If you got pinned (virtually, perhaps) during the COVID-19 pandemic, then you’re likely facing a whole slew of challenges nursing school didn’t cover. The fact of the matter is that the pandemic completely rocked the medical world. We watched as our colleagues, coworkers, and classmates were forced to adapt to a massive demand for intensive care, learn a whole new world of protective gear and, worst of all, deal with contracting the disease themselves on the frontlines.
All of this is just one more thing reinforcing the ever-growing nursing shortage. Before the pandemic, the lack of nurses loomed large. With a big chunk of the workforce aging into retirement and a more significant need for nursing than virtually any other field, the experts say there’s a need for over a million new registered nurses to make up for the loss. Indeed, the field is growing and the market is secure. The U.S. Bureau of Labor Statistics (BLS) projects a growth of about seven percent over the next decade, with over 100,000 jobs available annually.
But just because there’s clearly a massive demand for nurses doesn’t mean you’re guaranteed a job as a recent grad. Sure, you’ll probably be able to get a job relatively quickly, but you want to do everything you can to make sure you land within a solid health care system and position yourself to earn top-dollar now and down the road. Here are some things to consider on your job search.
1. Be as Adaptable as Possible.
If there’s one thing we learned in 2020, it’s to never take anything for granted. This is especially true in large, complex health care systems, which had to make do with staff shortages, budgetary constraints, and a lack of space. For these reasons, hiring managers want to see adaptability and flexibility as a feature of any new employee. Here’s how to express in your interview that you’re willing to adapt.
Be open to working in the intensive care unit. This year, critical care was, well…critical. The growing number of COVID-19 cases filled up beds across the nation, and nurses who previously had no ICU experience were forced to spring into action.
Consider travel and crisis nursing. Another thing we realized during 2020 was that shortages are more apparent in some regions than others, which triggered a whole slew of positions offering hazard pay and crisis pay for nurses willing to travel.
Understand the new needs. Hospitals and health care systems as a whole were forced to create brand-new positions and roles for nurses that are likely to linger. Emphasize that you’re willing to learn on the fly and cover whatever is necessary every day.
2. Show Your Tech-Savviness.
In today’s constantly changing world of telehealth, being tech-savvy is a requirement, not an option. You’ll be considered quite a valuable employee to any team if you’re comfortable working in highly digital environments. If you feel that this is one area where you could use improvement, express your ability to pick up new technologies fast and emphasize your commitment to lifelong learning. If you’re comfortable with the idea of working from home, be sure to express this during the interview process. With more and more health care systems offering telehealth services, you may be able to work remotely some of the time.
3. Show Your ‘Soft’ Skills.
In addition to the many key skills we learned in nursing school, success in this career path relies largely on soft skills, like good communication, a positive attitude, and a willingness to be a team player, as well as the ability to empathize, solve problems, and be patient where needed. If the person interviewing you asks you questions such as “What was your biggest challenge in your previous job?” use these questions to highlight your ability to properly communicate and work as a team.
4. Be Willing to Work to the Top of Your Skill Set.
One major trend in nursing involves empowering nurses with full practice authority. To emphasize this, Johns Hopkins recently launched its #ItCantWait campaign to help strengthen the health care workforce and make changes that would allow nurses to practice at the top of their skill set. With a potentially detrimental nursing shortage on the horizon and care gaps all over the country, especially in rural and underserved communities, it’s crucial that you emphasize your willingness to raise the line and be a leader in nursing where needed.
5. Consider Working with a Recruiter.
Make sure your profiles on LinkedIn, Indeed, and other job boards are well-optimized and up to date so that nursing recruiters might seek you out. Working with a recruiter can be extremely beneficial because he or she will be able to pair your skill set with a health care system in need. Recruiters have spent the entirety of their career figuring out how to get nurses placed, and that includes over the past year-plus that has been the COVID era. You can always ask your recruiter for tips on specifically how to land a job during this time.
As a new nurse, you’re in an excellent position to help fill an essential need within your community and to follow a stable, high-paying career path that could serve you through retirement. So, start stocking up on some affordable scrubs, and follow these tips to set yourself up for a long, rewarding life as a nurse.
Our research suggests that lack of internet access may be an important reason. And for the almost 13.8 million older adults in the U.S. who live alone, asking for help may not be an option.
The Computer as COVID-19 Connector
During the pandemic, the internet has been an indispensable health tool to millions.
