A critical portion of what Vathany Chea learned in the nursing program at Fresno State University in Fresno, California, didn’t occur in the classroom, but rather in the School of Nursing’s Mobile Health Unit that provides free health screenings.
The free mobile health clinic travels to rural communities in the Central Valley providing care to those who need it most. Many of the residents seen by nursing students are uninsured or underinsured, and face language and transportation barriers when trying to access health care. The mobile unit staff provides free education and screenings for blood pressure, blood sugar, cholesterol, heart and lung health, and more. They treat underserved patients who cannot afford care or who don’t have convenient access because of transportation challenges.
In caring for the underserved, nurses work in communities where many residents are below the poverty level, have a significant amount of chronic health problems and medical disabilities, reside in geographic isolated areas, and don’t have a sufficient number of health care providers to meet the demands for service.
For nursing students such as Chea, the experience of working with rural health patients offers a different perspective than working in a medical clinic or hospital. As part of the mobile health clinic, working with vulnerable medical populations helps to broaden the students’ experiences; assists them in developing a better understanding of the barriers to care the population faces; and gives them a better understanding of other ethnicities, cultures, and their unique practices and beliefs.
Chea says nursing students who work in the mobile health unit treat many patients who have chronic health problems such as diabetes, and that it’s been enlightening to learn some of the challenges rural patients face in managing their chronic condition.
“When we talk to our diabetic patients about eating healthier foods, many tell us they are limited with what they can eat because of affordability,” Chea says. “A diabetic homeless person once told me the shelter where she goes to eat offers a lot of sweets because that is what is donated to the facility.”
When faced with such dilemmas, Chea says nursing students learn to embrace challenges and to think on their feet offering solutions such as easy food alternatives that don’t require cooking, and teaching patients portion control and how to make better food choices whenever possible.
“We hope that providing access to patients and families who can’t get preventative care will improve health outcomes,” Chea says. “Many of the patients we treat don’t realize they have a chronic condition such as diabetes or high blood pressure, and by diagnosing them and starting them on the road to treatment, our goal is to help them to avoid health complications in the future.”
Many Programs Offer Loan Reimbursement
In addition to gaining valuable nursing experience, and helping vulnerable patient populations, working in an underserved community can also offer nurses more tangible rewards. Many programs, such as NURSE Corps, allows nurses to receive reimbursement for 60% of their student loans if they agree to work for two years in one of their designated Health Professional Shortage Areas. Many states offer similar programs. For more information on student loan forgiveness programs, visit here.
The experience of working in an underserved community is also attractive to potential employers. Holly Fenn, a nurse recruiter for Fusion Medical Staffing in Omaha, Nebraska, says nurses are in high demand in the travel industry right now, and that being fluent in other languages and having knowledge of different cultures are very desirable skills.
“We work with many health care facilities that have a high population of non-English speaking patients and being multilingual can be very helpful in explaining things to patients and putting them at ease,” Fenn says. “There are many communities that have refugees from Iraq, Sudan, Somalia, Turkey, and many others, so there is a need for nurses who can interact comfortably with patients who speak many languages and represent various cultures.”
Medical Missions Always Seeking Nurse Volunteers
For nurses who are looking to expand their clinical knowledge, language skills, and cultural skills by working in an underserved community, medical missions offer a unique way to accomplish this.
Sue Averill, RN, co-founded the organization One Nurse at a Time to help nurses to enrich their lives and the lives of others around the world. She maintains a directory of organizations seeking volunteer nurses, and offers scholarships to offset the cost of medical missions.
“Serving on a medical mission makes nurses more well-rounded,” says Averill. “We care for many patients who have never received formal medical care and may have walked for days to receive treatment.”
Other organizations such as International Volunteer HQ and Maximo Nivel also offer nurses 1-2 week programs where they can volunteer in rural clinics throughout the world.
“Medical missions are a wonderful thing for nurses to be involved with,” Fenn says. “The work they do is amazing, and not only does it offer additional experience to put on your resume, it also adds to your imprint on the world.”
An ongoing lack of qualified nursing faculty is impacting the nation’s ongoing nursing shortage as nursing schools across the country struggle with expanding fast enough to accommodate student demand.
