How Nurses Can Make Better Financial Decisions

How Nurses Can Make Better Financial Decisions

Few nurses have a solid grounding in personal finance about making decisions about their own financial future. Money management can be overwhelming. But you don’t need to learn the fine points of microeconomics – just the fiscal facts that pack a wallop on your wallet.

The good news is that the economic outlook for most nurses is rosy. Employment prospects are strong, says Donna Cardillo, RN, nurse entrepreneur and inspirational/motivational speaker. “The job market for nurses is much better. The market is cyclical and always has been. The last slump lasted about seven years, but that has all changed and many employers are now offering sign-up bonuses,” she explains.

The bad news? Many nurses still struggle to lead financially empowered lives, rather than being slaves to debt or just getting by paycheck to paycheck. Here are nine ways to make powerful personal and career decisions.

Evaluate an Employer’s Salary and Benefits Package

Often nurses decide to accept a job offer based only on the hourly wage, without being aware of the entire salary structure and how it can drastically pump up your pay.

Jon Haws, RN, CCRN, nurse educator and founder of NRSNG, wrote a popular article about how he doubled his first-year earnings as a new nurse. In “How I Made Over $70,000 My First Year as a Nurse (how I learned to game the system),” he recounts his experience as a newly graduated critical care nurse at a Level I Trauma center in Dallas, Texas.

According to Haws, that article “is a bit dated and I realize the $70,000 is nothing to a California nurse, but I outline some step-by-step ways to really maximize what you can make right out of school.”

Some of his steps included grabbing the pay differential for nights and weekends, getting an automatic raise after 6 months and a year, and working overtime and bonus shifts. That strategy requires that you make yourself an expert on your HR department or union contract rules, of course, which may be difficult before you’re hired. Not every employer is transparent about its pay policies. It’s easy enough to check Payscale.com or Salary.com for comparisons. Also, be sure to consult with a tax professional about the ramifications of higher compensation—you want to be ready when the tax bill arrives.

“The benefits package is something that employees don’t always take into consideration, but it can be significant,” says Launette Woolforde, EdD, DNP, RN-BC, vice president for nursing education and professional development at Northwell Health in New Hyde Park, New York.

She encourages nurses to plan for the next step of their education and especially note those related benefits. “Some organizations offer employees some sort of tuition reimbursement plan. When you get a job and get through adapting to your new role as nurse, that’s the time to take advantage of those benefits.”

According to Woolforde, some organizations provide employees with a discounted rate or deferred payment options for a number of nursing schools. “So a $500 a credit may be reduced to $400 a credit and the student isn’t invoiced until after the class is over. By then the tuition reimbursement will have kicked in so students don’t suffer out of pocket expenses that disrupt their cashflow,” she says.

In addition, many organizations pay a stipend or differential based on a nurse’s educational achievements. “For example, let’s say the salary is $50,000 a year to start, but if a nurse has a bachelor’s degree, they may add $5,000 a year. If you’re certified they may add even more,” she explains.

Decide on Your Financial Priorities and Make Every Step a Learning Point

There may be a sunny employment outlook for nurses, but you still have to earn and save to fund your priorities. Not every nurse will have the same financial needs and not every nurse will experience life transitions in the same order. Yet, there are some goals, such as starting a family, buying a house, or early retirement, which many nurses aim to achieve and can—with some work on their inner and outer game.

“I made $35,000 or $45,000 my first years in nursing and had to figure out a way to increase income or reduce spending,” says Brittney Wilson, RN, BSN, nurse influencer at TheNerdyNurse.com. “I opened the door to those possibilities.” Wilson carried $40,000 in student debt that she now believes was avoidable, if she’d lived at home, attended a community college, worked a part-time job, etc.

As a young wife and mother, she tried many methods to economize, as she wasn’t emotionally able to work more hours at the bedside. “One example, I tried extreme couponing and was able to take our $600 grocery bill down to $100. I had to figure out a way to get diapers and formula for my baby,” she explains. Wilson started her blog a couple of years later, mainly for personal expression, but she also started getting free products and fees from brands. “People kept offering me money but initially I felt some guilt about it,” she says. “When I came to terms with it and actively decided to monetize my blog, I hung the ‘I’m available to be paid’ shingle directly, and even more offers came in.”

As Wilson felt more and more confident that she was providing a valuable service, she increased her ad and consulting rates, and focused her blog on her nursing specialty. “Earning extra income is like walking down a hospital hallway. It’s a journey. You can open each door and look around or keep going down the path. Just keep opening doors until you find the one that is right for you,” she advises other nurses.

Wilson got so good at earning and saving that she and her husband are on-track to pay off their house mortgage in a little over five years.

If you’d like to get better at the nuts and bolts of budgeting, bill paying, and tracking various financial accounts, you may want to try apps and programs like Mint.com. By corralling everything into one place, you get a better handle on your spending and saving, and can see in charts and graphs how well you’re doing with your finances.

There are also minority personal finance experts you can follow for advice from someone who figuratively speaks your language. For example, African American pros include Michelle Singletary, who writes “The Color of Money,” for The Washington Post and syndicates. Or, if you prefer podcasts, Rich Jones and Marcus Garrett host Paychecks & Balances for Millennials aiming to pay down debt

Decide When to Make Major Purchases

Even if a purchase is appropriate for your life stage, try to minimize your total household overhead. Even well-paid nurses risk fatigue from worry or overwork to manage bills and payments for one-time splurges or ongoing financial commitments.

Woolforde encourages nurses to carefully consider whether a major purchase is a sound money investment. “I see this often—the first thing a nurse graduate buys is a flashy, brand new car, as a reward for all that hard work in school. A flashy new car is nice but it’s a rapidly depreciating item as opposed maybe holding out for a down payment on a new home that appreciates for a good long-term return,” she explains.