Telehealth services have provided a safe way for patients to make appointments for COVID-19 testing and other types of medical care. In fact, there was a 154% increase in telehealth visits during the last seven days of March 2020 compared to the same period in 2019. This was most likely due to public health mandates that required a shift away from in-person care.
This has been particularly true as the vaccine has been rolled out. Signing up for the vaccine has predominantly occurred online. This means that far fewer older adults from underresourced racial and ethnic minority communities have been able to make appointments.
In 2018, more than one in four Medicare beneficiaries had no digital access at home. Those without digital access were more likely to be 85 years or older, members of racial or ethnic minority communities and from low-income households.
Although people can make appointments for a COVID-19 vaccine by telephone, call centers are frequently overwhelmed. Hold times can be extremely long. Access to the internet, having an internet-enabled device and understanding how to use both have been necessary to sign up for the vaccine. Many advocacy groups and public health experts have begun to see internet access as a fundamental civil rights issue.
During the fall of 2020, we looked at this issue in more depth with Black and Latino individuals who are HIV positive and at risk for a cardiovascular event. In our research, we found that 17 out of 30 patients had no internet, no computer or lacked knowledge of how to use the internet or a computer. They, like many people with health issues or from underresourced racial and ethnic minority communities, are affected by numerous social determinants that amplify the negative health consequences they experience.
While online health services could be used to increase access and retention in care among vulnerable groups, not having access widens existing disparities.
To address the internet gap, we believe that policymakers must identify lack of internet access as a barrier and protect against its effects. This could include reserving vaccines in underresourced racial and ethnic minority communities for local residents and designating senior hours for those 65 and older.
Solutions Exist, but They Must Be Implemented
Policymakers could also mandate timely reporting of demographic information, even within medical settings, to monitor equity. Public health administrators could also partner with organizations that work with vulnerable populations, such as Meals on Wheels, to deliver food and vaccines to individual homes.
Departments of public health also could work with organizations and trusted community leaders to produce culturally consistent multimedia information on vaccinations and other health topics. They could also arrange for billboards, freeway signs and posters at local restaurants.
Nursing programs have had to innovate to meet the challenges posed by the pandemic. Restrictions imposed by shutdown orders, social distancing, limited in-person meetings, changes to course delivery and clinical placement requirements, and integrating technology into the classroom like never before are just a few of the ways that Covid-19 has impacted nursing education.
Ground-based nursing colleges and universities quickly created hybrid and online versions of their courses and materials and replaced live clinical assignments with scheduled simulation class events, web-enhanced synchronous meetings, and digital clinical experiences. Programs that were fully online already helped to provide support to those who had never taught in the online environment.
In both the nursing clinical and academic settings, a pervasive shortage exists. During the pandemic, many nursing faculty members were called back to the bedside to aid in addressing the demand for care. For faculty who were working in academia and the clinical setting, the pull and strain associated with competing priorities were evident. The stress and tension felt by faculty befell the students as well.
Nursing students already work to balance competing priorities. During the pandemic, they were having to work extra shifts, be placed on mandatory stay orders, travel far from home to agency assignments, and keep their families safe. Concern for their own safety and efforts to minimize exposure were often waylaid by the desire to serve and improve patient outcomes. Needless to say, the pressure to perform in a challenging crisis was intense and the tension palpable.
Nursing faculty members and administration found themselves in uncharted territory. How do we help students persist in their academic journey during a time of unprecedented emergency? We rose to the occasion by doing what we do best, supporting our students. We became confidants in practice. Assignment deadlines were extended where feasible, student support mechanisms were erected, and leveraging technology to facilitate learning became the norm.
Over time, and all during a pandemic that does not seem to be finding its end as yet, nursing faculty have found ways to bridge gaps that exist when a product that was designed for face-to-face delivery has to be moved to a virtual setting. Technology, like the applications Zoom, Webex, Microsoft Teams, and GoToMeeting, was used to help students feel connected. Learning management systems (LMS) like Desire to Learn (D2L), Canvas, Moodle, Blackboard, and many others were used to deliver content, keep students on track, and offer a way to persist without missing a beat.
Together, nurses do what they do best, see through the problem, not to the problem. We are innovative critical thinkers who also support one another and the profession. These times have proven challenging and often arduous, but the power of nursing presses on. We collectively advocate for each other and our patients. During times of crisis and ease, we progress, inspire, encourage, support, and work with compassion and diligence to serve our communities and our profession.
