New nurses, it’s time to look in new directions for employment and to utilize new ways to find and get those jobs. The nursing job market is tight in most parts of the country and hospital jobs are particularly scarse for nurses - especially new nurses. If you haven’t already, please read parts 1 and 2 of this series.

So if hospital jobs are scarce, where else can new nurses look? Consider some of the following options: Out-patient hemodialysis with a private company (as opposed to hospital-owned), cancer care facilites, birthing centers, psychiatric facilities, pediatric rehab, long-term acute care (LTAC), adult rehab – both acute and long term, long-term care, sub-acute care, and home care.

Other options include school and public health nursing, hospice and palliative care, and correctional health (prisons & juvenille detention centers) to name a few.

If you are willing to relocate to obtain a hospital job, you’ll find opportunities for new nurses more plentiful in parts of Texas, Arizona, Missouri, New Mexico, and some Midwest states. Use the search feature at http://www.nurse.com/jobs/ and enter “new graduate” in the keyword box. Although all opportunities that come up will not be right for you, you may find some that are. 

Consider joining the military – even the reserves – as a way to launch your nursing career.

Look for civilian jobs in hospitals and healthcare facilities on military bases.

Apply to the U.S. Public Health Service Commissioned Corp if you qualify http://www.usphs.gov/

Apply for loan repayment programs where you will be required to work in underserved areas http://www.hrsa.gov/loanscholarships/repayment/nursing/ 

Contact the Indian Health Service for opportunities  http://www.ihs.gov/MedicalPrograms/Nursing/

Consider starting your own business. Some innovative new nurses who couldn’t find employment started a sick-child daycare service!

Remember – you need to look in new directions for employment but you also need to utilize new ways of finding and getting those jobs as outlined in Part 2 of this series.

My latest guest blog post at American Nurse Today online:

As the world around us changes, the demographics and health care needs of the population are evolving and costs continue to escalate out of control. As a result, the healthcare system in the US is reinventing itself in significant ways to meet the needs of current and future generations. Nurses stand poised to take the lead in the future of healthcare –one of the greatest opportunities presented to us in decades. But are we ready to meet that challenge and seize the day? And if not, what will it take to get us ready?

Read on http://ow.ly/3omER

I am excited to announce that the long-awaited second edition of my first book, Your First Year as a Nurse  – Making the Transition from Total Novice to Successful Professional is finally in print. Today is the official launch date. You can get an autographed copy from my web site at www.dcardillo.com or find it on amazon.com or in bookstores just in time for the holidays!  

Survive and Thrive as a Nurse in Today’s New Health-Services Landscape

Welcome to the compassionate and caring world of nursing! You are entering a profession that offers great rewards and endless opportunities. But you must prepare for the challenges ahead and do everything you can to ensure that you experience the best that nursing has to offer.

Get off to the right start in your new profession by learning how to:
•  Find the job that’s perfect for you
•  Create your own patient-centered style of nursing
•  Develop positive relationships with doctors, patients, and other nurses
•  Stay positive, deal with conflict and adversity, and avoid burnout
•  Network, enhance your education and career, and become a leader

 And NEW! to this revised edition:
•  Invaluable information about nursing licensure, including an extensive FAQ section
•  Discussion of professional issues related to standards of care, nursing ethics, and  health-care reimbursement
•  Job-hunting challenges and solutions
•  Solutions for handling quandaries such as delayed career start, nontraditional practice, and more
•  Trends and opportunities for the future of nursing
•  A special section for second-career nurses

You can order an autographed copy from my web site at www.dcardillo.com or find it on amazon.com or in bookstores just in time for the holidays!  

Thanks to all who helped and supported me through this process!

When she first ran for office, now?U.S. Senator Barbara Mikulski explained her transition from social worker to officeholder by claiming that, “Politics is social work with power.” A nurse could just as easily declare that “Politics is nursing with power.” After all, nurses have a huge stake in issues like availability of immunization and preventive services, access to Medicare and Medicaid, and controls on health care and medications, not to mention the regulation of the nursing profession itself. And nurses are notably effective communicators, helping individuals to resolve problems and meet needs, bridging gaps in awareness and understanding. Why shouldn’t nurses apply their ethos of caring, their extensive knowledge, and their interpersonal skills to the larger world of public service?

