‘Research is the last thing on our minds, we are in crisis’: Experiences of Lagos state nurses towards research and scholarly endeavours

Abstract Aim To explore the experiences of Nigerian nurses in research and scholarly endeavours. Design Descriptive phenomenological qualitative study design. Method In‐depth interviews were conducted among 30 nurses until data saturation was reached. Data were analysed using the thematic analysis method, and consolidated criteria for reporting qualitative research guidelines (COREQ) were adhered to in reporting this study. Results Three themes emerged: (1) challenges of nurses with research; (2) the state of nursing research in Lagos state; (3) strategies to improve the state of nursing research in Lagos state. Some challenges nurses in Lagos State encounter with research include heavy workload and nursing shortage due to brain drain, faulty research foundation, lack of continuing education in research and the stressful nature of conducting research in Lagos. Conclusion As research is essential in addressing healthcare challenges, policymakers are encouraged to employ more nurses to reduce the workload and provide time for research activities. Training and continuing education in research can be incorporated into professional development programmes. Lagos State will benefit from nursing research units in the hospitals, and a coordinating centre for the units should be provided with adequate funding. Support could be obtained from the Institute of Nursing Research Nigeria in establishing these structures. Hospital management should embrace and welcome research output from nurses and ensure such results are implemented to improve patients' care. Nurses who excel in research might be recognised with awards and other incentives to inspire their peers.


| INTRODUC TI ON
Healthcare delivery is becoming more dynamic with various health challenges surfacing, requiring healthcare practitioners and nurses to think critically, systematically analyse situations and make clinically sound decisions . Globally, the research output of nurses has increased over two decades, with developed countries taking the lead and a disproportionate output from low-and middleincome countries (Yanbing et al., 2021). Critical gaps have been observed in nursing and midwifery research in Africa with poor skills and research output, which can be attributed to inadequate funding, lack of job satisfaction, poor access to technology, ineffective interprofessional education and practice and few PhD-prepared nurses (Klopper & Gasanganwa, 2015).
Research capacity in nursing has been defined as 'the ability to conduct nursing research activities sustainably in a specific context' (Chen et al., 2019). Ayandiran et al. (2013) observed that various modifications had been made to the structure of nursing education and practice to improve nursing research capacity in Nigeria.
For instance, nursing education was upgraded from hospital-based training to higher education institutions with a better focus on developing scientific knowledge and research. However, the nursing research capacity in Nigeria is not yet optimal (Ndubuisi et al., 2021).
According to Udoye (2018), postgraduate degree holders are key to determining the quantity and quality of research output in a field. This is because they are better equipped with the knowledge and skills to effectively conduct and disseminate research findings (Klopper & Gasanganwa, 2015). Even while postgraduate degrees, particularly PhDs, are expected to be the source of higher-quality research output in a field, there is a limited number of nurses with these higher degrees in Nigeria. A report revealed that between 1988 and 2014, out of the 880 postgraduate nursing students (MSc and/or PhD) admitted to Nigerian universities, only 88 students could complete the degrees. Similarly, there is a paucity of postgraduate nursing programmes in Nigeria (Onwe, 2018). The state of postgraduate nursing education in Nigeria is expected to influence research output from the country.
According to the study conducted by Oluwatosin (2014)  Some challenges facing nursing research in Nigeria have been documented. They include excessive workload, inadequate staffing, lack of nurse researchers, cost, lack of mentors in nursing research, lack of guidance with disseminating research findings, poor internet service and lack of organisational support (Edet et al., 2011).
Similarly, Oluwatosin (2014) observed the lack of capacity-building programs and facilities in most organisations' nursing units or departments (Oluwatosin, 2014). Furthermore, the Federal Ministry of Health (FMOH) in Nigeria (2015) reported a meagre allocation of funds to research (about 0.08%), instead of the usual 2%, with most of the funds used at the federal level, leaving nothing for the States.
To the best of our knowledge, there is a paucity of recent literature focused on the experiences of Nigerian nurses in research and publications, which prompted this study to explore the experiences of Nigerian nurses in research and scholarly endeavours.

| Study design
As the study focused on exploring the lived experiences of Lagos State nurses regarding research, a descriptive phenomenological qualitative study design (Shorey & Ng, 2022) was adopted. The consolidated criteria for reporting qualitative research guidelines (COREQ) were adhered to in reporting this study. See Supplementary material.

