Traditionally, the path to a PhD in nursing has resembled the proverbial long and winding road. RNs interested in continuing their professional education would go back to school and get a BSN degree, then work in the clinical setting for a few years. After a while, they would return to school, earn their master’s in nursing and then go back out into the “real world” to work, or in some cases, teach. For many of the current generation of doctorally prepared nurses, the decision to again go back to school and earn a PhD was made well into the middle stage of their careers.
Today, proponents of a more direct path to the PhD are hoping to increase the number of doctorally prepared minority nurses doing research--and even more importantly, get them into the lab much sooner. A growing number of universities now offer “express track” BSN-to-PhD programs that bypass the traditional MSN degree, giving students an opportunity to become nurse scientists at a significantly earlier point in their lives.
This approach flies in the face of what has long been held as the proper progression of a nursing career. “Before, we said we didn’t want [BSN students] to go straight into graduate programs. Now, we encourage that because time is just too valuable,” explains Gloria McWhirter, MSN, RN, assistant professor and coordinator of academic student resources at the University of Florida College of Nursing in Gainesville, which offers a BSN-to-PhD in Nursing Science program. She believes this slightly accelerated degree program is a good alternative, especially for younger nurses who have seen just enough of nursing to want to do more with their careers.
“When you first get out of college and you’re a nurse, it’s so exciting,” McWhirter says. “A few years later, after you’ve worked those 12-hour shifts, you start wanting to do more. You may want something more challenging and you’ll want to make [changes in the way things are done]. The only way you can do that is to take your education to a higher level.”
According to the American Association of Colleges of Nursing, about 50 colleges across the United States have BSN-to-PhD programs, and that number is expected to grow dramatically in the next decade. McWhirter believes the movement to channel students straight into a terminal degree program is a natural change that would bring nursing into line with other health professions. In fact, she thinks MSN programs may eventually disappear.
“Nursing is simply coming up to the standards that equal those of our health care partners. If you’re in the school of pharmacy, you come out as a Doctor of Pharmacy. You don’t come out with a master’s,” she argues.
Proponents believe those who stand to benefit the most from these programs won’t be the nursing schools that hire BSN-to-PhD graduates, nor those students now in BSN programs who will discover exciting research careers sooner. The biggest rewards will instead be reaped by patients. By putting many more nurses into research at an earlier age, these programs have the potential to radically expand the rate of development for new nursing practices, health care reforms and solutions for eliminating racial and ethnic health disparities.
“Historically, nurses [have gone] on to get their PhD degrees mid career,” says Daniel J. Pesut, PhD, RN, CS, FAAN, associate dean for graduate programs at the Indiana University School of Nursing in Indianapolis, which offers a 90-credit post-baccalaureate PhD in Nursing Science program. “Most people recognize that the factor of knowledge development in nursing depends on having [researchers] who have long career trajectories. Many nurses [who earn their doctorates later in life] only have a 15-year period where they have a research career and are creating new knowledge.”
BSN-to-PhD programs could add many valuable years to that window of opportunity and enable more nurses to spend the lion’s share of their careers in research and teaching, instead of spending the first half at the bedside, Pesut explains.
It’s not that those bedside careers aren’t important. Direct patient care will always be one of the most in-demand and rewarding aspects of nursing. But for nurses who already know that they want to move into research, these programs can help get them there sooner.
“We want to find young people who are committed to research and start them on that road after a minimum time in practice,” Pesut says. “Then, those graduates will have a 40-year career in nursing research.”
Putting nurses on the PhD track straight out of their undergraduate programs can also help them avoid the transition problems that often accompany mid-career changes. “We don’t want those good students to get out of the mode of studying,” says McWhirter. “Plus, they’re used to living as a student with little money, so they don’t have to cut back so much later to be able to afford graduate school.”