You might decide that your next major investment will be in your own higher education or specialized training. If so, be sure to take advantage of employer-provided assistance programs before taking out large student loans. Maybe your current workplace has a tuition reimbursement plan if you’ll commit to working there after graduation, but you hesitate to limit your options. Find out how often graduates using that program decide to stay with that employer; usually the figure is high. If your circumstances and goals match theirs, you’re likely safe in taking the same route.

So many students lament how little they knew about educational loans that a free interactive game called Payback was created by a financial literacy non-profit. The makers warn: “College can help you realize your dreams, unless it leaves you with a student loan nightmare.” Students navigate an online maze of decisions: What school to attend, what major to declare, whether to focus on studies for a higher GPA or social life for more connections, etc. At the end, if a player does decide to borrow educational funds, it’s with eyes wide open.

Choose a Specialty That’s Fulfilling—And Remunerative

Whether you’re a new nurse graduate or you’ve been in the field for years, now might be a good time to switch to a specialty or workplace with better long-term prospects for pay and benefits.

Cardillo encourages nurses to explore non-traditional career options and to take risks. “Your next job may not pay as much, but may have many other advantages. When it comes to being a bedside clinical nurse in a hospital, there’s only so much you can make, even with overtime. Some other health care related industries have greater earning potential over the long run even if you have to take a pay cut in the short term,” she says.

Cardillo points to a variety of popular nurse settings and roles that pay well, such as: Nurse informatics, quality management nurse, corporate wellness nurse, insurance nurse, or nurse consultant.

You may also want to check out DiscoverNursing.com for interactive features that guide you through the process of choosing from scores of specialties. Some under-the-radar titles have surprising rewards, including high demand or ease of entry. You’ll get information on the education, training, and certification required to fill a role, as well as its average salary and employment outlook.

Decide to Cut Hours or Leave the Bedside Altogether

Reducing your hours to, say, care for a family can be a difficult choice that depends on many conditions, but it can be the right choice, if done right.

“If you opt to get out of the job market for a while, stay in touch with nursing colleagues through professional associations [and] keep up with credentials and licenses,” advises Cardillo. “Keep yourself current, marketable, and connected.” She warns that nurses who let their licenses lapse—accidentally or not—won’t be ready to jump back in when they need to or want to.

“Some nurses drop out of the workforce to take care of elderly parents, but then the parents die and they’re left with literally nothing and can’t find a job,” she warns.

Cardillo recommends that you first explore opportunities to work at home, which are more common today for nurses. If that’s not possible, check to see if your state allows for an inactive status license, rather than outright letting it lapse.

Another life stage when nurses may be tempted to let their license lapse is at retirement, but Cardillo sees downsides to that. “Nurses retire, but after so many years they get bored or financially need to work again because they don’t want a lower standard of living.”

Care for Yourself and Your Career Longevity

“Nurses are leaders—they advocate for their patients, but they struggle with advocating for themselves,” says Diane Neustadt, director of operations at New York-based Forest Hills Financial Group.

Her firm supports the National Association of Hispanic Nurses New York chapter, of which Neustadt is an active member. Because of her involvement with the chapter, she’s able to explain the importance of managing one’s own financial life in terms that nurses relate to. “I tell them it’s like being proactive about your own health. Nurses work long, unpredictable hours so self-care is so important: physically, emotionally, and spiritually. I’m a spiritual person and also know the importance of financial well-being—live one day at a time but not just for today.”

Neustadt believes in “protection first,” which means having enough insurance and the right kind. “Employer-sponsored benefits are a good thing,” she explains, “but not only may company benefits not be portable and go with you, generally those employer-provided benefits are minimum benefits and should be viewed as the base of benefits to build upon. Three areas that normally need attention are disability, additional retirement income, and long-term care.”

Make the Most of Expertise from Family, Friends, and Coworkers

Woolforde received informal money mentorship from two unexpected sources who guided her to become financially savvy. The first was her older brother, who went to college when she was in her senior year in high school and was surprised at the expenses beyond tuition that he hadn’t anticipated. “When he came home at his first break he told me frankly, ‘You’re going to have to get scholarship money if you plan on going to college.’ So, we spent countless hours in the library combing through books and catalogs looking for scholarships. That was before everything was available online.”

She was doubtful about her ability to garner scholarship funds—others will have a higher GPA, more financial need, better applications. “At first, I said, ‘there’s no way I’m going to get it’ and he said, ‘you don’t know until you try,’” she explains. After piecing together several small scholarships—$600 here and $2,000 there from various sources—Woolforde was able to fund her freshman year at a commuter college. Good grades allowed her to garner full scholarship funding for the rest of her bachelor’s degree in nursing.

Woolforde next got valuable advice from a nurse preceptor who insisted they visit the hospital credit union after one shift. “She helped me open a retirement account and set up direct deposit of part of my paycheck into that account. I was just starting my career, so retirement was the farthest thing from my mind as a 21-year-old,” she says.

Try to find a money mentor who understands your situation and connects or relates to you in that way, advises Woolforde. “My brother understood the home situation and my preceptor maybe recognized me as her younger self—she was an African American female, too. Everyone who has walked this path, grown in professionalism, grown in a nursing career, it’s our responsibility to share what we’ve learned,” she says.

Make the Most of Your Employer’s Financial Programs

Your organization may offer employee benefit education, such as having an HR representative provide short updates at staff meetings, or making a vendor available for one-on-one consultations. Take advantage of these resources if they can help you fill in the financial puzzle pieces of your life.

“My family emigrated from Armenia when I was nine years old,” says Anna Dermenchyan, RN, MSN, CCRN-K, senior clinical quality specialist in the Department of Medicine at UCLA Health and a PhD student at UCLA School of Nursing. “At the time, my parents didn’t know the language or the culture, and thus we struggled financially as a family.”  When she worked at a bank as a senior in high school, she learned about financial concepts and became more proactive about managing money.