Brand-new RN, Nurse of the Week Chelsie Turrubiartez didn’t allow anything to stand between her and her dreams of becoming a nurse. Over the course of nine eventful months, the 23-year-old Adel, Georgia resident was hospitalized for Covid, graduated from the School of Nursing at Abraham Baldwin Agricultural College, passed her NCLEX, and found an RN position at the hospital where she’s worked since high school as a nurse extender. “It’s like a nurse’s aide,” she explained. “I have always wanted to be a nurse, and now it feels really good to be able to do that.”
In March 2020, as much of the world was locking down and healthcare workers found themselves on the “frontlines” of the pandemic, Turrubiartez was busy studying, attending classes at ABAC, and looking forward to graduating with her class. Then, on the very last day of March, she was hospitalized for Covid and began fighting for her life. “The ventilator was on max setting,” she told the Albany Herald. “They put me in the ambulance, and I had to be on my stomach the entire way. I don’t remember the ride at all. I was out of it.” Her condition started to improve in late April, and Turrubiartez was finally able to go home on May 4, 2020. She hadn’t seen her family since March 31, had missed her last month of school, her eagerly anticipated virtual graduation ceremony, and, well, you do not simply bounce back after spending weeks on a ventilator in the ICU.
As she recovered from her frightening ordeal, ABAC gave Turrubiartez the opportunity to repeat her spring semester coursework that fall and graduate on December 3, 2020. “I was really happy when I graduated!” she said. “I didn’t think I would get a chance to do that.” Adding to her happiness that day, during the pinning ceremony, Turrubiartez received the Lisa Purvis Allison Spirit of Nursing Award and a scholarship check for $500. She followed that up by passing her NCLEX, and then, Southwell Tifton Hospital hired their former nurse extender to work as an RN on their general medicine surgical floor.
Now—with some help from that scholarship check—Turrubiartez is planning to study for her BSN as well. For more details on her story, visit here.
In the best of times, patients with mental health issues face challenges in finding support. Cuts in community services and limits on long-term care facilities can mean difficulty in accessing mental health services. As a consequence, those patients may find themselves being cared for in acute-care psychiatric hospitals or units.
Add a pandemic to the mix, and the dilemma for patients needing inpatient psychiatric care gets far worse. “It’s getting to somewhat of a crisis point,” says Judy L. Sheehan MSN, RN-BC, Director, Nursing Education at Butler Hospital in Providence, Rhode Island. Sheehan, a nurse since 1977, is primary editor of the forthcoming Inpatient Psychiatric Nursing, second edition.
Inpatient psych hospitals are under significant strain from COVID. For example, the governor of Virginia stopped admissions to psychiatric hospitals to lessen the spread of COVID, according to an article in STAT. In Kingston and Brooklyn, NY, psych units were closed to increase capacity for COVID patients, the story notes.
At Butler, a nonprofit, free-standing psychiatric hospital, the patient census was frequently at or above capacity. A patient who develops or begins to show COVID symptoms has to be quarantined, meaning that two patients cannot be in the same room, notes Sheehan. Similarly, if an admitted patient initially tests negative for COVID but then tests positive in two or three days, the patient would need to be isolated to a single room and no other patients would likely be admitted to that unit.
What’s more, while COVID patients who do not need psychiatric care can go to a field hospital, “there are no field hospitals set up for psychiatric patients who have COVID or are recovering from COVID,” Sheehan says. “When someone is a psych patient, it’s challenging for the medical environment to care for them in a way that deals with the psychiatric symptoms in the same way that it might be done in the psychiatric hospital.”
The length of the pandemic has also taken its toll, with patients suffering from mental health sequelae from COVID, notes Sheehan. “We’re starting to see more people with anxiety disorders who may never have come into the psych facility before.”
Add to this the impact on healthcare staff. As the virus spread through the community, Butler staff found themselves unable to work due to exposure to the virus or because of their becoming infected. That has since improved, but now Butler is dealing with staff out of work due to the side effects of the COVID vaccine.
Telemedicine and outpatient programs can help relieve the burden, says Sheehan. “I think that telemedicine is going to continue,” she says. “I hope that people begin to replace some of the discharge options for people out in the community. It’s hard for people who need sustained help,” she says.
