If you want to earn an advanced practice degree—such as a Nurse Practitioner (NP) or a Doctor of Nursing Practice (DNP), among others—you will need to get a Master of Science in Nursing (MSN) degree. But there are many other reasons to have one as well.
Last year, Laura Browne, MSN, RN, CNL, a second-career nurse, graduated from Georgetown University with her MSN-CNL. This means she went through a master’s-entry to nursing program with a specialty in becoming a clinical nurse leader.
Browne works as a preop and recovery nurse in the Austin, Texas, area and provides content for an informational dental care website called Smile Prep.
“In general, MSN programs offer nurses the opportunity to grow their careers in various ways, whether applicants are new to the nursing field or established nurses looking for a change of pace,” says Browne. “A major benefit of master’s-level nursing education in specialties outside of the NP role, beyond coursework at an advanced level and deep exposure to evidence-based practice (EBP) projects, is the flexibility it affords you in your career. As a nurse with a master’s degree, you meet the education requirement to be a clinical preceptor for nursing students at many universities. This is a great opportunity if you are interested in nursing education.”
Sometimes, nurses know exactly what they want to do when entering nursing school. Such is the case with Nick Angelis, CRNA, MSN, owner of Ascend Health Center and author of How to Succeed in Anesthesia School. “I started nursing school with the goal of becoming a nurse anesthetist, which requires at least an MSN,” he says. The MSN degree is “a springboard to better opportunities. In some cases, it allows nurses to continue in the place where they currently work but receive better compensation. This is most worth it if an employer provides tuition reimbursement. Specializing as an NP or CRNA allows for better compensation and better work/life balance. Most outpatient clinics are open 9–5 and closed on weekends and holidays.”
Kate Rowe, MSN, CNM, DNP, a certified nurse midwife, says, “For those nurses who wish to work more in nursing education, nursing/healthcare research, academia or advanced practice, an MSN is for you. MSNs can specialize in several different fields depending on your field of interest. Women’s health, psychiatric care, adult/gerontology, midwifery, public and community health, and emergency medicine are just some potential avenues for providers to take.”
Angelis says that before earning his MSN, he worked the night shift, doubles, and traveled from hospital to hospital. “Now I take the time I need with each patient and make my schedule. I can immediately see the effects of my anesthesia as I take patient’s pain away and safely guide them through complex surgeries. I can also collaborate with therapists, physicians, and everyone else on the care team,” he says.
As for how long earning an MSN will take, that depends on whether you’re working part-time, full-time, or not. Rowe says that they typically take two years to earn, but there are accelerated programs that can take as little as five quarters.
While working full-time, Angelis says he took his core MSN classes. When he began taking anesthesia clinicals, he would take occasional nursing shifts. “Most MSN specialties allow students to work through school. Anesthesia school is unique in the massive amount of time and effort required for several years, including up to 40 hours a week in hospitals providing anesthesia. Accelerated online programs are available for some MSN specialties and can be completed within 18 months,” he explains.
The amount of work to earn an MSN is worth it, says Rowe. She adds, “The greatest rewards of earning an MSN involve the ability to give back to your community and positively impact the lives of your patients through all the hard work in graduate school and then again when you are in practice.”
Read the October issue of Minority Nurse focusing on the MSN and Magnet Hospitals here.
The World’s Columbian Exposition of 1893, held in Chicago, was known for many things: the World’s Fair that inspired the blockbuster book The Devil in the White City, where the first Ferris wheel premiered, and where the National League for Nursing (NLN) began.
The superintendent at Johns Hopkins Training School in Baltimore, Isabel Hampton, headed the group of superintendents at the fair. Together, they laid the groundwork for the first nursing association in the United States: the American Society of Superintendents of Training Schools of Nursing.
The name changed twice. First to the National League of Nursing Education in 1912 and finally to the National League for Nursing in 1952.
“The mission is to promote excellence in nursing education to build a strong and diverse nursing workforce to advance the health of the nation and the global community,” says Beverly Malone, PhD, RN, FAAN, President and CEO of NLN.
According to Malone, the NLN was founded because, at the time, there were no boundaries, criteria, or standards regarding how nursing should be taught. “In the United States, it was going on your own. Everybody determined what would be taught, and the public deserved to know the criteria,” she says.
