Once, when I was a non-clinical department manager, I received a call from administration advising me that the adult son of one of our patients was irate about the fact that his mother was scheduled to be discharged. The man believed his mother was too sick to go home and was making accusations about the care she received. He was demanding to see his mother’s medical record. The man was referred to me because I don’t think anyone else knew what to do with him. He had been making repeated calls and threats to administration and to the unit where his mother was a patient. It seems that everyone was afraid to let him see the chart because they assumed he was looking to find fault with his mother’s care. We tend to get upset when others are upset and sometimes develop a defensive posture rather then trying to help.
I did not look forward to receiving his phone call, and was somewhat annoyed that the situation has been “passed on” to me. But, of course I had no choice but to deal with it. When the dreaded phone call came, the man introduced himself to me. I could hear the anger and frustration in his voice. I asked him to explain his concerns and questions to me. With that, the man virtually exploded with his whole long story. Since he was so emotional, and clearly distraught, I could do nothing but simply listen to him. There was no opportunity for me to say something, even if I had wanted to. The more I focused on listening to him, the more I could hear the frustration and sense of powerlessness in his voice. He had an objective and had met nothing but obstacles every step of the way.
I calmly and quietly listened until he stopped talking (actually yelling). At that point he became silent for a moment. I remained silent in case he wasn’t yet done. He said “Are you still there?” I replied, “Yes. I’m listening.” With that, his voice immediately became calm and he said in an even tone, “Thank you for listening to me. You are the first person, of all the people I have spoken to about this, that took the time to listen and I appreciate that. Everyone else has had the need to become defensive and cut me off.” The conversation progressed from there. Although the man was still very upset, I was able to ascertain that he primarily wanted to look at his mother’s medical record and this had become a power struggle between him and the hospital staff. Since many staff people didn’t know if it was legal for him to look at his mother’s chart, they kept putting him off, which only infuriated him more and made him think they were trying to hide something. I told him that patient confidentiality was one of our prime concerns and that I needed to check with our director of medical records to see what the procedure was for such a request. I asked if I could call him back and he flatly refused. He demanded an immediate response. He was so frustrated that he also refused to let me put him on hold while I called the director of medical records. I told him that if I could not put him on hold, I would have to put the phone down and walk to that department and try to find the director. He reluctantly agreed to that, but cautioned me to hurry back and not leave him hanging. He was demanding an immediate response and resolution to his request. I cautioned him that the director might not be available, even if I went to her office. He insisted that I try.
Much to my relief, the director was in her office when I arrived. I posed the situation to her and she advised me that he could look at the record as long as his mother signed a release granting the hospital permission to allow him to do so. I ran back to my office to give him this news. I told him we only needed to get his mothers written permission and he could come down and review the record. He wanted to know when. Of course I really couldn’t answer that, but we set a tentative date and time and I assured him I would do everything possible to make that happen. I prayed that all would go smoothly, and in fact it did. We got his mother’s written permission. He came in the next day and reviewed the record and agreed to have his mother discharged. That was the last we ever heard of him. My listening, patience, and effort to help my other patient, the medical patient’s son, paid off. The bottom line is that not only should you allow someone his or her say, but through concentrated listening, you will be able to really understand what is going on and come up with a solution to the problem.
Do you wake up each workday with a headache or a knot in your stomach? Would you rather do anything than go to work? Do you feel disdain for your coworkers, supervisors and employer? Are you focused on the injustices and inequities of your work environment? Do you no longer get satisfaction from your job? Have you simply been in the same place too long and crave a change? If you answered “yes” to any of these questions, it may be time for you to move on – or at least start looking for another job.
Nurses stay in unhappy work situations for a variety of reasons. Some stay because they’re afraid of making a change. They know they’re in a rut, but they don’t want to leave the “comfort zone.” Others feel they have no options and therefore no place else to go. Some assume that in a tight job market they’re better off staying put, which is not necessarily the case. Many of us exist in a self-imposed prison, serving a sentence for a crime we never committed.
Staying in a bad or unsatisfying situation – whether it’s the work, the people or the environment that’s getting you down – is not healthy. It takes a toll on you physically, emotionally, and spiritually. It erodes your self-esteem, and if you stay long enough, the damage can be irreparable.
