Throughout history, new technologies have always sparked legitimate fears that some jobs will be radically changed or eliminated due to innovation. The telegraph, the telephone, the tractor, the steam engine, the internet, robotics, artificial intelligence — each of these developments has brought some form of change in the job market, the viability of particular professions and skills, and how things get done.
When it comes to nurses and the nursing profession, innovative technologies might give us pause to consider what nurses do, how they perform specific tasks, and if the profession might stand to lose something.
While medication-dispensing robots, telemetry, electronic fetal monitoring, artificial intelligence, and other technological advances have altered our work as nurses, fears that robots will replace us and send nurses into the historical career dustbin are likely unfounded. New opportunities are being created as nurses embrace emerging technologies and become educated and trained in valuable 21st-century skills.
The Human Touch
Nurses are the most trusted profession in the United States because they touch patients literally and figuratively daily. The trust between nurses and their patients is born mainly from the human-to-human interactions that make nursing a compelling combination of an art and a science.
No matter how efficient a robot may be in doling out medications and how powerful artificial intelligence and machine learning may become, the absolute humanity of nursing care would be impossible to replace with a machine entirely.
The physical assessment of a newborn, the expression of empathy, and the practice of hospice nursing are just three areas that come to mind where the human side of nursing care is so utterly crucial. While an immersive virtual or mixed reality application could be utilized to educate a patient about dialysis or provide basic diabetic teaching, no application can take the place of a nurse sitting on the edge of a patient’s bed, holding their hand, and providing emotionally intelligent supportive counseling as the patient mentally prepares for surgery.
The human side of nursing is the art that maintains the sacredness of the nurse-patient bond. Nursing may be partially driven by plans of care developed within the parameters of the nursing process, but where the rubber hits the road is where person-to-person interaction informs the patient experience and the nurse’s calling.
Nursing Embracing Technology
Rather than considering how technological advances might cause nurses to be replaced by machines, the more likely new reality is that of nurses embracing technology in the interest of their careers.
Nursing informatics has opened new career paths for nurses interested in computers, data management, and analytics. Nurses who master their facilities’ electronic medical records can make themselves invaluable as super users capable of training other nurses and staff in using an EMR.
Nurses pursuing master’s and doctoral degrees in informatics can pursue previously closed opportunities, including positions such as Chief Nursing Informatics Officer (CNIO). For nurses who can find such opportunities, companies creating new bedside technologies and digital interfaces will need skilled clinicians who can act as consultants on testing devices and applications that have yet to be ready for prime time.
The Robots Won’t Be Replacing You
Although science fiction could tell an entirely different story, the reality is that we won’t be seeing autonomous robot nurses speeding from room to room, providing hands-on patient care without ever needing a break for dinner or the bathroom, at least not anytime soon.
Rather than considering how the robots may be coming for your nursing job, perhaps it’s best to focus on how you can embrace them and leverage these new developments to the advantage of your nursing career.
Don’t worry — the robots won’t be rolling into town next week to staff the ICU. But if you’re a nurse wondering how the tech revolution could revolutionize your nursing career, there’s much to learn and new opportunities just around the corner.
In the world of nursing, certifications and their corresponding designations carry with them the concepts of excellence, professionalism, and focused dedication to career growth. Not all nurses pursue certification during their years of service in healthcare, but many hear the call and take inspired action to achieve such a goal.
Making an effort to become certified in your nursing specialty is like doubling down on your skills and knowledge. Doing this takes discipline and forward-thinking, demonstrating that you care enough to show the world that nursing excellence and professional mastery matter.
Every year on March 19th, we celebrate National Certified Nurses Day to honor the nurses who take their careers to the next level by becoming certified. This celebration encourages us to take a moment to acknowledge the role that certification plays in strengthening the nursing profession while improving care and patient outcomes. Being certified is meaningful, and we make meaning by pausing for the cause of reflection and recognition of the nurses who choose this path.
Nursing Certification 101
According to the American Association of Critical Care Nurses (AACN), the first nursing certification was issued in 1945 to recognize nurse anesthetists. Certification boards began to be created in the 1960s, and the number of available nursing certifications continues to grow to this day.
