Perspectives on the Experience and Role Adaptation of Nursing Doctors in Hospital Environment

We read with interest the recent article by Hengyu Hu et al., ‘Experiences and Role Adaptation of Nursing PhDs in Hospital Settings: A Qualitative Study’ (Hu et al. 2025), published in the Journal of Advanced Nursing. Through in-depth interviews, this study sheds light on the multidimensional challenges and developmental potential faced by nursing PhDs in Chinese hospital settings—a research gap that has been underexplored, particularly in non-Western contexts. As healthcare systems worldwide strive to integrate doctoral-level nurses to bridge the research-practice gap (Hassmiller 2021), this study is both timely and valuable. We commend the authors for their nuanced analysis of professional motivations, role conflicts and systemic barriers. Building on these findings, we offer three constructive suggestions to further optimise the integration and effectiveness of nursing PhDs in clinical environments. First, clarifying clinical–academic role structures (clinical–academic tracks) is necessary. Building on Hu et al.'s observation of role conflict, we suggest the use of structured clinical–academic posts to address ambiguity. The ‘high expectation–low adaptation’ dilemma (Cusack et al. 2023) shows that nursing PhDs struggle to balance clinical and research roles without dedicated posts. Hospitals could implement hybrid positions—such as ‘clinical researchers’ or ‘nursing innovation consultants’—with clearly defined responsibilities and metrics valuing both research and clinical impact. Providing dedicated research time (e.g., 1–2 days per week) and team support would also reduce isolation among PhD-prepared nurses. Second, doctoral education should be aligned with practice (rotations, DNP pathways and dual supervision). Hu et al. reported that research-focused nursing PhDs often lack clinical skills, as current programmes emphasise theory over clinical training. To remedy this, we recommend integrating mandatory clinical rotations, advancing practice-oriented pathways such as the DNP, and instituting dual supervision by pairing academic mentors with clinical experts. These measures ensure that doctoral training addresses real-world clinical challenges and improves workplace readiness. Third, strengthening organisational support (career pathways, flexible policies and childcare). Hu et al. identified work–life imbalance and unclear career pathways as major stressors. In response, we propose the implementation of structured career development plans, tailored transition programmes for new PhDs and regular professional satisfaction assessments. Flexible working arrangements and institutional childcare support could further alleviate personal burdens, particularly for early-career female PhDs, thereby enhancing retention and long-term professional growth. Hu et al. highlighted the tensions between individual aspirations and institutional realities for nursing PhDs in China. Their work has catalysed important dialogue on the global integration of doctoral nurses into healthcare systems. We appreciate their insightful research and encourage further studies to develop and evaluate scalable models of clinical–academic integration for nursing PhDs. Thank you for considering our feedback. We look forward to further development in this area. The authors have nothing to report. The authors declare no conflicts of interest. The authors have nothing to report.