Years ago, I worked for a miserable man whose wife also worked in the office. He regularly spoke in an angry, degrading tone to her and others in the office. One day, I heard myself using an expression of his that I hated. That scared me. It was then that I admitted to myself how unhappy I was with the job. Staying in that environment had a negative effect on me, and I’d been taking it out on my own family and friends. I realized it was time to go.
Why it’s so hard to make a change
It’s human nature to resist change. We want to maintain the status quo. When we have to step outside our comfort zones, we get nervous and anxious. While making a change, self-doubt creeps in. We start thinking of our own perceived inadequacies and ask ourselves, “Who else would hire me?” Or we think, “I’m not qualified to do anything else.” We imagine no one else would give us the same compensation or schedule and find many other excuses to stay in an undesirable situation. But face it, it’s our fear of change or our own feelings of inadequacy that are holding us back.
You owe it to yourself, your friends and family and the clients you serve, to find the right kind of work in a setting that’s appropriate and comfortable for you. Today, nurses have many choices in traditional and nontraditional settings. Many positions pay well, provide good benefits and offer a selection of work schedules.
Making a change, sometimes just to another department or another facility in your same specialty, can make a world of difference in your attitude. Of course, change for the sake of change is not enough, so don’t be rash in making a move. Take time to consider where you want to go. Then ask around to see what facilities and companies have a good reputation for treating their nurses well. Find out what companies are offering the position and the circumstances for which you’re looking.
Get started now
Because fear of the unknown is a powerful force for resisting change, your major objective in considering a move should be to make the unknown “known.” Build perspective by doing the following:
- Update your resume. Make sure it focuses on your accomplishments and shows a diversity of experience. You never know when an opportunity will present itself, and you want to be ready.
- Brush up on your interviewing skills. There are many good books, including “The ULTIMATE Career Guide for Nurses” and articles on the subject online and in libraries and bookstores. Polish your skills by reading and going on a few interviews to “test the waters.”
- Launch a massive networking campaign. Start attending professional association meetings, career fairs, conventions and recruiting events. Make connections and see what else is out there. Talk to people from other facilities and specialties and see what they like and don’t like about their job and employer. Set up a LinkedIn account and use social media.
- List your strengths and assets. Take time to write down your strong points. Think about what you’re good at doing. Everyone has special talents. Look for jobs that will give you an opportunity to develop yours.
- Think about what you enjoy doing. Some nurses jump from job to job in pursuit of the elusive “niche.” Give some thought to what you love to do. Is it teaching, direct patient care or working with computers? The key to being happy in your work is identifying what you love and then finding a way to make that work for you.
- Get motivated. Listen to your favorite motivational tapes or read motivational books to get yourself pumped up. This is important, especially in a time of anticipated change. Go to the library and borrow some books or tapes on the subject.
- Don’t burn your bridges. Even if you can’t wait to get out of your current situation and never want to look back, ease out with grace and style. Anything else will come back to haunt you later. You’ll feel better about yourself, too.
- Do some soul searching. Examine how your state of mind is affecting your personal life, self-esteem and physical and emotional health. Decide whether there are things you can change in your work situation to improve your outlook, sense of purpose and job satisfaction. If so, by all means try them. If not, or if you just don’t have the energy or desire to try, then it may be time for a change.
Start looking into your options and get yourself prepared for a change, even before you’ve decided that’s what you want to do. Life is too short, and the nursing profession holds too many opportunities to get stuck in a rut. Change can be frightening, but it also can be exhilarating.
Stay or move on – the choice is yours. But remember: The door is always open.
Copyright Gannett Healthcare Group (www.nurse.com). All rights reserved. Used with permission.
I was blessed to have Richard Bolles, author of the classic and iconic career book, “What Color is Your Parachute?” write the foreword for my book “The ULTIMATE Career Guide for Nurses.” I want to share what he wrote here because his message is powerful. Of course he makes reference to my book (I didn’t edit that out so as to not disrupt the flow of his words) but what all he has to say about our own healing and the horizons of our mind is very moving – a message all nurses need to hear and be reminded of. Enjoy!
By Richard Bolles
When you stop to think about it, job-hunting or career-change, is one of the healing arts. For healing is related to the horizons of our mind.