According to a survey conducted by the American Association of Colleges of Nursing (AACN) on Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing, U.S. nursing schools turned away 68,938 qualified applicants from baccalaureate and graduate nursing programs in 2014 due to an insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints.
Freida Outlaw, PhD, RN, FAAN, an adjunct professor in the department of human and organizational development at Vanderbilt University in Nashville, Tennessee, says the causes of the faculty shortage can be traced to several factors, including the advancing age of current faculty and compensation not keeping pace with the business sector.
“Many of the Baby Boomer generation are beginning to reach retirement age,” says Outlaw. “And those who are newer to the nursing profession are choosing to work in clinical nursing jobs because the pay is better.”
According to the American Association of Nurse Practitioners, the average salary of a nurse practitioner is $91,310. By contrast, the AACN reported in 2014 that a master’s-prepared faculty member earns an annual wage of $73,633.
In order to successfully recruit nurse faculty, Outlaw says nursing schools need to make salaries more comparable and consider new models of teaching.
“The Millennial generation is highly entrepreneurial and has different work expectations,” says Outlaw. “I think part of the solution is to offer potential nursing faculty flexibility, autonomy, and more of a clinician/educator role.”
For the past three years, Lorain County Community College in Elyria, Ohio, has utilized a clinician/educator model to increase the number of nursing faculty. The Professional Practice Clinician is a position where nursing faculty are required to have a master’s degree but aren’t mandated to serve on committees or conduct research. The college initiated the Professional Practice Clinician job to ease the transition for nurses who choose to move from a hospital to a classroom setting.
Creative Solutions to the Nursing Shortage
The U.S. Bureau of Labor Statistics projects a demand for 1.1 million new nurses over the next six years to fill 575,000 newly created positions, as well as a need to replace some 550,000 nurses who will retire by 2022.
In order to meet the demand for future nurses, many schools are engaging in creative solutions in an attempt to fill nurse faculty positions. Hospitals who partner with nursing schools to ease faculty shortages can also help themselves by being in the enviable position of having first crack at recruiting the school’s top graduates.
In Texas, Memorial Hermann The Woodlands Hospital has collaborated with Lone Star College-Montgomery for the past eight years in order to expand the college’s nursing program. As part of their partnership, the hospital covers the costs of an additional nursing faculty member for the college, allowing Lone Star to expand its nursing program.
The AACN reports that states are also taking action to ease the nursing faculty shortage. For example, two years ago, the state of Wisconsin announced a $3.2 million grant called the Nurses for Wisconsin Initiative that seeks to provide fellowships and loan forgiveness for nurses interested in teaching in the state after graduation. Led by the UW-Eau Claire School of Nursing, the Nurses for Wisconsin Initiative hopes to rapidly develop more nursing educators at UW campuses throughout the state.
Seeking a More Diverse Faculty Base
In addition to increasing nursing faculty, educators say diversity among nursing professors is also lacking. Elizabeth Florez, PhD, RN, an assistant professor at the DePaul University School of Nursing in Chicago, Illinois, says that while there is a great need for nursing professors overall, there is also a critical need to recruit more nurses from minority backgrounds as faculty members.
“We encourage master’s degree students to seek clinical instructor positions once they obtain sufficient nursing experience and to continue their advanced education to the Doctorate in Nursing Practice (DNP) or PhD level to obtain a faculty position,” Florez says. “Currently, DePaul University has a Bridges to PhD program, which is a National Institutes of Health (NIH) funded grant program affiliated with the University of Illinois at Chicago.”
Florez says the program is structured to increase the number of minority faculty with a PhD. Eligible DePaul nursing students enrolled in the master’s entry to nursing practice (MENP) program are able to apply to the Bridges to PhD program, and those who qualify will be provided with resources and support to ensure they are adequately prepared for the PhD program.
Monica McLemore, PhD, MPH, RN, an assistant professor in the family health care nursing department at the University of California, San Francisco, says she regularly hears about the lack of underrepresented minorities among nursing educators.
“Personally, I’ve never had a black faculty member for any course I’ve ever taken so I can relate,” says McLemore. “Students want and need to see role models who have been successful in nursing, and I’m extremely disappointed that more than 22 years after my initial nursing education, the numbers haven’t improved. “
To help increase the number of minority nurses in teaching, Johnson and Johnson and the AACN Minority Nurse Faculty Scholars program provides financial support to graduate nursing students from minority backgrounds who agree to teach in a school of nursing after graduation. Students must be enrolled full-time and preference is given to those in doctoral programs. For application information, visit aacn.nche.edu/students/scholarships/minority.
