The Nordic state of nursing research: The case of Norway

The evolution of research into nursing in Norway began in the 1950s, driven by pioneering individuals who sought to establish a foundation for systematic inquiry in nursing. However, it was not until the 1980s that research into nursing gained real momentum and became recognised as an academic domain. ¹ This development is closely linked to the institutionalisation of nursing science within higher education. Key milestones include the establishment of the Nursing Teacher Education programme at the University of Tromsø in 1977, the Department of Nursing Science at the University of Bergen in 1979 and the Department of Nursing Science at the University of Oslo in 1985. Together, these institutions played a decisive role in formalising nursing science as an academic discipline, creating a foundation for advanced education and sustained research activity. ¹ Since the 1990s, there has been a steady and substantial increase in the number of registered nurses (RNs) pursuing advanced academic qualifications, including master's and doctoral degrees, within Norwegian higher education institutions (HEIs). This growth has contributed to the broader recognition of nursing as a scientific discipline and strengthened the knowledge base underpinning clinical practice. The cumulative effect of these developments has been the gradual establishment of evidence-based nursing practice and meaningful contributions to the quality and organisation of healthcare services. Nevertheless, we appear to be standing at a critical crossroads. In recent years, nursing science environments have increasingly been dismantled or absorbed into broader health science structures. Today, research into nursing at Norwegian universities is largely conducted under the umbrella of health sciences rather than within dedicated nursing science units. This structural shift is not without consequences. McKenna and Thompson ² have warned that the future of nursing research is under threat in several countries. Although it may be premature to claim that Norwegian nursing research faces an imminent crisis, the erosion of independent nursing science environments should be a cause for concern. Complacency at this stage risks undermining decades of progress. In this editorial, we identify three interrelated challenges currently facing nursing research in Norway and propose strategic directions to mitigate their consequences and strengthen the future of nursing science.

Challenge 1: when recognition meets retrenchment: capacity under threat

The 12 May 2020 marked a significant milestone in the history of nursing: the 200th anniversary of Florence Nightingale's birth. Celebrated globally as International Nurses Day, the occasion coincided with the World Health Organization's designation of 2020 as the Year of the Nurse and the Midwife, highlighting the indispensable role of these professions in healthcare systems worldwide. Even The Lancet, one of the world's most prestigious medical journals, devoted a full weekly issue to nursing science and its contributions to health. ³ In Norway, however, this symbolic celebration was accompanied by a strikingly contradictory development. On the very same day, the Faculty Board of the Faculty of Medicine at the University of Oslo decided to close the Department of Nursing Science and merge it into the Department of Public Health and Interdisciplinary Health Sciences. This decision followed the discontinuation, in 2019, of the research-oriented master's programme in nursing science – a programme that had been instrumental in advancing nursing knowledge and producing a substantial number of doctoral graduates. With the implementation of these decisions, Norway no longer has a formal, standalone nursing science environment at university level.

This juxtaposition of international recognition and national retrenchment raises fundamental questions about the status and future of nursing research in Norway. While the global community increasingly acknowledges the scientific and societal value of nursing, national structural decisions risk weakening the discipline's capacity to generate knowledge, educate future researchers, and contribute meaningfully to healthcare development. For a profession central to patient care and health system sustainability, this trajectory warrants serious reflection and renewed commitment. To expand and sustain academic capacity in nursing, Norwegian universities and university colleges must prioritise doctoral education for nurses. Investing in doctoral-level training strengthens institutions by ensuring access to qualified academic staff while simultaneously advancing the discipline through active, practice-oriented research. At the same time, the healthcare sector's demand for robust, evidence-based knowledge continues to grow. However, many research environments struggle to meet this demand due to limited funding, fragmented organisation, or insufficient alignment between research questions and clinical realities.

Challenge 2: beyond isolated projects: toward programmatic nursing research

Despite clear growth in volume and visibility, nursing research in Norway continues to face methodological and structural challenges that limit its capacity to deliver robust and practice-changing evidence. An evaluation by the Norwegian Research Council in 2011 recognised that nursing research holds considerable potential to transform care practices and improve patient outcomes. At the same time, the evaluation concluded that, with few exceptions, research efforts within nursing were not sufficiently equipped to deliver the high-quality evidence required to inform and advance clinical practice. ⁴ The identified challenges were attributed to the field's early stage of development, the small size of research communities, a lack of well-defined research questions, methodological limitations, and a tendency to focus on already saturated research topics. These findings align with concerns raised by prominent researchers since the early 2000s and frequently captured under the concept of “research waste”.^5–10 Even so, some promising tendencies can be observed in the Norwegian context.

A study analysing 50 PhD theses defended at the University of Oslo between 1996 and 2016 demonstrated that nursing research had evolved from predominantly small, descriptive studies toward larger implementation-oriented projects aimed at identifying what works, for whom, and under which conditions. ¹¹ This development corresponds with observations by McKenna and Thompson, ² who describe how nursing research over the past 50 years has progressed from isolated, small-scale projects to more theoretically grounded, methodologically diverse, clinically focused, and collaborative studies. This progress is reflected in nursing researchers’ performance in national evaluations, leadership of interdisciplinary research teams, success in securing competitive funding and the gradual expansion of research capacity through an increasing number of doctoral-prepared colleagues. This trend is also evident in Norway. For example, an international bibliographic analysis of publications from funded projects ranked Norway tenth out of twelve countries, with a steady increase in publication output from 2008 to 2018 across all countries included. ¹² Despite these positive developments, increasing educational demands pose a growing risk. As HEIs place greater emphasis on educating larger numbers of nurses, academic staff face increasing constraints on research time. This situation threatens both individual professional development and the continued advancement of nursing science as a research-based discipline.