I used to notice these horizons when I was a parish priest and had to visit three hospitals in my community every day. I noticed that when a hospital patient was at death’s door, the horizons of their mind had shrunk pretty much to just what was happening with their body that day. And so it would continue. But when they started to get well, they started asking questions or talking about other people there are the hospital, then things going on with their family or friends, then things going on in the community, then the nation, then the world. They started asking for newspapers and magazines. Their mind was pushing outward and outward. Their horizons were expanding. They were starting to heal, and get well. The two things are intimately related.
As nurses, our routine over the years can become so stifling, humdrum, mind-numbing, or boring, that the horizons of our mind also start to shrink. I remember a nurse who said to me: “Home. Hospital. Supermarket. Church. Week after week. This is all there is to my life.” We too sometimes need healing.
So, what happens to us when we start to think about our future, as Donna Cardillo recommends in her excellent book here? What happens when we start to examine ourselves and our gifts more fully and imagine other places where we might use those gifts? Well, you know what happens. We start to push out the horizons of our mind. And the more we push them out, the more the extent of the healing.
As you read this book, think about every step that Donna recommends you take: the lists, the notebook, the self-examination, the accumulating of new experiences, the volunteering, the exploring of career options, etc. You will notice they all add up to one thing — the pushing out of the horizons of your mind and spirit.
This is why I think this kind of exploration should be mandatory for nurses, and the longer you have been in nursing, the more important it is. You’re not just doing some selfish meditation about your own future. You are practicing one of the healing arts. You will be a better healer with your patients and everyone around you, as a result.
And — lucky you — you have the country’s leading expert in career development for nurses to guide you.
Richard Bolles is the author of
What Color Is Your Parachute? A Practical Manual
For Job-Hunters and Career Changers – -
The most popular career guide in the world
10,000,000 copies in print, in 20 languages
Each of us has our heroes in nursing; someone we admire for their clinical skills, compassionate caring nature, level-headedness, what they’ve done with their careers. One of my nursing heroes is a gal named Rosemary. We worked together years ago and stayed in touch over the years. She has always been one of the most competent and caring nurses I have ever known. Her intelligence, clear thinking, uncompromising values, and commitment to her profession have always impressed me. I have learned much from her over the years. She’s one of the quiet heroes of our profession.
I recently asked her why she became a nurse. I was interested to know what brought her to where she is today. Her answer shocked me. “I almost DIDN’T become a nurse after a high school guidance counselor told me I wasn’t smart enough” she said. “I knew I wanted to be a nurse from the 5th or 6th grade. I had visited a Veteran’s Administration hospital with a Girl Scout troop one Christmas holiday. There were a lot of very sick people there and the place was kind of depressing. All of my friends couldn’t wait to leave yet I wanted to stay. I was somehow drawn to the place, the patients. I almost felt as if I belonged there. I later wrote a school paper about the nursing profession and got an “A” on it and I didn’t get too many A’s back then!
“So when it became time to plot my future, I not only knew exactly what I wanted to do, I even knew what nursing school I wanted to go to. When I relayed this to my guidance counselor, she uttered those words that I will never forget ‘You’re not smart enough to be a nurse.’ To add salt to the wound she added, ‘Besides, you would never get accepted into that school.’ I was devastated. I took her at her word and dropped my plans to follow my dream. I took an office job out of high school and was absolutely miserable.
“My mother knew how miserable I was and in an effort to help, mentioned an LPN program being offered in our area to county residents. My guidance counselor’s words rang in my head and I thought to myself, “But I’m not smart enough.” I decided to give it a shot anyway. I got a great education and happily worked as an LPN for 5 years. I then enrolled in a university program to become an RN/BSN. I was on a roll.”
Over the years Rosemary worked in critical care, cardiac rehab, staff education, telemetry, oncology, float pool, and utilization review to name a few. She eventually became a certified diabetic educator. Rosemary worked all of her RN career to that point in the same hospital. That is where I came to know her. I used to tease her that she should receive an award for having the most positions within the shortest amount of time. It was actually 16 different positions in 18 years but who’s counting? “I had so many interests and so many opportunities. I was always learning something new and open to new challenges and experiences.”
