In this time of increasing focus on efforts around diversity, equity, and inclusion, creating a more diverse nursing and healthcare workforce is a goal that many would agree is worth pursuing.
A more diverse workforce positively manifests for all parties involved, whether doctors, nurse practitioners, nurses, or other healthcare professionals. However, barriers to inclusion and diversity within the doctorally prepared nursing workforce are a challenge that some are beginning to address.
Advancing Equity in Nursing Education
Dr. Danielle McCamey, DNP, ACNP-BC, FCCP, is an expert critical care advanced practice clinician and the Assistant Dean for Strategic Partnerships at the Johns Hopkins School of Nursing. She is also the founder and CEO of DNPs of Color, an advocacy organization with a mission of inspiring more people of color to pursue advanced nursing education, particularly the Doctorate of Nursing Practice. In this regard, networking, advocacy, and mentorship are pillars of Dr. McCamey’s efforts to diversify the nursing workforce.
In terms of the representation of people of color in nursing, Dr. McCamey states, “We are not well-represented, as the literature shows, but we are much needed in order to close inequity gaps and advance health equity.”
And in the realm of the recruitment of people of color into the nursing profession, Dr. McCamey sees a path forward.
“We have to restructure our efforts so that we begin exposing the nursing profession early and consistently [to young people]. We must also remove financial and other barriers to access to nursing education, whether in the form of standardized tests or ensuring that we keep all pathways into nursing available, including CNA, LPN, ADN, and beyond.”
Expanding on the issue of nursing education, Dr. McCamey shares, “Honestly, nursing education needs to be free, and schools like Historically Black Colleges and Universities (HBCUs) and Hispanic-Serving Institutions (HSIs) need to be given more funding resources and other administrative support to be able to accommodate more students of color.”
Filling the pipeline of the nursing educational system is key to keeping the nursing workforce robust and well-populated. Yet, we also must be certain that diverse cohorts of talented and dedicated individuals can visualize an avenue to fulfill their educational and career goals, including at the doctoral level.
Patients and Quality of Care
A diverse nursing workforce benefits both patients and healthcare workers alike. When it comes to quality improvement in patient care delivery and the experience of healthcare professionals, an article in the New England Journal of Medicine states, “Lack of workforce diversity has detrimental effects on patient outcomes, access to care, and patient trust, as well as on workplace experiences and employee retention.”
No matter how we break this issue down, increasing diversity has qualitatively and quantitatively positive benefits that are well worth the effort of undertaking such initiatives.
Studies of a concept referred to as “race concordance” or “race congruence” have shown that patients like to be cared for by providers and staff who look like them. As noted in an analysis published on the National Library of Medicine website, “Research suggests that race concordance between patients and providers is associated with positive outcomes such as higher levels of perceived patient satisfaction of care, quality of healthcare, and more trust in their provider.”
Improved outcomes are certainly something everyone working in healthcare can get behind, and when we have a highly trained and diverse workforce, reaching patients where they are with providers who look like them and understand their lives is astronomically beneficial.
A Vision for the Doctoral Nursing Degree Path
When discussing people of color pursuing advanced nursing degrees, including the PhD and DNP paths, Dr. McCamey states, “Exclusionary practices and gatekeeping within nursing along with lack of mentorship have often stood in the way.”
Dr. McCamey mentors many up-and-coming nurses entering the doctoral field, and she understands the power of those relationships based on her lived experience.
She continues, “From my personal experience, mentorship was key to understanding some of the rules of the game and navigating certain spaces, as well as advocating for resources to contribute to my success and advancement in the profession. Having an affinity with those who’ve gone before is crucial.”
In terms of doctoral education, Dr. McCamey states, “Historically, PhD-level nurses are those that generate new nursing knowledge and science, while DNPs generally translate that science into clinical practice. However, we also see more DNPs pursuing nursing science and research.”