Many nurses choose to pursue certification of their own volition, while some employers may encourage or even require nurses in specific specialty areas to become certified. Having your employer pay for and support your certification goals can be a desirable benefit, especially if your certification process has a financial cost you’d rather not bear yourself.
A 2021 Journal of Nursing Administration study states, “Nurse specialty certification is ’a mechanism for validation or formal recognition by documenting individual nurses’ knowledge, skills, and abilities specific to their specialty’. It is a form of individual credentialing above and beyond entry-level education and licensing. By pursuing specialty certification, nurses exhibit a commitment to professional growth and lifelong learning while establishing competency in a specialized area of care such as oncology or medical-surgical nursing. The intended outcome of certification in nursing is to improve safety, quality of care, and health outcomes for those using healthcare services.”
No matter what certification you choose to pursue, rest assured that being certified is something to be proud of and to clearly and proudly document on your resume as a mark of nursing distinction and professional mastery.
Why Should You Consider Becoming a Certified Nurse
As mentioned above, certification is a demonstration of dedication to your area of specialty nursing practice. Being certified can serve many purposes and brings with it a variety of benefits, including:
Marketability: Being certified can make you a stronger candidate in the job market, especially if it sets you apart from non-certified applicants for the same positions.
Career mobility: Some employers may value nursing certifications very highly, with certified nurses more likely to advance on the organization’s clinical ladder or into positions of greater responsibility, including nursing leadership.
Respect and recognition: Certification can elicit in others a sense of respect for and recognition of your professionalism, expert knowledge, and skill.
Personal/professional pride: Certification may elicit pride in your expertise, mastery, and accomplishments as a dedicated nurse.
Certification is a feather in your nurse’s cap. It marks you as a nurse focused on career growth and expert skill and knowledge. By being certified, you benefit not only your career but also inspire others to follow in your footsteps and contribute to the improved quality of patient care, not to mention strengthen your employer’s organizational profile.
Certification Speaks Volumes
Having one or more nursing certifications speaks volumes about your professionalism and desire to develop yourself as a nurse of integrity and mastery. Being certified says a great deal about you, and your certifications can enhance your ability to advance your career in any direction you’d like to go.
Some nurses may sit on their laurels and do the bare minimum, while others may seize the day and take every opportunity to develop themselves professionally. Only you can decide if the path to certification is right for you based on your perception of the benefits of certification and the value of that process to your career.
In recognition of Certified Nurses Day, let’s acknowledge those nurses who’ve stepped up to the plate and taken on certification as a prospect worthy of their attention and hard work. And if you’re already certified, give yourself a pat on the back for going the extra mile and showing the world that you’re a nurse who wants to be the best you can be.
A nursing career offers many avenues for nurses of all stripes and interests to fulfill their professional goals. For some, earning a doctorate is a lifelong aspiration that they are keen to fulfill, and nursing offers three options for this accomplishment: the DNP, the PhD, and the Doctor of Nursing Science (DNS or DNSc).
Doctoral programs offer what is frequently referred to as “terminal” degrees since they represent the highest possible level of educational achievement in most disciplines (some areas lack a doctoral option. Thus, the master’s becomes the default terminal degree). Considering that a DNP is generally clinically oriented, and a PhD and DNS are geared towards academia and research, a nurse wishing to take their clinical knowledge and education to the highest pinnacle would do well to look at the DNP as a very promising direction.
If you’re wondering about the benefits of earning your DNP, there’s no time like the present to explore the career potential and professional development that such a high-level educational accomplishment can confer on your nursing career.
A Rigorous Education
One clear benefit of earning a DNP is that it offers an unequaled rigorous clinical training pathway. In some DNP programs, you can choose a clinical nurse specialist or educator track, or you can choose to focus on direct patient care as an expert clinician.
Your DNP program will provide a much deeper dive into the theory and science driving evidence-based advanced nursing practice. Your education may also steer you into organizational leadership, systems thinking, IT and technological advances in nursing and medicine, healthcare policy and advocacy, and quality improvement.
This form of doctoral education will enrich your understanding and professional perspective on multiple aspects of patient care, preventive medicine, population and community health, and other areas of study. Depending on the focus of the DNP program you choose, you may also gain a keener grasp of emerging ideas in nursing and medical science, the effects of climate change and the environment on populations around the world, the social determinants of health, and other trends to keep an eye on in the years to come.
