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Should you have work experience before getting your PhD in nursing?

This is a hot topic these days: Should someone be admitted to a PhD program in nursing without ever having worked as a nurse, straight from their bachelor's degree?

Good question.

A common reaction from most people is that well, of course they should! How can you know what healthcare is like from a nursing perspective if you don't have experience?

Of course, one could make the same argument about a PhD in public health where it is also common to go straight from an undergraduate bachelor's degree right into a PhD program. How can you understand the context of public health without any experience? Do we assume that bright people will be able to make reductionistic arguments about their research findings based purely on what trends in numbers show?  In many cases, it happens all the time.

Kind of like management consultants with no life or healthcare experience that make recommendations for hospitals and how they should operate. Happens more than you think it does.

Arguments are also made that we need more researchers with longer research career lives to keep answering nursing sensitive questions, along with having more PhDs to help address the faculty shortage.  A doctoral level degree also helps justify higher salaries for nursing faculty too. A faculty member without a doctoral degree often makes half of what a staff nurse or NP makes annually in the US. Weekends "off" and no shift work doesn't quite justify that pay cut.  Furthermore, with the DNP increasingly used as a faculty credentialing tool, arguments about needing more PhDs to specifically address the faculty shortage are weaker but no less important.  PhD prepared faculty will carry more international cache for a university (and therefore, always be in demand) since it is a globally recognized degree while the DNP is not.

On the other side of the argument is that the profiles of who becomes a nurse these days is somewhat different from the past.  More people with previous work experience in a variety of fields go into nursing and bring a wealth of experience with them.  Who is to say that someone, for example, who has worked in behavioral counseling for STD prevention doesn't have the right experience to go on a study for a research degree if that's the area that they're going to focus on?  Same could hold true for Peace Corps veterans and a variety of other jobs.

It would be harder to argue, however, that working a summer in retail in between university semesters is the kind of experience that would inform a program of research. Another thing that work experience as a nurse brings is --especially if you have never had a job before besides an externship-- is what it is like to report to someone, to have your performance critically appraised by multiple people who really won't care about your feelings or self-esteem, and to understand how organizations work.  A PhD from a BSN can take 5 years of work and study in an organization.  It helps to know how they and you work within them so you can do as well as possible.

From some of my own work, a survey of 606 bachelors and masters degree nursing students found the overwhelming majority valued work experience of any kind in nursing role as important before returning for PhD study.  Experience, it was expressed, helped people choose what they wanted to research or inspired the research itself because of what they saw with patients or their fellow healthcare workers.

Another important part about experience is that if you do not have any, it will be hard to be employed in a university setting because they will not know what you can teach. All clinical course content would be out and you definitely won't be teaching doctoral level content straight out of PhD and post-doc --at least not at a research level 1 university.

So what's the take home message?

If you are a traditional undergraduate student in a 4 year BSN program it is probably better that you work for at least a year before you start a PhD program.  Here's the reasons why:

  • Your first year as a nurse is a little nuts with getting yourself organized and figuring out how to pull everything together.  If you're trying to do that AND do a PhD program, you'll burnout quickly.
  • With a year of experience, you can work per diem either on your same unit, in the float pool, or somewhere else while you do your PhD.  Why do that?  Simple: You'll have more money and less financial stress while studying. If your PhD is funded you'll be earning $1500-2000/month with modified taxing schemes.  Do that math. It's enough for rent, food, and phone/internet service and barely enough for car insurance and gas if you have that to factor in too. That doesn't count buying books and other materials you might need while studying.  One 12 hour shift a week can add between $1000 to $1800 to your bank account each month.  That's a better cushion, whether you're single or coupled.

If you're an accelerated BSN student, see above and consider:

  • Do you know exactly what you want to study and research for your PhD?  
  • Does your potential research topic build from your previous experiences?
  • Do you want an academic career or do you see yourself using your PhD in other settings?

Above all else, it takes PASSION to get through a PhD program in any subject. Working on your mentor's research is not always inspiring enough to get through a PhD program. You have to love what you're studying and have that motivation come from somewhere, be it your patients, co-workers, or other experiences from life.

There's no one right path for a career in nursing and research may be a part of your path, or it may not.  Whatever you choose to do, make sure you know why you're taking that next step and have some ideas about where it might take you in the future.

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