If you’re currently a BSN student or recent BSN graduate, is a baccalaureate-to-doctoral program something you should look into? The answer depends on what you want to do with your career. BSN-to-PhD programs focus heavily on research and are ideal for students who want to become nurse scientists. If, on the other hand, you’re not interested in research, you might be better served by a different degree. Students who are more interested in clinical practice, for example, might consider the new Doctor of Nursing Practice (DNP) degrees that are offered at a number of universities.
“Students who just want to teach might consider a master’s degree with an emphasis on nursing education, because most schools of nursing do still hire master’s-prepared nurses to do a lot of teaching,” says Jennifer Gray, PhD, associate dean of graduate programs at the University of Texas at Arlington School of Nursing. “The PhD degree is a research degree, so it may not be right for everyone.”
Furthermore, BSN-to-PhD programs are not for the faint of heart. While they may be only a semester or two shorter than the traditional route to a PhD, they are very intense, because students become involved in writing and research immediately.
“Students who did not enjoy the science classes in their undergraduate programs may not be prepared to do research right away,” says Gray. “You really have to have a strong background.”
The BSN-to-PhD in Nursing program at the University of Texas at Arlington is one of the newer ones and Gray anticipates evaluating the curriculum after a year. “This may have been more challenging for the students than we had anticipated,” she admits. “It is a full-time program with nine graduate levels in the fall and spring semesters and six hours in the summer. You might be able to work 10 or 20 hours a week, but it’s very difficult.”
The UT-Arlington program focuses specifically on preparing nurse scientists to meet the health needs of diverse and vulnerable populations. It’s just one example of how nursing schools are reaching out to make sure minority students are well-represented in their BSN-to-PhD programs.
“We are working hard to attract more minorities to [the University of Florida’s] program,” says McWhirter, who is African American. As part of her job, she travels throughout the South to encourage nursing students of color to consider graduate school. The university has established relationships with historically black schools like Florida A&M University and Bethune-Cookman College that make it easier for alumni of those institutions to participate in the BSN-to-PhD program.
In her efforts to recruit minority students McWhirter finds herself constantly battling one fierce competitor: finances. “When you’re looking to recruit minorities, you have to prepare them financially, and we do [offer] some incentives,” she says. “Most minority students have financial responsibilities. They may have children. They have to have a stipend in order to attend.”
As with other graduate programs, research and teaching assistantships are competitive and coveted. They usually provide small stipends in addition to tuition waivers. Other types of assistance, like National Institutes of Health research training grants and private foundation money, are available at some universities to help students pay for PhD programs. However, many students must finance their education with loans.
While it’s usually impossible for nursing students in accelerated graduate programs to work, that rule doesn’t always hold true for baccalaureate-to-doctoral programs. The University of Florida, for example, has collaborated with local hospitals to allow BSN-to-PhD students to work weekend schedules. The students are able to earn some money while devoting weekdays to studies.
“Students [in these programs] do have an advantage, in that they are RNs,” McWhirter points out. “They can [work as nurses and] make money.”
While admission to BSN-to-PhD programs is competitive, most programs are eager to speak with potential minority students. Professional references are required and your undergraduate GPA should be at least 3.0 (on a 4.0 scale). Many programs require a 3.5 GPA.
“When I meet with [prospective] students, I tell them that their job is to get their grades up and get a good GRE (Graduate Record Examinations) score,” says McWhirter. “If you have that, people will come to you because you are good. Graduate school money is there for those students.”
She advises students to take the GRE seriously. As a general rule, graduate schools require a 1,000 composite score--i.e., 500 scored on both the verbal and quantitative reasoning sections--plus a 3.5 score on the analytical writing section. A higher score improves your chances of being awarded a scholarship or chosen as a research assistant,
“It’s documented that [many] minority students do have trouble with standardized exams,” says McWhirter. “Knowing that, I feel that we should by all means prepare ourselves for those exams. [A nurse] would never walk into surgery without preparing, so why would we take a test without preparing?”
