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High attrition rates fordoctoral nursing students(reported to be as muchas 50%) in the face of anincreasing demand for

PhD-prepared nursing faculty is agrowing concern. So, what’s at thecrux of this problem and how dowe solve it? When I was a doctor-al student, I researched how otherdoctoral students balanced work,family, and school. The goal wasto learn more about the strategiesused by these students. (See Moreabout the research.)

What’s a doctoral nursing student to do?Studying for an advanced degreeis time-consuming and competeswith the other demands of life—home, work, and professional re-sponsibilities. Doctoral nursingstudents use various methods, of-ten in combination, to manage

their time and stress. Seeking sup-port, planning, and creatingschedules were described by thestudy participants as the mosthelpful strategies.

Seeking supportParticipants identified help from aspouse or significant other withhousehold responsibilities as con-tributing the most to their success.Other sources of support camethrough mentoring and friend-ships. However, seeking supportdidn’t guarantee receiving support.Some participants said they hadlimited support, which contributedto feeling isolated. These partici-pants received most of their sup-port from coworkers and familyon an as-needed basis.

Many study participants saidthey often made compromises, for-feiting time with family and tend-ing to household chores in favor

of work and school responsibili-ties. But with the help of spouses,family, friends, and colleagues, thestudents were better able to per-sist in their graduate program.

Effective scheduling and planningStudy participants identified sever-al tools that helped with schedul-ing, planning, and triaging theirdaily activities, including sharedonline calendars, schedulingbooks, sticky notes, and multiplealerts using electronic devices, aswell as mentally making time forthemselves. Time for self-care,while limited, came in the form ofexercise, meditation, yoga, engag-ing in a hobby, quiet time, or sim-ply watching a favorite show ormovie.

Take a multipronged approachNo one method or strategy solvedthe challenge of balancing com-peting responsibilities. In fact,many participants revealed thatthey made adjustments day byday.

When you’re working to bal-ance multiple roles, you may feelisolated and alone in your efforts.The key to avoiding isolation liesin reaching out for support, rely-ing on that support to be a re-source and comfort, and being organized.

Nancy Bellucci is an online nursing faculty memberat Galen School of Nursing in Louisville, Kentucky.

Visit www.AmericanNurseToday.com/?p=25723 for a list of selected references.

Your doctorate and the path to persistence

Completing your doctorate requires support and more.

By Nancy Bellucci, PhD, RN, CNOR

My dissertation research study looked at specific strategies PhD nursing studentsused to achieve balance between work, family, and school. The participants repre-sented nursing programs from around the United States. Data analysis revealedsix major themes:

1 Multiple strategies and tools help to manage time.

2 Various approaches help to manage stress.

3 Support of a spouse, family, friends, and mentors is necessary to balance responsibilities.

4 Compromises are required to fulfill work and school responsibilities.

5 Many challenges interfere when working to find balance.

6 Most of the time in a given day is spent on work and school.

More about the research

AmericanNurseToday.com April 2017 American Nurse Today 39

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On a hot summer eveningduring my recent post- doctoral dream cruise, Iwas preparing to relaxand enjoy a show in the

beautiful lounge when, above theexcitement and din, I heard the un-mistakable sound of a human bodyhitting the marble floor. In fact, thedull thud of a head making contactwith an immovable object is asound any nurse would recognize.It was immediately followed by thesickening sound of ayoung child’s cry thatquickly grew from awhimper into a pitifulscream.

I instinctivelyjumped from my seatand ran in cartoonishfashion to the back ofthe lounge—my legsseemed to be movingfaster than my body.As if in slow motion,however, I noted thebewildered stares ofmy traveling com -panions in the seatsaround me. Before thefirst “where are yougoing?” reached my ears, I was al-ready at the back of the lounge andat the side of a very young boywho was now holding his head andstaggering to get to his feet. “Pleasedon’t move. I’m a registered nurse,”I told him and the small group ofpeople standing around him.

Before I could react further, afirm hand gripped my shoulder andtwo crew members authoritativelysaid, “Step aside.” One of themleaned down, quickly helped the

boy to his feet, patted him on thehead and simply said, “You’re allright, son. Now be a good boy andrun along.”

