It has been over a year since the first case of COVID-19 was confirmed in the U.S., and vaccines are now being distributed widely, with 304 million doses administered across the country to date. Vaccine distribution is key to ending the pandemic, but the impact of the virus continues to be felt in nearly every industry, but especially in healthcare, with nurses on the front lines as our heroes treating patients and containing the spread of the infectious disease.
Healthcare caregivers are, and have been, operating 24/7 under stressful circumstances, working to prioritize patient care and the wellbeing of all employees. While the number of COVID-19 deaths and cases is on the decline, the lasting shifts continue to be apparent in healthcare organizations as they work to recruit and hire the best healthcare talent. According to Jobvite’s 2020 Recruiter Nation report, 26% of recruiters have reported hiring is happening rapidly at healthcare organizations, whereas 37% have reported headcount and hiring have both been reduced. These inconsistencies showcase the rapidly changing needs of individual healthcare organizations. While every hospital is different, there have been several hiring trends that have come to the forefront that nurses should be aware of.
Nursing candidates can leverage these opportunities in order to stand out within pools of talent. By keeping these trends top of mind, job seekers can more easily navigate the hiring process, scoring positions in their departments and facilities of choice.
Managing increased levels of stress and burnout
The workload, and in turn stress, for all healthcare workers continues to increase – with 48% of new nurses now leaving within the second year, according to the same Jobvite report. This turnover rate has risen due to the pandemic and can be attributed to the unprecedented stress that comes with it, as well as individual health concerns with nurses at an increased risk of exposure to the virus.
Nurses must keep this in mind while looking for a job, as it is crucial that an organization communicates their expectations and workload during the hiring phase and allows nurses to better balance their already busy schedules. Nurses are often working more than 12 hours a day, multiple times a week, creating a greater need for stress management techniques and an open communication with nursing leadership. Setting realistic expectations and being able to plan, will greatly reduce stress and help manage burnout.
The Focus on patient-centric care
There is a growing need for nurses that embody compassionate, patient-centric care. One executive surveyed had shared: “I’ve never had to terminate a doctor due to his medical skills. It’s only been due to issues related to bedside manner.” This is often the case with nurses, too. Approximately 70% of hospitals named employee engagement as their top priority for patient experience, so having the right, patient-centric nurses, is critical to the success of any healthcare facility.
Unlike many other professions, nurses must be both knowledgeable, friendly, and polite in every interaction, even in the face of staffing shortages or while handling difficult patients. This can seem like competing priorities. Because these qualities are being heavily sought after by employers, nursing candidates can use this knowledge to their advantage during job interviews to highlight examples of how they embody and excel in demonstrating these patient-focused qualities.
By sharing personal anecdotes based on previous professional and life experiences during interview opportunities, nurses are able to exhibit their values and dedication to service, relating to the employer’s individual mission and goals. Connecting with employer branding can enable nurses to find organizations that share the same standards, leading to a more successful and gratifying nursing career.
Great tools that help increase hiring of underrepresented workers
Having a diversity of talent that represents everyone, regardless of an individual’s race, ethnicity, gender, age, veteran status, or other identifying factors, builds a stronger and more inclusive work environment. Employing healthcare staff, particularly nurses, that can communicate with non-English speaking patients is critical. For example, discharging a patient who cannot understand the directions on how to take their prescriptions is not only inconvenient, but also life-dangering. Having staff who share similar cultural experiences with their patients is critical in building relationships, and ultimately providing the best quality care.
Many healthcare organizations are using tools such as the complimentary Job Description Grader by Jobvite, which ensures job descriptions are engaging and inclusive. Along with the current best practices in diversity and inclusion, this tool uses AI, analytics, and benchmarking to review job descriptions and make recommendations for more inclusive language to prevent unconscious bias. Nurses seeking jobs should be sure to highlight any diverse skills and unique attributes that would allow them to attract desired employers. Other solutions, such as Bias Blocker™ from Jobvite automatically hides identifiable information from a candidate’s resume before hiring manager review. Knowing tools like these exist in the marketplace should help all nurses feel confident that leading TA teams are taking steps to reduce bias and increase the hiring of underrepresented workers.