Encouraging nurses – and women age 45 and up who are professionals in other fields underrepresented in government – to consider running for office is a goal of The 2012 Project, a campaign of the Center for American Women and Politics at the Eagleton Institute of Politics, Rutgers University. 2012 is a critical moment, the first election year after the decennial census. With redistricting creating more open seats than usual at every level, there will be numerous opportunities for newcomers to enter public office.

Nurses are not newcomers to the political stage. Right now, three serve in Congress, along with more than 50 in state legislatures. But there’s room for many more. Research shows that women are far less likely than men to be self?starters – to come up with the idea to run on their own. Women are more apt to run because someone has encouraged them. So we’re taking this opportunity to invite you to consider throwing your hat into the ring.

Want to learn more about this kind of nurse power? If you’re a political novice and don’t know where to begin, The 2012 Project can put you in touch with resources in your state to help you find training, mentoring, and inspiration. To learn more, visit our website at www.the2012project.us and click “Take Action” so we can follow up with you ?? or write us at info@the2012project.us .

Kathy Kleeman

Senior Communications Officer

Center for American Women and Politics

They’re popular with staff nurses but the research shows that they are adversely affecting nurses and patients alike. Read my recent guest blog post at American Nurse Today online and weigh in on this important issue.  http://ow.ly/2YkQv

OK new grads, fill out those online applications if you want and send in your resumes and cover letters to the human resource department of area hospitals if you must. But understand that this is the least effective way to land a job, especially in today’s tight job market. So what should you be doing? Read on.

Networking is well known to be the most effective way to find and get a job so here’s what you need to do:

Get yourself a conservative business suit – preferably skirted for a women and a traditional suit for a man. Looking top notch will make you feel more confident and make the best possible impression.

Have simple business cards made for yourself with your contact information on it. Carry them with you wherever you go.

Start attending local chapter meetings of professional associations such as the Association of Nurses Executives (AONE), your state chapter of the American Nurses Association, and any specialty association that interests you (e.g. Emergency Nurses Association). Here’s where you’ll meet the department managers that you’ve been trying to get to. You can attend as a guest if you don’t belong. When there’s something you want to do, it makes sense to rub elbows with those already doing that thing.

And since face to face networking is so effective, you should also be attending nursing career fairs, conferences and conventions when you can. It’s important for you to stay visible and well connected.

When meeting new people, use a full firm handshake, make direct eye contact and smile!  

Obtain business cards form those you meet and offer yours to them. Make follow-up phone calls when you get home and stay in touch with these folks. In other words, take the time to develop relationships. It’s all about relationship building. You may not want to do this but it is essential.

Do some informational interviewing (http://www.dcardillo.com/articles/thescoop.html) with nurses who work in specialties you might want to work in or that you want to learn more about.

Start volunteering somewhere healthcare-related to get a foot in the door. You’ll gain experience, make contacts, and have something to put on your resume. And volunteering often leads to paid employment.

Send thank you notes to anyone who helps you, refers you, interviews you, or spends time on the phone with you. Enclose your business card. Many people ask for help but few take time to say thank you.

Part 3 of this series will offer specific suggestions for specialties, types of employers/facilities, and other resources for finding nursing jobs.

It has been one year to the day that I wrote my last self-care blog post (See Self-Care: Walking the Walk October 3, 2009). At that time I vowed not to take on any new volunteer projects for one year and I am happy to report that I kept that vow. I never realized how many times I am asked to help out with things - be on a  committee, run for office in a professional association, chair this, do that - until I started saying No. It was difficult at first but got easier over time.

I did have a professional organizer come in and help me clean out my basement, garage, and attic. I had a huge garage sale this summer and got rid of so much stuff. What a weight off of me. And interesting that I should use that phrase because I am now on an exercise and weight loss regimen – down 12 pounds so far and in it for the long haul this time. I am finally ready to let go of this excess weight I have been carrying around for years. It seems I am shedding excess baggage in every aspect of my life. 