Dermenchyan now actively engages with the University of California system’s excellent financial program for employees and students, which include onsite classes as well as live webinars on financial wellness and retirement.

“I’m an early Millennial and we think about work-life balance and living in the moment, and this necessarily doesn’t help us save enough money for the future. We want to earn, spend, travel, and just enjoy life,” she explains. “However, financial health is part of achieving wellness and maximizing potential benefits for the future. Just like with Maslow’s hierarchy of needs—personal finance is at the basic level, and everything rests on it.”

Most nursing schools don’t include a financial component in the curriculum, so many workplaces fill in the gaps with seminars, consultations, and program “nudges” to encourage fiscal health. “At first, I just put in $100 a month towards retirement; that’s what I could afford after paying loans and family expenses,” says Dermenchyan. “The automatic deduction from each paycheck makes it easier, and some institutions make a matching contribution. In addition, I was advised by a financial consultant that with every salary increase, I should increase my contribution to retirement,” and she has continued to ramp up her rate of saving and investing.

Prepare for Retirement

Some nurse leaders point to numbers of disengaged older nurses who are forced to continue working because of under-funded retirement plans. They didn’t put aside enough money for the future, and early social security payouts at 64 are too small to support even modest lifestyles.

“Nurses are unlike other caring professions—police, firefighters, and teachers—because they don’t earn pensions from municipal government employers,” says Ric Edelman, a #1 New York Times bestselling author of personal finance books such as The Truth About Money and The Truth About Retirement Plans and IRAs. “That puts their financial future in jeopardy.”

Edelman is also the founder of Edelman Financial, one of the nation’s largest independent financial planning firms. His firm offers a free financial plan to nurses, waiving its customary fee for the two-meeting process—either in person or via teleconferencing—which results in recommendations for investments, insurance, estate planning, and more.

By starting the process toward financial stability and independence, you can empower yourself as an earner, saver, and investor. It is possible to experience the feeling of security that comes from having your financial life firmly in hand. This moment is the best time to take that first step.

Ace the NCLEX and Clear the Final Hurdle to Practice

Ace the NCLEX and Clear the Final Hurdle to Practice

Often it’s not nursing knowledge that makes the difference in passing nursing boards, but having strategies for answering questions so that it’s apparent that you really “get it.” There are ways to prepare for what is often a daunting test so you can take it with complete confidence that all the time, money, and hard work that went into nursing school won’t go to waste. We interviewed experts, educators, and other nurses who aced these exams—first time around or later—and share their most helpful hints with you here.

Jake Schubert, RN, BSN
Travel nurse and executive director of Nursity.com, an online NCLEX strategies and review course

jake-schubert1. Carefully consider your options.

“The average candidate takes one or two prep or review course, and spends an additional 40 to 50 hours on other independent study,” according to Schubert. He recommends that students talk to their peers about their experiences and read online testimonials. In addition, check to see if your school has partnered with a test-preparation program. “Some schools provide review courses as part of the capstone curricula—ATI, Kaplan, and HESI are the big corporations with relationships with many of the schools. Most students take an additional course as well,” he adds.

2. Understand the NCLEX format and how it works.

“When you intimately know the beast, it won’t be as intimidating,” says Schubert. Because this is a computer adaptive test that uses algorithms, it’s different from every other test students have taken in their entire academic career. You must also prepare for it differently. “If you did exceptionally well or performed extremely poorly, the exam will end at 75 questions,” he explains. But if you are somewhere in the middle, it can go up to 265 questions to assess how well you know the material and whether you’ll be able to perform as a nurse in a safe manner. (See Schubert’s YouTube video—“How to Pass the NCLEX with a 58%” for more details about this type of test.)

3. Strategize how you will approach questions in which you don’t know the answer.

Most students who graduate from nursing school have sufficient content knowledge, but because the test is computer adaptive it will find an area where you are weak, says Schubert. “The NCLEX will assess your judgment as much as anything else.” What will you do when you don’t know what to do? You need strategies for these types of questions. “How do you answer a question about content you never learned? Strategy. Ask yourself, ‘Why did they write this question? Is it a medication question? A judgment question?’ As a new graduate nurse, that’s all you do all day, is try to figure out what to do in situations you don’t necessarily fully understand. This is much of what the NCLEX is assessing—will you make a safe decision?” he adds.

4. Don’t wait to study or take the exam.

The longer you wait, the more you forget, and the worst you score. “Take the exam immediately after graduating from nursing school,” Schubert advises. “Begin studying for the NCLEX before you graduate, to keep the material fresh in your mind, which will improve your score. Pass rates go down the longer a candidate waits after graduation,” he says. To find out more about pass rates, we recommend you go directly to the source: the National Council of State Boards of Nursing website at www.ncsbn.org.

5. Figure out the best way for you to study, and then stick with your plan.

“Keeping to a study schedule and certain days and times is important,” says Schubert. “But don’t cram. Instead, spread it out over a longer period.” He also recommends reducing distractions, such as television, devices, and social media as well as calls or visits from family and friends. Make sure your study area and equipment are well set up so that you’re comfortable during each study session. Then take frequent breaks so that you don’t deplete your energy, and switch among various subjects every half hour or so to maintain focus.

Launette Woolforde, EdD, DNP, RN-BC
Vice president of system nursing education at Northwell Health in New Hyde Park, New York

launette-woolforde1. Find a role model with a similar background.

“When you don’t have minority role models that reflect who you are, it can hamper your optimism and pursuit of certain goals,” says Woolforde. “For example, I remember reading that 12% of the U.S. population is African American, but only 2% of nurses in the workforce are African American.” The lack of role models may extend to educators, staff, and mentors who can help monitor and guide students. On the other hand, those missing pieces of the career puzzle “can serve to motivate students to start a new trend and make a clean break from what’s happened before,” she adds.

