Choosing the Best MSN Specialty to Meet Your Career Goals

Choosing the Best MSN Specialty to Meet Your Career Goals

Getting your MSN degree in nursing is a significant step in mapping out the next part of a nursing career. But making this decision and choosing the right program for your personal and professional goals takes a lot of research and thought.

An MSN degree offers more profound knowledge and experience, leading to more significant career opportunities. However, with many specialized degree options, you must reflect and research to find the best program.

MSN programs are diverse and focused on specific career paths, including nurse practitioner, so choosing the right program for you will pay off.

“It’s important to look at your career goals and your interests,” says Dr. Latina Brooks, Ph.D., CNP, FAANP, and assistant professor and director of the Master of Science in Nursing Program and the Doctor of Nursing Practice Program at the Frances Payne Bolton School of Nursing at Case Western University. For example, she says if you’re seeking more knowledge or something different from your current career path, you’d naturally look to an MSN degree as one way to move forward.

If you want to become an advanced practice nurse practitioner (APRN), look for schools that offer clinical programs aligned with what you see yourself doing. Many nurses can narrow down their preferences while in their pre-licensure programs and through required clinical rotations and nonclinical courses, says Brooks.

“It starts in the RN programs, and then while they are working as an RN or in different areas, they will understand their strengths and interests,” she says. With that clarity, you can start to think about what you need to do to meet your career goals.

Changing Advanced Practice Qualifications

While the MSN is the fundamental path to advanced practice and licensure as a nurse practitioner, there are changes toward making the DNP a benchmark requirement for NP work. The difference seeks to ensure consistency of experience upon graduation with an MSN. Still, only some nurses want to pursue a DNP path, says Anne Derouin, DNP, APRN, CPNP, PMHS, FAANP, assistant dean and director of the MSN program at Duke University School of Nursing.

“A very dynamic change is happening,” she says, “and not all nurses are prepared in the same way.” Unlike a BSN program, where the end goal is to graduate and become a working registered nurse, the master’s degree in nursing offers vastly different outcomes.

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Anne Derouin, DNP, APRN, CPNP, PMHS, FAANP, is the assistant dean and director of the MSN program at Duke University School of Nursing

As a prospective MSN student, you’ll quickly notice curriculums vary widely. To find the program that matches the degree you need for the job you want, check all program guidelines and options to see all the courses and what the curriculum requires based on your credentials. While some programs are shorter, they aren’t necessarily going to give you the clinical hours you need for a particular role or that an organization requires.

Accelerated programs for those with a bachelor’s degree in a field other than nursing may require students to complete prerequisites to advance into an MSN program. Other schools have MSN programs that are accelerated MSN/DNP programs, so you’ll graduate with both degrees.

Pay Attention to Your Interests

“When I counsel students considering a master’s degree, I ask what they are passionate about and what patients or populations they love to care for,” says Derouin. The answers should guide prospective MSN students because they will show the result that will help them become the nurse they want to be.

MSN programs can be clinical for an advanced nurse practitioner specialization or nonclinical for nurses who want to work in management, with data or technology in informatics, or who plan to become an educator.

Within the APRN clinical routes, there are additional choices.

A family nurse practitioner path offers the greatest flexibility and job potential, but Derouin says it’s not the best option for every nurse. For a student to make that decision, she says, you’ll need to be comfortable caring for patients across the lifespan.

A pediatric specialization will give greater you depth and breadth of experience and knowledge if you prefer to work with infants and children. And if you enjoy working with older or cardiac patients, the degree path geared toward those populations will offer a better career and skill match, she says. “Then you are no longer a generalist but an expert,” Derouin says. “Think of what you love to do and hone your skills in that area.”

Brooks agrees, noting that nurses should keep their minds open when considering different paths. For example, nurses who enjoy technology or business might find careers in nursing informatics or management that blends their interests and goals.

Look into Every Aspect of MSN Programs

When assessing programs, Derouin advises students to look at certain factors. For example, ensure each program is accredited and that the faculty are practicing nurse practitioners or nurse educators, as those faculty will have the most current industry knowledge.