With the promise of the most extensive clinical training possible for a nurse, doctoral education can open your mind and help you look at the world around you with a more discerning, critical, and perceptive eye. It will also deepen your understanding of identifying trends that can impact how you practice, the state of the broader healthcare system you are a part of, and your patient’s health and the well-being of larger communities and populations, including the most vulnerable.
DNP Earning Power and Job Opportunities, and Professional Parity
The Doctor of Nursing Practice designation demonstrates to your colleagues, your patients, and the world that you have pushed yourself to achieve the highest possible level of education as a nurse, accumulating more extensive knowledge and expertise.
In many job markets, nurses with a doctoral degree can sometimes command higher salaries than some of their masters-prepared counterparts. According to Payscale, DNPs earn an average of $112,000 annually, and NPs earn an average of $106,413, an arguably nominal difference.
However, CRNAs can expect to earn an average annual salary of $179,343. And since a DNP will be the entry-level degree for all CRNAs as of 2025, newly enrolled CRNA students have been automatically enrolled in DNP programs since 2022.
When applying for executive leadership positions, candidates with a doctoral education can have an advantage over their masters-prepared colleagues since a DNP education provides advanced training in organizational management, systems thinking, and the leading of multidisciplinary teams. Executive leadership positions include chief nursing officer (CNO), patient care director, nursing home administrator, director of nursing, or chief nursing information officer. As far as earning power, a CNO can expect to earn an average of $141,000 per year.
Professional Parity
Since many healthcare colleagues — including MDs, dentists, and physical therapists — are required to achieve a doctorate, earning your DNP can provide you with professional achievement and equality of standing regarding professional parity.
As a nurse with a DNP, you will find yourself collaborating with multidisciplinary colleagues, often in a leadership position. A doctoral degree can bestow a feeling of self-respect and the right to expect and demand equal treatment as a highly educated, knowledgeable, professional healthcare leader.
Achieving Your Highest Goals
Nurses are all individuals whose personal circumstances and preferences dictate what level of education will bring them a sense of achievement and satisfaction. An aversion to accumulating student loan debt can be enough of a deterrent for some nurses to advance their education. For some, an ADN, BSN, or MSN is enough to scratch their educational itch, and the idea of a doctorate feels foreign, excessive, or simply unnecessary to reach their career goals.
However, there are always some ambitious nursing professionals whose eyes have always been on the prize of a doctorate, whether for personal achievement, professional advancement, or a combination of these and other motivating factors. Doctoral education is an intense and enriching educational experience that some individuals look forward to with relish and excitement, if not a healthy dose of trepidation at the amount of work that completing their education will entail.
Whether for personal reasons, professional advancement, earning power, career mobility, professional parity, or simply as a quest for knowledge, earning a DNP can deliver a unique sense of accomplishment for each individual.
Only you can decide if the DNP pathway is right for you and your career. Before you take the plunge:
Do your due diligence.
Research your options.
Talk with those who’ve walked this route before you.
There are many benefits to earning your DNP, and you can make a prudent decision once you’re armed with enough information to choose from a place of wisdom and certainty.
Health disparities have historically impacted multiple populations throughout the U.S. When it comes to health and access to healthcare, consider the plight of Native Americans, undocumented immigrants, people experiencing homelessness and the chronically mentally ill, and rural communities in places like Appalachia, and we see a picture of what’s broken. The undeniable disservice that continues to millions of the most vulnerable is inexcusable, yet this legacy is slow to overcome.
In terms of Black communities and people of color, the disservice is centuries-old. To this day, the legacies of structural racism live on in health disparities that would have no place in 21st-century America if we had already learned our lessons and lived up to the potential outlined in our country’s founding documents.
Nonetheless, disproportionately negative statistics don’t lie. We know beyond the shadow of a doubt that Black Americans have received short shrift in the realms of health and healthcare since the first days of the American colonies, and the work to undo these wrongs is daunting and ongoing.
