Nursing education can be a lifelong process. When you started, you may have earned your LPN, RN, or BSN, and you moved forward into your career with all sorts of hopes, goals, and aspirations. You may have wanted to work in a particular specialty, had your sights set on the traveler lifestyle, or were focused on making sure you could pay the bills, give your kids a good life, and plan for your eventual retirement.
During the many years of your career, you may have chosen to pursue various certifications, joined workplace committees, and accumulated countless skills and competencies. But how do you know when it’s time to advance your education?
The Educational Edge
Going back to school is a big decision with far-reaching implications. There’s the financial cost, of course. Still, there’s also the time commitment, the potential inconvenience to your family, and how going to school and working can complicate your life unless you’re lucky enough to be in the position to take time off from work while you’re back in school.
For LPNs/LVNs, the decision to return to school can directly relate to wanting more career mobility. Many acute care and other facilities only employ RNs, and if you want to move up the nursing career ladder, earning your RN can be a very practical step, with the added benefit of increasing your earning potential.
When you have your RN, advancing to a BSN can boost your earnings, and we know that some facilities lean much more heavily toward nurses with a BSN. In the original 2011 Future of Nursing Report by the National Academy of Medicine, the recommendation was for the number of baccalaureate-prepared nurses to be increased by 80% by 2020. The 2020 updated report states that the number of nurses with a BSN has now surpassed the number with an associate’s degree.
The same 2020 report also makes the following statements:
“…Nationally, a higher percentage of Black/African American, Hispanic, and particularly Asian RNs relative to White RNs have a BSN,” and “proportionately, more Black/African American and Asian RNs than White and Hispanic RNs have a master’s degree, or a doctor of nursing practice (DNP) or a PhD in nursing.”
The report adds, “Analysis of data from the American Association of Colleges of Nursing (AACN) shows that between 2010 and 2017, the number of RNs who obtained a doctoral degree increased rapidly, with those obtaining a DNP far outnumbering those obtaining a PhD.”
And finally, “…the proportionate growth among POC RNs was even greater. For example, the number of Black/African American RNs who obtained a DNP increased from 139 in 2010 to 826 in 2017 (a nearly 5,000 percent increase), while the number earning a PhD increased from 52 to 107 (105 percent) over this same period.”
According to the Bureau of Labor Statistics (BLS), registered nurses (without distinguishing between RNs and BSNs) earned a median annual salary of $86,070 in 2023. Meanwhile, nurse practitioners enjoyed a mean yearly wage of $128,490. For nurse anesthetists (a specialty that requires a doctoral degree), we see an annual base salary of $183,025.
We can conclude that educational advancement in nursing most definitely impacts earning potential. As we can see from the statistics, nurses of color have been increasingly embracing the career mobility offered by advancing their education. This translates into a more educated nursing workforce and likely a more competitive job market based on the proportions of nurses who have that extra educational edge.
Taking the Plunge
So, when do you go back to school? Is it best when the kids are young, or do you wait until they’re teenagers and need you less? If your spouse is shouldering more of the childrearing burden, how will that impact their life and career?
Like anyone else, nurses may find themselves caring for elderly parents, possibly while also raising children. What do you do if you’re a so-called “sandwich generation” member?
There’s also the question of getting older. How does it feel to return to school in your 30s instead of your 50s or 60s? How much energy does it take, and can you summon the stamina for what’s to come?
When it comes to choosing between strictly online learning, a “brick-and-mortar” school, or a hybrid program, making the right choice is imperative. Sometimes, getting out of the house and sitting in a classroom is a welcome break from the distractions of home. Online learning can be convenient, but if kids run around and have constant messes to clean up, you might find it hard to get any schoolwork done.
Whether it’s timing, cost, type of program, or other concerns, there’s a lot to consider when advancing your nursing education is on the table. Considering the potential benefits and weighing your options, you’ll decide what makes sense for your career. School isn’t for everyone, but for those who take the plunge, it can open countless doors along the nursing career pathway.
When we think about nurses getting published, our thoughts naturally turn to nurses in academia doing research or teaching. However, being published is actually for everyone.