For nurses who wish to pursue a doctoral-level education but are uncertain about the choice between a PhD and a DNP, Dr. McCamey shares her clear opinion:
“I am biased towards the DNP because it has made doctoral studies more accessible, specifically for nurses of color. Unlike a PhD track, the more flexible DNP curricula allow students to engage in other life obligations while also going to school.” She continues, “For many of us, this flexibility is vital since we support our families and communities, whether financially or in caregiver roles.”
Dr. McCamey states to attract more nurses of color into doctoral studies, “I would like to see more consistent branding and marketing of the valuable contributions DNP-prepared nurses bring to nursing practice. I also want to see more nurses who reflect the diverse communities that we serve.”
Every human being sees the world through a variety of lenses. There are lenses of family roles (e.g., mother, father, child, grandparent), lenses of identity (e.g., gender, sexual orientation, race, citizenship, religion), and many others, including lenses of profession and career. How we see the world is filtered through the lenses we wear, most of which we wear simultaneously.
Nurses have a particular lens through which we see the world, and even though we may also identify as queer, liberal, disabled, Catholic, or as a mother or grandparent, our nursing lens is difficult to turn off once it’s turned on. And that lens is one that we’ll likely wear for the rest of our lives, even if we leave the profession or retire.
The Power of Lenses
Our many lenses serve multiple purposes. They help us navigate the world, make decisions, and choose the paths we travel.
If I identify as heterosexual, socially conservative, patriotic, and religious, I might view the homeless woman on the corner differently than my colleague, who identifies as queer, atheist, and liberal. I may have come from a family that provided lenses I rejected, or perhaps some of my family’s lenses still provide essential perspectives.
The thing about nurses is that, like anyone else, we can come from any background or persuasion, but we have also superimposed the lens of our business over those lenses.
Just as police officers, priests, psychologists, or schoolteachers have their professional lens through which they view the world, we employ the nursing lens. And no matter what we do, our nursing lens must function in the context of the many other lenses we wear.
The Nursing Lens
The moment you sat down in your first nursing class, your nursing lens began to take shape, even as it began to shape you. As you learned the nursing process, studied nursing theories, and started learning to think like a nurse, you began to see the world differently.
Did your community rotation in a local homeless shelter alter your viewpoint or perspective? Did tending to a dying patient impact how you viewed the value of your own life or your relationship with those around you? Did understanding the physiological, social, or psychological effects of cancer, heart disease, diabetes, sickle cell anemia, or addiction affect how you saw the world?
When we witness others’ suffering, the world around us changes. We may realize suffering’s universal nature and have new feelings for others that we didn’t have before. Maybe we’re more understanding of others who are different from us, or maybe we see how suffering shapes a person’s behavior, personality, and choices.
When we learn how to feel loving kindness and provide care for even the grumpiest and most sexist and judgmental older adults or the most innocent, sweet, and loving child dying of metastatic cancer, we’re using our nursing lens even as we’re transformed by what we’re experiencing. Older adults and young children are both windows into the human experience, and no matter how many lenses we’re wearing, their suffering gets through to us, and we address it using the nurse’s skills.
Transcend Your Lenses
Our lenses do indeed shape us and influence us, yet some lenses must sometimes supersede others, and the nursing lens is one such lens. Would we want the paramedic to refuse to treat us because she disagrees with our politics or lifestyle? Would we like the dentist to ignore a cavity because he knows we belong to a different church?
Yes, you may wear the lens of the gay, progressive white man who supports reproductive rights and votes for candidates who fight for racial justice. Still, your nursing lens also forces you to see with the eyes of compassion the conservative, Hispanic, Catholic woman who pickets in front of abortion clinics. She needs your undivided attention to her blood transfusion, and it’s your moral and ethical responsibility to set all other lenses aside.
When you walk into a patient’s room, enter their home, send them a follow-up email, or prepare for their physical assessment, many other lenses must take a back seat. Your nursing lens must dominate for the moment, leading you to focus with laser-like intensity on the patient.
We see the world through many lenses, but in the final analysis, it’s the nurse’s lens that must guide your hands, mind, and heart. The nurse’s lens can often lead to a sense of compassion and caring that makes all other lenses fade away, if only for a moment in time.
