Reflections: The Responsibility of Doctoral Nurses to Lead a Change in Practice

Abstract

This paper aims to consider the responsibilities of doctoral nurses to lead changes in practice through a very personal reflection of over 52 years in nursing. The reflective learning moves from an early training experience where I learned to ‘do’ to becoming a nursing professor with a doctoral qualification and an ‘evidence-based doer.’ The change witnessed has been considerable. As the highest educated professional, I have learned that doctoral nurses are responsible for leading and directly influencing clinical practice, either as a practitioner, an educator, or a researcher. They are capable of encouraging the development of critical thinking skills and helping practitioners to be curious, take risks with ideas, identify gaps in the evidence base, and be creative in their problem-solving. If the strategic vision for nurses globally is to provide the best quality of patient care, then evidence-based practice is key to leading from the head, hand, and heart. Doctoral nurses understand the patient benefits of a high staff-to-patient ratio and having a critical mass of university qualified nurses and must strive to influence policy to this effect. As each country, particularly in Latin America, develops a critical mass of doctorally qualified nurses, then they can harness their innovation, create new ways of working, attract them back into practice, and strengthen their political voice to lead strategic change. Doctoral nurses must develop their leadership skills and their confidence to lead. They have a responsibility to realise their potential and identify the opportunities to really make a difference.