Years later Rosemary decided to go to graduate school and become a nurse practitioner. She was ready to take her practice to the next level. After 5 years of blood, sweat, tears, and many personal sacrifices, Rosemary is a Certified Family Nurse Practitioner. Today she works in a busy cardiology practice. She is still one of the most intelligent and intuitive people I know.
Rosemary’s advice to others: Be true to yourself. Don’t ever let someone else tell you what you should or shouldn’t do with your life. And don’t let anyone else shatter your dreams. If you want to do something bad enough, there is always a way to do it. Go for it!
(Excerpted from The ULTIMATE Career Guide for Nurses by Donna Wilk Cardillo)
Who is your nursing hero?
“The patient was trembling as she told me she was 20 weeks pregnant and her water had broken while flying across the country. She was 3,000 miles from home, scared, and alone. I assured her she was at one of the best obstetric and neonatal facilities in the country. She lost the baby that day but later told me, ‘You are doing what you are meant to do with your life.’ Often compassion and sharing your heart are just what a patient needs. Never be afraid to share your heart with your patients. You may be the only person they have at that moment in time.” ~Lynn Visser, RN from: A Daybook for Beginning Nurses
I always marvel at how hung up on age so many of us are — even when we’re still relatively young! I often receive Dear Donna questions such as: “I’m 28 years old. Am I too old to become a nurse?” or “I’m 48 years old and just got out of nursing school. Will anyone hire me at this age?” or “I’m 55. Is it too late to go back to school for a higher degree?” If only I had a nickel for every time someone asked me if they were too old to do something — I’d be rich!
Recently, while in a stationery store, I saw a card that read, “What age would you be if you didn’t know what age you were?” What a great question to contemplate. Some people feel old at 28 and others feel young at 75. So many people in their 50s talk to me as if their lives are almost over, even though life expectancy is at its highest point ever. I always ask, “But what if you live to be 100? What do you want to do with the rest of your life?” How can you stay young at heart, mind, and spirit and get the most out of life and your career? Here are four ways:
Never stop learning. The day you stop learning you become old — at any age. Just as weight lifting is to your muscles, learning is to your brain. To keep it sharp, strong, and high functioning, take a class, engage in self-study (books and tapes), do more challenging reading, take music lessons, learn a new language, talk to people who do something different from you. Learning keeps you young and makes you feel alive and engaged in life.
Keep laughing. There is an expression: “You don’t stop laughing because you get old — you get old because you stop laughing.” There is humor in almost every situation if you look for it. Learn to laugh at yourself. Humor is therapeutic. It reduces stress, lightens the load, and keeps you young at heart.
Set goals. As soon as you stop setting goals, you switch from fast forward to stop or even reverse in your life and work. You need to be continually striving for something, challenging yourself in some way. Stretching yourself helps keep you feeling strong and brave and enthusiastic.
Step out of your comfort zone. Always be trying new things, whether a new project at work, applying for a higher-level position, or working in a new specialty. Otherwise you get stuck in a rut and start to decline. The comfort zone is a danger zone because you’re not learning or growing while you’re in it. And if you’re not growing, you’re stagnating or even worse — decaying.
Whether 25 or 85, you’re only as young or old as you determine yourself to be. Stay engaged in life, live every day to the fullest, and continue to learn about yourself and the world around you at every age.
You’re probably aware that many hospitals (and other healthcare facilities) across the country are not hiring new graduate nurses or are hiring very few. This has resulted in the newest members of our profession being forced to work in non-clinical settings right out of school, not finding any employment in health care for over a year after graduation, or leaving the profession entirely. Hospitals cite that they do not have the funds, the personnel, or the desire to hire and train these new nurses. But, while as much as half of the current nursing workforce is poised to retire en masse and the healthcare system is increasingly stressed by the aging population, this trend will likely result in a catastrophic lack of experienced nurses over the next decade.
To compound matters further, if a new nurse has been out of school for over a year, most hospitals will not place that nurse in its new graduate nurse orientation program, even if he or she does not have hospital experience. Additionally, it takes years for a new nurse to gain the valuable experience he or she needs to work independently, safely, and competently. In other words, it takes a village, and time, to mold a newly minted nurse.