Any nurse has the opportunity to be published, which can open the doors of possibility and reveal unforeseen career opportunities.
Why Get Published?
Dottie Roberts, EdD, MSN, MACI, RN, OCNS-C, CMSRN, CNE, has been the editor of the MEDSURG Nursing journal since 2002 and sees getting published as an equal opportunity.
“We think of publishing as something done by researchers and academics,” Roberts states. “However, all nurses are responsible for communicating information about practice innovations, particularly those impacting patient outcomes.”
Roberts continues, “Publishing allows nurses to share their knowledge and expertise and provides the foundation for evidence-based practice. Peer-reviewed journals offer an excellent medium for publication because of their high standards and wide readership.”
Roberts encourages a focus on peer-reviewed journals affiliated with nursing specialties.
“Dissemination of our experiences is critically important to benefit other nurses in their practice,” Roberts submits. “We share the results of our quality improvement or evidence-based activities or describe our encounters with patients with uniquely thought-provoking diagnoses.”
She adds, “We need to communicate research results to help nurses understand current challenges and mold future practice. Presenting at a conference is valuable, but publication benefits the profession more broadly by reaching a wider audience and building a body of literature that benefits current and future practitioners.”
For an individual nurse’s career, Roberts sees many potential benefits.
“Being a published writer brings recognition. Peers admire the nurse’s knowledge but also the ability to bring that knowledge to the profession. Along with presentations, publication can be recognized within clinical ladders and impact the potential for promotion. For nurses seeking entry into a competitive graduate program, being a published author brings an application additional attention.”
Roberts adds that sharpening writing skills can lead to career opportunities such as freelance writing, which can help a nurse earn extra income while educating others.
She describes her first major publication as “a book chapter for my member organization, the success of which gave me the confidence to take on other writing assignments for that association but also to write for national nursing textbooks and international journals.”
“I wrote exam prep materials and white papers for nursing certification programs. One opportunity led to another, and I know many nurses who have followed that same path in building their writing skills and resumes as reliable, effective authors.”
But How Do I Get Published?
Roberts advises, “Writing for publication requires work, but it’s open to anyone willing to devote the time to create an excellent product, and it’s not reserved solely for academics.”
“Nurses don’t need to be researchers to have a message worth sharing.” Roberts reflects. “Before that book chapter, I wrote a reflection for my hospital newsletter about a patient who had touched me greatly through her resilience.”
She continues, “I know every nurse has unforgettable patients, and experiences with those patients can inform peers and keep memories of patients alive. While journals don’t always publish personal reflections, they often publish case studies informing readers about specific patient care situations. Turning a reflection into a case study is a great way to start as a novice author.”
When seeking the right publication, Roberts states that editors always look for valuable topics for their readers. She recommends nurses familiarize themselves with specific journal styles and audiences to find the best fit for their writing.
She advises, “Although not all publications require it, you might submit a query letter explaining how your manuscript would benefit the journal’s readers. After the work of writing, finding the right publication will make acceptance much less difficult.”
Getting Involved
Nurses interested in being published can get involved in workplace projects and initiatives that lend themselves to being captured in writing. In this regard, Roberts shares:
“Quality improvement and EBP activities represent great opportunities for authorship. For example, clinical nurses may be involved in QI efforts to prevent falls or decrease CAUTI.”
“Readers are always looking for innovations to improve the quality performance of their units and may choose to replicate a project they read about. A nurse involved in developing a new policy can synthesize the relevant literature in a systematic or narrative review. Nurses who have returned to school often implement capstone or DNP projects in their practice settings; these reports also make great manuscripts.”
Where to Begin?
If you’re wondering how to get started, consider these steps shared by Dr. Roberts:
Identify journals representing your specialty
Examine journals’ websites for author guidelines, topic wish lists, and types of articles the journals seem to prefer
Submit queries about topics you’re considering writing about
If an editor is uninterested, ask for a referral to a more appropriate publication
Identify yourself as a novice author, and ask directly if the editor and editorial board mentor less experienced writers
Roberts states, “At MEDSURG Nursing, we give a writer’s award each year to a first-time author to recognize this important step in professional growth. Unfortunately, there is no list of novice-friendly publications I can identify, but there’s no substitute for simply communicating with editors. The editor is likely hearing from readers and editorial board members and knows very well what topics would be valuable to them.”