| Participants and settings
The study was conducted among nurses from selected healthcare institutions in Lagos State, Nigeria. Participants were selected using a purposive sampling technique considering various ranks, years of experience and facility (See Table 1). The study was conducted in Lagos State, located in the South-Western part of Nigeria. Lagos State is the smallest in Nigeria in terms of size but has the highest urban population, which was 24.6 million inhabitants as of 2015.
Lagos has a high mix of tertiary, specialist, general and private hospitals (Lagos State Government, 2022).

| Data collection
Individual in-depth interviews were conducted among 30 nurses from February 2022 to April 2022 until data saturation was reached.
Data saturation refers to a state in which new insights or meanings can no longer be drawn from the data collected (Glaser & Strauss, 1967). Each interview took about 30-40 min. The study included all cadres of registered nurses employed and working in any healthcare facility in Lagos State, Nigeria. However, retired nurses and nurses employed in states other than Lagos were excluded. The interviews were conducted online via Zoom. The first and second authors, male registered nurses with PhD and bachelor's degrees in nursing with experience in qualitative data collection, conducted the interviews. An information sheet with the research details was presented to the participants, and their consent was obtained before the interview, after which demographic data were collected. Experts in nursing research developed the semi-structured interview guide from a detailed literature review. The interviews were conducted virtually and were audio-recorded after the participants gave their consent. The structure of nursing cadre in Nigeria is such that years of experience is a major determinant for getting promoted to another cadre. A minimum of 3 years of experience is required for promotion from one nursing officer cadre to the next.

| Data analysis
Data were analysed using the NVIVO 12 software. The authors trained in data transcription did a verbatim transcription of the recordings. Thematic analysis was utilised for data analysis. The six phases include: familiarising with the data, generating initial codes, searching for themes, reviewing themes, defining and naming the themes, and producing the report (Braun & Clarke, 2019;Polit & Beck, 2019). See Figure 1.
Various strategies were taken to ensure rigour in this study.
Credibility and confirmability were ensured through member checking and peer debriefing, while dependability and transferability were ensured through audit trails and detailed method descriptions (Anney, 2014;Elo et al., 2014).

| Ethical consideration
Ethical approval to conduct the study was obtained from the Ethical Review Committee (ERC) of the Lagos University Teaching Hospital (LUTH) and Lagos State Health Service Commission (LSHSC), with approval numbers: ADM/DSCST/HREC/APP/4930 and LSHSC/ DNS/RESEARCH/VOL III/169 respectively. In addition, informed consent was gained from participants before joining the study.
Confidentiality was assured, and the participants' right to refuse to participate was respected. Table 1 shows that most of the respondents were females (76.67%) with bachelor's degrees (60%) working in tertiary settings (56.67%).

| RE SULTS
The respondents were drawn from the various ranks in nursing, with Nursing Officer I having the highest percentage (23.33%). The years of experience also varied among the participants, with 26.67% having less than 5 years of experience in nursing. Although 73.33% had more than 5 years' experience in nursing, 83.33% had less than 5 years' experience in research, and 93.33% had conducted less than five research.
More than 80.00% do not have any publication, and 90.00% had not presented a paper at a local or international conference.  Table 2).

| Faulty foundation in research
Some participants decried the quality of research they were exposed to as students. Some lamented that they did not have good supervisors, while others were not interested in research.
I realised that the supervisors are practically the problem of the students. Some don't know how to simplify supervision; they make it so complex. Because they have the privilege to supervise your project, they take advantage of that to rubbish your work without giving you directions. Research supervisors are supposed to be like mentors, but they often condemn whatever you do without giving proper guidance.
(P20, 40 years, ACNO) F I G U R E 1 Six-Step Approach to Thematic Analysis. …the research I did in the nursing school then was not top-notch; it truly affected my interest in it. Although I knew it was necessary, I did not fancy it. I saw it as an academic requirement to move to the next level.
(P25, 30 years, NO II) We did not take it seriously because of how we were taught. So, my competency is so low; honestly, I cannot regard myself as a researcher.

| Lack of continuing education in research
Many participants also revealed that they had not been exposed to continuing education in research since they graduated from their schools.
…after school, there's no training on research, most of the training we do is just to renew our license and keep the work going-the MCPDP or something….
(P18, 35 years, NO I) 3.1.4 | The stressful nature of conducting nursing research in Lagos A major concern of the participants was the stress associated with conducting research in Lagos state.
Conducting research in this Lagos state is a bit stressful. Like the last I did on children with neuro disorders, sometimes, before I get there, it's already rowdy; mothers are not patient. If I give out ten questionnaires, hardly will I get five back because everybody is concerned about seeing their doctors. Even after that, they just want to go home. Even for me, moving from Ikorodu to Lagos Island to go and get data is very stressful.
(P18, 35 years, NO I) 3.1.5 | Brain drain Another major challenge that emerged was the loss of nurses that are good with research through migration for greener pastures.
…those nurses I know that are excellent in research are leaving the country for better jobs, and once they go, they go with all their intellectual abilities.