In the last year I also worked with a coach for 3 months to help me prioritize my life and work through some obstacles that have been holding me back from moving forward with bigger plans and dreams I still have for myself and my life.

I took a vacation by myself  (1st time I ever did that!) and went to Miraval spa in Arizona where I attended a wellness program by Dr. Andrew Weil himself.  I re-read Cheryl Richardson’s Take Time for Your Life, attended a meditation workshop at the Kripalu Center, and have started reading more about mindfulness, Buddhism (as an approach to life), and embracing the second half of life (I’m over 50).

As I’m “cleaning up” one area of my life, it’s opening up a space for new energy in another. What are you holding onto in yourself, your life, and your surroundings that no longer serves you?

In case you’re not already aware of this, the job market for ALL nurses across the country is very tight right now with a few exceptions such as Texas, New Mexico, Phoenix area and a few others. Some new nurses think this challenge exists only in their home state. And some seasoned nurses think new grads are having trouble finding work because they’re being too picky. Neither of these perspectives is accurate. We all, new and seasoned nurses alike, must face the reality of the current job market and do what we can to support one another, especially our new nurses. New graduate nurses are being affected most profoundly, as many cannot find nursing jobs. Some are still looking for work a year or more after graduation.

Before I continue, let me be clear that this situation will reverse itself any time as economic conditions improve and older nurses start to retire. Of course that provides no solace to those currently unemployed, underemployed, or those about to graduate. But take heart that the situation will improve. 

That being said, new nurses must change their mind-set and their job finding strategies in order to move forward in their careers. While many of us come out of nursing school having been groomed primarily for traditional hospital positions, those jobs simply aren’t plentiful right now, especially for new nurses. That doesn’t mean it’s impossible to get a hospital job. It does mean that you have to go beyond submitting applications online and sending out resumes by mail. It also means that many new nurses will need to explore other employment settings and non-traditional specialties. And since care is continuously shifting out of the hospital into alternate care settings, out-patient treatment centers, and the community, this is not necessarily a bad thing. Some experts predict that hospitals will eventually be just one big ICU where only the sickest patients go for treatment. So why not get on the bandwagon and explore other options beyond the hospital walls now?

Part 2 of this series will enumerate the most effective ways to find and get a job. In subsequent installments I’ll suggest many different areas/resources to seek work beyond the hospital.

A growing number of nurses and other healthcare workers have been fired from their jobs for postings on social media sites deemed to violate patient privacy.  This is a real concern and will be the subject of another post. But here’s another scenario that needs to be addressed – private conversations held in public places in healthcare facilities.

My husband was recently an in-patient in a hospital. While I was visiting him, a psychiatrist came into the room to have a consultation with my husband’s roommate. In the course of that interaction, the roommate admitted he was depressed and had thoughts about suicide. I felt so uncomfortable and embarrassed to overhear this. It was impossible for me to tune it out because of the small size of the room and volume of their voices. I would have had to leave my husband alone if I chose to leave the room (my husband was bed-bound) and he would have heard it even if I had left. This is one reason why the trend in hospital design is to have all private rooms!

I also overheard conversations in this and other healthcare settings, while visiting a loved one, that should have been held in private.

If I had been the man in the next bed, I would not have been willing to discuss such personal health matters in ear-shot of strangers. But he was older and perhaps didn’t consider his privacy or didn’t feel comfortable asking for a private setting in which to talk. Some folks do not always assert themselves in healthcare situations and accept things as they are even though they feel uncomfortable in some way.

With all of our concerns about HIPPA regulations and the privacy of what is in writing in medical records, reports, and social media sites, perhaps we all need to take a good hard look at what we say out loud in healthcare settings and even in public/social settings.  These might include patient room communication, conversations behind the nurses’ desk and in the charting/break room when the door is open, discussion over meals and breaks in caferterias, and even when out to dinner with a friend. You just never know who is listening.

Every healthcare consumer has a right to safe and confidential care and should be able to feel confident in knowing that their personal information is respected and kept private by all healthcare workers in all settings.