The importance of finding the right journal cannot be overstated. “It all goes back to identifying the right journal for your planned writing effort,” Roberts concludes. “It may take some patience and willingness to try again if you receive an uninterested response. However, if you identify a topic that would be helpful to you and your peers, chances are other nurses would also benefit from its publication.”
In the final analysis, being published can help nurses gain recognition, advance in their career, and contribute to the growing body of nursing literature. While it may not be for everyone, the experience of being a published author can offer a significant career boost and a sense of great personal and professional accomplishment.
We generally don’t study the classics of philosophy in nursing school. Unless we encountered philosophy in high school, a previous time in college, or out of personal interest, we nurses may not frequently think about Socrates, Plato, and Aristotle, let alone Heidegger, Kant, and the rest.
Nurses aren’t alone. Even though philosophy could be argued to be the underpinning of civilization, not many people spend much energy trying to understand it. We know it’s essential, but it’s not easy reading, and we have a lot of other things to do, like managing our careers, planning our next vacation, paying bills, and raising our families.
However, certain philosophical questions and statements are part of the popular consciousness, and sometimes, a brief reflection can yield some valuable gold for our life’s journey.
The Unexamined Life
The statement that “an unexamined life is not worth living” has been attributed to Socrates for thousands of years. While the exact wording is sometimes slightly different, the general idea is there: if we don’t look deeply at our lives and consider our motivations for what we do and the truth of who we are, life may not hold as much meaning as it could otherwise. Whether that examined life is not worth living is a matter of opinion, but we get Socrates’s point.
If you take a good look at your nursing life, what do you see? What gold is there to mine from your experiences, and what has being a nurse brought you? Have your original motivations remained with you, or have your experiences significantly changed how you view your career?
This is not to say that you can’t simply go to work each day, do your job, and come home to your family. There’s nothing wrong with doing your job well and enjoying the rest of your life. You probably work pretty darn hard, and you deserve enjoyable and restful time away from work.
Not everyone is predisposed to philosophical reflection. But when we realize the potential value in taking a deeper look at what we do and why we do it, sometimes we’re led down a path that bears the fruit of what Socrates was getting at.
A Precious Gem
Taking the above statements to heart, there’s much to say for periodically pausing to reflect on your nursing journey.
You could visualize your career as a precious gemstone expertly cut into multiple facets, be it a diamond, a ruby, a tourmaline, etc. Holding your faceted nursing career up to the light, what do you see? Consider these questions as a place to begin:
What were my original motivations for becoming a nurse?
What has changed for me since I first graduated? Do I see my career differently?
Is there something I’ve always wanted to do in my career that I haven’t yet accomplished?
How do my colleagues perceive me? What do they see and experience when interacting with me?
What impact do I have on patients? How do they experience and perceive me?
What have I learned about myself in the course of my career? Has anything about me fundamentally changed based on my experiences as a nurse?
Does my work as a nurse hold enough meaning for me?
What would I tell my younger self if you could message the nursing student or new grad I once was?
The precious gem of your nursing career has many facets; depending on how you hold it up to the light, you will see different things. If you take the time to examine your life and career, you may discover things about yourself that you’ve never realized. Focused self-examination has the power to reveal a great deal.
To Examine or Not to Examine
There are no rules about how introspective anyone has to be. Life in the 21st century is complicated, and as mentioned earlier in this article, we have a lot of other things to do just to keep afloat. If you’re raising children, have aging parents, or are feeling your own aging process, there’s plenty demanding your attention.
You probably work hard, have many responsibilities, and always have a lot to think about and do. There’s no need to take a deep dive into your deeper motivations and desires, but if you do for a moment, there may be some valuable insights about you, your life, and your identity as a nurse.
Is an unexamined (nursing) life worth living? You don’t need Socrates to tell you — you know the answer that works for you.
In the 21st century, several holistic approaches to medicine have become increasingly popular among clinicians and patients. One such approach continuing to gain steam is functional medicine.
