In order to be successful in the future, nursing administration must have the same rigor and quantity for its research as we find in the advances we have made with clinical research. To paraphrase Victor Hugo's1 oft-quoted statement about the future: "We have the potential for multiple futures." If we are weak in our approach, the future potential will be unattainable. If we lack courage, we may have unexpected outcomes. But if we are deliberate and thoughtful, we have a bright future. Our task is taking the multiple challenges that face the issue of administrative research and creating coherency. Key to creating coherence is addressing critical questions.
Nursing administrative research has been around for a long time. We could argue that Florence Nightingale's basic principle,2 "to put the patient in the best condition for nature to act," provides the mandate for administrative research. In fact, her work studying the system issues (the military and healthcare) provided evidence for revolutionizing care for the soldiers at Scutari and later healthcare in Great Britain and beyond.
Over the decades in the United States, nurse researchers whose primary interest focused on administration developed studies to describe or predict how organized nursing services needed to perform certain functions or practices in specific ways. Even today, we see, as evidenced by the articles in this issue of JONA, issues of great importance to administrators being addressed. These efforts have been made to harness the environments of care to put the patient in the best condition, thus improving the health of the nation.
The complexity of the challenge to meet the demands for administrative research poses several areas for specific consideration. These include (1) educational preparation, (2) capacity to match the need, and (3) partnerships to enhance research efforts. The one thing we do not lack, however, is an identifiable list of priorities. When we asked the membership of the Council on Graduate Education for Administration in Nursing (CGEAN) to pose their most pressing research questions, we were deluged with ideas.3
Educational Preparation
The educational preparation for nurses holding managerial and above positions ranges from less than a baccalaureate degree to doctoral preparation, and the profession seems to be divided roughly into thirds, with one-third each being prepared at the associate level and baccalaureate level and the remaining one-third almost evenly divided between diploma and master's/doctoral level.4 We can anticipate some rapid growth in the numbers of nurses prepared at the doctoral level due to the enthusiastic response to the creation of the DNP programs. This practice-based degree is not designed to produce future researchers (although some of the graduates likely will seek this role).5 These degrees focus on preparation to evaluate and implement evidence to influence positive change.
For nurses who hold aspirations to be researchers, the universally accepted terminal degree is the PhD. As the CGEAN Position Statement on the Educational Preparation of Nurse Executives and Nurse Managers points out, we need both DNP- and PhD-prepared leaders to meet the challenges of the future. Strengthening all of our research, including administrative, is critical to our ability to address the challenges we face with the rapidly changing complexities of healthcare delivery. The questions to answer are: How can we create incubators that support nurses young in the profession to move quickly to the doctoral degree to enhance the longevity of their contributions? How can we change work expectations to capitalize on the talents that each well-educated nurse brings so that they produce their best? How can we optimize the efforts of interested nurses who may not have traditional preparation and who bring the intellectual curiosity for research? What can the profession do to create the equivalent of postdoctoral fellowships so that someone might be immersed in relevant research? What can we do to increase the dissemination of research throughout the nurse leader population to promote adoption of new strategies or to improve ongoing research?
Capacity to Match the Need
Several other factors influence our capacity to meet the need for administrative research. The usual factors of time and money weigh heavily in creating administrative research. Funding agencies may not see the implications of supporting projects to improve care without addressing the care delivery model in which the care is delivered. As with patient safety, improvement of care is a systems issue and requires the broad view of the workplace and related issues. New researchers committed to a successful academic career may limit their involvement in administrative research because of the limitation of funding opportunities. Securing external funding is a common expectation to advance in a career, so researchers may see this scarcity of funding as a career-limiting option.
Researchers willing to conduct research in practice settings value the real-world laboratory of administrative research. These sites are primed for the inquisitive mind being metric-focused and data-rich. How do doctoral programs prepare researchers to capitalize on such wealth of opportunities? Clinical administrative research is even more influential as we consider the rapidity and intensity of change in recent years. The constant churn of change often makes any research difficult because it is challenging to track original intents with outcomes. Additionally, the person who leads the nursing organization does not need to be a researcher to create a research-friendly environment; however, that person must create the supportive environment in order for research to flourish. Finally, the increasing challenge is having someone focus on doing administrative research when other members of the nursing organization seek advice for unit-based research endeavors. Both are important. The questions to answer are: What can organizations provide in terms of time and money to "free" researchers to focus on critical issues related to administration? How can we overcome "selective" research findings that do not always fit our needs? How can we appropriately acknowledge the churn evident in healthcare today without making the churn the scapegoat for any findings we do not support? How can we be "bicultural" in supporting clinically focused, unit-based research without allowing it to become the sole focus of our research endeavors?
Partnerships to Enhance Research Efforts
Few professional nurses operate in a single-person environment. Rather, we are members of teams; often, we are members of many teams. The practice of research teams is not yet common practice in nursing, yet the answers for many dilemmas lie here. Consistent with 2 Institute of Medicine reports,6,7 we have the potential to create more interdisciplinary research and to extend between schools of nursing and service organizations the ability to conduct collaborative research.
As the largest group of professionals in almost all healthcare organizations, nursing has the potential to invite other disciplines to join us in administrative research when the questions apply to others as they do the nursing. Capitalizing on our relationships with colleagues allows nurses in service settings and in academic settings to collaborate on issues of mutual interest. For example, who in nursing is not interested in the question of appropriate staffing? Yet, most research that has been accomplished thus far relates to acute care facilities. The numbers of types of organizations yet untouched by this research are fodder for a broader perspective. The questions to answer are: Who are our best allies? What will be mutual benefits? Where does the best talent for a particular topic lie? How can we promote this approach as a model for many administrative issues?
Many other issues exist related to how we will move forward in an orderly, yet quick, manner so that the multitude of research questions that exist can be addressed in a way that many of us benefit. Whether the research is focused on solving a distinctive administrative issue that relates only to 1 type of setting or group of nurses and patients or whether the research is focused on addressing a broad perspective issue that most of us face, research in itself brings value to the organization where the research is conducted, to the nurses we lead, and to the patients we serve. Nurse leaders can impact the research agenda immediately and powerfully.
Creating an environment that explicitly supports research is key. An explicit research strategic plan can guide and educate the organization and others in the development of collaborations and resources. Nurse leaders can be strong advocates for influencing prospective funders to establish priorities that support administrative research. Addressing the challenges and questions will benefit us all.
Acknowledgment
Special recognition is provided to the author's "thinking partner," Dr Fran Vlasses, past vice president for Stakeholder Relations, CGEAN.
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