Navigating the job search despite the 24/7 work life
Patients don’t all get sick between 9-5, and because nurses work around the clock, it makes it difficult to connect and schedule job interviews. Many healthcare workers are on their feet all day and not at a computer job searching. Nursing candidates on-the-go can utilize capabilities to text with recruiters, easily scheduling interviews and completing applications on their phones.
Fortunately, interviewing trends are adapting with the surge of video conferencing amid COVID. While nurses are primarily working on-site, many in this industry are becoming increasingly comfortable communicating via video in today’s job market. In fact, many healthcare practitioners are also communicating with patients virtually with the expansion of telehealth nationwide. Therefore, it’s important that prospective nurses are able to effectively communicate both in-person and through a screen.
Acing a remote job interview involves establishing a quiet space and professional appearance. Nurses typically wear scrubs in their day-to-day work lives, but this is often not recommended for nursing job interviews, as business professional or business casual attire is preferred. Additionally, checking connectivity beforehand and practicing maintaining eye contact can lead to a favorable interview. Nurses shouldn’t forget to ask the interviewer questions, too! Knowing details about the training program, culture, and the specific unit can be beneficial when making a decision about which employer is the best fit.
The stakes for hiring the best nurses has never been higher. By being aware of these trends, nursing candidates can better understand the industry and optimize their chances of finding the right healthcare employer and position.
In the spring of 2020, the coronavirus pandemic first gripped the world by the throat and its deadly menace continues to unfurl with renewed ferocity. In the United States, medical and scientific experts issued a series of early recommendations to slow or halt the spread of the virus that causes the disease COVID-19. Such public health measures are clearly warranted. As of this writing, over 285,000 Americans have perished from COVID-19 and the infection numbers are soaring across much of the country. Recommendations to combat the virus spread include handwashing, covering the face when coughing and sneezing, wearing a mask when in public spaces, and social distancing. The most challenging anti-virus measure was the lockdown or stay-at-home orders issued by state and local governments. In many communities, people rushed out to stock up on food, water, and household supplies before they began sheltering in place. The lockdown preparations and implementation clearly highlighted the pervasive and persistent inequalities impacting every aspect of American life that are attributable to social determinants of health (SDH). The World Health Organization defines SDH as “the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.” During the current public health crisis one key question for researchers, policymakers, and clinical providers alike to ask is: Which populations in the U.S. are most likely to experience adverse effects from SDH?
As an academic nurse researcher with expertise in health disparities, I closely monitored news about how the spring lockdowns were impacting various population groups. I paid special attention to the dramatically different experiences of white-collar employees, many of whom had the privilege of safely sheltering in place while working from home, and front-line essential workers who had no such option. This later group, often employed in grocery stores, meat-packing plants, bus stations, and other crowded environments, had higher risk of exposure to the coronavirus. Many of these essential workers are people of color and the devastating consequence of this reality was all too predictable. According to the U.S. Centers for Disease Control and Prevention, communities of color have experienced considerably higher rates of infection, severe illness, and death from COVID-19. This population includes approximately 100,000 individuals, largely African American, with sickle cell disease (SCD), an inherited red blood disorder. The major symptom of this disease is persistent, disabling pain, including excruciating episodes known as a pain crisis. SCD is a lifelong illness with a life expectancy of 48 years for women and 42 years for men.
With a primary research focus on pain management disparities experienced by SCD patients, I worry how coronavirus-related stressors are exacerbating the considerable pain already endured by these individuals. My research indicates that systematic stressors such as healthcare injustice—defined as unfair treatment an individual receives from important medical figures such as healthcare providers — predicts increased pain in patients with SCD. They are particularly vulnerable at this time because the coronavirus pandemic can magnify the negative SDH already experienced due to their race and disease trajectory.
