Healthcare Research

Linda Aiken: Pioneer in Nursing and Health Care Research

Linda Aiken, Ph.D., RN, grew up in the college town of Gainesville, Florida, where much of family life centered around activities at the University of Florida.

For as long as she can remember, she said, she wanted to be a nurse. She would have become a remarkable nurse wherever she had studied, but Aiken’s choice of the new college of nursing at her hometown university proved to be a central decision in her life. Dorothy Smith, dean of the school of nursing, became Aiken’s mentor and role model. The dean noticed her even when she was an 18-year-old freshman.

Aiken believes that Dean Smith, who was also the chief of nursing practice at the university’s teaching hospital, created an ideal nursing environment, teaching the importance of basing the practice of health care upon evidence.

“I’ve always loved nursing, from the first day of school,” Aiken said. “Being a student nurse was intellectually challenging. It demanded competence, good judgment, and forced us to make decisions.” She felt that every new patient presented her with a different puzzle to solve.

Aiken said she also learned from Dean Smith that nurses were professionals who had the responsibility to be inquisitive, see the big picture, and publish. The college of nursing was part of a new health sciences center that emphasized the equality of the disciplines and the importance of interdisciplinary learning. The rich culture encouraged questioning. It fueled Aiken’s curiosity and taught her to consider long-range implications and solutions.

After graduating, Aiken discovered that nursing practice was different from the academic world she had left. Her education had taught her to see far beyond an immediate situation, while nurses in practice focused on what was right before them. Realizing that much of what she saw in the hospital lagged behind that which she had learned in school, Aiken tried to apply her college studies to the outside world of health care. She found herself returning to the principles she had learned in school--ask important questions, do rigorous research, base practice upon evidence, and strive to see the big picture.

Aiken soon experienced the difficulty of being young, new and trying to makes changes in an environment that had been entrenched for years. She said she didn’t want to wait “the 40 years it would take to have the clout” to affirm her ideas. She turned to earning a Ph.D. Not only would she learn more, the degree would give her the respect she needed to put her ideas into practice. It was while she was working on her Ph.D., she said, that she realized she could have an influence on health care. Her doctorate in sociology and demography gave her new tools to ask the right questions and report her findings.

For more than 20 years, Aiken has made major contributions to studies of health care workers and outcomes research. She is recognized for pioneering research using statistical data to link nurse-to-patient ratios and patient safety. Her influential work also includes the development of Magnet hospitals across the nation. She is director of a multi-state study of nursing care and patient safety currently in the field, which involves surveys of 225,000 nurses and the outcomes of tens of thousands of patients in California, Pennsylvania and New Jersey. The study will yield important information on the link between nursing practice and patient outcomes in hospitals, nursing homes, and home care, in addition to providing information on why some nurses have left clinical care.

Hospitals are beginning to make important changes in nursing and improvement of patient safety, she said. She believes that her most important task today is to continue to educate the health care community and the public about the key role nurses play in keeping patients safe.

Aiken has won every major award in the field of nursing and health services research and is a member of many prestigious organizations, including the American Academy of Arts and Sciences and the Institute of Medicine of the National Academy of Sciences.

She is the Claire M. Fagin Leadership Professor of Nursing, a professor of sociology, and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania. Before joining the University of Pennsylvania, she was vice president of the Robert Wood Johnson Foundation. She directs the International Hospital Outcomes Study in eight countries and recently completed a nursing quality initiative in Russia and Armenia demonstrating the applicability of Magnet hospital standards in developing nations of the world.

Originally published on

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