Ask about clinical placement, she says, as it’s an extraordinarily competitive part of many programs. Find out what kind of clinical access is available, if the school places students, or if the students have to research and secure their placements.

And use your time out of school to find out more. Ask people in your chosen field if you can shadow them or talk with them to see their daily work. “Most NPs are willing to share their journey into their role,” Derouin says.

“If you go on to graduate-level education, it opens up a whole other world of all that you can do,” says Brooks.

If researching an MSN path, you still aren’t sure what area of nursing you want to pursue, or if you have the resources to devote to an advanced degree, she recommends taking more time to make a decision. “You don’t want to waste your time or money if you’re not sure it’s something you want to jump into,” says Brooks. Then, investigate all the possibilities to reap the full benefits of an advanced degree.

“With graduate programs, there are so many avenues you can take, and that’s the beauty of our profession,” says Brooks. “There are so many aspects to nursing.”

Check out our Career Center to connect with employers seeking diverse nursing candidates.

Promotion Ready? 4 Tips for the Big Ask

Promotion Ready? 4 Tips for the Big Ask

Career advancement through a promotion or job change takes more than just hard work. Nurses, so good at advocating for their patients, have to advocate for themselves when they want to get ahead.

Asking for a promotion is a good place to begin. But just asking for a promotion might not get you the results you’re looking for. How can you make sure you’re prepared to get the promotion you want?

Here are a few ideas for promotion preparation.

List your successes

Are you uncomfortable talking about how great you are at your job? When you’re hoping for a promotion, you have to show your supervisor how much you have accomplished. Supervisors know what you do, and they know your duties. They assign responsibilities to you, but they aren’t going to remember everything. Bring a list of your increasing successes in your position. Talk about how you boosted efficiency, saved your unit money, mentored a new nurse, educated your colleagues by leading seminars, or introduced a new process that increased patient or nurse safety. Remind your organization why you are such a valuable employee.

Be open to change

Have you considered all the possibilities of moving ahead in your organization?  Before you ask for a promotion, assess where your organization needs help. Where does your organization need your skills to increase its overall performance? Moving into a role that is a professional stretch but gives you an opportunity for real job growth will jump start your career. And showing exactly how your professional skills will have a positive impact on the larger organization demonstrates a broad perspective companies want from leaders.

Show your initiative

If you want a promotion, show your supervisor that you’ve taken on additional work to sharpen your skills and increase your preparation. Think about your possible next career steps and look at the people who are in similar roles. Compare your experience and skill set with theirs so you can find any gaps where you’ll need to gain extra training or knowledge. Consider if you’d need to take classes or other professional development to prepare for a role you want and get started on what you can.

Branch out in the professional community

Have you joined a professional organization like the National Black Nurses Association or the Academy of Medical-Surgical Nurses? If you haven’t done that yet or you’re in an organization but aren’t an active member, it’s time to change. Professional organizations offer many benefits to members including rich opportunities for networking, professional development opportunities, support, and mentoring (maybe even an unexpected job interview!). Nurses in professional organizations are also able to take on increasingly complex leadership roles within the organization. Those roles are separate from their work, but leadership positions or active participation in events and advocacy are excellent examples to show your supervisor when you’re asking for a promotion. Your outside involvement with a nursing organization demonstrates your commitment to the industry as well.

When it’s time for a promotion, be an active participant in the process to increase your chances of getting ahead in your organization.

Navigating the Road to Nursing Leadership

Navigating the Road to Nursing Leadership

Leadership—it’s the Holy Grail that’s stressed in business and health care administration. But how can you get there? And how do you know if nursing leadership is even right for you?

“Not everyone has the skills, desire, or disposition to be an administrative leader,” says Laura S. Scott, PCC, CPC, ELI-MP, CPDFA, president and founder of 180 Coaching, an executive coaching and leadership training provider based in Tampa, Florida. “I recommend that my clients go to a trusted supervisor and ask, ‘Where do you see me going as a professional and leader?’ and then just listen. You might be surprised at what you hear. If you have a role in mind, ask that trusted supervisor if they think you would be a good fit for that role and ask, ‘Why or why not?’”