She also recommends that minority students who hope to be accepted into a BSN-to-PhD program take a pre-GRE tutoring course, such as those offered by Kaplan Test Prep, even though some may cost as much as $1,000. “It’s worthy every penny,” she maintains.
In addition, an essay or a career mission statement is usually required. This is where applicants have the chance to rise above peers and perhaps recover admission points lost in other areas. Speak with an admissions advisor within the program to find out exactly what is expected in the essay, since requirements vary. At Indiana University, for example, administrators look to the essay to see where students want to go with their PhD.
“We look for career aspirations in our essays,” Pesut explains. “Some students want to tell us about where they have been in the past, but we’re most interested in where they want to go in their future.”
The number of BSN-to-PhD programs being offered today is still small, but each one is different. Finding that ever-elusive academic “perfect fit” is perhaps nowhere more important than here. When researching schools, a good place to start is the American Association of Colleges of Nursing’s Web site, www.aacn.nche.edu, which has a fairly comprehensive list of schools offering baccalaureate-to-doctoral programs as of fall 2004.
Fortunately, deciding on a program will become much easier once you’ve chosen what your specialized interest will be. This is the area of nursing in which your studies and your research will be concentrated. It could be a specialty area of nursing, like geriatrics, or it could be related to a specific disease, like HIV/AIDS. It can even be as specific as using preventive care to delay aging in the Hispanic population.
Your area of expertise will narrow the possible choices down considerably, as you’ll want to find programs with faculty who are active in that area.
“We generally don’t accept students who are not in some way attracted by the set of expertise represented in our faculty,” Pesut says. To show how important this connection is, applications to Indiana University’s program must include an additional letter of reference: one from an Indiana University faculty member.
“This program involves a lot of mentoring, and the connection between a student’s interest and those of our faculty is vital,” he continues. “For example, if a student was interested in doing neonatal research, we have only one person on our faculty with that expertise and that faculty member is not currently doing research. The opportunities to focus on that area would be limited. We know students’ focus may change somewhat as they move through the program, but initially we want students who are interested in the special expertise our faculty offers.”
Pesut suggests nurses interested in BSN-to-PhD programs do a literature review and read the latest research in their chosen interest. “Find out where the best experts in that area are and try to go study with them.”
For minority nurses, another factor in choosing the right program might be the nursing school’s commitment to diversity. Does anyone on the faculty look like you? How successful have minority and male students been in various degree programs at that school, not just the BSN-to-PhD program?
“Everybody likes to see a role model who can be a source of inspiration and support as well as a strategist and mentor. [For example,] if you were the only male student in a program, you might feel isolated,” Pesut says.
If you think a BSN-to-PhD program is right for you, here are some things you can do in advance to make sure you are prepared for the challenge.
• Improve your computer skills. “Students must make sure their computer skills are very good before the program begins,” Gray advises. “You might even want to take a continuing education class in PowerPoint or MS Word. You’ll be using those skills a lot.” Database management programs, like Access, are also required. Find out which specific applications will be used in your program and get ready to use them.
• Get a copy of the American Psychological Association stylebook. This could be considered the Harbrace Handbook for graduate school. In it, you’ll find the rules of writing papers, reports and even your dissertation. It’s not exactly an entertaining read. Topics, after all, include punctuation, source citations and capitalization. The sooner you blend these rules into your writing, the better.
• Make friends with a librarian. Take a tour of the library at the university you’re planning to attend, as well as any nearby public libraries. Sign up for any workshops they offer on finding data. Learn what is available locally and what might be available in the not-quite-so-immediate vicinity. “Students are really going to have to retrieve and compile materials, so working with a librarian is a good start,” McWhirter says.
• Line up your support system. Tell people at your church, your friends and your family about your goals. Don’t just tell them you want to get a graduate degree--tell them why you want a graduate degree. Tell them your dream. Take advantage of the chance to educate your non-nursing friends about the importance of recruiting more people like you into higher levels of nursing. Share that with your children, your nieces and nephews. Who knows? You might become an important inspiration for the next generation of nurses.