Distrust, Disparities, and Deceit
The Kaiser Family Foundation website states, “While Black people have made great contributions and achievements in the United States, they continue to face many health and health care disparities that adversely impact their overall health and well-being. These disparities have been exacerbated by the uneven impacts of the COVID pandemic, ongoing racism and discrimination, and police violence against and killings of Black people. Moreover, the long history of inequitable health outcomes among Black people reflects the abuses faced during slavery, segregation, mass incarceration, and their persistent legacies.’
Kaiser’s statistics point out that Black people face more significant financial obstacles to receiving appropriate healthcare and have a higher uninsured rate than white people. And with higher rates of poverty and food insecurity, it’s clear that many factors contribute to this calculus.
“The growing gap of health disparities within the American healthcare system is resulting in the unnecessary deaths of people of color and the continued mistrust of the healthcare system,” states Jasmyn Moore, MBA, BSN, RN, co-host of the Distrust and Disparities podcast.
“If you take a deep look into most health disparities that plague communities of color,” Ms. Moore continues, “you will see that the root cause is systemic racism. The medical field was built off experimenting on Black bodies.” In this statement, Ms. Moore is referring to a legacy exemplified by the Tuskegee experiments, where Black men were misled by researchers to believe that their syphilis was being treated, but in actuality, the course of the disease could be observed by scientists from the U.S. Public Health Service.
“We have all heard the negative statistics surrounding the health of Black, Indigenous, and people of color,” Moore states. “Black mothers are three times more likely to die during childbirth. Black infant mortality is twice as high compared to white babies. African Americans are more than twice as likely to die from cancer.”
Disturbing statistics are nothing new in the world of racial minorities in the United States. Moore comments that “the life expectancy gap between marginalized ethnic groups continues to widen despite health advancements. We are constantly bombarded with those negative and disheartening statistics. The blame is often placed on individuals and families versus a health care system that was not designed to promote and protect our health and livelihood.”
Moore concludes with the following food for thought: “Behind each of those statistics, racism plays a big factor that is often ignored. A report released by the National Academy of Medicine in 2003 pointed out how, in America, race is a determinant of health quality. Their study detailed how Black people and other ethnic minorities receive lower quality of health care than white people even when age, income, insurance status, and severity of conditions are comparable.”
Heightening the Focus
“The COVID-19 pandemic and nationwide racial justice movement over the past several years have heightened the focus on health disparities and their underlying causes and contributed to the increased prioritization of health equity,” states the Kaiser Family Foundation. “These disparities are not new and reflect longstanding structural and systemic inequities rooted in racism and discrimination.”
Aggressively addressing disparities at their root — including police violence against Black citizens, maternal-infant mortality, discriminatory housing policies, income inequality, the impact of climate change on vulnerable populations, and access to care — can lead to us cooperatively working together to find multifaceted and forward-looking solutions.
As the Kaiser Foundation pointed out, these disparities are nothing new; thus, dismantling the structural and societal issues that cause them is an uphill battle. That said, many individuals and organizations have set their sights on these issues, and the 21st-century racial justice movement is an intrinsic part of that process.
Those of us in the healthcare industry must maintain awareness, examine our own biases, and demand that our workplaces do their part in decreasing disparities impacting the populations of color that we serve. We carry that responsibility; stepping up and speaking out is our individual and collective moral obligation.
When new graduate nurses enter the labor market, many will clamor for the chance to land a position in new nurse residency programs. Presented as a game that only a lucky few can win, new nurse residencies provide great career-launching benefits for a small cohort of novice nurses. Meanwhile, their less fortunate new grad colleagues take positions where they may be subject to extremely poor (or veritably nonexistent) precepting and essentially set up to sink or swim.
Why are new nurse residencies so few and far between, leaving countless thousands of new graduate nurses to fend for themselves after being thrown to the lions? Is this seriously how we want our neophyte nurses introduced to their new careers? And who does such a system serve? Indeed, not our patients or our society as a whole.
Feeding Our Young, Not Eating Our Young
When asked about new nurse residencies, some old-school nurses may gruffly say,
“When I graduated, nobody held my hand. It was trial by fire, and I had only myself to rely on. Why should these new nurses be coddled? We never were. Let them sink or swim!”
In these more enlightened times, we realize that just because something wasn’t done in the past doesn’t mean we shouldn’t do it now if it has qualifiable or quantifiable benefits. From the point of view of many nurse educators, new nurse residencies are more than worth the time and effort needed to create and administer them.