“No, no,” I said and once againasserted, “I’m a registered nurse. Heshouldn’t be moved yet…mightneed a cervical collar…an X-ray andevaluation…at least!” The crewquickly turned their attention to meand delivered the same, but slightlyrevised and more mature version, ofthe “now run along” message and

concluded with, “Go have some funand relax! Don’t worry about it.That’s what we’re here for.”

Although it seemed to last aneternity, the whole incident fromstart to finish lasted less than 30 sec-onds. I stood in stunned silence un-til two friends in my party retrievedme. Needless to say, I discoveredthat it was far easier to be instantlytransported from vacation mode tonurse mode than vice versa. All Icould think about was the boy. A

patient…er…a passenger fall? Wherewas the incident report? Follow-up?Then I thought, “Should I follow thestaff’s advice, stop being such anurse, and just enjoy myself?”

The answer was ultimately no. Icouldn’t stop being a nurse for thatone moment, that evening, the du-ration of the cruise, and, I expect,even a lifetime. Needless to say,based on the crew’s less than ro-bust response to the incident, I hada different perspective of myself,

the passengers, crew,and surroundings. Forthe remainder of thetrip I noticed things Imight not have before.

For example, everytime I reported to thegym for an early morn-ing workout, I notedthat there were nostaff members on duty.I looked around thelarge workout area that hugged the ship’sstern. Just a few peo-ple, most of whom appeared quite over-weight, very sweaty,and breathing heavily,

were using the treadmills. I won-dered if they were trying to workoff some diner’s remorse from theprevious night’s 4,000-calorie din-ner. Was it safe for them to be en-gaged in such strenuous exercise?Were they instructed in the properuse of the equipment? Was theirheart rate in their ideal workoutrange or should they stop and takea break? But, Oh, stop worrying…just relax and enjoy yourself.

Although I ultimately managed to

Nursing my vacation: How being a nurse (almost) ruined my dream vacation

Can nurses ever turn the nursing switch to the off position?

By David Foley, PhD, MSN, RN, MPA

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take my own advice, I have to pass along a few rec-ommendations. I’m sure that any group of nurses whogot together over coffee could come up with more, buthere are mine:• If you or a member of your party experiences a fall

or other injury while on a cruise or at a resort, insiston an incident report and a medical evaluation. Yourchances of receiving appropriate—and deserved—follow-up care substantially diminish if you leave thescene of an incident without insisting on both.

• Don’t leave medications or valuables sitting on bath-room counters. Noting the frequent occurrence ofopen doors and un-attended staterooms all over theship, and given that bathrooms were located just in-side each stateroom’s entrance, I envisioned some-one stepping into the bathroom and stealing valu-ables or medications in hopes of making a quickscore or obtaining narcotics.

• Take an economy-sized container of antibacterialwipes. When you arrive at your stateroom, use themto sanitize all surfaces in the bathroom as well asthe TV remote, credenza, and door handles.

• If you choose to use exercise equipment while onboard, read the warning signs and disclaimers care-fully. Let someone know you’re going to work outand ask him or her to check on you if you don’t re-turn by a certain time. Exercise sensibly, and keepin mind that working out at sea isn’t like your base-ment or local gym. For example, even in relativelycalm seas, you may need to hang on to the tread-mill to avoid falling.

• Avoid eating leftovers or recycled food. Hot foodsshould be prepared, stored, and served hot, andcold foods should be prepared, stored, and servedcold. Although we can’t observe all three processes,we can certainly check the temperature of soups,salads, entrees, and cold desserts right before eat-ing. When in doubt, don’t eat it.

• Pack sunblock with a minimum 30 SPF. Common sense?If so, then why did I see so many passengers walk-ing around with second-degree sunburn by day two?

• Stay hydrated throughout the cruise, especially dur-ing shore excursions, where the ship’s amenitiesaren’t readily available. Will I ever develop the ability to leave my nursing

identity behind on vacations? I don’t think so. Nursingis what I do and a huge part of who I am. I don’tknow about you, but I just can’t help myself. I do in-tend, however, to arrive for my next dream vacationbetter prepared and more self-sufficient. Only then will I be able to nurse my vacation less and instead nursemy own need to engage in well-deserved self-carethrough rest and relaxation.

Editor’s note: Read more about Foley’s adventures at https://www.americannursetoday.com/blog/nursing-vacation-nurse-almost-ruined-dream-vacation

David Foley is an assistant professor of nursing at Cleveland State University inCleveland, Ohio.