If you’re looking for a new nursing job or hoping to take your career to the next level, there are a number of strategies that can help you make 2016 your best year ever.
“Nurses need to have a variety of skills and training experiences to be successful since nursing is so much more than just clinical bedside work,” says Philip Bautista, BSN, RN, PHN, a PhD student at the UC Davis Betty Irene School of Nursing in Davis, California. “I’ve met nurses with previous careers in law, business, technology, social work, public health, first responder backgrounds, and a multitude of other experiences that are all invaluable to nursing. I believe this is where nursing truly finds its humanity as we are caring for people, not just diagnoses and bed numbers.”
Whether you’re looking for new challenges, more flexibility, or seeking to maximize your earning potential, it’s possible to advance your nursing career in a number of ways. We asked some nursing stars to share their insights on career success.
Harness the Power of Professional Contacts
Networking isn’t just for sales people. Having a strong network of health care contacts is also the best way to find out about new jobs, advance in your career, and more.
“I keep a black book of professional contacts and get my nursing CEUs from attending seminars in person rather than taking them online in order to network with others in health care,” says Brandon Cloud, RN-NAC, director of nursing services for Life Care Centers of America, in Fort Worth, Texas. “We recently had a psychiatric hospital marketer come to our facility and I talked her into having her medical director tour our facility in the event they have discharges from their facility that need to be in a locked Alzheimer’s/Behavior unit.”
Cloud says these types of professional contacts are valuable since you never know when you need the expertise from a different field whether it be from psychiatric, hospital, hospice, or home health.
“It also gives you a valuable tool when looking to move forward in your career because you already have contacts on the inside of the institution,” Cloud says.
Consider an Advanced Degree
Continuing your nursing education doesn’t just make you a better nurse; it can also make you a more desirable candidate. The Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, has identified increasing the educational levels of nurses as a critically important component of professional development, and has recommended that 80% of all nurses have baccalaureate degrees by 2020. Consider getting an advanced degree or specialty certification if you’re looking to progress in your career.
“Advanced degrees in nursing should be part of any nurse’s five-year career plan,” says Fidelindo Lim, DNP, MA, RN, a clinical assistant professor at NYU College of Nursing. “The basic entry-level education of nurses is so short and with very limited hands-on experience. Some programs are only 11 months—how can anyone learn all that evidenced-based practice in such a short time?”
Find a Mentor
New nurses as well as those who are going through a career transition can all benefit from having a mentor. By sharing their own experiences, mentors can help their mentees navigate new skills and work environments, and serve as a sounding board and role model.
“I was fortunate to serve in the United States Navy as a Naval Nurse,” says Denetra Hampton, founder of the Nursing Education and Study Center, an online education start-up for nurses in Suffolk, Virginia. “I did have a nursing mentor and as a young nurse this is an important experience. My mentor showed me what compassion was. She was a believer in ‘getting the facts,’ and even now as a leader, entrepreneur, and nurse, I reflect on the compassion she had towards me, and it helps guide a lot of my decisions.”
Join Professional Organizations
As the American Nurses Association’s California Membership Director, Bautista knows firsthand the rewards of belonging to a professional nursing group.
“My involvement began as a student leader in my local school chapter,” he says. “Overall, these experiences in leadership, networking, and professional involvement have helped push my career forward, most notably in my current experience as a PhD student.”
In 2011, at a convention for the National Association of Hispanic Nurses (NAHN), Bautista met the recruiter for his current school.
“NAHN has provided me networking and mentorship,” he says. “Finding leaders, mentors, and role models can be worth years of experience, education, and skills.”
Stay Current on Health Care Trends
Cloud says professional organizations have also allowed him to stay current with new innovations and trends.
“Many professional organizations, such as AANAC [American Association of Nurse Assessment Coordination], have websites that update you with information, trends, and changes in the field and they also send out monthly or quarterly newsletters,” he says. “It’s important to keep abreast of changes in nursing as they happen very frequently when it comes to regulations and best practices.”