The impending nursing shortage is real and is predicted to be the worst one we have ever experienced. We had a similar situation in the 1990’s when hospitals were downsizing and laying off experienced nurses and not hiring new nurses. Then the need expanded and suddenly there weren’t enough experienced nurses to meet the demand. Patient care suffered. The next shortage will likely hit like a tsunami and where we all be then? We already know what happens when there aren’t enough experienced nurses at the bedside: mortality and morbidity rates soar.
What’s maddening to me (and even more so to new grads) is that many recruiters are telling these newbies that they must have one year’s nursing experience. This is confusing and frustrating to the new nurse. It’s better to just say that you are not hiring new nurses and leave it at that. And even though you may not want or need these nurses today, you will likely be begging them to come work for you in the not so distant future. So be kind, professional, and compassionate; they are your future workforce.
None of this is meant to imply that every nurse must start out in a hospital or even an in-patient setting because that simply isn’t the case. In fact, much care is rapidly shifting out of the hospital into the ambulatory and primary care setting and alternative in-patient settings. Some nurses entered the profession with the intent of working immediately in alternate areas such as public health, rehab and so on. Likewise, others and I are encouraging new grads to seek alternative work settings rather than stay unemployed. But that is easier said than done.
And for those of you who still think the problem lies in new nurses being too picky about shifts, specialties, and salaries, there are hordes of new nurses who would do just about anything for any type of nursing work on any shift, in any specialty, at any salary at this point in time. The new nurse job shortage is much more severe than many experienced nurses realize.
Healthcare/nursing administrators need to have a long-range plan for providing expert nurses at the bedside in years to come. You must prepare novice nurses to carry the torch when your current staff is ready to retire or move on. Each in-patient facility should commit to hiring a good number of new graduate nurses annually, support them in their professional development, and maintain a healthy balance of new and experienced staff nurses. New nurse orientation programs need to be extended to a two-year period of time post graduation. Facilities should consider offering fee-based refresher courses and internships for those who need or want them, regardless of how long it’s been since they’ve graduated. Otherwise, we will all pay the price in the future and the biggest loser will be the patients, who could be any of us or our loved ones.
* Orirginally posted at American Nurse Today Online
I’ve been writing an online advice column as ‘Dear Donna’ at nurse.com for over 10 years. Nurses (and others) write in their career related questions and I answer them. Here’s one such Q&A. Tell me what you think about the questioner’s observations and my response to her.
I work for an insurance carrier. Many of my peers (nonnurses) comment on the lack of professionalism among nurses. Even though I’d like to defend our profession, it’s becoming increasingly hard to do so. I’ve had applicants wear Capri pants to interviews and short shorts to job fairs. I’ve seen staff refuse to follow direction by nonmedical supervisors simply because a nurse didn’t give them the direction and staff insist on wearing scrubs to work because they’re nurses and shouldn’t have to follow the business casual dress code. The problem is further magnified when nursing applicants demand higher salaries in spite of that. Nurses have a wealth of knowledge that is beneficial in many different work settings; however, it’s difficult to persuade management of this fact when nurses are doing very little to promote themselves or display a team-player attitude. I’m not at all trying to bash the nursing profession, but I’d appreciate your thoughts on this subject.
Desperately Seeking Professionalism
One simple explanation for lack of “professional” job finding skills with many nurses is the fact that historically we never needed these skills. There was a time when nurses could walk into any hospital and get hired on the spot. We didn’t need a résumé, we weren’t interviewed, and a license to practice was more important than what we were wearing. We became very casual about job finding.
Of course, times have changed, but that message hasn’t gotten out to all nurses yet. On my first interview outside the hospital years ago, I dressed rather casually and didn’t have a clue as to how to conduct myself. I learned from experience, trial and error, observation, and self-study. But some other nurses have not yet had that opportunity or that experience.
Besides all of that, many nurses don’t even own “business” clothes. Their wardrobe consists of uniforms/scrubs and casual clothes. It’s not an excuse. It’s just a fact. When I had my first job out of uniform, I was panic-stricken because I didn’t know how to dress if it wasn’t white and sold in a uniform store.
