“I’m sorry. We tried. We really did. But there is no way we can adjust your work schedule to accommodate your school schedule.”
When the director of the nursing administration department where I worked uttered those words to me, the sheen of pride and joy that had radiated from me over the last few months, after being accepted into two highly competitive (and fully funded) nursing PhD programs, dimmed like the lights just before a California heat wave induced power outage. I had prepared myself for this worst-case scenario (and, in fact, had already submitted several job applications), but her words and the finality of the decision was like a slap across the face.
When I originally announced my PhD program acceptance, everyone at the world-famous prestigious academic healthcare facility where I worked said they were happy for me and “so proud” of me. So why wasn’t my accomplishment being celebrated and lauded like I had seen so many others’ accomplishments celebrated? Several nursing colleagues were pursuing DNPs with the full support and flexibility needed to keep their jobs and be successful in their programs. Yet, I knew the main difference here was that DNPs could often align their academic projects with work projects, often with the full blessing of bosses and supervisors. For PhD students, things were a bit more complicated.
However, I knew that the PhD route was the only academic road I wanted to travel. I wanted to conduct research that would help dismantle healthcare disparities for the most vulnerable of patient populations, and I wanted to become nursing faculty so that African American students and LGBT students entering the nursing profession would see at least one instructor who represented them. That said, I had not anticipated having to give up my livelihood in exchange for pursuing this dream.
In “The research doctorate in nursing: The PhD,” published in a 2016 issue of Oncology Nursing Forum, Rice writes, “The research-focused doctorate in nursing prepares nurse scientists to lead the field and to advance the science of nursing. In addition to conducting independent research and developing their own programs of research, nurse scientists will also likely work in multidisciplinary and interprofessional teams to achieve broad research outcomes”.
Then why aren’t healthcare employers supporting these budding nurse scientists? How can all this new nursing knowledge be generated if doctoral nursing students must choose between their livelihoods and this advancement into nursing research? When the choice boils down to paying your rent or earning a PhD, the obvious choice hurts not only the aspiring nurse scientist, but also nursing as a discipline. What message is an organization sending when they tell a nursing PhD student: “Well done, but now you’ll have to find another job.”?
Throughout the COVID-19 pandemic, many American healthcare employers have showed tremendous flexibility and innovation related to staffing and to workplace accommodations. Why not have these examples be a reminder that healthcare work schedules and job descriptions need not be written in proverbial stone, but that these things can be fluid? They can be living, breathing documents, able to be revised and updated as needed, especially when it comes to nurses who are motivated enough and tenacious enough to embark upon the challenging journey of pursuing a PhD.
While it’s true that many nursing PhD programs offer full funding due to the shortage of doctorate-prepared nurses, this funding is usually nowhere near comparable to a full-time clinical or administrative nursing salary. A graduate nursing student, especially if also a parent, living only on a PhD stipend would need a wealth of support from family, friends, grants, and scholarships just to survive. Thriving would be another matter altogether and would up the ante significantly. Also, without a job, what of access to clinical researchers or to patient populations and real-time research data? These necessary components to a nurse scientist’s success are more readily available to a nurse with an active connection to a healthcare facility.
As nurses, we know that sometimes things don’t work out the way they are supposed to, nor the way we had hoped or anticipated. Therefore, we have perfected the proverbial “work around”, alternate ways to get from point A to point B when unanticipated bumps in the road or detours arise. I was lucky in that, not 2 weeks after that fateful conversation with my supervisor, a recruiter from a previous workplace called me out of the blue and asked if I was available to return to my old job as a nursing informaticist. I immediately jumped into work-around mode; I negotiated for school schedule flexibility and for a salary that matched my current one. I even got a shorter commute as a “bonus”.
But what if I had not found a job willing to work around my full-time PhD program schedule? Would I have had to turn down the acceptance into the PhD program? Probably. Let’s work together to change this narrative and to implement innovative ways to make sure that nurses pursuing a PhD never have to make the decision between making a living or making a difference.
Daphne Scott-Henderson is a PhD student at the University of California San Francisco School of Nursing and clinical informatics RN at Watsonville Community Hospital in Watsonville, California.