Khaliah Fisher-Grace, PhD, RN, CPHQ, PCCN-K, will begin the role of Director-at-Large as part of the American Nurses Association (ANA) board of directors starting January 1, 2024. In June this year, the ANA’s Membership Assembly elected nine new board members (American Nurses Association, 2023). During an interview in October this year, Dr. Fisher-Grace described the journey, inspirations, and opportunities resulting from being a PhD nurse.
Being a life-long learner is vital for nurses to stay up to date on evidence within the profession. All nurses must participate in lifelong learning, whether for annual competencies, a requirement for license renewal, or career advancement. Some nurses, however, choose to do this by becoming doctoral-prepared. Becoming a PhD nurse takes work, however. Several factors impact a nurse’s ability to achieve the level of PhD. Some of these factors include the conditions and structure within an organization, how supportive the environment is, the attitudes, motivation, and values of the nurse, the perceptions of barriers to being successful, and the perceived impact on practice a nurse will have upon completion (Mlambo et al., 2021). Dr. Fisher-Grace expressed how she overcame some of these factors when asked about the inspiration to earn a PhD.
“My Inspiration to earn a PhD in nursing has evolved. When I started my nursing career at Kent State University in the BSN program, this is where I thought my education would begin and end. Much of my inspiration came from working in the nursing field with nurses with advanced degrees and roles. They inspired me. I liked the idea of taking clinical knowledge from the bedside and applying it to the problem. After getting my MSN degree, I started to work in quality improvement. I loved it because I gained experience in looking at data, how to change systems, creating order sets, and working with interdisciplinary teams. I wanted to do more of that and have an opportunity to create studies and ways for nurses to impact patients and healthcare systems. I initially thought to get a Doctor of Nursing Practice (DNP) degree. I thought it would assist with what I already do, but when talking with some of my nursing colleagues, I got encouraged to pursue a Nursing PhD. I already had experience working on projects and process improvements. A PhD degree would allow me to advance beyond the level I already had and give me the ability to work on research. Also, if I decide to move out of the healthcare system, for example, teach full time, I have the ability and the credentials to obtain funding from Federal agencies. I wanted to keep building on my quality improvement work skills and begin designing studies and programs that would be helpful to patients, nurses, and the healthcare systems” (K. Fisher-Grace, Personal Communication, 0ctober 9, 2023).
The interactions with other doctoral-prepared nurses, professional opportunities, and the desire to contribute to the nursing practice inspired Dr. Fisher-Grace to earn a PhD. While inspiration is essential to achieving a PhD degree, access to resources also plays a vital role in successfully navigating this journey. A study of 563 PhD nursing students from 53 nursing schools found five resources essential to success: faculty issues, time management and balance, insufficient preparation for dissertation research, financial barriers, and COVID-19 impact (Lee et al., 2023). Several of these themes emerged when citing resources available to Dr. Fisher-Grace during the doctoral process. Dr. Fisher-Grace references her most significant resource as having access to doctoral-prepared nurses from professional organizations such as ANA-Ohio.
Additionally, the ability to apply the new knowledge being learned while maintaining work in a full-time capacity was critical. Keeping a full-time job also helped with financial barriers. As a full-time employee, “I received tuition assistance from the hospital where I work, which had just bumped up to $7,500 a year for graduate school, which was a big help” (K. Fisher-Grace, Personal Communication, 0ctober 9, 2023).
Planning and keeping an organized schedule is essential when pursuing a doctoral degree. Dr. Fisher-Grace identified the importance of, “living by [a] calendar” (K. Fisher-Grace, Personal Communication, 0ctober 9, 20243). She credits her manager for helping her organize a calendar that balanced managing a full-time job and a doctoral program.
“… my manager was one of the individuals I asked for a reference, and she happily agreed. She was happy to help me excel and move on in my career. At one point later, I was worried because I took a promotion at work while in school. I did not expect that to happen, but it was a good step for my career. During the interview, I said: One thing I need you to promise me when I start working on my dissertation is whether I will be supported in my job and allowed to finish my degree. Can you promise me? This was a negotiating aspect during my transition to a new position. I remember not accepting the position until I could converse with my manager. Moreover, she assured me that by guaranteeing I will get through school. That meant so much to me that I dedicated a portion of my dissertation to her. Without that resource of a supportive manager and balanced work schedule, I could not have been successful” (K. Fisher-Grace, Personal Communication, 0ctober 9, 2023).