“It’s the same issues we have now,” Malone continues. “The public deserves transparency regarding the quality of nurses’ preparations. We were stretching beyond being the doctors’ handmaid. So, how does one stretch to become a professional? You start determining your standards. Not only would we determine them, we would live by them and operationalize them. That’s what the National League for Nursing started with, and that’s what we continue to do.”
The NLN Today
The NLN offers services for over 45,000 individuals and more than 1,000 institutional members.
In addition to its mission, Malone says that the NLN is also guided by its four core values: caring, integrity, diversity and inclusion, and excellence.
Malone explains what the first and last core values mean to the organization. “Caring promotes health, healing, and hope in response to the human condition. I think hope is something that we don’t appreciate enough,” she says. “The ‘excellence’ piece is cocreating and implementing transformative strategies with daring ingenuity. We don’t do anything by ourselves. We are into cocreating and co-implementing, and then transformation.”
The NLN offers members professional development, networking, assessment services, nursing research grants, and public policy advocacy. Regarding professional development, the NLN accomplishes this through a variety of centers.
The Center for the Advancement of the Science of Nursing Education, Malone says, deals with the scientific background for nursing education. While patients are expected to receive evidence-based care, that starts with nursing students receiving evidence-based education.
“With technology moving as fast as it is, we must understand the scientific basis for nursing education,” says Malone. “This distinguishes the National League for Nursing’s belief in the evidence-based.”
In addition, the NLN has a division for credentialing nurse educators. To date, about 15,000 nurse educators have received credentials. They have a certification for clinical educators and credentialing for newly-developed nurse educators.
“I believe that this is so critical to the nursing profession of holding us not just accountable, but also providing an opportunity for recognition,” says Malone.
The NLN’s Center for Transformational Leadership provides nurses with education regarding leadership, and its Center for the Innovation in Education Excellence gives education about simulation and technology and how it will be incorporated into the teaching and education of nurses.
Malone says these exceptional programs for nurse educators make the NLN crucial. “We believe wholeheartedly that unless you address the issues for nurse educators, including salary, the nursing shortage continues,” she says.
The National League for Nursing offers so much more for nursing educators. For additional information, check out their website.
Tara Rynders, RN, MFA, BSN, BA, admits she hasn’t had the easiest life. From when she was a child, though, she would heal from it through dance. In fact, she wanted to be a professional dancer before she thought about being a nurse.
“My earliest memory is of holding a neighborhood performance in my backyard—and it’s a lifeline that I’ve held on to through all of life’s highs and lows,” Rynders explains.
So Rynders graduated high school and headed to Hollywood. But she soon realized that the business was more focused on outward appearance rather than the inward healing dance provided.
“After my time in Hollywood, I realized that I wanted to be able to offer both emotional and physical healing. Nursing allowed me the entry point into that space. It’s a profession that offers flexibility to keep connected to my lifeline—dancing,” she says.
Trauma Hits Home
Rynders came to embrace dance and bring it into the world of nursing after her tough times. She cared for her mother until she passed. Rynders says that losing her mother made her entire world fall apart. At the time, she was working as a nurse but decided to reach out again to what had always helped—dance. So, she cut down her nursing hours to earn a master’s degree in dance.
Her sister became ill during that time and went into a coma for months. Rynders took off a semester and went to live with her in rehab until she was transferred from California to Colorado, where Rynders was living.
“In my sister’s hospital room, my dance and nursing worlds began to collide,” recalls Rynders. “Every night, I would dance to Miley Cyrus’s ‘Party in the USA.’ And I discovered that although my sister couldn’t speak, she could laugh. That became my goal—to make her laugh.”
When Rynders returned to school, she created an immersive theater performance called You & Me that was connected to her experience as her sister’s caretaker and her work as a charge nurse in the ER.
The show You & Me traveled nationally and internationally to more than five countries.
“What I realized when I cared for my sister was the gift that comes from having one-on-one intimate moments with another human being—to bathe her, feed her, and help be her voice,” says Rynders. “During the day, I would hold the suffering and loss with my sister, and at night we would hold the joy as I danced. It felt like I had both my joy and my grief coupled together in all that I did.”