Use caution when thinking about getting into leadership. “Don’t rush into what isn’t easily seen as an opportunity,” says Alisha Cornell, DNP, MSN, RN, a clinical consultant with Relias, a health care talent and performance solutions company. To decide whether a leadership role is right for them and what they want get out of it, Cornell says that

self-exploration is necessary. “How did the nurses identify that they even wanted to be nurses? My recommendations are to stick to the original design. Whatever got you to nursing school and whatever helped to push you out of there, that’s your personalized equation.”

If you’re not sure if you want to be a leader, Romeatrius Nicole Moss, DNP, RN, APHN-BC, founder and CEO of Black Nurses Rock, says, “First, it is determined by the specialty you enjoy, followed by what you can contribute. Leadership starts now, as a staff nurse.” She suggests you ask yourself these questions:

  • Do people often come to you for help, advice?
  • Do you offer suggestions at meetings?
  • Are you the go-to person for issues on the unit before elevation to leadership?
  • Are you available, outgoing, approachable?

“If you are the unit leader, charge nurse, etc., these positions are set up to move you to the [higher] levels when opportunities arise,” explains Moss. “So be ready.”

If you know that you aspire to a leadership position, then move ahead. If you don’t or you try a leadership role and don’t like it, that’s okay. “If you don’t like nursing leadership, you can always go back to patient care,” says Thomas Uzuegbunem, BSN, RN, an RN administrative supervisor as well as the editor of the nursing leadership blog, NurseMoneyTalk.com. “Some nurses can get enough leadership fulfillment by being on a board. Others find that it’s not enough, and they want to move into nursing leadership as a career.”

Make sure that after self-reflection, you are the one making the decision to move into a leadership position. “Nurses who are seen as good caregivers are often promoted. While patient care is extremely important, being able to care for a patient does not mean that a nurse can care for a team of peers,” explains Bill Prasad, LPC, LCDC, CTC, a licensed professional counselor who has also worked as a hospital director and a leadership coach. “A nurse must understand that moving to a leadership role means you are moving from a focus on health care to a focus on organizational health.”

If that doesn’t fit in your life goals, there’s no shame in not pursuing leadership or moving into management. Yanick D. Joseph, RN, MPA, MSN, EdD, an assistant professor of nursing at Montclair State University in New Jersey sums it up: “Not everyone is destined to lead or to be an administrator,” she says.

Skills and Characteristics Needed for Nursing Leadership

“Leaders are born, but there are no born leaders,” says Prasad. “Becoming an effective leader takes training and education. Without this, you don’t know what you don’t know.”

Communication, flexibility, and organizational skills are the most important skills that Moss believes nurses wanting to move to leadership need to have. “Leaders should have the skills that allow them to be calm in stressful situations such as in crisis, emergencies, schedule management, and more,” she says. Nurses also need the “ability to work with different personalities and change leadership styles based on the staff member. Nurses should understand this even while working with their teams: you cannot use the same leadership style on everyone. Some people do better with taskers and checklists, while others need a little supervision to flourish.”

Moss says that leaders must be relatable and personable. “Allow your staff to see you get your hands dirty. Be the expert on the unit/department and show the team your skills and that you can handle the unit if need be. Start IVs, jump in on a code, participate while letting your team lead.”

One other characteristic Moss believes is imperative for nurses who want to lead is to be calm when challenged or with disagreements. “It is important to understand differences of opinion and to negotiate the best options. It’s even more important when dealing with difficult staff, family, etc. to not get emotional and to always be open-minded.” She admits that this was tough for her when she began to lead. “I had to understand the different personalities, politics, and overall strategic plan, and how they all come into play with decision making. Once you get this, your life will become less stressful,” she explains.

Scott agrees that good communication skills are crucial. “Effective communication and opening the channels for two-way feedback is very important. Also important is knowing what keeps these staff and providers on board and engaged so that you can give them what they need to stay motivated and fulfilled,” says Scott.