But what exactly is functional medicine, and what does it have to offer patients looking to dive deeper, as well as providers and clinicians who want to help their patients improve their overall health and well-being?
Putting Out the Fire
Hally Brooke, NBCHWC, FMCHC, CPT, is the Founder and CEO of Live Nourished Coaching, a nationwide health coaching agency. As a Certified Functional Medicine Nutrition Counselor and a Nationally Board-Certified Health and Wellness Coach, Ms. Brooke brings a nuanced, expert perspective to understanding functional medicine’s role.
When asked to define functional medicine, Ms. Brooke begins, “Functional medicine is root cause medicine, which means we go after the true root of the symptoms instead of slapping a Band-Aid on the symptom.”
She continues, “Consider eczema or psoriasis — these are both symptoms of inflammation, a root cause of almost every chronic disease. But inflammation itself is actually only a secondary root cause — something lit that fire in the first place.”
She explains further, “Inflammatory root causes include food intolerances, intestinal permeability, toxicity, mold exposure, or infection. If you treat the skin with a steroid, the problem will go away only as long as you use the topical ointment. If you treat the root cause of the inflammation causing the problem, it goes away forever. Treating the symptoms is like turning off the fire alarm and leaving the house ablaze. Treating the root cause actually puts out the fire.”
Brooke further differentiates functional medicine from mainstream medicine: “Functional medicine looks at the whole person—body, mind, and spirit—and emphasizes the importance of personalized care and lifestyle changes.”
“Functional medicine differs from mainstream medical practice in several key ways,” Brooke offers, and she breaks it down for us in this way:
Root Cause Focus: Instead of just treating symptoms, functional medicine aims to find and address the underlying causes of illness.
Personalized Care: Treatment plans are tailored to the individual’s unique genetic, environmental, and lifestyle factors and are focused on lifestyle change, not prescription medication.
Holistic Approach: It considers the whole person, including physical, emotional, and spiritual aspects, and how they interact.
Prevention and Wellness: There is a strong emphasis on preventive care and promoting overall wellness, not just disease management.
What About Nutrition?
“Functional nutrition is an approach to diet and nutrition that emphasizes whole, nutrient-dense foods and considers each individual’s unique needs,” Brooke shares. “It looks at how food affects the body on a biochemical level and aims to support optimal health.”
“Our current approaches to nutrition often fail us because they can be too generalized and don’t take into account individual differences. Many mainstream diets focus on calorie counting or macronutrient ratios without considering food quality, nutrient density, and how different foods interact with our unique bodies.”
Barriers to a Functional Approach
While functional medicine may sound great to many of us, providers might see this practice as a barrier.
Discussing why providers might be hesitant, Ms. Brooke explains, “Conventional medical appointments are often short, making it hard to delve into complex, root-cause investigations.”
She adds, “Meanwhile, many providers aren’t trained in functional medicine principles during their medical education, let alone being trained in nutrition, which is a key fundamental of functional medicine.”
“Most western doctors would say, for example, that nutrition has nothing to do with Hashimoto’s Disease, but by changing a person’s diet, we can completely reverse Hashimoto’s in many cases.”
In terms of the medical culture, Brooke observes, “The traditional medical model focuses more on acute care and managing symptoms, which can lead to skepticism towards approaches that are perceived as less evidence-based or more time-consuming.”
The Benefits to Patients
When considering how patients can benefit from a functional approach, Brooke states, “Patients can experience numerous benefits from a functional approach, including:
Improved Health: by addressing root causes, patients often see more significant and lasting improvements
Personalized Treatment: Care plans are tailored to individual needs and lifestyles, taking their whole being into account, leading to more effective and relevant interventions
Empowerment: Patients learn more about their health and how to manage it, resulting in greater self-efficacy and well-being. Instead of the doctor being the end-all-be-all, it’s the patient taking their health into their own hands, guided by the provider.
Prevention: Functional medicine often helps prevent future health issues by promoting overall wellness and balance.”
Nurses, Functional Medicine, and the Future
Brooke advises nurses wanting to be trained in functional medicine basics: “There are multiple pathways for nurses to get involved in functional medicine. Nurses can partner with a health coach to create a collaborative care model or become certified functional medicine health coaches themselves.
