The Research Active Clinical Nurse: Against all Odds

Purpose:

Evidence-based nursing practice is dependent upon the clinical nurses’ ability to both use existing knowledge and generate new knowledge specific to the issues clinical nurses confront on a daily basis. Clinical nurses are in the best position to identify clinical patterns and problems in need of solutions (Siedlecki 2008). Yet, historically, doctoral prepared nurse researchers, employed in an academic environment, have conducted most nursing research. An academic environment fosters an expectation of scholarly inquiry and dissemination, supported through university resources. Although limitations in academia, due to conflicts with teaching obligations, can hamper the development of research (Conn 2013), these obstacles are minor compared to what clinical nurses must overcome to conduct research in a practice setting, since primary responsibilities are direct patient care, clinical education of staff, and administrative oversight. In addition, nurses practicing at the bedside or in ancillary roles rarely have doctoral education; and are likely to have limited exposure to research through previous education programs. Yet, in spite of potential and actual limitations and barriers to the conduct of research in a clinical setting, some clinical nurses are research active (Tanner & Hale 2002).

The purpose of this presentation is to share the findings from a qualitative study that helps to explain the conditions and characteristics unique to those clinical nurses (N = 26) who are actively generating knowledge that will transform nursing practice and have a positive impact on patient outcomes.

Methods: The purpose of this study was to develop a theoretical understanding of the conduct of research by clinical nurses. The specific aim was to explore beliefs, values, and perceptions of nurses who conduct research, and to identify strategies employed by these nurses to overcome barriers to the conduct of nursing research. Since the purpose of this study was to develop a theoretical understanding of the conduct of research by clinical nurses, a grounded theory approach was used. Clinical nurse principal investigators identified from a nursing research database were contacted and asked to participate in this study. Once written informed consent was obtained, the informant was asked to complete a short questionnaire providing demographics and research experience information; the researcher then conducted a semi-structured interview lasting 20 to 30 minutes, which was tape recorded and later transcribed verbatim. The final sample for this study consisted of 26 clinical nurses who had experience as a principal investigator on a completed nursing research study.

Results: . The informants were primarily female (n = 26) and ranged in age from 27 to 61 (M = 50; SD = 7.7); more than half had an MSN (n = 17; 65%); and most were either clinical nurse specialists (n = 11; 42%) or nurse managers (n = 9; 35%). The sample consisted of nurses who had been a principal investigator on a single study (n = 6; 23.1%), as well as those who had completed several research studies (n = 20; 76.9%). Characteristic patterns noted by the researcher during each of the interviews were associated with varying levels of enthusiasm, curiosity, and excitement about research. Constant comparative analysis resulted in identification of concepts (themes) and relationships that led to development of a theoretical framework about the conduct of research by clinical nurses. The data examined during this grounded theory study generated a complex multidimensional model.

Using a grounded theory approach we found that several conditions are needed to facilitate research by clinical nurses. These include a triggering event, and absence of usable evidence, curiosity, and research awareness, access to a research mentor, and a nursing research supportive organizational culture. Any single condition alone is insufficient to promote research activity by clinical nurses; thus organization trying to encourage the generation and translation of knowledge into practice should consider ways to address each of these conditions.

Conclusion:

Implications from this study provide a beginning understanding of the research active nurse and conditions that support and facilitate their decisions to conduct research: sometimes, against all odds. The study findings  also point to the need to rethink the way we use and introduce students to nursing research in the academic setting; and from an organizational perspective it supports the need to provide access to research mentors in order to develop a research-active nursing department.