The National Institute of Nursing Research: A Glance Back, and a Vision for the Future

Over thirty years ago, a committed group of nurse scientists witnessed the end of one journey, and the beginning of another. In 1986, the Unite States Congress established the National Center of Nursing Research (NCNR) at the National Institutes of Health (NIH). This was the culmination of a long and difficult effort on the part of these visionaries to advocate, convince, and cajole those policymakers at the highest levels of government into recognizing that nursing science was an essential component of the health research enterprise. While some in the scientific community remained skeptical, nursing science now had a foothold at the NIH, and the opportunity to demonstrate that it belonged. Now the fledgling NCNR had to begin the hard work: devising a mission, developing a base of grantees, establishing research programs, and determining the best way to organize the Center to address the health challenges of that time and well into the future. Nursing science had successfully completed one journey, but what about the next one?

Fast forward to today, and the progress we have made on that journey has surpassed all expectations. NINR-supported science, and the unique clinical perspective it brings to the science of improving health, has established itself as an essential part of the health research community, contributing to improved health and quality of life for countless Americans, and many others around the world. At universities and hospitals across the United States, nurse scientists provide the evidence base to support the practice of the largest healthcare profession and improve wellness and quality of life for all individuals, regardless of age or health status. Thanks to nursing science, adolescents have been taught skills to successfully manage their diabetes; young minority women have reduced their risk for acquiring HIV; there is a better understanding of why men and women respond differently to pain medication; and clinicians have improved tools for discussing palliative and end-of-life care with seriously ill patients and their families.

Advances made by NINR-supported investigators that have had a profound impact on health and health care span all aspects of nursing science. Just a few of these advances have included:

• Providing training in coping skills, such as social problem solving, communication, and conflict management, to adolescents with type 1 diabetes that significantly improved their quality of life (Davidson, Boland, & Grey, 1997).

• Determining that higher nurse staffing levels and increased nurse education reduces preventable hospital deaths (Aiken et al., 2014).

• Designing and testing a program to support the parents of premature infants, which resulted in improved knowledge and parenting behaviors, and reduced healthcare costs by about $5,000 per infant (Melnyk et al., 2006).

• Showing that modified electrocardiogram monitoring in the prehospital setting can predict health outcomes for patients with symptoms of acute coronary symptoms (Drew et al., 2011).

• Testing interventions to improve communication between clinicians and family members of dying patients that improved care at the end of life (Lautrette et al., 2007).

• Supporting the development of a point-of-care diagnostic “mCHIP” device able to rapidly detect HIV and other infectious diseases in remote settings (Chin et al., 2011).

• Developing a sensor system to use in homes and residential facilities to detect changes in movement patterns in older adults that may be a sign of oncoming changes in clinical status (Rantz et al., 2015).

• Discovering a potential role for the protein tau in long-term complications of traumatic brain injury (Olivera et al., 2015).

• Helping us understand what may cause fatigue in patients undergoing radiation therapy (Feng, Suy, Collins, & Saligan, 2017).

• Establishing a Palliative Care Research Cooperative that has brought together over 160 research sites with the goal of facilitating the conduct of palliative care research (Ritchie, Pollak, Kehl, Miller, & Kutner, 2017).

The continued development of the nursing science workforce is also a source of pride for those who have followed the field over the past three decades. Nurse scientists of today are more innovative and multidisciplinary than ever before, leading and participating in teams across many fields of science. Many have taken advantage of programs such as the NINR’s Summer Genetics Institute and Symptom Methodologies Bootcamp to expand their knowledge base and take their research in new directions. Others have used NINR-supported research fellowships to work with established investigators and gain the experience necessary to embark on their own research journeys. The nurse scientists of tomorrow must continue to seize these types of opportunities for continuous learning and reach out to colleagues from all disciplines to leverage their expertise in order to solve pressing problems.

The future of nursing science has never been brighter. What has been accomplished by NINR-supported scientists since the Institute’s establishment has set the stage for the discoveries of tomorrow in symptom science, wellness, self-management of chronic conditions, palliative and end-of-life care, and the new areas of nursing science yet to develop. The new era of precision health holds promise for managing symptoms on an individualized basis. New data science and clinical research methodologies will allow tomorrow’s nurse scientists to conduct assessments of larger datasets and analyze more complex study populations. Ultimately, nursing science must remain flexible and adaptable, always ready to take on whatever challenges and opportunities present themselves.

The future will not be without challenges, however. The past several years have seen a concerning decline in the number of nurses pursuing a research doctorate (American Association of Colleges of Nursing, 2018). While the decline most likely has multiple causes, including, for example, a difficult funding environment and competing career tracks, it is urgent that we develop innovative solutions to reverse this trend and ensure the future of nursing science. Those just beginning a nursing program need to be aware that a research career is a possibility, and how important such work is to the future of the profession. Funding organizations must constantly be thinking about new ways to reach diverse groups of nurses interested in science and encourage their career development. And those who have been successful in nursing science need to recommit to their roles as mentors, providing advice and encouragement to students at their institutions and beyond. It will be a team effort, but reversing this decline is a task at which we cannot fail.

I will soon be concluding my tenure as Director of the NINR. The opportunity to lead this organization for over 23 years, and to help guide the dedicated community of nurse scientists, has been the honor of a lifetime. Witnessing the real-world examples of individuals and communities made healthier as a result of NINR-supported research is profoundly gratifying. I know that the next individual to lead this incredible organization will experience this as well, and I hope that those of you with an innovative strategic and scientific vision for nursing science will make your voices heard as the NINR moves into the next phase of its history.

I am forever optimistic about the future journeys of nursing science, and I look forward to learning about the discoveries of tomorrow. We have much to be proud of in what has been accomplished so far, and there is so much more we can do. The opportunities for the NINR and for nursing science to contribute to the health and quality of life of all Americans have never been greater. Let us seize this moment and enjoy the journey.