In March 2025, a new national evaluation of research within medicine and health in Norway was published, ¹³ reaching conclusions largely consistent with those of the 2011 evaluation. ⁴ Many nursing research groups producing lower-quality research consist of only a small number of permanent researchers, many of whom work part-time on research while carrying heavy teaching responsibilities – particularly within university colleges – or substantial clinical duties in healthcare services. Under such conditions, it becomes exceedingly difficult to meet the rigorous and resource-intensive methodological requirements associated with internationally competitive research. These challenges are especially pronounced outside the major cities, where hospital trusts and HEIs are smaller due to limited population bases, making the establishment of larger and more robust research units unfeasible. In addition, the national committee observed that the integration of research with knowledge translation, implementation, and implementation science remains underdeveloped. There is often a lack of a continuous and coherent process linking research findings to intervention development and, ultimately, to implementation in nursing practice and healthcare services.

Therefore, advancing nursing research in Norway requires stronger strategic collaboration and a methodological shift from isolated, project-based initiatives toward more coherent, programmatic research frameworks. A long-term, nationally coordinated approach may enhance methodological rigour, facilitate a stronger focus on intervention studies and support the investigation of complex healthcare challenges over time. Programmatic research refers to a series of coordinated projects designed to align with a shared strategy and collectively contribute to a common overarching goal. ⁶ Such an approach does not necessarily require research to be organised within traditional, formal research programmes. Strategic research platforms represent a more flexible alternative, addressing some of the limitations associated with conventional programmes, including exclusivity and limited capacity to accommodate diverse perspectives. A platform may be understood as a collaborative framework defined by shared principles, strategic plans and arenas for interaction that connect projects and researchers across institutional and disciplinary boundaries. ¹⁴ An example of this approach is the CARE research platform at Lovisenberg Diaconal University College, where several projects are developed within shared theoretical and methodological frameworks. ¹⁵ This model facilitates both intra- and interdisciplinary collaboration and contributes to the production of cumulative, evidence-based knowledge with clear relevance for clinical practice and health policy. ² Taken together, these findings suggest that the central challenge is no longer the absence of nursing research activity, but rather the need for greater methodological coherence, strategic coordination, and sustained investment to ensure that nursing research can realise its full potential.

Challenge 3: who will lead nursing research? recruitment, leadership and sustainability

Today, Norway awards a substantial number of doctoral degrees to RNs, and Norwegian nursing researchers contribute a significant volume of publications, several with international impact. Despite this progress, persistent structural and demographic challenges threaten the sustainability of research into nursing.

A Norwegian inquiry from 2018 found that only a small proportion of PhD candidates within health research were RNs and that RN candidates tended to be older than the average doctoral candidate, resulting in shorter postdoctoral careers and potential recruitment challenges linked to retirement. ¹⁶ In 2022, the average age at PhD defence among nurses was 48 years. ¹⁵ Based on both experience and curricular developments – particularly the increased emphasis on research methods in undergraduate nursing programmes – it is reasonable to expect this average age to decline in the coming years. Increasingly, the PhD is viewed not as a capstone at the end of a clinical career but as a genuine research education opening pathways to sustained academic careers. Nonetheless, recruitment to doctoral positions in nursing remains challenging. Relatively low PhD salaries make these positions less attractive compared to clinical roles, particularly in the context of widespread nursing shortages. Addressing this imbalance requires strategic leadership and institutional commitment to making academic career pathways competitive and viable.

Strengthening national and international collaborations among nursing researchers is essential for building resilient research environments and sustainable and strategic research platforms. Such partnerships facilitate the exchange of expertise, shared infrastructure and methodological innovation. While interdisciplinary collaboration is critical to addressing complex healthcare challenges, its success depends on each discipline contributing distinct theoretical perspectives and methodological strengths. Nursing must therefore continue to articulate and develop its unique scientific contributions within interdisciplinary contexts.

Such collaborations enable the sharing of expertise, resources and perspectives, all of which are essential for addressing the complex and multifaceted challenges facing contemporary healthcare systems. Fostering interdisciplinary research is widely recognised as a key driver of innovation and scientific advancement. However, for interdisciplinary collaboration to be genuinely productive, each participating discipline must contribute clearly articulated theoretical frameworks, robust methodological approaches and discipline-specific insights. Nursing, therefore, must continue to develop, consolidate and articulate its distinctive scientific contributions to participate on equal terms within both intra- and interdisciplinary research teams. A strategic emphasis on long-term, programmatic research initiatives – rather than a predominant reliance on short-term, project-based efforts – can provide the continuity, critical mass and conceptual depth required to build sustainable research capacity and to generate high-quality, impactful and enduring knowledge. Such an approach involves deliberate investment in research infrastructure, systematic mentoring of early-career researchers, and the establishment of incentives that promote collaboration across sectors, institutions and professional boundaries. By prioritising these interconnected strategies, research into nursing in Norway can strengthen its credibility and position itself to produce knowledge that meaningfully informs clinical practice, health policy, and nursing education over time.

Concluding remarks

Nursing research in Norway has reached a level of maturity that requires deliberate and informed stewardship rather than further structural dilution. At a time when healthcare systems increasingly rely on nursing competence to ensure quality, safety and sustainability of care, weakening the scientific foundations of the profession is not merely short-sighted but potentially detrimental to future healthcare development. Decisions concerning the organisation, leadership, and resourcing of nursing research will be decisive for whether nursing science continues to evolve as a distinct, credible and influential discipline, or gradually becomes marginalised within broader health research landscapes.