When communicating with others, Cornell says to keep this in mind: “Nurses are well-versed in the scientific methods of providing care from an academic perspective, but relating to ourselves, learning to listen for the conversation instead of solving a problem, and not reacting spontaneously are all critical skills of a strong leader.”

Nurses also need to be patient and have courage. “These characteristics are important because the normal job responsibilities of the nurse require quick thinking and paying attention to details. However, being a great leader requires the brain to slow down and digest the information in order to resolve a problem or at least know where to look to resolve it,” says Cornell.

Nurse leaders, Uzuegbunem says, must have an ability to accept diversity and understand technology. “Nurse leaders must be able to embrace diversity and adapt to those cultural differences of the nurses they lead as well as the patients the nurses take care of,” says Uzuegbunem. “Technology is having more of an influence in health care. From electronic medical records to the equipment nurses use. [Leaders] need to be able to adapt to these technological changes.”

Educational Necessities

While our sources have different opinions on how much education leaders need, one thing is certain: if you want to hold a leadership position, you must keep learning all the time.

“Nurses need to obtain additional education, certifications, and always continue to have a thirst for knowledge,” says Cornell. “A nurse leader should have, at minimum, a master’s degree in a focused area of nursing.” While she says other advanced degrees are helpful, one focused specifically on nursing “drives the objectives of nurse leadership and the shared experiences of nurse leaders. At the advanced leadership level—which includes directors and CNOs, they should have a doctorate. The terminal degree is a collaborative journey of nursing experience and leadership needed to facilitate a structured systems approach to patient care and organization of nursing teams.”

“A nurse aspiring a position in leadership should attain the highest level above what the unit or department requires,” suggests Moss. “Managing nurses who have higher credentials could lead to resentment or turnover as the staff nurse doesn’t see progression at the top. A unit should be led by the expert, in my opinion, the go-to person. This person should obtain the needed certification, education, and training to support this.”

Scott reminds nurses to check to see if the facility you work for provides funding for earning advanced education. “Many hospital groups will offer tuition reimbursement to qualified candidates, so you don’t have to go into deep debt to get this education,” she says.

Uzuegbunem believes that there’s no set educational path to leadership. “Depending on who you talk to, you’ll get different answers. Some will say that nurses should have at least a BSN before being able to get into leadership. I don’t. I also don’t think a certification is needed. All that’s required is a desire to lead others and a willingness to serve those you lead,” he argues.

Money, Money, Money

Besides the other skills, characteristics, and education that prospective leaders need, there’s another that many don’t consider—financial knowledge. Jane C. Kaye, MBA, president of HealthCare Finance Advisors, states that nurses in supervisory positions in all types of health care facilities need to have some financial skills. “The financial health of health care organizations depends on how well nurse leaders manage staff and supply costs. For example, salaries are the single largest expense line in any health care facility, and nurses represent the largest share of salaries. Similarly, nurses lead large departments such as surgical services, where supply costs are very high. If salary and supply costs are not managed, the sheer size of these spending areas can jeopardize the financial health of the health care entity,” explains Kaye.

According to Kaye, the types of financial skills nurse leaders need include: management of full-time equivalent staff, management of supplies, expense variance analysis techniques, knowledge of budgets, an understanding of operating statistics, and an understanding charge capture techniques so that all services performed are included on the patients’ bills.

For nurses who don’t have good math and finance skills, Kaye suggests that they find a trusted colleague in finance to help them understand financial concepts. “They should never be afraid to ask questions,” she says.

Attending webinars, seminars, and workshops on finance may also help.

Prep Work

A good way to prepare for a nursing leadership role, says Scott, is by taking on leadership roles outside of work. For those who want to become more confident speakers and grow in leadership presence, she recommends looking into Toastmasters, a national organization with chapters across the U.S. that help members learn to give great speeches.

Cornell says that networking is a must but can begin way before nurses are even considering leadership roles. “Knowing colleagues in the industry is always a plus, and it helps to learn what other nurses are doing. Volunteering for committees and sitting on boards are all great experiences, and nurse leaders should participate in these activities,” says Cornell. She cautions that doing this should be fine. If it’s not what the nurse is aligned with liking or doing then s/he will lose interest fast.