Regarding some of the other issues you raise, the whole nursing culture has taught nurses to be somewhat paranoid about what they do, whom they take orders from, where they work, and even whom they speak to. (When I went to school, we weren’t even allowed to reveal a BP reading to a patient. We had to defer to the physician.) Historically, nursing was kept separate from other hospital departments, and we began to believe we truly were separate in every way. We isolated and insulated ourselves to our detriment. When hospitals began converting to a “business” model rather than a “charitable” model and incorporated the nursing department into that model — as it should be — nurses rebelled against it, thinking “health care” was good and “business” was bad. However, neither is mutually exclusive.
Like it or not, health care is a business today. And if nurses want a good salary, benefits, and work environment, we need to have a more businesslike orientation in the delivery of care in any setting with our appearance, our communication skills, our workplace and social savvy, our ability to promote ourselves, our profession, and our programs. Why? Because, becoming more integrated in any work situation and developing a professional image to match the professional people we are will promote understanding and appreciation of what we do, as well as the value we bring to any healthcare situation. You’re right when you say nurses have a wealth of knowledge that is valuable in many settings. That is a well-kept secret, even among nurses.
Nurses have been fighting for so long to get paid a decent wage in the hospital that some believe they have to be paid the same salary everywhere or they’re giving up something. Some who move into nontraditional areas don’t consider the fact that they will no longer have to work weekends, holidays, or overtime, take call, or do shift work. One nurse recently told me that a family member who was not a nurse was goading her to ask for top salary at an insurance company because of the “nursing shortage.” I explained to her that the shortage applies primarily to patient care areas, but she wasn’t aware of that. The “business world” outside the hospital is like a foreign land for many nurses. But even in the hospital, nurses need to understand the importance of workplace savvy, image, and integration. More important, they need to understand how this can help them individually and how it will help the profession as a whole.
So how can we change all this? Nursing educational institutions, professional associations, and even places of employment need to provide education and training to nurses (and many other employees) about the concepts of “professionalism” and “image.” There are many educators and consultants who do this work, including me. In nursing, we often define professionalism as strictly related to patient care issues. We have to expand that definition and learn the related skills.
Even you, D.S.P., have an opportunity and a responsibility to be a role model, a mentor, and an educator. It isn’t that nurses don’t care. It’s simply that many of us come from a longstanding culture with deeply embedded beliefs and practices and have never heard about other ways of doing things or the reasons behind them. Nurses need to learn these things from other nurses.
Regina* had decided to give up on nursing. After 25 years in the profession, she had a “been there, done that” mentality and felt bored to tears. Her experience included multiple traditional and non-traditional specialties and multiple employers from hospitals to insurance companies. “I felt that I had exhausted my options in this profession and desperately needed a change. I was still telling myself, ‘I don’t know what I want to be when I grow up!’”
She opted to go for career testing thinking that would reveal what she should be doing with her life. The testing indicated that she might be good as a librarian, teacher, or psychologist. When Regina contacted me, she had been trying to find a position as a librarian with no success. She was seeking help in securing work in that field.
For starters, I informed Regina that career testing does not tell you what you should be doing per se, but rather points out what other people are doing who have similar interests and traits to yours. She was surprised to hear that and suddenly felt less certain about the path she was now pursuing. I also pointed out that I wasn’t surprised to hear the career paths that were presented to her since they have much in common with nursing. And that although the day to day work might seem different in some ways, these careers still had teaching, nurturing, and healing at their core – just like nursing.
As we discussed what Regina loved to do most and where her strengths lie, she revealed that she was an avid reader, committed to lifelong learning, and that teaching was always a love she had although she was adamant that she had no interest in teaching nursing. “Why not do something with all of that in nursing that is a complete departure from what you’ve done in the past?” I presented. Regina looked at me skeptically and said “I don’t think any such thing exists –at least not anything that would interest or excite me.”
We discussed various teaching options she had such as community education, working for a private education company, or doing health education in schools. While doing some informational interviewing with others in the education field at my suggestion, Regina learned of a position that was being created at a local high school for a “healthcare careers coordinator.” The school was looking for a nurse (no degree necessary) who could develop related curriculum, arrange for students to become certified nurses’ aides while still in school, teach/advise them about various healthcare career paths, and compile related resources for the school library!
When Regina heard about this position, she was stunned because she had no idea any such thing existed. I informed her that many schools had or were developing these special programs since healthcare is a great career path.