I once heard someone say, “Life is not boring; people are boring.” The implication is that if someone feels bored, it is his or her own fault because there is always something interesting to do, see, and learn in life. The same could be said for nursing. Yet I often hear nurses say, “I’m in a rut. I get up and go to work everyday, do the same thing, eat, sleep and do it all over again.” If you are feeling bored in your job or career create some positive momentum to liven things up and breathe fresh air into your world. How can do that? Read on.

Look for a project at work (or through volunteer work or your professional associations) that showcases your special talents or where you can develop a new skill set. For example, if you like teaching or would like to gain some teaching experience, volunteer to be a preceptor, present at grand rounds, or do some community education. Don’t do it for your employer; do it because of what’s in it for you.

Look into furthering your formal education. Learning keeps you young and makes you feel alive. It keeps the blood coursing through your veins and stimulates those brain cells. When you cease to learn you cease to live. And if you’re not growing, your stagnating. Education is a gift you give yourself.

Get out to a networking event be it a career fair, nursing association meeting (you can attend as a guest if not a member) or seminar. Meet some new people and get a fresh perspective. Practice your communication skills on subjects other than your clinical specialty! 

Take a risk and try something you haven’t done before but would like to do. Consider submitting an article for publication, running for office in a professional association, applying for another job, or getting on a committee at work that interests you. Every time you push yourself and step out of your comfort zone, you get a little braver, a little wiser, and a little more aware of youself, your capabilities, and the world around you.

And last but not least, nursing offers virtually endless options of specialties, types of employers, work settings, schedules, employment vs. self-employment, etc. If you’re not fully aware of all the opportunities available to you in this profession or aren’t sure where you’d fit in, take steps to learn more by reading, surfing the Internet, attending related seminars, talking to nurses doing something different from you and so on. You never know where the spark, the idea, or the inspiration – not to mention the opportunity – will come from.

If you’re feeling bored, it’s time to shake things up a little. Life is too short and too precious to not feel excited, even if a little scared, about facing a new day and looking toward your future with eager anticipation. If you’re in a rut, start moving in a positive forward direction and experience all that nursing - and life - has to offer.

I recently came across the Florence Nightingale pledge, the one I took 35 years ago when I graduated from a hospital-based diploma nursing program. When reading it on the eve of the year 2010, it occurs to me that it needs to be updated to better reflect where nursing practice is today.  Here’s the original composed by Lystra Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan, and was first used by its graduating class in the spring of 1893. It is an adaptation of the Hippocratic Oath taken by physicians : “I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.” The pledge is still widely used at nursing graduation/pinning ceremonies.

Here’s my updated version: “I solemnly pledge myself  before God and in the presence of this assembly, to live my life with integrity and to practice my profession faithfully. With dedication will I endeavor to uphold the ethical, scientific, and legal standards of my profession, and devote myself to the welfare of those committed to my care.”

What say you – sacrilege or high-time? Perhaps we need something new entirely.  Any takers?

We in the nursing profession spend a lot of time reading clinical journals and books. But an equal amount of time needs to be devoted to personal and spiritual growth and development for balance and harmony. So here are my top ten must reads for nurses (and others, too). Each has been transformational for me in some way and has contributed to my being a better nurse and a better person – more fully engaged in life and work.

1. The Power of Now by Eckhart Tolle

2. The Success Principles by Jack Canfield (note who’s quoted on pg 204)

3. Full Catastrophe Living by John Kabat-Zinn

4. The Second Half of Life by Angeles Arrien (for the over 50 set)

5. Love Yourself, Live Your Spirit by Sonia Choquette

6. The Artist’s Way by Julie Cameron

7. Write it Down, Make It Happen by Henriette Anne Klauser

8. The Gift of Change by Marianne Williamson

9. Transformation Soup by SARK

10. The Hidden Messages in Water by Masaru Emoto

If you’ve already read some of these (or even if you haven’t), consider listening to the book on CD (if applicabale), especially those read by the author. You get a different perspective when listening rather than reading. Besides, there’s always something new you pick up the 2nd or 3rd time around. What are your favorites?