Pursue Lifelong Learning
A 2011 report from the Institute of Medicine noted that the nursing profession is called to lead change and advance health, and to meet that challenge, nurses must practice a commitment to lifelong learning. Whether that involves on-the-job training, taking CEUs, or pursuing a credential, lifelong learning equips nurses with the skills and knowledge they need to advance in their careers and to support patient needs.
“The first nursing manager I had when I worked in emergency services really taught me quite a lot about nursing, prioritization, and bedside manner,” Cloud says. “It’s really important to see all other nurses as part of your toolkit. The key to being a good nurse is to never be afraid to ask questions or to feed off the experience and knowledge of others. I always say the day I quit learning and growing as a nurse is the day I will retire.”
Lim notes that one of the first steps for nurses is to do a self-assessment and find out personal knowledge or practice gaps.
“When you know what you don’t know, the next steps you take in terms of professional development will be more obvious,” he says. “I also suggest nurses surround themselves with colleagues who are engaged in professional development and emulate them.”
Look to the Future
Nursing specialties such as geriatrics are expected to grow as the Baby Boomer generation continues to age, creating an increased need for more geriatric, home health, and hospice nurses.
“No matter what area you decide to specialize in, geriatric nursing is bound to be part of your professional future,” says Cloud. “Older adults are the core business of health care in this country today, representing the majority of primary and home care visits, hospital admissions, and long-term care residents. Regardless of your choice in specialization, you will be dealing with a sicker population that is living to be much older.”
For this reason, Cloud encourages all nurses to consider obtaining additional education in the areas of geriatrics and dementia. For instance, Nurses Improving Care for Healthsystem Elders offers webinars to help practitioners enhance practice. Each webinar provides 1.0 contact hour. Additionally, the National Council of Certified Dementia Practitioners can prepare you to become a Certified Dementia Practitioner (CDP) and Certified Dementia Care Manager (CDCM).
Seek Out Support
While all nurses face challenges, those from underrepresented groups often face additional obstacles including stereotypes, economic barriers, few mentors, gender biases, and lack of direction from early authority figures.
“There are certainly unique challenges faced by racial, gender, and sexual minorities in nursing,” says Lim, who also serves as the faculty liaison to various student groups at the NYU School of Nursing including (UNSO, Asian Pacific-Islander, Men Entering Nursing, and the LGBTQ). “My suggestion is for those affected to inform themselves of the general issues and those that may affect them directly. Be open and talk about it.”
For example, when applying for a nursing job, Lim recommends checking how the hospital meets the LGBT core measures set by the Healthcare Equality Index by the Human Rights Campaign.
“Nurses can also start an identity or interest group where they work and build support among each other,” says Lim, who belongs to the group NYC Men in Nursing.
Think Outside the Box
If you don’t believe that your current nursing job is a good fit, consider changing to a different type of nursing job. In addition to working in hospitals, skilled nursing facilities, and medical clinics, nurses also work as researchers, travel nurses, entrepreneurs, and flight nurses, and in settings such as corporations and insurance companies.
Hampton became a small business owner after seeing a need in the nursing market. “My entrepreneurial path was not something I decided to pursue since I was comfortable being a Naval Officer, and quite frankly, did not want to leave,” she says. “It all started with me seeing a struggling nursing student not able to pass their NCLEX. I offered to help, they were successful, and the word spread around. Soon, students were coming to me for guidance, and I created this study course that turned into the Nursing Education and Study Center.”
Practice Self-Care
It’s impossible for nurses to continue giving to others, if they aren’t taking care of themselves. Handling stress in a positive and proactive way can also keep nurses from experiencing burnout.
“As a male nurse, I have been ridiculed, mocked from both patients, and even my own social circles,” Bautista says. “I have had many people ask me, ‘You’re so smart, why not just become a doctor instead of a male nurse?’ My response has evolved over the years, but carries the same basic message.”
Bautista says he learned from his former dean and mentor, Dr. Michael Russler, who always responded to inappropriate comments by saying, “I’m not just a male nurse; I take care of females too!”
“Finding humor and turning around potentially detrimental situations is an important skill not just in life, but also in nursing,” Bautista says. “Some advice given to me by another professor was to respond to situations instead of reacting to them so that we do not say or do things that we may later regret.”