Regina wound up applying for and being offered the position. She found something that was completely different from any position she’d ever had but that still made a positive impact. In addition to using her nursing knowledge and experience, Regina felt like she was also part teacher, psychologist, career coach, and even librarian in a way! She had found a way to merge her credentials, experience, and interests and continue to “nurse” in her own unique way. Regina has reinvented herself within the nursing profession and is now helping others decide what they want to be when they grow up.
Expose yourself to new ideas, new people, new information, and new ways of working as a nurse through seminars, networking, reading and formal education. Although looking outside of the profession sometimes seems like the only way to go, looking deeper within yourself and your chosen profession often makes the most sense.
* Not her real name
Have you ever wanted to go into law enforcement, heard that people in the computer industry are making good money, or wondered what it would be like to be part of the legal team in a courtroom? If you answered “yes” to any of these questions, there is no need to leave your current profession to seek another. Rather, combine your nursing with your other skills, interests, and loves, and discover a whole new way to practice within the profession.
If you think the nursing profession offers limited opportunities, you have been misinformed. Nursing continues to hold rich and diverse opportunities. In fact, there are more opportunities in nursing today than ever before.
It is important to look beyond what you think you know about your chosen profession and get “in the know” about what nurses are doing across the country. Learn about the options within the field and plan a career that meshes with your interests.
Nurses Can Do Almost Anything
Today’s nurse might be doing medical investigating as a forensic nurse, preparing courtroom exhibits for a medical malpractice case as a legal nurse consultant, training nurses on the use of patient charting software as a nursing informatics specialist, or writing for a medical association newsletter as a medical writer. Today’s nurse might also be working as a faith-community nurse leading a bereavement support group for a local religious congregation. He or she may be working in the field of telehealth giving telephone advice and referrals to members of a managed care plan, or teaching smoking cessation classes in a corporate setting as an independent consultant.
If any of this sounds intriguing, it’s only the tip of the iceberg. Nurses have been forging new territory, professionally speaking, for the last two decades. We are moving in directions in which we have never before explored. Just in the last ten years we have seen the emergence of several new specialties. As nurses, we are versatile and multitalented. We have many transferable skills that can be used in the healthcare arena. There are many ways and places to have a positive impact on healthcare and the world around us.
Go for It
Are all of these new specialties still considered nursing? You better believe it. Being a nurse is about who you are, not about where you work. For most of us, our identity is often wrapped up in the physical environment where we work. We tend to see ourselves in a very limited role. It’s time to break out of the mold and expand our own views of who we are and what we do, and to open our eyes to virtually limitless opportunities out there if we just take a good look.
As the healthcare industry is changing, so too must the nursing profession. It’s time to step out of the box and open your eyes to what nurses are doing. Combine your interests and loves with your nursing background and revitalize your career. Even if you are happy where you are, it’s important for every nurse to understand the scope of what your colleagues are doing. You’ll be better able to anticipate and understand the changes happening around you. It’s time to celebrate the diversity of nursing.
In case you don’t frequent twitter, the nursing blogosphere, Facebook or other online nursing communities, Amanda Trujillo is a nurse in Arizona who is under investigation by the State Board of Nursing there. In short (you can read her account here) Amanda relates that when she became aware that a patient awaiting a liver transplant had considerable misunderstanding about the procedure and the lifelong aftercare that would be required, she spent time with the patient discussing related issues and ordered a hospice/case management consult at the patients request so the patient could explore his/her options, something that was within her scope of practice and not against her employer’s policies.
The patient’s surgeon, when he found out about this, became irate and demanded that she be fired and her license taken from her. Amanda was then fired by her employer Banner Del E Webb and reported to the state board. Much of the nursing community is enraged about the situation while some nurses are reserving judgment, wanting more information or waiting to see how things unfold. There are also some who doubt the validity of her story and believe she is simply seeking publicity after getting fired. But regardless of what actually happened between Amanda, her patient, the physician and her employer, there are many troubling facts in the case – things that all nurses should be concerned about.
Regardless of your thoughts about/knowledge of the actual events leading up to Amanda’s dismissal, the case has evolved into something much bigger. Yes, Amanda’s license, livelihood and reputation are on the line and she deserves our support. If given the choice, I’d much prefer to err on the side of supporting her than on the side of doubting her. But what’s even more disturbing is how Amanda is being treated in the course of the investigation.
