The impact of PhD nurses on health policy and advocacy

impact of PhD nurses

From every angle, nursing is a very hands-on, practical profession. This attracts many people to the field – it is an opportunity to engage directly with people in need and help to transform, or even save, lives. However, the idea of a nurse taking a PhD and focusing on research seems odd to some people.

It is sometimes a deliberate choice made by nurses whose own physical health is deteriorating or likely to deteriorate. They are looking for a way to remain active in the profession even if they won’t be able to continue physical work over the long term. Most people who choose it do so because they want to draw on their practical experience to advance their work, or the nursing profession, on a larger scale.

PhD nurses have vital roles to play in shaping health policy and advancing patient advocacy. This article explains how and is a great place to start learning for anyone thinking about becoming one.

Informing policy

Health policy change may be driven by numerous factors: concern about a particular health issue, pressure from the media or public, the need to save money, an opportunity to take advantage of a new technology, or something else entirely.

What all these things have in common is that they must be paired with an intimate understanding of how the healthcare system works before they can give rise to positive change. Policymakers understand the broader aspects of the system, such as overall budgeting and external political pressures. For the most part, however, they lack that insider knowledge. For this reason, they are keen to bring in PhD nurses as consultants.

The task of a nurse in this position is to analyze the key ways in which the policy will change healthcare provision and then identify the research questions necessary to establish the likely effects. They then carry out any necessary research or manage research teams, with the aim of building a more in-depth picture of the likely effects of the policy. This could be as simple as a literature review or as complex as running focus groups across multiple demographics, then undertaking a comparative analysis of the results.

Analyzing policy outcomes

Even when new policies have been carefully considered before they are introduced, they can still have unexpected outcomes. It’s important to identify and analyze these as quickly as possible. They may result in the policy being altered or withdrawn, or they may be considered so minor that they are outweighed by benefits. Unexpected positive outcomes may also occur, which could prompt faster or more extensive rollout, or could mean that aspects of the policy are worth exploring in more depth for usefulness in other contexts.

Additionally, the interactions of the new policy with existing policies must be examined. PhD nurses are perfectly placed to do this work because they possess both advanced research skills and a deep understanding of healthcare at the ground level. They also have a broad networks of useful contacts.

Nurses who take on this kind of work will find that maintaining close connections with nurses who are still in practice is invaluable. This connection gives them an up to date understanding of what’s happening in wards and the community, enabling them to put research findings in context.

Undertaking commissioned research

Sometimes policy makers specifically commission PhD nurses to undertake research on specific topics, with the aim of fine tuning the development of a policy or identifying areas where policy changes might be needed. This is one of the better paying options for a nurse at this level. It is natural to want to make a good impression to secure further commissions, but nurses must keep in mind the professional ethics which keep them from simply telling commissioners what they want to hear.

Commissioned research differs from simple consultancy in that the research questions are usually defined by the employer, although this may be in collaboration with the researcher. In this context, nurses may raise other points of interest or concern which become apparent during the research. However, they will not usually pursue these unless subsequently commissioned to do so. Nurses might make recommendations for broadening the scope of the research or narrowing its focus to key areas if they feel the data can be collected in accordance with the initial design are insufficient for the established purposes.

Nurses as thought leaders

Spending a lot of time on research gives PhD nurses a rich understanding of their areas of focus, meaning they don’t need to limit themselves to exploring ideas proposed by others. They can highlight areas of interest and, in some cases, initiate research projects which involve large teams. They may draw attention to areas in which policy is falling short or where they suspect that significant improvements could be possible. They can introduce fresh perspectives on old ideas. They can also approach policymakers to initiate the process of policy development by informing them that change is required in a particular area.

Some PhD nurses produce research supported by academic institutions, or even publish books, to explore their areas of interest more broadly or build arguments for large scale change. Nurses doing this work are often invited to speak at events or sit on panels, and can use such opportunities to influence policymakers. Though, more often, they focus on shifting attitudes and laying the groundwork for a general area of policy than on individual policies themselves. In doing so, they provide a voice for the entire profession.