2. Be aware that factors such as language, cultural norms, and your environment can influence your standardized testing experience.

Being a first-generation nurse or college student, for example, means you have to figure out your own way around in academia and career preparation, says Woolforde. “Minority nurses might not fit the norm in their family or culture. But I’m happy to see so many nurses exceeding these norms. Soon, minorities will be the majority in the U.S.”
Minority test-takers may have to “think against” their own cultural norms, cautions Woolforde. “Maybe in your culture women do not make decisions. You have a question about a patient coming into the ER—a male with a wife—and the wife is upset and vocal about it. How would you answer the question? The correct response is ‘Reassure the wife,’ but what if in your culture, wives aren’t spoken to? A wife may be dismissed in that culture.”

3. Do two or three things to “pump yourself up” each day.

“Overthinking and overprocessing while studying is a problem,” says Woolforde. “Don’t try to master everything. Do a little bit every day. Take tests over and over. Spend more time doing practice tests than in reviewing your general knowledge.” Some review services provide assessments, so take a look at your pharmacology scores, for instance, and decide if you need to allocate more time to that section of the test. Nursing students know a lot, but when they look at the questions they may not understand what the question is really asking. “It’s not ‘What is this medication for?’ but more about ‘What would you do to prepare a patient?’ For example, if a patient is taking Lasix then he needs a diet that’s rich in potassium,” she says. “Review what you’ve learned over the years. Believe in yourself. You’ve come this far, so you can pass this exam. There’s great positivity that comes from that belief. There’s power there.”

4. Don’t let fear hold you back.

Fear of failure and fear of the unknown are two major hurdles for many minority nursing students, says Woolforde. “They ask, ‘Am I smart enough?’ They’re afraid that they’ll fail the test because they don’t know the right answers. They’re afraid there’s material that they didn’t get in school or that they didn’t study it enough. I usually tell them all that might be true—you might not know the answer outright. But you can usually rule out two answers and reduce your choices. Then reread the question, think about it, and let the right answer surface,” she advises.

5. Think beyond the NCLEX.

“Even during your orientation, you can be thinking about specialty certification,” says Woolforde. “If you work in oncology and pediatrics but like peds, then you may decide, ‘This is where I want to spend my career.’” Next, consider specialty board certification as a stamp of expertise in an area of practice. In order to maintain that certification, you have to maintain a minimum number of continuing education hours and must practice for a minimum number of hours there. “Certification shows that you’re current with best practices; you’re currently practicing and staying on top of trends and issues in that specialty,” she adds.

G. Rumay Alexander, EdD, RN, FAAN
Interim chief diversity officer and director of the Office of Inclusive Excellence in the School of Nursing at the University of North Carolina at Chapel Hill

1g-rumay-alexander. Keep your mind in the game.

For highly vulnerable students, every test becomes a test of language proficiency, says Alexander. Multiple choice questions are especially problematic, she adds, so practice to understand how they’re structured and how to answer them. “Outside of the U.S., most countries don’t use multiple choice questions on tests, so international students may need more help to pass. Non-English speakers typically need to translate questions into their own language and then retranslate their answer in English. Older students are another minority group that is disadvantaged; they’re out of practice with test-taking.”

2. Understand that half the battle is staying level-headed.

“Try not to let your brain get hijacked by emotions,” advises Alexander. “Avoid being hungry, angry, lonely, or tired [“H.A.L.T.” is a good memory aid]. Make sure you’re well-nourished, well-rested, and really and truly try not to get panicked because you don’t know the answer immediately. Answer the questions you are certain you know and then revisit the questions you skipped.” It’s normal for people taking the NCLEX to think that they’re failing, so try not to be overwhelmed if you need to skip questions. Usually, you are doing fine, so just stay the course.

3. Tap the various staff members and other resources that your school provides.

“We have student advisors who meet with students and take them through different tests and practice exams,” says Alexander. Practice questions come from the end of textbooks, or students go online and get questions that best address their weak spots. “Students who have test anxiety can get help at a center that helps with managing anxiety and practice with testing, too,” she adds.

4. Find your happy place.

When highly vulnerable students were not passing gatekeeper exams at her school, Alexander asked the school’s “cultural coaches” to work with them. “We told the distressed group to forget about the exam and we asked them this question: ‘If you didn’t have that coming up, what would you do?’ Their response was ‘Let’s have a party!’ so we blasted music for 40 minutes and they taught each other new dances. There was laughter, joy, and smiles. Then they went on to study for the exam.” The nursing students were advised to do visualization exercises for stress reduction, like the school’s winning basketball team did before a game. “We told them, ‘When you’re stuck on a question during the exam, go back to this time. Remember the dance or anything that makes you feel peace, joy, or sense of accomplishment.’” The visualizations worked, and students later reported that their anxiety was greatly reduced when they applied the technique.

5. Understand that not everyone will pass the exam on the first try—and that’s OK.

“If you failed, well, you’re not the first person who has,” says Alexander. “Maybe you need to practice more or review a certain part again. Students repeat exams all the time. It’s not a denial of your dream; it’s a delay. Maybe you need to work more on test anxiety or preparation. Failing should inform you, not defeat you.”

Sometimes students face difficulties right before the exam that throw them off course, such as a suddenly ill child or a minor fender bender. Everybody has a bad day, Alexander explains, and the main thing is to resist the urge to ruminate. “Instead, focus on what’s next,” she suggests. “Ask yourself, ‘What do I want? What’s my next move?’ Remember, there is a skill to test-taking and it takes intentional preparation. Prepare, don’t despair!”

There are so many ways to prepare for the nursing boards now, what with new technology as well as in real-life social support. You can pick and choose the techniques that work best for you. Take an online review course, use an app, study with a group, or set up an at-home program. Success is absolutely within your reach!