I am concerned about how SCD patients are coping with today’s magnified societal stressors, particularly when trying to avoid a stress-related pain crisis that would require hospitalization and potential exposure to the coronavirus. Given the comprised hematologic profile of patients with SCD, which reduces oxygen circulation, these individuals are at elevated risk for both COVID-19 severity and mortality. Statistics from early in the pandemic document this grim reality. A recent study found that between March and May 2020, 178 infected individuals were entered into the SCD-coronavirus disease case registry. Of these, 122 (69%) were hospitalized and 13 (7%) died. (These hospitalization and death rates are much higher than for infected individuals in the general population.) Healthy stress management techniques that decrease emotion-triggered pain crises could greatly improve the well-being of SCD patients and potentially reduce their hospitalizations and deaths. Healthcare professionals can play a key role in encouraging patients to consistently utilize non-drug coping strategies to complement medication regimens for pain management.
Our research team found that patients with SCD who experienced healthcare injustice from nurses reacted to this psychological stressor by isolating themselves. Meanwhile, those who experienced healthcare injustice from doctors reacted by both isolating and pain catastrophizing. These negative coping strategies are associated with poor health outcomes. For example, pain catastrophizing corresponds to lower health-related quality of life for patients with SCD. On a more positive note, patients who experience healthcare justice also cope with prayer and hopeful thinking. These healthy strategies have long been endorsed within African American communities, where deep spiritual beliefs and regular religious practices have helped them deal with the harsh realities of slavery and the systemic racial discrimination and injustice that sadly remains a powerful force in American culture.
Another coping strategy for SCD patients dealing with stress and pain is guided relaxation. This can include deep breathing and counting backwards from 10 to 1 while focusing on a specific spot within an object. This technique has been shown to effectively reduce stress and pain for adults with SCD. Another recent study found that music therapy also reduces pain and improves mood. It is important that these vulnerable patients know there are a number evidence-based drug-free strategies they can utilize during this unprecedented and pressure-filled coronavirus pandemic.
Unfortunately, SCD patients in the United States, like other citizens the world over, cannot individually control the course of the pandemic and the havoc it is wrecking. However, these patients do wield tremendous control over how they choose to cope with coronavirus-related stressors that can intensify their SCD pain. In addition to the non-drug options described above, individuals can explore and try other safe coping strategies to better manage their physical and emotional health challenges. It is vital that patients are proactive on an ongoing basis to reduce their stress and pain and improve their overall well-being as the world awaits better coronavirus treatments and an effective vaccine.
When you’re thinking of a career move, you know your success depends on more than an impressive resume. Standing out from a crowd of highly qualified nurses takes a combination of professional skills, personality match, networking contacts, and knowing how to promote your best qualifications and qualities.
Minority Nurse recently caught up with Marisa Streelman DNP, RN, CMSRN, and director of the Academy of Medical Surgical Nurses (AMSN) to find out how nurses can emerge as front runners when they’re applying for a new role and seeking the best career move.
Q: When a nurse is thinking about starting a job search, what are the top three areas of a job history to really focus on?
A: When nurses are thinking about a job search there would be a different approach to job history depending on where they are in their career.
New graduate nurses would need to focus on their clinical experiences and highlight the skills they improved upon, location of their clinical, number of hours spent with direct patient care, and if they took a full patient assignment, specifically during their final clinical experiences.
For experienced nurses, the job history they would want to highlight would be dependent on the job they are seeking. I would recommend including areas that match the job they are seeking, as well as leadership roles, clinical or patient awards, quality improvement projects, and committees they have been a part of in their most recent roles.
For both the new graduate and the experienced nurse, highlighting any volunteer nursing work is also valuable, as it could resonate with the hiring manager and make the individual stand out from the other candidates.
Q: What are some of the qualities and skills recruiters or hiring managers notice and want to see in a job candidate?
A: Hiring managers today are looking for job candidates who can discuss—and have participated in—quality improvement projects either in school or in their most recent positions. A nurse candidate who understands nursing quality indicators, such as Central Line Associated Blood Stream Infections (CLABSI), Fall Prevention, or Catheter Associated Urinary Tract Infections (CAUTI), and the evidence-based practice which is needed to improve patient outcomes, would be valuable to a hiring manager.
Leadership skills, precepting other nurses, teamwork, and being on a unit or hospital-wide committee are also valuable for a hiring manager. Many hands-on skills in nursing can be taught, some of the softer skills in nursing such as having a positive attitude, a good bedside manner, and working well within a team, are what hiring managers would be looking for during the interview process.