Nurse advocates

While advocacy is always an important aspect of nursing, PhD nurses take it to the next level. They go beyond advocating for individual patients to address areas where systemic improvement is needed for the treatment of particular patient groups. They step in when, for instance, data analysis reveals that patient outcomes for a particular racial group are worse than those for others. Furthermore, they may step in when a hospital doesn’t know how to provide for the physical needs of patients whose mental health issues make them frightened or uncooperative.

They use their research skills to establish what is going on in such cases, or to spot problems which staff members have failed to identify. They explore different potential solutions and analyze the results of pilot initiatives. They take a leadership role, helping other nurses understand the issues and become more effective advocates themselves.

As good leaders, they also make time for listening, and make themselves available for nurse practitioners who wish to raise concerns. Occasionally, they may choose to step in and help with specific cases, especially if they believe that those cases could result in setting precedents which would help patients more generally.

Nurses as policy makers

In some cases, nurses with PhDs choose to take up policy-making roles themselves in individual institutions, larger health sector organizations, on state health boards, or even at the federal level. This may end or limit their ability to actively carry out research, but it means that they can use the expertise they have acquired to inform policy initiatives and commission research from others. If a nurse decides to do this, they will likely already have strong ideas about necessary changes or the best ways to tackle particular problems. Such ideas are usually a prerequisite to getting into such a role, whether by employment or election.

Once in post, these nurses will use their network of contacts, built up over the course of a career and supplemented during studies, to stay informed on developments across the healthcare sector and track changes in best practice.

It is important for a PhD nurse in this role to avoid becoming cut off as part of a decision-making elite, and to maintain connections at a grassroots level to properly understand how policy changes will play out in practice. This enables policies to be designed around the specific needs of nurse practitioners rather than being retrofitted by people who don’t really understand the situation.

The wider reach of nurse advocacy

What a health policy is exactly, is usually based on the point of origin of the policy. However, policies developed in all sorts of other areas can have major health implications. For this reason, PhD nurses are working in various sectors, using their expertise to identify and assess such implications and assist policymakers in factoring them into the decision-making process.

Naturally, this kind of work gained particular prominence during the early stages of the COVID-19 pandemic, when PhD nurses were in high demand. At this time, every industry needed to make rapid changes to comply with quarantine protocols and minimize risk to workers and customers. Nurses contributed to key decisions which helped to control infection while ensuring that people could still purchase essentials and receive advice to help them exercise and maintain their mental health. As society opened again, nurses advised on everything from infection reduction procedures on public transport to air filtration and hand washing in schools. They also carried out studies to assess the effectiveness of measures, feeding back into policy development.

Shaping the future

Despite this wealth of interesting career options, some PhD nurses decide to stay in academia where they can carry out research and focus on developing the skills of the next generation. They play a key role in the development of NP certificate programs and other nursing courses, working directly with students at institutions like Wilkes University, which specializes in bringing real-world expertise to the classroom. The classroom is virtual at Wilkes University, and the expansion of online learning options for nurses has made the profession accessible to an increasingly wide range of people. This is particularly exciting where advanced education is concerned because of the more diverse perspectives it introduces.

By engaging with students and helping them develop their potential, PhD nurses can ensure a healthier future for the nursing profession. With COVID-related health issues ongoing and more people living into their 80s and 90s, leading to higher rates of chronic illness, there is an urgent need to recruit more nurses and train them to meet the challenges ahead. This is best done by people with in-depth academic understanding of the issues involved, with a practical understanding of what it is like to work as a nurse.


Getting a PhD is a fantastic way to shift the focus of a nursing career to bring about widespread change. All the questions which have puzzled nurses over the years and all the possible changes they feel could make things better, will be theirs to explore after graduation.

The above opportunities and more will be waiting for them. Many PhD nurses explore more than one opportunity as they take control of their careers and pursue their own priorities in research, advocacy, and policy development. It is a highly rewarding way to work and well worth the time and effort needed to qualify.

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