Communication and collaboration are central to healthcare, and there are many tools for improving teamwork among medical facility staff members. Medical improv is an increasingly popular experiential strategy that adapts concepts and activities from theater improvisation to improve communication-related skills among healthcare professionals and critical outcomes in organizations.
The Background of Medical Improv
Beth Boynton is a nurse, author, educator, consultant, and medical improv expert. In describing medical improv and its impact, Boynton states, “We’ve known for over 20 years that communication, leadership, and human factors are leading root causes of sentinel events, yet many interventions have been unsuccessful in attempting to ensure best outcomes. Medical improv promotes essential competencies experientially where effective learning needs to occur.”
Boynton continues, “Medical improv provides professional development in competencies associated with emotional intelligence, interprofessional and therapeutic communication, teamwork, and leadership. These competencies, in turn, impact patient safety, patient experience, the health and well-being of the workforce, and even cost-effectiveness.”
Although it uses techniques from theatrical improv, medical improv is not focused on performance.
Boynton clarifies, “By taking the focus off of performance and entertainment and putting it on the learning process and healthcare teams’ goals, staff taking part in medical improv training have the opportunity to practice being together in a safe space outside of their usual stressful clinical environments. In this context, they can build caring, respectful relationships, and even laugh a little together as they learn about themselves and each other.”
“Experiential activities are integrated with other teaching methods (e.g., lectures, discussion, and reading materials) to address skill-building and/or outcome-related topics, “Boynton adds.
“The traditional teaching methods provide intellectual context about the topic and the experiential activity provides fun opportunities to practice skills with peers, reflect on one’s own behavior or habits, and discuss relevance to healthcare goals. The combination is much more effective than either of these teaching methods alone, and experienced medical improv practitioners can tweak activities to meet a variety of goals and objectives.”
“Yes And….”
A central exercise in the theatrical and medical improv worlds is “Yes And.” In this exercise, any idea one participant says is immediately enthusiastically accepted and validated by their partners. Rather than countering an idea with “No, but,” which can derail creative thinking, saying “yes and” allows the person sharing to continue thinking aloud without interruption. This strategy can be directly applied to actual meetings and brainstorming sessions to stimulate creativity and collaboration.
In another exercise known as “Radical Acceptance,” participants enthusiastically respond with “Yes!” no matter what their peers may say.
Boynton shares, “Some of the dynamic magic of this process is that some people will learn to listen better at the same moment that someone else is learning to be more assertive. By listening, we teach each other to speak up, and by speaking up, we teach each other to listen — these exercises provide a structure for that.”
Skill-Building with Medical Improv
Discussing the skills built using medical improv, Boynton points out that the experience of medical improv can improve communication, bolster social development, increase emotional intelligence, and strengthen interprofessional collaboration.
“These experiences can also help to reduce stress, burnout, and bullying behavior and increase patience, empathy, and forgiveness,” Boynton points out. “This can all be accomplished while allowing participants to learn how to take ownership of their experience and learn from their communication-related mistakes.”
Boynton adds, “Through exposure to medical improv, healthcare professionals become more able to learn from diversity, contribute to cultures of safety, and enjoy their work. Participants experience improved relationships and teamwork, less bullying, blaming, and burnout. Just as you can feel the tension in the air between stressed-out professionals in a team, participants experiencing medical improv can feel relief from these persistent and pervasive problems.”
In describing her work with healthcare teams and medical improv, Boynton is keen to clarify that every participant’s experience is different, and all come to this type of work from their own level of emotional development and experience.
Everyone is different in terms of their comfort level and the emotional risk that might be involved in developing emotional intelligence, and communication and relational skills. It requires expert facilitation to create a safe enough environment to ensure the best learning experience for everyone.”
Boynton adds, “It also requires familiarity with a variety of activities and the risk level involved. Workshops must be designed to gradually increase the risk level of activities so that people gain confidence in themselves and their peers, and trust in the facilitators.”