She continues, “There are many courses and certifications in functional medicine that nurses can take to enhance their practice. Nurses can also apply functional medicine principles in their current roles by incorporating holistic assessments, personalized care plans, and lifestyle counseling.”
Brooke adds, “HI believes health coaching and functional medicine are the future of healthcare because they address the limitations of the traditional medical model by preventing disease and promoting wellness, rather than just treating illness. They also provide more individualized, patient-centered care, which itself leads to better outcomes.”
“Finally,” Brooke concludes, “healthcoaching and functional medicine consider all aspects of a person’s life and health, fostering a more comprehensive and effective approach to care. They empower patients to take an active role in their health, which can lead to more sustainable health improvements and overall well-being.”
Mental health nursing is a specialty within our profession that may be frequently overlooked and underappreciated. Nurses working in the realm of mental health perform an excellent service for many individuals and families living with the effects of a wide variety of conditions, including depression, anxiety, PTSD, and substance use disorders.
While the first half of the 20th century may have been the Dark Ages for mental health in the United States in many respects — including the longstanding stigma surrounding mental illness — the 21st century has seen a renaissance in our willingness to address conditions that are more common than ever previously accepted or acknowledged.
In this respect, the nurse’s role in the mental health of their fellow Americans is crucial.
Decreasing Stigma, Raising Awareness
In the 21st century, we are witnessing a new openness in terms of ordinary people being willing to discuss mental health honestly and authentically.
According to a 2019 survey by the American Psychological Association (APA), “most Americans harbor positive views about mental health disorders and treatment.” The survey findings state, “A total of 87% of American adults agreed that having a mental health disorder is nothing to be ashamed of, and 86% said they believe that people with mental health disorders can get better.”
These statistics are a convincing argument that the stigma of mental illness, while not wholly eradicated, has significantly decreased from days gone by when those with mental health disorders were more likely to be considered dangerous and thus removed from society and locked away.
With attitudes changing, the public’s mind-opening, and healthcare providers increasingly willing to talk about mental health with their patients, the table has been set for Americans’ mental wellness to take a front seat in the healthcare space.
In a 2021 editorial on the website of the American Academy of Family Physicians (AAFP) titled “Integrating Behavioral Health Into Primary Care,” author Sarina Schrager, MD, MS opines that “fully integrating behavioral health in primary care is the gold standard for care.” She adds that “integrated behavioral health has been shown to improve depression scores and improve the patient and physician experiences.”
As providers adopt this outlook in the exam room, patients’ comfort in talking openly about their concerns and symptoms will likely increase.
Paradigm Shifts
With the FDA poised to approve MDMA (Ecstasy) for the treatment of PTSD, and psilocybin and ketamine for the treatment of depression, a paradigm shift in the worlds of psychiatry and psychology is upon us.
“ANA is pleased to officially recognize cannabis nursing practice as a nursing specialty…This recognition highlights the essential role and special contribution of cannabis nurses to the health care system and promotes enhanced integration of cannabis therapies for health care consumers across diverse health care settings.”
Cannabis nursing certification programs and pertinent training, conferences, and literature are adding even more credence to the fact that these previously fringe ideas and treatments are beginning to intersect with mainstream medical care.
In these exciting times of change and expansion in the mental health field, nurses are seeing the emergence of new avenues for career advancement, entrepreneurship, personal and professional fulfillment, and recognition of, and certification for, their knowledge and expertise.
The Future is Unwritten
The future of mental health care in the United States is unwritten, yet there are courageous, intelligent, forward-thinking professionals who are paving the way as these new paradigms emerge.
As providers become more confident in talking with patients about mental health, new treatment options are made more widely available, and the stigma of mental illness continues to wane, we can all embrace the future of mental health care as it unfolds.
Nurses are natural change agents, often leading innovation in mental health care. The trust the public generally places in nurses will serve us all well in the years ahead.
As complicated human beings living in an equally complex world, challenges to our mental health may always be with us. Yet, our attitudes, practices, and beliefs will ultimately shape the direction our society takes in this regard. At this time in history, we are heading in the right direction.
