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Making Time for Clinical Practice as a Busy Faculty Member

I am a neonatal nurse practitioner and have practiced in the Neonatal Intensive Care Unit (NICU) throughout my career starting as doctoral student at the University of Pennsylvania and continuing as junior faculty and now as tenured faculty at George Washington University. As my education, work, and career advanced, I found that staying with my clinical practice was important to me.  My research focuses on the neurodevelopmental outcomes of high-risk babies. The wide range of outcomes that we see in the NICU drive my research questions. The time I spend in the NICU helps me to focus my academic research program (and my lab) in a way that I feel would be different had I not had the opportunity to practice. But, as a PhD prepared, tenured faculty member with an active NIH program of research and teaching responsibilities, I am often asked, “How do you find time to continue practicing?”

My response to the question is, I don’t find time. I make time by developing a plan. That plan must include aligning my interests with the interests of institutions, seeking institutions with great leadership, being truly present in my clinical area, and find meaning in the clinical work.

Develop a plan: Creating time for practice means not only figuring out what hours you’ll work, but how you will accomplish follow-up, keep your national certification, when and where to get continuing education, and making sure your teaching, research, and other service responsibilities are attended to while you are in the clinical setting.  This takes time management and careful planning-- making sure that you align the work you do in clinical practice so that it all coalesces around a population or a topic of interest. Do this with the help of an individual development plan at the beginning of the year and using a short term, intermediate, and long-term schedules to accomplish your goals.

Align your interests with the interests of institutions: Aligning your goals as faculty with your goals as a clinician will make you successful. Both the clinical institution and the academic institution have goals and strategic missions. In addition, both institutions benefit from having a practicing academic as an employee. However, both institutions need to be flexible to accommodate the hours that you are not present due to your work at the other. Make sure that what you are interested in achieving, such as being clinically competent and generating ideas for knowledge development, meets the needs of each institution in meaningful ways.  Be familiar with the goals and strategic missions of each institution and discuss how you can contribute to these through your practice, research, and teaching with the leadership of both institutions.

Great leadership: One of the things that I have found to be true in all the institutions where I’ve worked is that I’ve had really great leadership from my deans and department chairs. They have encouraged me to do the things that excite me and that drive my research questions. If you do not have support and encouragement of your leadership, keeping an active practice will be difficult. If your current leaders do not support active practice, seek institutions that have leaders who understand the benefits and challenges associated, yet still encourage you to continue.  

Spend time in your clinical area: While this may go without saying, an active clinical practice is just that, active. This takes time. Sometimes, big chunks of time. For me, that means I spend about at least one shift a week in the NICU. Our shifts are typically long shifts (12-24 hours).  Often it means that I am working during off-hours from the University setting (i.e academic holidays, weekends or night shifts). This time is incredibly important to stay up-to-date on the evidence, your own clinical skills, and the workflow issues involved in clinical research and practice. Include this time in your schedule as well as time needed to recover and attend to your personal life.

Find meaning in the work: Some of my best research questions and most informative conversations come from the interdisciplinary team that I work within the NICU, from the parents of the patients under my care, and from the patients themselves. I enjoy the time that I spend in the NICU environment. I think one of the big benefits it offers me is that it gives me perspective. It reminds me of why I do the work and the patients who are impacted by the work we do. Finally, it reminds me that sometimes when the academic world can be challenging and feel like the never-ending chain of emails and red tape, that nursing science AND nursing care matters to patients. That is why I continue to be a clinician scientist.

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