In terms of her approach, Boynton elucidates, “I invite and sometimes nudge folks to step into their stretch zones, and I promise to make their experience as successful as possible. It’s also helpful to explain to participants that medical improv is not about improv comedy or telling jokes, and I reassure them that they’re likely to have the most fun if they don’t try to be funny.”
“I welcome all healthcare professionals to explore medical improv resources while also advising that experiencing it is the best way to understand how it works and why it is such an incredible teaching process.”
Boynton concludes, “I see healthcare leaders, managers, and positive change agents as perfectly positioned to learn about the process and integrate activities into their staff meetings. With a commitment to learning how to teach these simple yet profoundly effective skills, this is an affordable and time-efficient intervention that any earnest leader can use for the benefit of all.”
Nurse entrepreneurship has grown exponentially in the 21st century. These days, it doesn’t take much research to discover that nurses are now enjoying the fruits of their labors in product development, consulting, coaching, writing, podcasting, and many other large and small business endeavors.
Nurses are knowledgeable, forward-thinking, and savvy. It’s no surprise that the most trusted profession has found many niches to leverage that trust.
My Side Hustle Story
In the first decade of the century, nurse entrepreneurship lived on the fringes of the online conversations occurring by and about nurses on social media platforms like Twitter and Facebook. At that time, podcasts were a new phenomenon beginning to catch hold in some industries, and blogging was growing quickly. During that first decade, nurse entrepreneurs began to capture increasing attention as pursuits like blogging, podcasting, and coaching began to catch fire.
I launched my blog in 2005, and as it focused on nursing, it became one of the first nursing blogs on the internet. During this time, I also learned about the growing field of coaching. As I attended workshops, gained knowledge, met others, and saw the growing potential of the coaching field, I found a way to launch a small side hustle as a career coach focused on nurses and other healthcare professionals.
Meanwhile, around 2011, conversations about podcasting were heating up on Twitter, and it wasn’t long before two colleagues and I launched RNFM Radio, arguably one of the first nursing podcasts in existence. This was soon followed by The Nurse Keith Show, my current nursing career podcast, which has reached almost 500 episodes.
At the same time, I discovered that many healthcare-related websites were beginning to seek out nurses with writing skills who would be willing to create relevant content for their growing online audiences. The freelance nurse writer concept was fairly novel in those early days, and I and several colleagues all found ourselves in demand as content creators for various online brands.
Building side hustles in blogging, podcasting, coaching, freelance writing, and public speaking has been a multifaceted undertaking with a steep learning curve and many twists and turns, but it underscores the reality that many nurses are seeing an avenue to self-generated income and opportunity through an enormous array of business opportunities.
The Current Nurse Business Environment
In this third decade of the 21st century, the notion of the nurse entrepreneur comes as little or no surprise to most individuals paying attention to these developments. The role of the “influencer” has found its way into numerous industries, and nurses are no exception. With nurses gaining traction with a growing number of traditional and online media outlets, some nurses have found themselves in the position of health coach, media correspondent, and resident expert.
For nurses seeking opportunities using their podcasting, speaking, coaching, and writing skills, the ability to create financially and personally rewarding side hustles and full-time businesses has never been stronger.
Along with the growth of nurse entrepreneurship has come the increasing profile of older established organizations like the National Nurses in Business Association (NNBA) and newer groups such as the Society of Nurse Scientists, Innovators, Entrepreneurs, and Leaders (SONSIEL). Online forums and networks also provide excellent support to nurse entrepreneurs, as do nurses who have fashioned themselves into business coaches able to support other nurses on these journeys.
Even though nurses don’t necessarily learn applicable business and marketing skills in nursing programs, this has not stood in the way of those of us who have chosen to pursue opportunities beyond the bedside. With access to a world of information and support currently available on the internet, self-taught nurse entrepreneurs are finding success, as are nurses who have coupled their nursing education with degrees in communication, marketing, and business administration.