| Poor institutional support
The participants lamented their institutions' poor support in academics and research.
And another thing is that the system does not encourage you like you want to do research okay o, let's give her two weeks break because she's doing research, nooo, you will do it on your normal duty, who sent you research (laughs). Even if they take you to the nursing leaders, they will tell you, who sent you, is it part of the work we employed you to do….
(P25-30 years NO II) TA B L E 2 Themes and Sub-themes.

| Support from institutions, governmental and non-governmental organisations
The participants also emphasised the need for more support from the relevant stakeholders in the State.
…if Lagos state can do it in a way that upon approval, researchers will be given a time frame to conduct their research with job security.

| Involve young and male nurses in research
Some participants observed that male nurses seem more interested in research and can mobilise the younger nurses; hence, they recommended that they be involved in research.
Male nurses are learned, and I think they are interested in research. If they can be approached because they influence the junior nurses, I think they will know how to mobilise others.

| DISCUSS ION
Clinical decision-making is based on sound, evident, valid and currently available research output which helps in optimal healthcare (Coyne et al., 2016). Nurses are open to various roles in research ranging from being a participant or investigator to an end user, i.e. utilising the outcomes (Hernon & Dalton, 2019). However, being an investigator and also utilising outcomes require knowledge and experience in research.
This study aimed to explore the experiences of Another major challenge pointed out by this study was the poor institutional support nurses that nurses receive. Lagos is a diverse and overpopulated state, with many clinical responsibilities placed on nurses. Unfortunately, due to short-staffing, hospitals do not approve leave or break for workers to participate in research activities, which further reduces nurses' interest in carrying out research. This challenge aligns with the finding of Asuquo et al. (2013), which indicated that most nurses are not well represented at the institutional level in decisions related to research. Furthermore, the Nigerian health sector is currently witnessing the "brain drain" phenomenon, wherein the country's best professionals are leaving the country for academic or professional purposes (Lawal et al., 2022). This has affected all aspects of healthcare delivery, including research activities (Olorunfemi et al., 2020). This study revealed that the migration of nurses out of the country is a challenge affecting research capacity as many that are good at research are leaving the country's shores, taking along all their intellectual abilities.
The second theme reflected the state of nursing research in Lagos state. Findings from this study showed that although research is mandatory for awarding a nursing certificate from diploma to postgraduate level (Emelonye et al., 2016), most nurses do not get involved in clinical research after graduation, re-iterating the poor attitude of nurses to research. This is consistent with the study carried out by Abam et al. (2014), where nurses were found to have a low motivation towards research due to a lack of enabling environment and support. There is, therefore, a need to motivate nurses to see research as an integral part of their practice while also providing support and encouragement to carry out research. Perceived research competence among nurses in this study was placed at an average. Although a study by Grande et al. (2021) showed that most nurses are familiar with the research process. However, training programmes for nurses are crucial to developing competence in research (Wu et al., 2019).
The third theme for this study was the strategies to improve the state of research in Lagos state. Enlightenment of nurses on the importance of research was one of the major strategies. Furthermore, as the need to improve funding of nursing education in Nigeria has been identified in the literature (Arowolo et al., 2023), adequate funding to cover research expenses will go a long way in increasing the research capacity of nurses (Torres et al., 2017). In addition, the

| Implication for policy
To improve the research knowledge and skills of Lagos state nurses, policymakers in nursing should incorporate training and continuing education in research into the professional development programmes. Also, as time is a significant constraint to conducting research, nurses can be given a break or leave for research activities.
Hospital management should embrace and welcome research output from nurses and ensure such results are implemented to improve patients' care. Lastly, awards and other means of motivation can be used to encourage research participation.

| Strength and limitation
As this descriptive phenomenological qualitative study was conducted among a few nurses in Lagos, Nigeria, this might not reflect the experiences of nurses in other States in Nigeria, which might limit the generalisability of the study. Hence, this should be considered when interpreting the findings. However, this study has addressed a significant gap in the literature.

| CON CLUS ION
This study has provided insight into the experiences of Lagos State nurses in research alongside the challenges they face and strategies to improve their research capacity and that of nursing departments in the state. It is hoped that suggestions from this study will improve the state of nursing research in Lagos state.