One more scary experience brought Rynders to where she is today. When her twins were six months old, she learned she was pregnant again. But this time, it was an ectopic pregnancy.
“When I arrived at the hospital, things moved quickly. I remember the ER tech rolling me on the bed with too much force to start my IV; the ER physician and his caring face took extra time to see and listen to me. I remember feeling his compassion for my situation. I remember being transferred to a room when my fallopian tube burst and my abdomen began to distend with blood,” says Rynders.
“They called a code yellow—the code they call before a code blue when your heart stops. My room was full of people,” she says. “I passed out, but I could still hear everything being said. I felt my nurse grab my hand. She leaned into my ear and said, ‘I am here, and you will be okay.’ I remember thanking her for remembering me because I was so scared and couldn’t speak.”
This experience caused Rynders to have an epiphany.“I realized that nurses are everything to their patients–their voices, their advocates, their support, their healing hands. I experienced this firsthand as a patient and realized how many opportunities I was missing as a nurse to connect and see my patients authentically. I became passionate about this in my practice as a nurse and began researching authentic connection in nursing,” she says. “Everything pointed to one thing: our nurses are tired, overworked, and our healthcare systems are not set up for them to thrive and successfully care for patients.”
Rynders decided she was going to change that.
Bringing Dance to the Nurses
Pre-COVID, Rynders says that nursing leadership was downplaying nurses burnout. And in 2017, nurses weren’t ready to talk about it openly.
But the CNO and CEO where she worked approved her creating a two-hour immersive theater experience at the hospital to raise awareness of compassion fatigue and burnout. She created the performance with artists Jadd Tank and Lia Bonfilio and worked with playwright Edith Weiss.
“The 2-hour performance took place in the hospital and was open to the general public. The nurses, doctors, and other healthcare personnel testimonials were breathtaking. Most along the lines of ‘Thank you for giving us a language to understand the unrelenting grief and trauma we have been carrying with us,’” says Rynders.
After raising awareness about burnout, Rynders co-created, with Dr. Clare Hammoor, a six-week grief and trauma workshop series. The nurses connected with it so much that they began having monthly meetings post-workshop, which continued until COVID.
“At the height of COVID, my CEO asked me if I would come off the floor and focus on caring for our nurses as they cared for our COVID patients. This told me he also saw that our staff would need ongoing support,” says Rynders. The position was temporary, though; she would eventually work as a clinical nurse educator at another health care system.
Today, Rynders is also an advanced grief recovery specialist and a RESTORE (Resiliency and Equity Support and Training for Organizational Renewal) peer responder who is on call for health care personnel when they need immediate support.
“I help teach resilience, equity, and anti-racism courses for our entire system. I do this alongside my position as executive director of The Clinic Performance. I see both of these roles mutually honoring each other as I bring my whole self into all my experiences,” she says. “We dance in the hospital at our meetings, and having a pulse on nursing in the hospital setting is vital to creating workshops that tend to our nurses—meeting them where they are emotionally.”
Tara Rynders in her dance workshop
Rynders workshops touched many people and were so effective that Kaiser Permanente asked her to bring them to nurses across California. These six eight-hour workshops with up to 600 nurses began in April and will run through September.
“Our workshops are now titled (Re)Brilliancy, a play on the word resiliency. I was tired of hearing everyone tell us to be more resilient during the pandemic. Nurses are some of the most resilient humans I know. We need resilient systems that reflect the brilliant and resilient humans we already are. (Re)Brilliancy workshops help us reflect on and honor the brilliant and resilient humans we already are,” says Rynders.
Until they experience the workshops, nurses often don’t even realize that their stories or experiences have continued to both of them.
Rynders knows that her workshops are keeping nurses from leaving the profession. “I have seen firsthand nurses ready to leave—completely burned out and done with the profession. [They’ve] attended our workshops on an ongoing basis and have a rekindled joy and fervor for caring for themselves and their patients,” she says.
But more needs to be done.
“Nurses go into this field to make a difference in the lives of others. At some point, we begin sacrificing ourselves to do this. We don’t have to sacrifice our mental well-being. These workshops help us disentangle our worth and identity as caregivers from being directly related to how much we can sacrifice our well-being. Our workshops help remind us what we love, what we are passionate about, and what we need to feel seen, heard, and cared for,” says Rynders. “If healthcare systems want to retain their nurses, they need to start thinking creatively and bringing in non-traditional and innovative ways to care for their teams. Wellness must be embedded as a cornerstone that everything else builds upon.”