With the flourishing ability to create an online presence through blogs, websites, podcasts, online video channels, and social media accounts, so has nurses’ ability to reach wider audiences grown exponentially.
Whether nurses seek to create online businesses, develop their medical products, work as consultants with large corporations, or establish traditional “brick and mortar” businesses like home health care agencies, wellness clinics, or aesthetic medical spas, the potential for success has never been more significant.
Nurse entrepreneurship has indeed come into its own. For nurses with the drive to have a few side hustles or a full-blown business endeavor, there have never been more possibilities and avenues to pursue.
So, you’ve built a solid resume that adequately represents who you are as a nurse. You’ve sharpened your professional summary, created a “Skills and Accomplishments” section that highlights your expertise, and you’ve made the “Experience,” “Education,” and “Licenses and Certifications” sections shine. What next?
While no single enhancement will be the silver bullet that puts your resume over the top, you should consider the cumulative effect of the many elements of a strong resume. Explore those overlooked resume sections that can make your resume come alive.
1. Upgrade Your Resume
If your resume demonstrates who you are as a healthcare professional, looking for ways to upgrade, enhance, or otherwise massage your resume to the next level is wise. After all, when push comes to shove in a competitive job market, those extra touches can make your resume stand out.
Even though resumes are most often considered tools in your job search toolkit, they can also be crucial for applications to graduate school, various types of fellowships and grants, and opportunities such as presenting at conferences. Resumes serve many purposes, and it’s wise to have yours looking sharp and ready for anything that might come along.
2. Community Service
Community service and volunteerism may not seem like a big deal to you. Still, involvement in such “extracurricular activities” paints a picture of a well-rounded individual who takes their place in society seriously.
Volunteerism serves many purposes: it strengthens the fabric of communities, benefits organizations and groups that rely on people’s power to get things done, and brings together individuals who work on common goals for the good of the whole.
If you decide to apply to graduate school or perhaps ask to be accepted for a fellowship or grant, a robust list of how you’ve been involved in various types of community service over the years could strengthen your case.
3. Publications
Having your name on a piece of published writing in a professional journal is an excellent addition to your resume, and it’s a false opinion that getting published is a pipe dream for the average nursing professional interested in writing, researching, or communicating their perspective.
Having an article published in a professional journal is an honor, whether that journal publishes solely online or in print format.
While some academic journals might only be interested in writing by a nurse with an advanced academic record of degrees and other accomplishments, some publications accept manuscripts from boots-on-the-ground nurses.
Remember that findings from even a small study done in your ICU can be worthy of an article revealing your conclusions. For example, research done on the impact of nosocomial infections of a new procedure for urinary catheterization can be worked into a solid piece of professional literature.
Original writing and research have a place in the world, and some editors would be interested in your ideas, whether you’re working by yourself or with a group of colleagues. And each professional participant in that endeavor can add that publication to their resume.
4. Presentations
Nursing and healthcare conferences allow professionals to display posters or give talks presenting the findings of their observations and research. The results from the study above on nosocomial infections in an ICU can be transcribed onto a large-format poster that could be accepted for presentation at a professional conference. Subsequently, that poster presentation or talk could also be included on your resume.
5. Affiliations and Memberships
It may seem insignificant to be a member of a local, state, regional, national, or international nursing organization, but listing your memberships on your resume adds something to the overall picture of who you are as a nurse.
If you hold elected office or participate in particular activities of an organization (e.g., you’re a member of the Government Relations committee, or you sit on the board of your state nursing association), this is a feather in your cap that absolutely belongs on your resume.
6. Committees and Other Workplace Activities
Do you participate in shared governance, facility-wide research, or other activities in your workplace? Taking part in committees, research, or working groups can be added to your resume to show how you do more than the minimum expected. Employers are interested in employees who give back to the workplace community.
Your resume is a living document that is a perpetual work in progress. To infuse your resume with life, get involved in professional activities that add breadth and depth to your overall career history. This adds color and vibrancy to your resume and others’ view of you as a curious and dynamic professional interested in being the best version of yourself that you can be.