Q: How can nurses translate those good qualities and skills in a job search so they can stand out?
A: It can be hard to stand out in a job search, especially for new graduate positions. Adding bullet points or a cover letter to describe their nursing skills and attributes in a narrative form can help the hiring manager get a better sense if they would be a good fit for the position. It is important to always list the place they worked or completed clinical, their role, and time they were there—either years or clinical hours.
Many times new graduate candidates stood out to me with listing their non-nursing experience as well as their clinical information. For example, if someone managed in a restaurant, that tells me she is a leader, can multi-task, and probably has good customer service skills.
As I mentioned earlier, adding volunteer experiences can also make a candidate stand out to a hiring manager, even if it is not all nursing-related. This lets the hiring manager know a little more about the candidates and their skills for the position.
Q: What are the best ways nurses can leverage all the job hunting tools at their disposal—LinkedIn, Indeed, job boards, networking, etc.—and how can they do that to get the best results for a good career move?
A: There are so many different sites and job hunting tools out there to use it can be very daunting to nurses starting their job search. Being a part of a professional nursing organization, like the Academy of Medical Surgical Nurses (AMSN), is one way to narrow the search to areas which you are familiar, or you are looking to go into, and can network with other nurses within the organization.
Many professional organizations have career centers and resources that provide current openings from around the country, as well as networking areas on their websites so nurses can ask questions of other members. AMSN has an entire web section devoted to med-surg specific career development.
I have found the best way to apply for nursing positions is to apply directly to positions on companies’ websites, and follow up with the nurse recruiter via phone. Also, referrals from friends, co-workers, or classmates are helpful to hiring managers. As a manager, nurses would refer someone they used to work with or a friend, and I would always complete an interview with them. Sometimes they worked out, and sometimes they didn’t, but referrals are one way to get your resume looked at by a hiring manager.
Another way to check out an organization is to attend a career fair, which many organizations have. These are a great way to talk directly to nursing recruiters and hiring managers. At times they complete an interview on the spot.
Q: How is the job search process for a career move changing right now and what do job seekers need to know to help them?
A: The major way the job search process is changing would be the number of positions in nursing may be lower than usual due to the coronavirus and the financial impact healthcare systems are experiencing currently and throughout the last five to six months. Some areas of the country are working on recovery while others are now dealing with a new surge of cases.
Candidates may need to widen their view of what they are looking for as the “perfect” job might not be available in this current environment. Certain units within organizations are so consumed by caring for COVID-19 positive patients they do not have time to respond to inquiries or interview requests, while others are actively hiring to fill vacancies, and still others are on a hiring freeze.
As a candidate, research is needed to understand how the pandemic is impacting their local area or the place they are looking for a new position. Another item to consider would be that many career fairs are now virtual. Candidates will need to have access to technology to attend and if selected for an interview, it might be virtual as well.
Experts agree that mentoring is vital to your professional and personal development as a nurse. Good mentoring can lead to getting into—and through—nursing school, getting a great job, and getting into graduate school. However, as a minority nursing student or nurse, you may have little experience being a mentee and have many questions. Questions like: How do you approach a person you would like to have as a mentor? Do you only need one mentor? How do you know if you have a good mentor? Some minority nursing students and nurses have had mentors of the same culture or ethnicity as you and you may feel uncomfortable asking a nurse, instructor, or professor from an ethnicity or culture different from yours to be your mentor. The following tips may help you find a mentor and set the foundation for a rewarding mentee-mentor experience.
How do I know if I need a mentor?
All of us need a mentor. A mentor is an experienced person that advises you as you work to accomplish a goal or guides you through your education or career. As a nurse, there are many benefits to having a mentor. One benefit of having a nurse mentor is having someone who is impartial and can listen to you and give you direction. When your mentor shares their knowledge and experiences with you, you gain knowledge and insight. Thus, you can make choices, decide to gather more information, or even seek the advice of another mentor. Another benefit of having a mentor is often they will extend their network to you to help you. Many nurse mentors are willing to introduce you to other nurses that may be of assistance to you. For example, your mentor is a cardiology nurse and you are interested in going back to school to become an Adult-Gerontology Nurse Practitioner (AGNP). If your mentor knows one, they may often put you in touch with the AGNP because they cannot answer the types of questions you have about becoming one.