The New Health Care Workplace

The New Health Care Workplace

As you know, health care is opening to a world of opportunities, as we’ve seen sweeping changes unlike any other in the last five decades. Social, political, economic, and technological trends form a “perfect storm.” Today’s nurses are trailblazing new roads in the profession, as they adopt different roles and operate in nontraditional workplace settings.

Nurses today still care for patients, but they must also provide it in the right manner, at the right time, and in the right place. Health care organizations still seek to provide the best patient experience, but they also must cut costs, boost outcomes, and ensure safety. There is growing demand for registered nurses, both in and outside hospital doors, that demands caretakers develop a new skillset and a new mindset. Below are five ways that demonstrate how nursing has morphed and shape-shifted recently, and how nurses can make the most of tomorrow’s opportunities.

Trend #1: Jobs are moving outside of hospitals.

Inpatient units—and sometimes whole hospitals—are being closed and patients are being moved into alternative settings, such as long-term care, rehab, and subacute care facilities. Case in point: Experts estimate that today 65% of health care services are delivered in ambulatory settings, rather than hospitals. That transition from inpatient to ambulatory care settings occurred slowly over the past decade.

Why the switch? The Patient Protection and Affordable Care Act of 2010 was a major factor that hastened what hospitals were already doing: offering services outside their doors. Health care organizations want to cut down on admissions (and re-admissions), and they seek to do that by pumping up preventive care and caring for patients at home, or on an outpatient and community basis.

Andrea Higham leads Johnson & Johnson’s Campaign for Nursing’s Future, launched in 2002 to recruit and retain more nurses and nursing faculty, including minority, male, and other underrepresented groups. “Nursing is at a very exciting time, and nurses are on the frontline of health care, providing delivery of care across the board,” says Higham. “So many people are entering health care because of a confluence of so many forces, such as the Affordable Care Act and an aging population. Nurses are working not just in hospitals, but also in home health care, at clinics, as advanced practice nurses, and managing the entire health care journey. There’s a strong need for nurses in many places outside of the traditional health care setting.”

Think about opportunities outside of the hospital. For example, if you’re interested in pediatrics or working with adolescents, consider openings in pediatric long-term care, pediatric home care, pediatric rehab, or at group homes for children or teens.

According to Phyllis Quinlan, PhD, RN-BC, president of MFW Consultants to Professionals and a nursing coach, nontraditional settings, such as subacute care, are fine places to practice if applicants can overcome their preconceptions. “Long ago and far away, it was considered grandma’s nursing home, but now it’s a combination of residential care and short-term rehabilitation. It could even include pediatric or non-geriatric care,” she explains. “Hospitals are shutting down med-surg floors, and shifting patients to other, lower-cost venues for treatment. Say someone falls and breaks a hip—now they have to learn how to walk with that new hip. That’s when they need bridge care—skilled care, rehabilitation, nursing care—until they can go back home. It’s not about disease care anymore, but about preventative care and home care for managing diseases today. Hospitals soon will be only for emergency care, cardiac care, burns, traumatic injury, [and] cancer centers.”

In addition, health care organizations within the private, government, and nonprofit sectors also need qualified registered nurse candidates to fill the high demand for traditional and alternative roles.

Trend #2: New or returning nurses must develop job-search savvy and resolve to land coveted hospital positions.

“For those new graduates hoping for good med-surg experience after nursing school but can’t get a job in a hospital, don’t despair,” says Quinlan, even though hospitals have adopted stringent nurse recruiting requirements and sought to cut costs in every way without compromising care.

“Most urban area hospitals aren’t hiring, but in other areas, that’s not the case,” she explains, suggesting that new grads and nurses with some experience apply for residency or internship programs to “fast track” their careers with intensive preparation for 12 to 18 months.

“Some health care systems are rich with nursing training resources, others do it but in a more conventional way,” she adds. Another way to get your foot in the door at a hospital: “Move to [an] area where they are hiring. The State of Texas is hiring new nurses, and other states are recruiting nurses to serve a special need or a growing population.”

Nurses who are open to filling short-term temp assignments also have a leg up on other candidates; hospitals are offering six-month contracts rather than making long-term commitments they may not be able to honor.

Trend #3: Nurses must further education, clinical skills, and knowledge to keep up with complexities.

Once, a two-year associate’s program could prepare a nurse for a secure and fulfilling career. Not anymore. “Most places now will hire a nurse with an associate’s degree but ask that she sign a hiring agreement to get a baccalaureate within five years or so,” says Quinlan. “Across the 50 states, the culture varies, but independent facilities and major health systems tell me ‘we’ll only hire baccalaureate-trained nurses,’ so you need to make your peace with the fact that the minimum preparation for practice is now a bachelor’s in nursing.”

The other source of tidal change is digital technology and big data, which make it possible for nurses to do more with their expertise and deliver care from practically any corner of the world, while enjoying the advantages of telecommuting, like other professions.

“Technology allows nurses to practice off the beaten path in more ways than ever before,” says Brittney Wilson, RN, BSN, also known as The Nerdy Nurse. “With jobs like remote case management, telephone triage, and even informatics consulting, nurses can use the clinical knowledge and technical skills to help patients from the comfort of their home.

“Opportunities to work from home and attend to patient care needs virtually do come with a price,” adds Wilson, who is a nurse expert with experience as a clinical informatics nurse. “You have to have above-average computer skills and must be able to learn new software quickly.”

There’s a big need for nurses who have a business background. Traditional nursing programs do not address business aspects of health care. Nurses who go on for a master’s degree in business administration or health administration will understand policies and procedures that are governing health care now.

Trend #4: Nurses must focus on their own personal and career development to progress in the profession.

Clinical and other technical skills are important for any nurse to develop, but so are “soft skills”—for example, effective communication and problem-solving know-how.