“Becoming part of committees and boards allows you to gain the experience and confidence you need to speak out on your opinions, work with different personalities, and see your strengths and weaknesses,” says Moss. “It can really show you what type of leader you naturally are.”

To prepare for taking a leadership role, Joseph suggests the following: reading professional journals, attending seminars, networking, joining LinkedIn, researching the role you want, reaching out to professional organizations for best practices, speaking to a mentor or someone who has made the transition, being proactive and enthusiastic about learning the intricacies of the new role, and being visible.

No matter what, being true to yourself is most important. “Being a leader is challenging, arduous, demanding, trying, and hard,” says Joseph. “But the joy of doing what you are born to do and have a passion to accomplish is indescribable.”

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The 5 Steps to Becoming a Transformational Nurse Leader

The 5 Steps to Becoming a Transformational Nurse Leader

Due to the ever-evolving nature of health care in contemporary society, more and more nurses are being looked upon as transformational nurse leaders among the scientific community. If you are interested in becoming a transformational nurse leader yourself, here are the five steps you must take to inspire change among your patients and your colleagues alike.

1. Set a Vision

Having a vision is an essential characteristic of a transformational nurse leader because it addresses the “why” and “how” of their actions. Transformational nurse leaders must not only be inspirational but also courageous in conveying their unique beliefs and viewpoints in order to bring their vision to life.

2. Foster Creativity

It’s imperative for potential transformational nurse leaders to foster creativity because it encourages innovation and adaptation to change. The transformational leadership style is vital to this approach because it identifies areas in which change is required while inspiring followers to embrace innovation in the clinical setting.

3. Communicate Effectively

A transformational nurse leader who communicates effectively not only focuses on what other individuals are attempting to convey but also essential themes important to those individuals. Effectual communicators adapt their communication style based on each individual’s ability to process and comprehend the interaction successfully despite cultural and socioeconomic differences.

4. Inspire Positive Change

To become a successful transformational nurse leader, an individual must also be charismatic and inspire real positive change across generational gaps. A transformational nurse leader must know how to inspire change because it not only promotes self-reliance but also trust in others to commit to their vision.

5.  Be a Role Model

Lastly, knowing how to be a role model is a crucial trait of the transformational nurse leader because it motivates others to become better versions of themselves. Nurses who are not only transparent but also honest embody the value of integrity that is vital in promoting trust among their followers. Leaders who display integrity are consistent when it comes to their actions, values, and expectations and are considered reliable and trustworthy. Therefore, individuals who yearn to be transformational nurse leaders must be willing to demonstrate their commitment to excellence by striving to become a positive example to those around them.

How to Weigh Job Offers

How to Weigh Job Offers

Getting a job offer is thrilling, but having two offers on the table can actually heighten both excitement and anxiety. Because nurses are in demand and much needed right now, you could someday find yourself having to choose between two (or even more) job offers at once.

How will you know what to do? What specific parts of each job will make it the right job for you? Nurses should look at each job move strategically and analyze each offer carefully. One job might offer a significantly higher salary, but the other might tempt you with flexible hours and more vacation time.

The process of choosing the right job for you is stressful. You have a lot riding on this choice and the companies you are interviewing with have a big financial stake in choosing the right candidate, too, says Kathy Quan, RN, BSN, PHN, author of The Everything New Nurse Book, and founder of TheNursingSite.com. You don’t want to waste their time—or yours. And if you choose the wrong job, you don’t want to find yourself back at square one looking for another job.

“When weighing job offers, there are financial considerations and work/life considerations,” says Kerry Hannon, author of Love Your Job: The New Rules for Career Happiness and Getting the Job You Want After 50 for Dummies. “And there’s some soul searching.”

Hannon says you should think hard about what makes you love your nursing work and what makes you happy in life so you know what each job can do for you. Are you leaving a position where your shift never ends on time or one where your boss is horrible? “What are your deal breakers?” asks Lisa Mauri Thomas, MS, a job search strategist and author of Landing Your Perfect Nursing Job. List those up front and rank them to give you a sense of what you absolutely won’t accept, she says.