Strengthening the concept of integrated multidisciplinary care can help mental health institutions deal with patients with medical diseases, notes an article in Translational Psychiatry, which offers recommendations learned in China.
Fortifying community-based mental health services, full use of information technology, and strengthening the coordinating role of government are other recommendations the Translational Psychiatry paper makes.
“Psychiatric patients do in fact have medical issues, and medical patients do in fact get psychiatric issues. So we’ve got to be more integrated in our approach. We have to be able to become well-versed in both behavioral health and medical care,” Sheehan says.
Mary Barnett is one of about a dozen seniors who got a covid-19 vaccine on a recent morning at Neighborhood Health, a clinic tucked in a sprawling public housing development on the south side of downtown Nashville, Tennessee.
“Is my time up, baby?” Barnett, 74, asked a nurse, after she’d waited 15 minutes to make sure she didn’t have an allergic reaction. Barnett, who uses a wheelchair, wasn’t in any particular rush. But her nephew was waiting outside, and he needed to get to work.
“Uber, I’m ready,” she joked, calling him on the phone. “Come on.”
Seniors of color like Barnett are lagging in covid vaccinations, and the Biden administration plans to redirect doses to community clinics as soon as next week to help make up for the emerging disparity. Tennessee is one of a few states allocating vaccines to the network of clinics known as FQHCs, or federally qualified health centers.
In most of the states reporting racial and ethnic data, a KHN analysis found that white residents are getting vaccinated at more than twice the rate of Black residents. The gap is even larger in Pennsylvania, New Jersey and Mississippi.
“Equity is our north star here,” Dr. Marcella Nunez-Smith said at a briefing Tuesday, announcing vaccine shipments to the federally funded clinics. “This effort that focuses on direct allocation to community health centers really is about connecting with those hard-to-reach populations across the country.”
Nunez-Smith, who leads the administration’s health equity task force, said federally funded clinics — at least one in every state — will divvy up a million doses to start with, enough for 500,000 patients to get both doses. Eventually, 250 sites will participate.
The administration said roughly two-thirds of those served by FQHCs live at or below the poverty line, and more than half are racial or ethnic minorities.
Seeking People Out
In Nashville, more than a third of eligible white residents have gotten their first shot, compared with a quarter of Hispanic residents and fewer than one-fifth of Black Nashvillians.
Unlike many local health departments, Neighborhood Health is not fending off crowds. They’re seeking people out. And it’s slow work compared with the mass vaccination campaigns by many public health workers and health systems.
Barnett lives in a public housing complex that gathered names of people interested in getting the vaccine. She was lucky to have her nephew’s help to get to her appointment; transportation is a challenge for many seniors. Some patients cancel at the last minute because a ride falls through. Often, the clinic offers to pick up patients.
Aside from logistical challenges, Barnett said, many of her neighbors are in no rush to get their dose anyway. “I tell them about taking it, they say, ‘Oh, no, I’m not going to take it.’ I say, ‘What’s the reasoning?’”
Usually, Barnett said, they don’t offer much of a reason. Her own motivation is a sister with kidney disease who died of covid in July.
“You either die with it or die without it,” her brother told her in support of getting the vaccine. “So if the shot helps, take the shot.”
Same Story, Next Chapter
People of color have made up an outsize share of the cases and deaths from covid nationwide. And, predictably, the same factors at play driving those trends are also complicating the vaccine rollout.
Rose Marie Becerra received an invitation to get the vaccine through Conexión Américas, a Tennessee immigrant advocacy nonprofit. A U.S. citizen originally from Colombia, she’s concerned about those without legal immigration status.
“The people who don’t have documents here are nervous about what could happen,” she said, adding they worry that providing personal information could result in immigration authorities tracking them down.
And unauthorized immigrants are among those at the highest risk of covid complications.
Even with 1,300 total community health centers around the country, Neighborhood Health CEO Brian Haile said his 11 clinics in the Nashville area can’t balance out a massive health system that tends to favor white patients with means.
Haile said everyone giving vaccines — from hospitals to health departments — must focus more on equity.
“We know what’s required in terms of the labor-intensive effort to focus on the populations and vaccinate the populations at the highest risk,” Haile said. “What we have to do as a community is say, ‘We’re all going to make this happen.’”
Republished courtesy of KHN (Kaiser Health News), a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.