“New to nursing? Maybe you have great ideas, but maybe you’re missing skills in how to talk to a patient or family members or how to collaborate with others,” says Higham. “You can always access our avatar-based online program, Your Future in Nursing, on the Campaign’s website.” The cutting-edge format, a game-like simulation environment for practicing key on-the-job concepts and skills, helps a student nurse prepare to make the often tough transition to practicing nurse.

Accelerating change in the health care workplace may require that new and seasoned nurses adjust their attitude and become more flexible about new ways of doing things. According to Quinlan, author of the recently published Rediscover the Joy of Being A Nurse: A Holistic Approach to Recovery from Compassion Fatigue, there’s no point in lamenting the good old days. “Nurses are some of the most creative people on the planet; they’ll make something out of nothing on a daily basis,” she says. “Some feel that they’re expected to adjust instantly to changing conditions and expectations, and they resent it. Those nurses must make peace with the new health care environment, themselves, and their profession.”

Until then, “they’re at a crossroads, and risk starting to swing to the dark side, having lost connection with the joy of practicing,” Quinlan adds.

Trend #5: Nurses will take on expanded and pivotal roles as part of tomorrow’s health care team.

How will we prepare nurses to transition to these advanced practice roles? That question has long been central for Donna Tanzi, MPS, RN-BC, NE-BC, director of nursing education and innovation at North Shore-LIJ Huntington Hospital in New York. “Nurses are going into master’s programs early on in their careers—after getting a baccalaureate, they’re going straight into a master’s or even doctoral degrees,” she says. “They have less clinical experience prior to getting an advanced degree, so we have an obligation as a profession to support them. Entry to DNP takes seven years from entry to graduation, similar to the medical model.”

Tanzi recommends nurse residency programs or fellowship programs for an extensive, tiered approach as students make the transition into their complex new roles.

“Nurses were tending to leave a job in the first year, or to leave nursing totally, because they weren’t prepared for the demands of the role,” she explains. “The bottom line and the message that I want to get out there is go into nursing for the right reasons. Recognize it’s an art and a science and we have the ability to impact people’s lives every day. Continue learning—there [are] always new directions and avenues to explore. There’s no reason to ever become stagnate or get bored in nursing; there are too many opportunities.”

There are many areas where advanced practice nurses apply their expertise gained through a master’s (or increasingly, a doctorate) in nursing or a related field. Clinical nurse practitioners are opening independent practices, or working with an academic affiliation in hospitals, or affiliated with physicians in their practices. Administrative leadership roles usually call for an MBA or MHA. Demand for nurses continues, so we need nurses to teach in nursing schools. At a minimum, instructors must have a master’s in nursing or in nursing education. Entrepreneurship, consulting, and research and development are also growth areas for advanced practice nurses.

Everywhere we look, nurses are being called on to surf the tidal waves of a changing health care environment and the emerging opportunities that come forth from it. Tomorrow’s nurses, with the right technical skills and personal qualities, can look forward to a rewarding career where they can deliver even greater value to their patients and communities.


Photo courtesy of Johnson & Johnson

What’s Your Dream for 2016?

What’s Your Dream for 2016?

Today is Martin Luther King Jr. Day, so naturally we remember Dr. King’s “I have a Dream” speech. As you may know, he delivered the stirring message in 1963 at the March on Washington, in a dramatic and impassioned call for an end to racism.

What you might not know is that his address to the nation is ranked by scholars as the top American speech in U.S. 20th century history! It still lives on for everyone moved by his dream of equality.

But some people, especially younger Americans, have forgotten the reason for MLK Day. To them it’s just another three-day weekend, like President’s Day. Mainly, they ponder whether to go to the shore or to the mountains or to stay at home and binge-watch Netflix.

One way we can be reminded and reinspired by Dr. King is by viewing the movie about a major episode in his dramatic life, Selma. This phenomonal film is racking up accolades and awards, including at the Golden Globes. Some believe it was snubbed at the Oscar — it’s nominated only for Best Picture and Best Song, and not for its many fine performances or the strong vision of its young, female, African-American director. You can see a trailer and find out more here. It’s playing at theaters in major markets throught the US.

Another thing we can do is to read the entire “Dream” speech here. Amazingly Dr. King almost didn’t deliver it because his adviser, the Rev. Wyatt Tee Walker, feared it was “hackneyed and trite.” Right before the march, Walker and his staff drafted a replacement titled, “Normalcy Never Again.” (Doesn’t quite have the same ring, does it?)

Gospel singer Mahalia Jackson is responsible for Dr. King’s change of heart; she called out to him, “Tell ’em about the dream, Martin” as he started speaking. He paused and said, “I still have a dream.”

Here is one small, electrifying snippet from his address to the crowd:

“I still have a dream, a dream deeply rooted in the American dream – one day this nation will rise up and live up to its creed, ‘We hold these truths to be self evident: that all men are created equal.’ I have a dream…”

Maybe you don’t consider yourself a dreamer. Most nurses are practical, ingenious workers and their patients and communities value them highly for their hands-on care. But most likely you do hold tight to dreams of equality, freedom, and compassion on Earth.

There are so many ways to affect social justice as a nurse, even if it’s just in your own little corner of the world. How does your heart and imagination inspire you to act? What is your dream for 2016? We’d love to hear about it.

Jebra Turner is a freelance health and business writer in Portland, Oregon. Visit her online at www.jebra.com.

Finance Your Nursing School Education with Scholarships

Finance Your Nursing School Education with Scholarships

Often, minority nurses are encouraged to pursue more education so that they can advance in their careers. Going into deep debt to finance that education, though, isn’t always a smart move. Fortunately, there is scholarship money available for nurses who go after it. Unfortunately, the hunt for funds can be daunting.