Many nursing students and nurses have more than one nurse mentor. You can have an all-round mentor, an education mentor, and one that is career specific, one that is research specific, and one that is a mentor in your practice specialty. You can have as many mentors as you need. It is better to find a mentor early in your nursing education or soon after you graduate because mentors are excellent recommendation writers for jobs or school because your mentor has listened to you talk about your aspirations and goals and can write about what they know about you.
The person I would like as my mentor is of an ethnicity or culture different from mine. Can that work?
Absolutely! In nursing, it can be very hard to find a mentor that is of your ethnicity or culture. It is perfectly fine to ask what has been their experience mentoring a person from a background different from theirs, what they learned, and what the challenges were. Keep in mind that you are deciding if this nurse will be a good mentor for you so ask what you need to know so you can make an informed decision.
How do I approach someone I would like to have as a mentor?
Before you approach your prospective mentor, think about or write down why you would like to have them as your mentor. It does not have to be elaborate. It could be that you aspire to be like them and you want to get their advice. It could be that you are interested in the type of nursing practice or research they do, and you want to shadow or work with them. Whatever your reason is, make sure you can concretely express it. Your potential mentor wants to know how they can help you. Remember, mentors are agreeing to share their time with you and they do not want to waste your time either.
Next, you should contact them by sending an email or calling them. When you contact them, you should let them know what you want and why. After an email response or call, you should ask to meet with them to begin the mentor-mentee relationship. This meeting can be over the phone if meeting face-to-face is not possible. This meeting is important for the two of you to get to know each other.
They have agreed to be my mentor! How do I prepare for our first meeting?
There are three goals for your first meeting. One is to have your mentor get to know you; the second is for you to get to know your mentor; and the third is to define your mentee-mentor relationship. In some cases, where a deadline or project is involved, a timeline may be necessary—and that is your fourth goal. There is no way for you to know everything about your mentor and for them to know you in one meeting. The important topics should include: where you are from, why you chose nursing, your goals and aspirations, and why you believe your mentor can help you. You should ask those same questions and add a question about why they choose their nursing career path, and their current goals and aspirations. Having this conversation is an excellent way for you and your mentor to connect and begin to build the foundation of a good mentee-mentor relationship.
Defining the mentee-mentor relationship should be the focal point of the first meeting because it establishes the foundation of your interactions. It defines what you want from the relationship and leads to the discussion on how to make your mentee-mentor relationship work for you both. There are three areas to cover in defining the relationship; the first is deciding whether the mentee-mentor relationship is formal or informal. An informal relationship does not require much work. Usually a verbal agreement to stay in touch with some regularity and the person agreeing to be your mentor is enough for an informal mentee-mentor relationship. A formal mentorship is usually in writing because it usually entails a project or deadline. Mentee-mentor relationships can go from being informal to formal and from formal to informal. Communication between the two of you is essential to navigating that part of the relationship.
Second, you need to decide how often you are going to meet. In informal relationships, this could be as needed or once a month. In a formal relationship, the frequency of meetings is often defined by what the project or deadline is.
Third, you must decide what type of meetings you are going to have and how long will they be. Again, in an informal relationship that may not be necessary as you will not be meeting frequently, and you can set the length of the meeting as it fits you and your mentor’s schedule. In the case of a formal relationship where regular meetings are necessary, the length of the meetings are important so that the appropriate amount of time can be set aside. In a formal mentoring relationship, an agenda or key discussion items are sent to your mentor in advance of the meeting. The agenda helps keeps you both on target.
In the case of most formal relationships, a documented timeline (i.e., a beginning and end) of the relationship or project is established. In establishing a timeline, you incorporate meeting dates, dates when you will send something to your mentor, and the timeframe when you should expect their feedback. When you do this step early in the relationship, it tends to keep everyone on task and on target. Of course, things happen, but it is important that each of you honor your formal agreement and renegotiate timelines as needed.