Maybe you’ve taken time off from nursing to raise your family, or you’re seeking a new challenge after working for years on a specific hospital unit. As you begin to look at your options in the job market, one of the most important tools you can have in your arsenal is a well-structured resume.
Mary Wagoner, editor-in-chief and senior writer at Nurse Prose, a Virginia Beach-based company that offers resume services to nurses, says it can be difficult for nurses to effectively communicate their work experience without either downplaying their accomplishments or overstating their nursing background.
If you’re an experienced nurse looking for a new job, here are some tips for creating a strong resume.
Explain Any Gaps in Work History
If you’re returning to nursing after taking time off to care for an elderly parent or raise your children, don’t expect your hiatus to be a disadvantage.
“It’s not uncommon to see gaps in a nurse’s resume since many nurses take time off to care for their children or aging parents,” says Yvonne Roddy-Sturm, RN, MSN, CCRN, chief nurse executive with Kaiser Permanente in Ontario, California. “We’re always on the lookout for nurses who are seeking long-term employment and who want to advance and grow in their careers. We have a very low turnover rate with our nursing jobs.”
Roddy-Sturm recommends being upfront about gaps in your employment history. Also, be sure to mention any volunteer work or skills related to your field that you learned while you weren’t working.
Make Professional Development a Priority
Whether nurses are looking to change jobs or reenter the workforce, Wagoner says it’s important for nurses to keep up with the latest nursing trends and new technology. “One of the most important things for nurses to do is to keep their professional credentials current, and to expand their areas of expertise,” she adds.
Whether this entails taking online continuing education courses or taking a nurse refresher course, Wagoner says nurses must demonstrate knowledge, comprehension, and application of practice changes, such as dispensing medications and charting, two functions that are now computerized.
“Many hospitals including Kaiser Permanente are on a Magnet journey, where they are recognized by the American Nurses Credentialing Center [ANCC] after demonstrating excellence in patient care in more than 35 areas of focus throughout the entire hospital,” Roddy-Sturm says.
To qualify for Magnet status, 100% of nurse managers in the organization must hold at least a bachelor’s of science in nursing (BSN), and while ANCC doesn’t specifically mandate a BSN for direct care nurses, approximately 52% of nurses in a typical Magnet hospital have a BSN.
“At Kaiser Permanente, we encourage our nurses to advance their education and offer tuition reimbursement to those who have an interest in pursuing advanced degrees,” says Roddy-Sturm. “We have many nurses who are pursuing their bachelor’s, master’s, and doctorate.”
Tailor Your Resume for an Applicant Tracking System
Many hospitals and health care organizations now use an applicant tracking system (ATS) where nurses apply for jobs by filling out an online application. In the past, resumes were reviewed by a human resources representative, but today many large health care organizations are now using an ATS that creates unique data files on candidates, allowing information to be conveniently searched and matched to job openings.
To craft a resume that improves your chance of matching the results provided by the ATS, experts recommend using Microsoft Word to write a resume that is simple and doesn’t include fancy fonts, headers, or footers. Avoid listing your entire work history in reverse chronological order, and be sure to include as many keywords and phrases as possible in your resume that fit the particular job description.
Emphasize Your Nursing Expertise and Key Skills
Rather than offering a fairly generic description of your job duties, such as “provided patient care,” Wagoner recommends nurses list their specific skills and job duties.
“If you cared for patients with nasogastric (NG) tubes or administered specific medications, you want to note this on your resume,” Wagoner says.
Also list any electronic medical record software that you have used, such as Epic or MEDITECH, and note skills such as fluency in a different language, or knowledge of sign language.
List Your Last 10 Years of Experience
While some seasoned nurses may worry about age discrimination, Roddy-Sturm argues that nursing is one field that promotes a multigenerational workforce.
“We have millennials [those born in the 1980’s through the early 2000’s] working side by side with Baby Boomers [those born between 1946 and 1964],” Roddy-Sturm says. “Having a workforce composed of nurses of various ages and backgrounds stimulates creativity.”
According to a 2013 report issued by the U.S. Health Resources and Services Administration about one-third of the nursing workforce is over the age of 50.
“As a rule of thumb, it’s recommended that you list only the last 10 years of your work experience, unless the work done earlier in your career is an exact match to the job that you’re applying for now,” Wagoner says.
