Nurses and the doctorate: a mixed study in French healthcare organizations.

AIM: This research aims to understand the place and role of nurses holding a PhD or PhD students (Nurse Doctor (ND)/Nurse Doctoral Students (NDS)) in healthcare organizations in France.

CONTEXT: Worlwide, many nurses are undertaking doctoral studies. France is no exception. However, in France, there is no doctorate dedicated to nursing. The question of ND/NDS' integration into health organizations is thus raised in a specific manner.

METHODS: We used a two-stage mixed methodology. The first stage used data from questionnaires which were sent to 165 ND/NDS in France. To contextualize issues raised by these data we used qualitative methods which comprised 45 semi-structured interviews with nurses, 10 interviews with health managers and chief nurses, and 27 hours of in situ observations with research coordinators.

RESULTS: Seventy-nine participants (47.9% response rate) completed questionnaires. The data showed that work organization in some departments - intensive care units (ICUs), oncology, and psychiatry - favored the development of scientific expertise among nurses. Favorable elements promoting the professional and academic development of ND/NDS included the potential for medical teaching in health care services, participating in research projects, and most importantly, medical proximity. Conversely, our data also identified poor visibility and recognition of nursing doctoral courses in French health organizations: a lack of task missions, a lack of suitable posts, and poor integration into the nursing profession. Currently, French nurses define their profession as providing direct care to patients and their families - yet this definition fails to consider other important professional elements, such as research.

CONCLUSIONS: Our study identified how proper ND/NDS integration is important to healthcare organizations. We identified key organization factors facilitating the integration of ND/NDS, such as participation in research teams and providing research support management.

IMPLICATIONS FOR NURSING MANAGEMENT: In recent years, the nursing profession has significantly evolved. We are interested in the impact of these changes in work organizations following the development of new scientific skills. Our study investigates all aspects of the nursing profession (teaching, practice, research, and organizations). Our study advocates managerial roles, among others, to improve Nurses Doctor (ND) and Nurses Doctoral Student (NDS) integration into work organizations. We directly observed work organizations which helped develop nursing research. Our study is also aimed at managers who have roles as decision-makers in promoting and facilitating research and nurse researchers.