What do I do if my mentor is not a good fit for me?
Do not worry. Sometimes, the mentee-mentor match up does not work out as planned due to timing, different approaches, communication, and personality, among other things. Being an expert nurse, professor, or nurse researcher may not always mean that they will be a good mentor for you. If after your initial meeting or even after multiple meetings you find that you and your mentor are not a good fit, then the professional way to handle it is to end it. In the case of informal relationships, it is easier since there is no agreement for regular contact. However, it is best to thank your mentor for their time when you end the mentee-mentor relationship. In the case of a formal mentee-mentor relationship, a call, email, or letter is the most professional method to end it. Again, if you have spent time with your mentor, you should thank them for their time and what you state after that should be very professional, honest, and give at least one reason you no longer want to have a mentee-mentor relationship with that person. Keep in mind that if this is a person working in your career field that you do not want to “burn bridges,” so a scathing email or letter is not professional. When in doubt about what you have written, ask another trusted mentor or colleague.
How do I know I have found a good mentor?
Inc.com give us seven key qualities of an effective or good mentor. The seven key qualities are:
Ability and willingness to communicate what they know. A good mentor is able to make complex concepts and issues easy (or easier) to understand. A good mentor is open to sharing all the “secrets” of success with you in an effort to help you succeed. You just have to be open to listening and learning.
Preparedness. As a mentee, you should have an agenda or at least tell your mentor what you would like to discuss before you meet so that your mentor can be prepared. A prepared mentor has given thought to your questions or topic and is ready to have an efficient and directed conversation with you.
Approachability, availability, and the ability to listen. As part of the first meeting, you as the mentee have set up dates and times with your mentor and your mentor should keep those commitments and be ready to listen.
Honesty with diplomacy. A good mentor is going to be honest about whatever you are discussing. Being honest with you should be done in a professional and tactful manner, especially if your mentor is giving you feedback or critique.
Inquisitiveness. Your mentor may know a lot, but that does not mean they know everything. A good mentor is willing to learn new things about you and new topics. In essence, a good mentor is a lifelong learner.
Objectivity and fairness. A good mentor is looking forward to helping you succeed and that is it. There are no favors involved. Most often, your mentor may give you networking suggestions or offer to give you the name of a person who may be able to give additional support or a “foot in the door.” However, an expectation of a job or anything else because of the mentee-mentor relationship is not part of a mentee-mentor relationship. In the case where you and your mentor are working on a project, publication, or other work related items, the way your mentor will be acknowledged should be finalized before the project begins. For example, if you are a nursing student working on a research project you should know if you would be listed on a conference abstract or publication. If you are leading the project, you should ask your mentor how they would like to be recognized on the project.
Compassion and genuineness. Essentially, your mentor should be a good person. Being honest, fair, and objective does not equal mean and cold. A good mentor listens when you are having difficulties and is happy when you succeed. A mentee-mentor relationship is not a friendship; you may not be Facebook friends or follow each other on Instagram. However, a good mentee-mentorship relationship comes awful close to a good friendship and over time, who knows?
Taking the first step to establish a mentee-mentor relationship is usually on the mentee. Like any relationship, a good mentee-mentor relationship takes planning and having clear expectations and goals for the relationship. For minority nursing students and nurses, finding the right mentor and having a productive mentee-mentor relationship can be a daunting task when you have not had previous mentee experience and there are very few minority nurses to select as mentors. However, understanding how to establish the mentee-mentor relationship may make it less daunting and even more fruitful to enhancing your nursing career.
As you know, health care is opening to a world of opportunities, as we’ve seen sweeping changes unlike any other in the last five decades. Social, political, economic, and technological trends form a “perfect storm.” Today’s nurses are trailblazing new roads in the profession, as they adopt different roles and operate in nontraditional workplace settings.
Nurses today still care for patients, but they must also provide it in the right manner, at the right time, and in the right place. Health care organizations still seek to provide the best patient experience, but they also must cut costs, boost outcomes, and ensure safety. There is growing demand for registered nurses, both in and outside hospital doors, that demands caretakers develop a new skillset and a new mindset. Below are five ways that demonstrate how nursing has morphed and shape-shifted recently, and how nurses can make the most of tomorrow’s opportunities.