Remember, your dream job could be another nurse’s nightmare, so figuring out what is important to your happiness makes a big difference in finding the job that will suit you. “Like most professionals, nurses can be easily swayed by salary,” says Nancy Brook, RN, MSN, of Stanford Health Care and author of The Nurse Practitioner’s Bag: A Guide to Creating a Meaningful Career That Makes a Difference. “But that shouldn’t be the whole decision if you are trying to establish a career path.”

“Nursing is so stressful,” says Hannon. “Know what will help you balance that stress.” Is time off so you can recharge away necessary? In that case, vacation time might be worth more to you than a higher salary. Do you need a schedule where you can work three 12-hour days so you can have four days off to take care of family? You need flexibility. Will a big jump in pay help relieve your worry over a mountain of bills? Then focusing on your financial goals can help you weigh what’s best for you.

Start Digging Early

How can you find out all this information about a job so you know enough to make the right decision? When you are considering a new position, find out as much as you can during the interview process, but then dig deeper.

“Interviewing is a two-way street,” says Hannon. “You are in the driver’s seat. They think you have something that can make their workplace better.” Both sides are trying to find a good fit, so the interview is when you can ask questions about culture, job duties, and management style, but save any salary, benefit, or flex time questions until you have an offer. Ask your interviewers why they enjoy working at the company, and ask if you can talk to a few people in the department where you would work.

Turn to social media to find out even more. Look up any connections you might have to company employees. See if someone can make an introduction for you. Check out www.Glassdoor.com where former and current employees rate companies.

And if you are hesitant about checking into a company blatantly, you have to ask yourself an important question. “If it backfires, do you really want to work there?” says Hannon. As you gather all your information, think about what might make you want the job. Some common factors include cold cash offers and culture, but there are other ways you can determine if a job choice will make you happy.

Consider Salary and Benefits

Of course, salary plays a huge part in choosing a job offer that’s right for you, and money weighs heavily in most job decisions. “If you’re not being paid what you are valuing your worth, you’ll be resentful,” argues Hannon. Have an idea of your ballpark salary and see if the organization comes close to it. But consider the value of all the other things in the job offer package. Some, like health benefits, might be worth thousands of dollars, while other items might not have a monetary value directly attributed to it (e.g., leadership opportunities), but that might have direct value on your life or lifestyle.

What’s the Work/Life Attitude?

Reflecting on what you honestly want will help you decide if the job is for you, so consider how the job fits into your life and how your life fits into your job—otherwise known as the work/life balance.

“The most important thing when making a decision about the work/life balance is to look at the bigger picture,” says Hannon. “There are things that don’t relate to money but that circle around things that make us happy.”

Flexibility and autonomy are often especially important for nurses. If you have a busy family life, you are probably looking for a schedule that includes flex time to some extent. Although flex time discussions shouldn’t happen until the job offer is made, you can certainly get an idea of how things work by asking other nurses about their typical schedules.

Does the Company Culture Match Your Values?

When you are interviewing, be extra-observant of the people and the surroundings so you can get a sense of what the atmosphere is like. “Does the vibe suit you?” asks Hannon. “Do you think you will fit in there?” Thomas recommends asking to meet with members of your potential team to ask about the leadership style or to describe the mood on the floor.

“Find out who will be your most direct manager,” says Betsy Snook, MEd, BSN, RN, and chief executive officer of the Pennsylvania State Nurses Association. The fit here is crucial to your future job satisfaction. “People don’t leave work, they leave a manager,” says Snook. When you meet with the team, don’t put them on the spot by asking about the manager, but you can ask about the management style and any challenges they have with the style. Or ask them to give some adjectives that describe the style of management. Brook recommends finding out how long the nurses have worked there. If many have years at the company, that’s a good sign that they are satisfied with how things are going.

