhD with research about the efficacy of and the quality of life after two  conservative treatments for urinary incontinence after radical retropubic prostatectomy in 2011. Present EAUN chair Dr. Susanne Vahr (DK) defended her PhD thesis about the effects of tobacco and alcohol intake on postoperative outcomes in cystectomised patients in 2017. Dr. Giulia Villa (IT), EAUN board member, has developed two new tools of self-care for ostomy patients and obtained her PhD in 2019. And Mrs. Jeannette Verkerk-Geelhoed, chair of EAUN SCO and another EAUN board member, will very soon begin with her PhD research on Peyronie’s disease. Lastly, one of the authors, Mrs. Corinne Tillier, EAUN Board member, has just started on the path of pursuing a PhD degree. She will conduct research on individual prediction of urinary incontinence and development of an individualised algorithm to predict incontinence and severity of incontinence after robot-assisted radical prostatectomy (RARP).

Although certainly not a requirement, these achievements will probably lead to the current EAUN board becoming the board with the most PhD holders and students in the history of the EAUN. Florence Nightingale would have been proud.

Reference
1. H. Michael Dreher, PhD, RN, FAAN, Mary Ellen Smith Glasgow, PhD, RN, ACNS-BC, ANEF, FAAN. Role Development for Doctoral Advanced Nursing Practice. Springer Publishing Company. Edition 2011

_____________________________________________________________________________________________

Corinne Tillier, Nurse Practitioner Uro-oncology, Antoni Van Leeuwenhoek Hospital, Dept. of Urology, Amsterdam (NL), c.tillier@eaun.org

Franziska Geese, MScN, Advanced Practice Nurse, Research Assoc., University Hospital of Berne, Berne (CH), franziska.geese@gmail.com