Health systems are squandering the research potential of nurses who split their time between the bedside and the lab, a Penn Nursing scholar argued in a letter published July 4 in The Lancet.
Kathryn Connell, PhD, RN, an assistant professor at Philadelphia-based University of Pennsylvania School of Nursing and a clinical nurse at Pennsylvania Hospital, said nursing is a profession where “dual expertise” is pervasive but “structurally invisible.”
Nurses make up the largest segment of the healthcare workforce, and many enter the field after their own encounters with illness, caregiving or health-system failure, she said. Yet, they are still positioned as caregivers rather than knowledge producers.
The mechanics are unforgiving. Unlike physician-scientists, who benefit from established infrastructure, nurses rarely have formal hybrid roles, Dr. Connell said. To sustain both, many work clinical shifts on nights and weekends, on top of full-time academic appointments.
Her own work shows what bedside access yields. Dr. Connell’s research on ICU “co-patient illness severity” — how the workload, acuity and stability of one patient in a nurse’s assignment affect outcomes for other patients — began at the bedside of a deteriorating patient she could not adequately attend to because her attention was pulled to a second patient.
“That clinical experience became a research question that no amount of secondary data analysis alone would have surfaced,” she wrote.
Dr. Connell called on health systems to create formally integrated clinician-scientist roles with protected research time; to align promotion and evaluation systems so active clinical practice counts as an asset to scientific inquiry rather than a distraction; and to build environments where nurses can draw on lived experience without risking their scholarly credibility.
The letter lands as more organizations test the role. Cancer centers and many of the country’s largest systems have added clinically based nurse scientists in recent years, and the dual role is gaining traction — though formal positions remain rare.
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