“Nurse residency programs are crucial for healthcare organizations to enhance new graduate nurse retention by providing a structured transition from academia to clinical practice,” shares Damion Jenkins, MSN, RN, a nursing staff development and education specialist, NCLEX prep expert, and nurse career coach and mentor.
“These programs offer a supportive environment that fosters professional development, allowing nurses to gain confidence and competence in their roles,” Jenkins adds. “Improved retention translates to a more experienced and skilled nursing workforce, positively impacting patient safety through better continuity of care.”
In terms of the long-term care environment, Jenkins states, “Residency programs often don’t exist [in long-term care], and getting administrators to allow enough staff to manage them is difficult. Long-term care facilities may often only have one nurse educator. Without qualified nurse educators to develop and manage these programs, these facilities will continue to face extremely high turnover rates.”
Jenkins is correct—with the constant threat of nurse turnover amidst a nursing shortage that never seems to go away, we need our new nurses to stay in the profession, not abandon it before they even have a chance to find their sea legs.
If 18% of new nurses leave the profession within the first year (likely a significant understatement), we’re losing nearly one in five of our new nurses just when we need them most. Whether the cause is overworking, stress, understaffing, bullying, incivility, or other factors, the plain fact is this: we should be feeding our young, not eating them, and one way to feed them is through the model of new nurse residencies.
A Culture of Learning
According to Jenkins, new nurse residencies serve multiple purposes, including creating the work environments we want to see in healthcare. “These programs contribute to a culture of ongoing learning and collaboration, ensuring healthcare teams stay abreast of the latest updates in the delivery of care and best practices for optimal outcomes,” Jenkins states.
If new nurse residencies are led and staffed by nurses who feel deeply about the positive aspects of education, learning, and the optimization of care, the culture of the entire workplace will feel the repercussions of that way of looking at the system of which we’re all an intrinsic part.
Back then, a nurse would attend a nursing school run by a particular hospital. In this setting, the student nurse would receive intensive hands-on training and, more often than not, be hired as a staff nurse following graduation. While these diploma programs weren’t degree-based, the clinical training was robust, and one can assume that a new nurse residency wasn’t needed based on the rigors of a hospital-based education.
In the 21st century, with varying degrees of success in integrating didactic university or college-based education with supervised clinical experiences, new graduate nurses need more high-quality hands-on training to succeed.
Healthcare is significantly more complex than in centuries past, and the amount of clinical and didactic knowledge that nursing students need to absorb is astronomical. In other words, new grads need all the help they can get, and we owe it to them, ourselves, and society to ensure our new nurses are fully prepared for the complicated 21st-century care environment we’re hoping to launch them into.
Are Universal Residencies Realistic?
As Jenkins previously shared, new nurse residencies must be fully staffed, and many facilities start from a default position of having too few nurse educators. Hospital budgets are enormous, and the line item of a new nurse residency program is easy pickings when cuts are needed.
However, if the federal government is sincere about its commitment to the nursing workforce and nurses’ central role in American healthcare, funding could be available to create a robust system of nationwide new nurse residencies. Perhaps it could be shown that a massive investment in the retention of new nurses would save even more money over time when it comes to improved quality of care, decreased workforce attrition, and a less severe nursing shortage.
And perhaps, in a historic public/private partnership between the federal government and foundations dedicated to healthcare—such as the Kaiser Family Foundation—funding sources could be found for hospitals to be incentivized to successfully create and maintain new nurse residency programs in the interest of the health of the country.
Some may say that universal new nurse residencies are an unrealistic pipe dream that could never come to fruition. Still, with creativity, forethought, and an eye toward innovation, we could create a system where every new grad nurse who wanted a spot in a residency could have one.
Do we want our new nurses to leave the profession in droves? Doesn’t it serve us all to support our recent graduates and usher them into their new careers with increased confidence and skill?
The days of throwing our novice nurses to the lions need to end. Instead, we need to feed them the educational and experiential nutrition they need for success. After all, every new nurse’s success is one that our society can share.
Read the January issue of Minority Nurse focusing on RN-to-BSN and Nurse Residency Programs here.