Six scholarship-savvy nursing students, financial aid pros, award grantees, and thought leaders offer their advice and insights. Follow it and win the funds you deserve. It works for scholarships (e.g., merit-based awards), grants (e.g., needs-based awards), and fellowships (for graduate students, and either merit- or needs-based).

Austin Nation Austin Nation, RN, PHN, MSN
PhD student at University of California–San Francisco School of Nursing

What’s your greatest scholarship success?

I just did a workshop, a “Scholarships 101,” because people found out that I was able to pay for most of my graduate education, and now my PhD, with awards. In the past, I garnered enough scholarship monies to get the down payment for a house! If students are also interested in teaching, there’s a lot of need and money available. I now have a stipend that’s routed directly to me, which is ideal. Before that, I was using credit cards to pay for financial aid. Remember, besides tuition and books, there are living expenses you need to cover, like housing and food.

What are the best resources for finding scholarships for students?

Look for departmental, college-wide, and university-wide scholarships. There’s a goldmine at the local level, and then at the professional and cultural organizations. Corporations, like Pepsi and Coke, may have scholarships. Also, go after scholarships for people with disabilities—which could mean being the first generation in your family to go to college.

Do you have any advice for nursing students about the whole process?

Just mining this stuff is almost like a little part-time job. The scholarship application period is in April of each year. Cast a wide net; my goal was always to do 10 to 15 applications a year, which seemed to yield the best results. Recently, the fifteenth application I sent out was the one I got. It was federal funding for a minority student that’s good for five years. (It’s capped at $30,000 or $40,000 a year, based on the state.) I’m graduating in June of next year and going back to get additional certification. This program will pick up the tab, so why not?

Are there any tactics you employ to stand out from the competition?

The cornerstone of an application is the personal statement. What makes me a good applicant? Who am I? What have I done in the community? My specialty area and who I am as a person are very specific. I’m a male nurse. I’m a queer nurse. I’m a nurse doing work in HIV. Disclosing my background and status isn’t easy. I’m the first person in my family to go to college. My dad has only a fourth-grade education. That may be embarrassing, but that’s who I am. That’s where I came from. It’s a reflection of my character and how I’ve dealt with adverse circumstances.

Jake SchubertJake Schubert, RN, BSN
Founder of the nurse licensure prep site www.nursity.com and a travel nurse

What’s your greatest scholarship success?

I won a scholarship provided by a woman’s club made up of wives of university faculty. Very few men applied. When shown a list provided by the university of available scholarships, most men would say, “Oh, it’s a woman’s club…” But you have to put yourself out there—the club was for women, but their scholarship was for anyone. They were glad I applied because most men don’t, and guess which application stood out?

What are the best resources for finding scholarships for students?

Do ask what is available at different institutions you’re looking to attend. But don’t stop there. I know a student who got a 50% offer at a private school and a 100% ride at a state school. He wrote the private school a polite letter, explained his preference and the situation, then asked, “would you consider giving me 100%?” They gave it to him and called his mom to say how amazing he was, and how they’d never had anyone ask for more aid before.

Reach out to organizations of various kinds. Many have scholarships, though they might not be publicized. They may be discretionary, instead, based on a faculty member’s recommendation. I won a university scholarship that wasn’t even listed and wasn’t available to the public—all based on my relationships with the faculty at my university.

Do you have any advice for nursing students about the whole process?

You have to get in the game. Many people are reluctant to apply because they’re afraid of failure. A lot of times people think they’re going to get a full-ride scholarship that will take them all the way through school. It doesn’t work that way. Most are only $500 to $3,500. Think not of winning one, but of winning lots of scholarships; they add up over time. Once you apply for one, it’s easier to apply for the second, and when you get to the fifth application it’s almost a piece of cake. You can just recycle parts of other applications.

Are there any tactics you employ to stand out from the competition?

Look for what makes you remarkable and highlight that trait or activity. It doesn’t have to be the standard nursing things. One applicant I know used to be a music producer, and that stood out. But be careful not to spread your message too thin—pick one or two activities and dive in; invest time and energy in those. Take a leadership role and show your passion and commitment. Focus on one really rich experience on your application and weed out the minor ones. For example, when I was in nursing school I had written an article to highlight the work of a physician I admired and worked with. At my first job interview, that magazine issue was on the nurse manager’s desk. I casually mentioned, “Have you read my article…?” At my second interview, another manager greeted me with “So… we read your article.” That made a remarkable difference. That’s not why I wrote the article, but it showed that I’m engaged in the community. I’m not somebody who will take the money and run and never be seen or heard from again.

Brittney WilsonBrittney Wilson, RN, BSN
“The Nerdy Nurse” author, social media influencer, and blogger at thenerdynurse.com  

Do you have any advice for nursing students about the whole process?

My best piece of advice for nursing scholarships is to apply for everything. You often hear people joke to “vote early and vote often.” This actually does apply to scholarships. Apply early and apply often. Even if you’re not 100% sure you’re the perfect fit for the scholarship or don’t feel you meet the right demographics, go ahead and give it a shot. Unless the guidelines specifically exclude you, then you should assume they include you.

Are there any tactics you suggest to stand out from the competition?

I would also suggest to apply to scholarships that aren’t just for nursing students. Because nurses hold such a strong place in many hearts and are constantly voted as the most trustworthy profession, you may have an edge over other candidates for more general scholarships. You’ll also likely be competing with fewer nursing students and have an ability to stand out. Applying for scholarships that you wouldn’t think would be a good fit could actually give you an edge and let you stand out against other applicants.

Donna CardilloDonna Cardillo, RN, MA
“The Inspiration Nurse” keynote speaker, author, and columnist at donnacardillo.com

What’s your greatest scholarship success?