Trend #1: Jobs are moving outside of hospitals.
Inpatient units—and sometimes whole hospitals—are being closed and patients are being moved into alternative settings, such as long-term care, rehab, and subacute care facilities. Case in point: Experts estimate that today 65% of health care services are delivered in ambulatory settings, rather than hospitals. That transition from inpatient to ambulatory care settings occurred slowly over the past decade.
Why the switch? The Patient Protection and Affordable Care Act of 2010 was a major factor that hastened what hospitals were already doing: offering services outside their doors. Health care organizations want to cut down on admissions (and re-admissions), and they seek to do that by pumping up preventive care and caring for patients at home, or on an outpatient and community basis.
Andrea Higham leads Johnson & Johnson’s Campaign for Nursing’s Future, launched in 2002 to recruit and retain more nurses and nursing faculty, including minority, male, and other underrepresented groups. “Nursing is at a very exciting time, and nurses are on the frontline of health care, providing delivery of care across the board,” says Higham. “So many people are entering health care because of a confluence of so many forces, such as the Affordable Care Act and an aging population. Nurses are working not just in hospitals, but also in home health care, at clinics, as advanced practice nurses, and managing the entire health care journey. There’s a strong need for nurses in many places outside of the traditional health care setting.”
Think about opportunities outside of the hospital. For example, if you’re interested in pediatrics or working with adolescents, consider openings in pediatric long-term care, pediatric home care, pediatric rehab, or at group homes for children or teens.
According to Phyllis Quinlan, PhD, RN-BC, president of MFW Consultants to Professionals and a nursing coach, nontraditional settings, such as subacute care, are fine places to practice if applicants can overcome their preconceptions. “Long ago and far away, it was considered grandma’s nursing home, but now it’s a combination of residential care and short-term rehabilitation. It could even include pediatric or non-geriatric care,” she explains. “Hospitals are shutting down med-surg floors, and shifting patients to other, lower-cost venues for treatment. Say someone falls and breaks a hip—now they have to learn how to walk with that new hip. That’s when they need bridge care—skilled care, rehabilitation, nursing care—until they can go back home. It’s not about disease care anymore, but about preventative care and home care for managing diseases today. Hospitals soon will be only for emergency care, cardiac care, burns, traumatic injury, [and] cancer centers.”
In addition, health care organizations within the private, government, and nonprofit sectors also need qualified registered nurse candidates to fill the high demand for traditional and alternative roles.
Trend #2: New or returning nurses must develop job-search savvy and resolve to land coveted hospital positions.
“For those new graduates hoping for good med-surg experience after nursing school but can’t get a job in a hospital, don’t despair,” says Quinlan, even though hospitals have adopted stringent nurse recruiting requirements and sought to cut costs in every way without compromising care.
“Most urban area hospitals aren’t hiring, but in other areas, that’s not the case,” she explains, suggesting that new grads and nurses with some experience apply for residency or internship programs to “fast track” their careers with intensive preparation for 12 to 18 months.
“Some health care systems are rich with nursing training resources, others do it but in a more conventional way,” she adds. Another way to get your foot in the door at a hospital: “Move to [an] area where they are hiring. The State of Texas is hiring new nurses, and other states are recruiting nurses to serve a special need or a growing population.”
Nurses who are open to filling short-term temp assignments also have a leg up on other candidates; hospitals are offering six-month contracts rather than making long-term commitments they may not be able to honor.
Trend #3: Nurses must further education, clinical skills, and knowledge to keep up with complexities.
Once, a two-year associate’s program could prepare a nurse for a secure and fulfilling career. Not anymore. “Most places now will hire a nurse with an associate’s degree but ask that she sign a hiring agreement to get a baccalaureate within five years or so,” says Quinlan. “Across the 50 states, the culture varies, but independent facilities and major health systems tell me ‘we’ll only hire baccalaureate-trained nurses,’ so you need to make your peace with the fact that the minimum preparation for practice is now a bachelor’s in nursing.”