The desire to become a PhD is often associated with available opportunities to advance one’s career and influence the profession. During a thematic analysis of 22 peer-reviewed articles investigating the impact of doctoral-prepared nurses’ career path, findings concluded that doctorally-prepared nurses, with strong careers, are essential to health care and nursing. They generate and implement new knowledge into clinical practice and thereby support the improvement of nursing care and patient outcomes (Hafsteinsdottir et al., 2023). This is evident in Dr. Fisher-Grace’s post-doctoral career path. Within six months of finishing the PhD program, Dr. Fisher-Grace had the opportunity to lead the development of a department. One goal of this department was to systematically align processes and documentation policy to move towards zero patient harm. Being a PhD-prepared nurse allowed Dr. Fisher-Grace to “…use my knowledge from my PhD coursework by implementing fund-seeking skills as I was creating this department’s budget, demonstrating need and possible risks and a path for safety and technology use. I was also using my ability to build the theoretical framework and analyze data…” (K. Fisher-Grace, Personal Communication, 0ctober 9, 2023).
The recent appointment of the ANA Director at Large can also be attributed to Dr. Fisher-Grace’s desire to use her new knowledge to impact the profession. The American Association of Colleges of Nursing (AACN) outlines The Essentials of Doctoral Education for Advanced Nursing Practice. These essentials outline the advanced knowledge doctoral-prepared nurses have to develop the profession in areas of research, clinical practice, development of the next generation of nursing, and leadership (AACN, 2021). Dr. Fisher-Grace’s desire to serve on the ANA board of directors aligns with these essentials. “I have always wanted to serve on the ANA board. This is because I wanted to take many of the things I have learned locally and see how they might apply nationally. Learning from what healthcare organizations, nursing, patient, and family issues are, and how to leverage or pull many levers to address those complex problems” (K. Fisher-Grace, Personal Communication, 0ctober 9, 2023).
Dr. Fisher-Grace offers support, encouragement, and guidance to those nurses who may want to become involved with the ANA on an organizational level. There are many opportunities that a nurse can choose from to get involved, including evaluating professional practice, policy council, the bylaws committee, or others. Dr. Fisher-Grace feels that “Serving on the committees at ANA is very powerful as I am learning more about after being an ANA delegate and serving on the Policy Committee” (K. Fisher-Grace, Personal Communication, 0ctober 9, 2023). Additionally, participating in the association’s activities can be one way to meet mentors. Being involved in the ANA at the state and local levels has benefitted Dr. Fisher-Grace’s personal and professional goals. Entering the role of Director at Large for the ANA Board of Directors will allow Dr. Fisher-Grace to apply the expertise of a PhD nurse to impact patient outcomes and the nursing profession.
References
American Association of Colleges of Nursing. (2021). The essentials: Competencies for professional nursing education. American Association of Colleges of Nursing. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf
American Nurses Association. (2023, June 17). American Nurses Association elects new National Leaders at its 2023 Membership Assembly. ANA. https://www.nursingworld.org/news/news-releases/2023/american-nurses-association-elects-new-national-leaders-at-its-2023-membership-assembly/
Hafsteinsdottir, T. B., Broome, M. E., van Dongen, L., Suhonen, R., & Leino-Kilpi, H. (2023). Review for “career development of doctorally prepared nurses.” Support for Doctoral Nursing Students in PhD Programs in the United States, 46, 225–230. https://doi.org/10.1111/jan.15847
Lee, M. A., Prevost, S. S., Scott, L. D., & Zangaro, G. (2023). Support for doctoral nursing students in Ph.D. programs in the United States. Journal of Professional Nursing, 46, 223–230. https://doi.org/10.1016/j.profnurs.2023.03.018
Mlambo, M., Silén, C., & McGrath, C. (2021). Lifelong learning and nurses’ continuing professional development, a meta-synthesis of the literature. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00579-2