Angela Purcell, a nurse making a difference, has helped save patients’ sight and taught others how as part of the Flying Eye Hospital.
Purcell didn’t start her career expecting to help save people’s eyesight around the globe. In fact, she didn’t even start working as a nurse until an amazing experience changed her life permanently.
Purcell, now an RN with an Ophthalmic Nurse diploma and the Associate Director of Nursing for Orbis International’sFlying Eye Hospital, began her career as a legal secretary.
“When I was unexpectedly hospitalized, my life and career path changed forever. During that brief experience as a patient, I was inspired by the nurses around me. Good nursing depends on discipline, keen observation, and sound clinical skills. Those attributes attracted me to the profession,” recalls Purcell. “It was then I decided to start my training to become a nurse. I knew it was the right decision as I thought about the lives I could change by helping to improve the well-being of others.”
Purcell attended nursing school at Cambridge University Hospital in England, earning her RN degree in 1985. Her first job out of nursing school was working as part of intensive care teams at a cardiovascular heart and lung specialty hospital. “After a few years in this high-intensity specialty, I moved to specialize in eyes and earned my diploma in ophthalmic nursing,” she says.
During her ophthalmic studies, Purcell attended a conference where she heard an Orbis representative talk about their work. “I was captivated. I promised myself that I would join their Voluntary Faculty, a global force of more than 400 medical experts who share their skills with local eye care teams around the world,” says Purcell.
And beginning in 2012, she did just that. She began working as a volunteer faculty scrub nurse, and a few months later, she was offered a permanent position as Orbis’s Head Nurse with the Flying Eye Hospital Team.
Angela Purcell is the Associate Director of Nursing for Orbis International’s Flying Eye Hospital. Photo credit: Geoff Oliver Bugbee/Orbis International
Eyes in the Skies
According to Purcell, the Flying Eye Hospital is a fully accredited ophthalmic teaching hospital on board a plane. It travels to locations that don’t have access to quality eye care, and the staff trains eye care teams–ophthalmologists, nurses, anesthesiologists, and biomedical engineers–on how to deliver the same care in their community.
“Training is at the heart of everything Orbis does and everything I do in my daily role. I provide in-person, hands-on training to local nurse teams in infection control and emergency preparedness during training programs. I work with them on the plane and in the partner hospital,” explains Purcell. “During training programs, we care for children and adults with a wide variety of eye diseases, including cataracts, glaucoma, strabismus, and other conditions that can cause vision loss or blindness.”
Globally, she says, 1.1 billion people live with vision loss–90% of which is avoidable.
“The work I do is fighting to decrease this statistic,” says Purcell.
During the pandemic, when she couldn’t teach people in person, Purcell began teaching on Cybersight, the Orbis telemedicine and e-learning platform. Even when in-person programming returned, Purcell continued to teach online. “I found that virtual training is a great way to reach everyone,” she says. “It’s a fabulous complementary tool to every nurse’s training.”
Another crucial part of Purcell’s job is that she plays an important role in ensuring that the standards to obtain accreditation for the Flying Eye Hospital from the American Association of Accreditation for Ambulatory Surgery, are met and adhered to.
“In my role, I also ensure [that] Orbis employees are benefiting and growing, which, in turn, benefits my occupational development,” says Purcell.
One of Purcell’s greatest rewards in her job is hearing some of the patients’ stories. She shared this one:
“One of my favorite stories in my nursing career happened in April 2018 when I went to Trujillo, Peru, with the Flying Eye Hospital for a three-week training program. I worked with a volunteer nurse to care for patients before and after their surgeries. While she was preparing a patient for surgery–a young man of about 25 years old–I spoke to his mother. To my surprise, this was the second time her son had been a patient at the Flying Eye Hospital.
Twenty years ago, her son had surgery on his eye on the plane as a small child. She said she was so grateful and surprised the plane was back in Peru when her son needed urgent surgery. He had just had an accident and injured the same eye that had been operated on as a child. His mother proudly showed me pictures from the day of her son’s first surgery on the plane.