Reports are that the board notified Amanda’s university (she is an NP student) that she was under investigation even though other insider sources say that should/would never be done while any investigation is underway. What could have been the board’s motivation to do that other than to possibly negatively influence her university against her before the investigation is completed?
Even worse, Amanda has been required by the board to have a psych consult, allegedly because she brought the case to the media and is “speaking out.” Some might say that there is a witch-hunt going on – that the powers-that-be are searching deep and wide for anything they can use to make their case. Just for argument sake, even if there were communication, chain of command, or policy issues in question (I’m not suggesting that there are), how does that warrant the type of humiliation and violation of privacy issues that she is being subjected to? And then – what if they still find nothing? What lengths might the board go to, to prove a point or ruin her career?
The case is pivotal not only because of what is happening to Amanda but also because if it happens to her, what’s to prevent something similar from happening to any other nurse in any state? Didn’t we take an oath, public or private, to advocate for our patients, educate them, and operate in their best interests? I’m sure a case can be made for either side on this issue depending on your title, whom you work for, or what your credentials are. But the bottom line is that a fellow nurse is under attack in the course of doing her job to the best of her ability.
Let’s join forces and give Amanda our support and the benefit of the doubt. But beyond that, let’s speak up for fair and equitable treatment for all nurses and the allowance of due process. Remember, anyone can report a nurse for any reason to their state board. It’s then up to the board to determine if there was wrongdoing of any sort or not. It can easily turn into a David and Goliath situation when a board holds enormous power over an individual nurse and her license and exerts undue influence in the state.
While rummaging through the attic recently, I came upon my nurse’s cap. Now more than 40 years old, it had become a bit yellow and misshapen. As I held it in my hands, I felt a nostalgic smile cross my lips and was flooded with memories of what that cap had meant to me over the years.
I attended a three-year, hospital-based, diploma nursing program. As freshman students, we wore our school uniform but no cap, so we were easily identifiable as plebes. Those of us who survived that first rigorous year “earned” our cap and were presented with one at a capping ceremony. When I donned the cap, it was official: I felt like a real nurse.
At the end of our second year, we received a half stripe to designate our progression in the program and identify us as second-year nursing students. We affixed it to our cap mid way, continuing to one side. It was a status symbol, and it reminded each of us that there was a light (and a full stripe) at the end of the tunnel. I still get goose bumps recalling what it felt like to place that full stripe on my cap at graduation. That narrow piece of ribbon—and that cap—meant the world to me. It represented where I had been, what I had accomplished, and where I was going. It symbolized a dream come true.
I remember the ritual of washing our caps. The other nursing students and I would undo the folds (held together by a plastic grommet) and carefully, and lovingly, bleach and starch it in our dormitory room sink. Then we did the all-important “shaping” so it dried just right. My school cap was of the more traditional design. It had a boxy center and wing-like appendages off to the back when in its original form. But at my school, it was in vogue to get those wings to stick out to the side as much as possible, creating what resembled a crescent – the wider the better! To achieve this look, we rolled up a pair of white gym socks and inserted them behind the wings so they would dry in just the right shape. We had this procedure honed to a fine art form!
For those of you newer to the profession, each school had/has a distinct cap. You came to recognize those from the more prominent schools in your area. Interestingly, there is a nurse artist who paints caps to preserve the images and the memory.
I always felt proud to wear that cap. When I walked (or ran) down the hall in any healthcare facility, everyone immediately knew I was a nurse. The cap is a symbol that still represents the profession today.
Even though nurses don’t wear caps anymore (although there are a few holdouts), some schools of nursing still have pinning/capping ceremonies because the female graduates crave that iconic representation even if they won’t get to wear the cap at work. Many female new nurse graduates even have their graduation pictures taken with caps on their heads. It is a symbol that still evokes an emotional response from many.
I certainly understand why nurse’s caps have been relegated to attics, history books, and vintage photos, but I am proud and happy that I had the privilege and opportunity to wear that cap for so many years.
Feel free to share your “cap” stories here. I, for one, would love to hear them!
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