Free money is the best kind of money. Some scholarships will even give you money for living expenses. I was going to have to drop out, but I got that scholarship for the next year. I was recommended for the scholarship by a professor at school. Community and women’s groups sometimes contact the school and ask for the name of a deserving student. In this case, they wanted to find a community leader. I’d talked to this professor about my personal and financial situation, so she recommended me. Share your story. People want to help and support you.

Do you have any advice for nursing students about the whole process?

The more you apply, the better your chances of getting money. Every scholarship has different criteria. Some are for entry to practice, some are for advanced levels. Don’t get hung up on meeting all the criteria. You have to cast your net wide if you’re going to catch some fish. Try ethnic community associations, like the Hispanic American Club, in addition to ethnic nursing associations. It’s worth making the scholarship search a part-time job. Contact your state chapter of the American Nurses Association and ask if there’s anyone there who can help you with scholarship information. Ask at the financial aid office, too. Ask a librarian for resources, such as the current edition of Peterson’s Scholarships, Grants and Prizes. Remember, if you don’t ask, you don’t get. Make as much effort to apply for scholarships as to apply to school.

Are there any tactics you suggest to stand out from the competition?

Read the questions carefully and tailor your application to match, each time. Learn how to write a good essay. They don’t know you, so you have to convince them. Don’t hesitate to share your difficulties; for instance, a background as a single parent or with an illness. People want to be touched, moved. “Oh, I don’t want to go into that,” students say, but it’s important to tell your personal story.

I know many people who’ve financed their whole education through scholarships and grants. When I went to graduate school, I had literally no money. I presumed I’d apply for student loans and pay them off the rest of my life. I applied for a scholarship that I didn’t qualify for because I wasn’t taking enough credits. (I was only taking one course a semester.) In my application, I explained that I wanted to take a full course load but had to work and care for a family, so I couldn’t fit it all in without financial support. I was awarded a special scholarship that year because of my circumstances.

Cynthia J. Hickman, RN, BSN, MSN/Ed
PhD student, established the Cynthia J. Hickman “Pay It Forward” Nursing Scholarship

What’s your greatest scholarship success?

I received the Johnson & Johnson [Community Health Care Leadership] award while working for St. Luke’s hospital [in Houston, Texas]; someone suggested I “pay it forward.” My way of making the world a better place is to help others complete their education toward the goal of becoming a registered nurse. Students must have the first two years, and the scholarship is for the last two.  The scholarships at the national and local Black Nurses Association are for $1,000; however, they have not been active the past few years. When my foundation application and nonprofit status has been complete, I plan to make them available back to my organizations. The scholarship at St. Luke’s is self-renewing, for $2,000 or whatever is the interest for that year. Recipients are encouraged to pay it forward when they graduate. I want to expand the scholarship to high schools—Houston has health services focused schools and some are already offering college courses.

Do you have any advice for nursing students about the whole process?

The scholarship search turns many people off—they see the scholarship application and what they ask for, put it aside and say “No.” I tried to make it easier to apply by talking to other schools and looking at their guidelines. Once I ascertained that, I knew I didn’t have to include certain questions, for instance GPA. Nursing schools require a 2.5 GPA.

Are there any tactics you suggest to stand out from the competition?

Do a dummy application before the real one. You have to be able to write. It’s not as hard to write if you pick your passion. If I applied for an engineering degree I’d have difficulty, but I’m a nurse so I can write with passion about that. Examples are everything. I always wrote about early on, when I was a lifeguard, and saved a life. That job turned into my career in nursing. Safety is part of both fields; be someone who thinks beyond the obvious.Q: Are there any tactics you employ to narrow down applications for a winner?

Be dedicated, focused, and pay attention to instructions—that’s very important. Complete the application. As a nurse, you have to complete things. Someone’s life is at stake; you can’t half do it. I’ve heard about application review committees who break up into teams. One team looks only for completions. Another team looks only for errors. They may start with 3,000 applications, but quickly narrow it down to 150. Each scholarship committee has its own specific criteria. Mine is community service; you have to show a history of community service. If you’re a pediatric nurse, that’s great, but then do something else outside of that. If they’ve had breast cancer, then volunteer for that cause. Now you’ve added another layer of expertise based on your personal experience and passion.

Maria Elena C De GuzmanMaria Elena C. De Guzman
Student funding coordinator at University of California–San Francisco School of Nursing

What’s your greatest scholarship success story?

The greatest success story I’ve encountered so far is from one of our students who is a single parent with a daughter who is also in school. She’s a minority student and is the first in her family to attend a university. She came to my office to get counseled on how to improve on her scholarship applications since she has not been very successful. After that visit, she received a number of awards. Her success was about not so much the amount of scholarship money she received, but how she managed to overcome the personal challenges in her life, with funding being one of them. She was then able to focus more on her studies.

What are the best resources for finding scholarships for students?

Start with your school. Then there are professional organizations, employers, and organizations related to cultural or ethnic backgrounds. I don’t know if something similar is available for undergraduate students, but the UCSF COS [Community of Science] Pivot database that we offer our graduate students is one of the best and most comprehensive. It covers funding opportunities for most disciplines from federal agencies, and private U.S. as well as international foundations. It alerts users every time a new funding opportunity comes up related to their discipline or area of interest. It also has a tool for research networking—quite cool!

Do you have any advice for nursing students about the whole process?

Make sure you meet all the eligibility criteria. Take your time, and do your research when applying for scholarships and grants because they are competitive. After spending time and effort writing an application, use it as a template for other applications. Apply to as many scholarships as possible, including those that are not just for minorities. There are substantial amounts of free money available, but scholarships and grants are always competitive, which is why preparation is so important. Be aware that there are some “free” monies which are not really free because there are commitments attached. These need careful consideration.

Continue to gain experience at work or in school, and do your share for the community by volunteering. Whether the money comes from private or public sources, other people have contributed to put up the scholarship. Your education is a gift that will enable you not only to help improve your life, but also to make a more meaningful contribution for others to succeed as well.