“Look at the culture,” says Snook. “Their values, their mission, their vision—does it match your core vision?” Snook says nurses might flock to the latest and greatest hospital in the area, but they should also step back and look at the new leadership as well. “What’s the management style of the leaders? Where did they work prior to here?” If you loved your previous job because you felt like you were part of the larger picture, then consider the overall corporation. “Is this a place where you believe in the ethics there or their purpose and mission?” asks Hannon. And is the organization stable, asks Snook. A quick Google search can reveal any merger talks, financial instability, strikes, layoffs, or worker dissatisfaction.

Is There Career Advancement?

For a strategic career move, assess your bigger goals and figure out how each position brings you closer to meeting a specific goal. “Always think of your next step,” advises Thomas. Career mapping, as Thomas calls it, means that while you might accept a position, it doesn’t mean that is where you have to stay for 10 years.

Quan agrees. “If you are looking to move up the ladder, you have to make choices that make sense,” she says.

If an advanced degree is in your plans, a job package that includes some kind of tuition reimbursement for the classes you want to take will be very attractive to you. Look into other opportunities for learning. For instance, will you be able to learn new things through courses and workshops? Some companies will pay for you to travel to conferences in your specialty. Consider what kinds of new challenges will be available and how you can take advantage of those. And as Snook mentions, make sure the timeline aligns with your own. If their nurse managers typically take a decade to achieve a certain position and you have a realistic goal of achieving that position sooner, will you want to wait?

What if you aren’t looking for lots of challenges? Are you at a time in your life where your health or other personal issues are so demanding that you don’t want to be constantly challenged at work? Be honest with yourself. If you are interviewing for a job that sounds ideal, but that requires lots of travel for training or that will give you a fast track to a management role that you aren’t seeking and wouldn’t be comfortable with, then this isn’t the right job for you.

Do the Nuts and Bolts Add Security?

Finally, throw in all the other small things that can add up when you consider taking a job. “In general, pay is important, but you want to look at lifestyle, too,” says Brook. Does the great health plan include your favorite providers? How long is the commute? It is a traffic-jammed mess that you’d have to navigate every day, or is it an easier ride than your current job? How much will you end up spending in gas (and consider fluctuating fuel costs)? Does the company offer smaller perks? Would on-site child care help you? What about things like dry cleaning services or a wellness program? Do you like the idea of frequent company outings and get-togethers, or does that seem like an imposition on your time away from work?

What about the job expectations? Are you expected to sit on committees? Will you work holidays? Will any of these extras help you get closer to your career goals faster? For instance, will committee work, whether part of your job or as an unpaid volunteer, broaden your network or position you for leadership roles?

What Do You Do With Offers in Hand?

Now that you have a couple offers, you have some wiggle room if the offers are close. Before you make any move, it’s essential to have the job offer in writing, advises Thomas. “If they don’t offer one, you should request one,” she says. You can verbally accept a position contingent on receiving everything in writing—including hours, vacation time, and even any job training you’ve been promised. “Anything you have negotiated should be in there,” Thomas says. “Nurses are good at caring for others, but they have to be their strongest self-advocates. If an employer is shaky on that, I would question if that’s a place I want to work for.”

If you need time to consider the job offers, ask for a few days to crunch the numbers, says Thomas, but don’t mention that you are deciding between two offers. If you really can’t decide, determine what information is missing. If you need to spend time with nurses on the floor, ask to shadow someone. Say your intentions are good, but you need this information to help you make a solid decision, says Thomas. Show respect for their time as well and schedule anything right away.

Saying No Thanks to an Offer

When you do choose one job over another, decline the other position with grace, says Thomas. “You don’t want to burn bridges,” she says. Instead, be very gracious and thank the company profusely for the interviewing opportunity. You can let them know it came down to certain variables—like the shorter commute time or the tuition assistance—the other company offered. As the job market changes so often, you want to keep the doors open and tell them you would like to remain in touch.

As Snook says, you have to do your homework so you know the hard facts, but if you’ve taken the time to figure out your needs and you have all the details on the table, you’ll probably find yourself leaning toward one company. “When all is said and done, you just have to go with your gut,” Snook says.

And take pride in your accomplishments. “You are coming in with value,” says Brook. “Be confident in your ability to bring a good deal of value to the organization and make a decision that is right for you.”

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