“As I looked at the pictures of the little boy and the nurse caring for him, I realized this was the same nurse preparing him for surgery again, so many years later. The nurse remembered him as a child, and the nurse, the patient, and the mother had a sweet, sentimental reunion. For me, as a witness to this fascinating story, I will always remember how it made me realize that miracles do happen in our ‘hospital with wings.’”
Purcell says she’s realized how well her job fits her skill sets. “I am great at networking and communicating with people from different cultures. Working with a global organization allowed me to collaborate, innovate, meet targets, help others, and challenge myself. Some of the highlights of my current role working at the Flying Eye Hospital have enabled me to meet quite famous individuals, including Cindy Crawford, HRH Duchess of Wessex, many heads of state, and the list goes on,” she says.
But there are many other reasons why she loves the work she does. “I love my Flying Eye Hospital team. We are like a family. We are a small, multi-cultural, close-knit team that supports one another and encourages progression and collaboration. We all share the same vision and are dedicated to fighting avoidable vision loss together,” says Purcell. “I am inspired by the people around me and how rewarding it is to see the results of our work.”
You’ve been working as a shift nurse for a few years. You love it, and you love caring for patients. But there’s always been something else calling to you: leadership.
How do you start? What steps should you take? Do you need more education?
Don’t worry; we’ve got you covered.
Making the Shift to Leadership
“Think about how you want to influence the health care system at large,” says Rachel Neill, MSN, RN, CPPS, Founder of InnovatRN Consulting, Chief Clinical Advisor for HealthEdGlobal, and a Clinician Advocate at Vivian Health. “Leadership roles often provide opportunities to affect change at higher levels and support health care teams across disciplines.”
If you’re not certain that leadership is for you, Ophelia M. Byers, DNP, APRN, WHNP-BC, NEA-BC, CPXP, CDE, Chief Nursing Office, Overlook Medical Center, and Associate Chief Nurse Executive, Atlantic Health System says “it’s important to gain knowledge that will inform decision-making.” Read nurse leadership textbooks, journal articles, and books by or including nurse leaders. She suggests Fast Facts for Making the Most of Your Career in Nursing, edited by Dr. Rhoda Redulla.
Once you’ve decided to move to leadership, Byers says you need to determine your track. “There are two formal leadership roles: supervisory/managerial and non-supervisory/functional. In supervisory or managerial leadership, the leader has direct and indirect reports that comprise a team and is responsible for the care of those people and the operation, e.g., staff on a clinical unit. In non-supervisory or functional leadership, the leader does not have any reporting team members but rather is responsible for overseeing a specific function (e.g., Nurse Educator) or program (e.g., Magnet Program Director),” she explains.
Find a mentor, says Desiree Hodges, MBA, RN, CCRN, NE-BC, The Vice President of Care Services at the ALS Association North Carolina. “Having someone in your corner is truly key. I recommend having a trusted source give you a 360 evaluation, taking personality surveys, etc. We all have blind spots when it comes to communication, which allows you to recognize your bias,” she explains.
Know about the tasks you may be doing that you aren’t doing now. “You may oversee budgets, organize staff training, and otherwise ensure that nurses follow the right procedures and protocols,” advises Kelly Conklin, MSN, CENP, SVP, Chief Clinical Officer for PerfectServe.
If you don’t have that experience, you may need to earn a higher degree than the one you hold and/or obtain certifications. “Know your organization’s requirements, reach out to your current leader and discuss your plans to obtain the necessary degrees or certifications,” says Hodges. “The American Association of Critical-Care Nurses has an online course designed just for nurses new to leadership roles that cover the basics of finance, human resources, safety, and quality, as well as the leadership skills to be successful in the role of nurse manager.”
Trust your instincts as well, Neill says. And don’t forget your experiences as a nurse at patients’ bedsides. “When moving into a leadership role, it is important to have a direct leader and health care system that will support you as you navigate this transition. In addition, the nurse leader serves as the first-line advocate for the nurses doing the daily work. You cannot support the nurses adequately without a team/system to support you as a leader,” she says.
Conklin says that no matter what you choose to do, “Don’t cut yourself off from opportunities—whatever they may be—that challenge your thinking and bring you to a higher knowledge.”