The other source of tidal change is digital technology and big data, which make it possible for nurses to do more with their expertise and deliver care from practically any corner of the world, while enjoying the advantages of telecommuting, like other professions.
“Technology allows nurses to practice off the beaten path in more ways than ever before,” says Brittney Wilson, RN, BSN, also known as The Nerdy Nurse. “With jobs like remote case management, telephone triage, and even informatics consulting, nurses can use the clinical knowledge and technical skills to help patients from the comfort of their home.
“Opportunities to work from home and attend to patient care needs virtually do come with a price,” adds Wilson, who is a nurse expert with experience as a clinical informatics nurse. “You have to have above-average computer skills and must be able to learn new software quickly.”
There’s a big need for nurses who have a business background. Traditional nursing programs do not address business aspects of health care. Nurses who go on for a master’s degree in business administration or health administration will understand policies and procedures that are governing health care now.
Trend #4: Nurses must focus on their own personal and career development to progress in the profession.
Clinical and other technical skills are important for any nurse to develop, but so are “soft skills”—for example, effective communication and problem-solving know-how.
“New to nursing? Maybe you have great ideas, but maybe you’re missing skills in how to talk to a patient or family members or how to collaborate with others,” says Higham. “You can always access our avatar-based online program, Your Future in Nursing, on the Campaign’s website.” The cutting-edge format, a game-like simulation environment for practicing key on-the-job concepts and skills, helps a student nurse prepare to make the often tough transition to practicing nurse.
Accelerating change in the health care workplace may require that new and seasoned nurses adjust their attitude and become more flexible about new ways of doing things. According to Quinlan, author of the recently published Rediscover the Joy of Being A Nurse: A Holistic Approach to Recovery from Compassion Fatigue, there’s no point in lamenting the good old days. “Nurses are some of the most creative people on the planet; they’ll make something out of nothing on a daily basis,” she says. “Some feel that they’re expected to adjust instantly to changing conditions and expectations, and they resent it. Those nurses must make peace with the new health care environment, themselves, and their profession.”
Until then, “they’re at a crossroads, and risk starting to swing to the dark side, having lost connection with the joy of practicing,” Quinlan adds.
Trend #5: Nurses will take on expanded and pivotal roles as part of tomorrow’s health care team.
How will we prepare nurses to transition to these advanced practice roles? That question has long been central for Donna Tanzi, MPS, RN-BC, NE-BC, director of nursing education and innovation at North Shore-LIJ Huntington Hospital in New York. “Nurses are going into master’s programs early on in their careers—after getting a baccalaureate, they’re going straight into a master’s or even doctoral degrees,” she says. “They have less clinical experience prior to getting an advanced degree, so we have an obligation as a profession to support them. Entry to DNP takes seven years from entry to graduation, similar to the medical model.”
Tanzi recommends nurse residency programs or fellowship programs for an extensive, tiered approach as students make the transition into their complex new roles.
“Nurses were tending to leave a job in the first year, or to leave nursing totally, because they weren’t prepared for the demands of the role,” she explains. “The bottom line and the message that I want to get out there is go into nursing for the right reasons. Recognize it’s an art and a science and we have the ability to impact people’s lives every day. Continue learning—there [are] always new directions and avenues to explore. There’s no reason to ever become stagnate or get bored in nursing; there are too many opportunities.”
There are many areas where advanced practice nurses apply their expertise gained through a master’s (or increasingly, a doctorate) in nursing or a related field. Clinical nurse practitioners are opening independent practices, or working with an academic affiliation in hospitals, or affiliated with physicians in their practices. Administrative leadership roles usually call for an MBA or MHA. Demand for nurses continues, so we need nurses to teach in nursing schools. At a minimum, instructors must have a master’s in nursing or in nursing education. Entrepreneurship, consulting, and research and development are also growth areas for advanced practice nurses.
Everywhere we look, nurses are being called on to surf the tidal waves of a changing health care environment and the emerging opportunities that come forth from it. Tomorrow’s nurses, with the right technical skills and personal qualities, can look forward to a rewarding career where they can deliver even greater value to their patients and communities.
