Nursing: a demanding career with many options
Nursing can be an exciting and rewarding career. What does it take to become a nurse, what are some professional options available, and what kind of individual is likely to do well?
It starts with education. Although it is still possible to work in some aspects of nursing with a two-year associate’s degree, many hospitals and other healthcare facilities today look for individuals with a fouryear bachelor’s degree.
“A bachelor’s degree has become the norm for entry into practice,” said Dr. Cindy Munro, PhD, dean and professor at the University of Miami School of Nursing and Health Studies. “Many hospitals have a high preference for that.”
But individuals who need to earn while they learn may start to work after receiving a two-year degree, said Dr. Tommie Norris, DNS, dean of the Benjamin Leon School of Nursing at Miami Dade College. After completing a two-year associate program, a student can go to work as a nurse in some healthcare facilities while he or she progresses to a four-year degree. “We encourage them from day one when they enter the associate’s program to go on to the baccalaureate program,” Norris said.
THE BASICS
The first year of a nursing program usually focuses on prerequisites, science-based courses like anatomy, physiology, chemistry, microbiology and genetics, as well as basics like English and math. Later studies focus on instruction in clinical settings in addition to classrooms. “You learn to understand and differentiate common themes to support your ability to translate knowledge into clinical decision-making and care delivery,” said Dr. Debbie Simmons, DNP, chief nursing administrator for Kaiser University.
At UM, technology and communication are woven into the curriculum throughout the program, along with cultural awareness. “We want our graduates to be able to understand their patients,” Munro said.
Schools may have options for completing a program, such as attending part time, or night or online classes if a student needs to hold down a job while studying. Some schools offer accelerated nursing programs for students who have a bachelor’s degree in another field and want to change careers. Giamina Santos, a nurse practitioner and assistant professor at
MDC, says it’s not unusual for individuals to make a career change into nursing. “Nursing offers stable work opportunities,” she said. “It’s challenging and there are chances to advance and specialize, and we save lives.”
EXPLORE OPTIONS
Schools offer a variety of settings and ways to learn. At the University of Miami, students may work in a simulation hospital, trying to diagnose the conditions of actors who present them with particular problems “They practice skills that they can then apply to a real patient,” Munro said.
A program at Barry University uses telepresence robots in classrooms and simulation labs, allowing students and professors in remote locations opportunities to observe lessons and procedures in an interactive environment, mimicking in-person learning interactions.
Many MDC students must continue working to support themselves and their families. Partnerships between the college and hospitals allow schedules with the needed flexibility, and classroom instruction is sometimes held at the hospitals where the students work.
DIFFERENT DEGREES
A four-year nursing degree (BSN) allows an individual to work in a variety of settings, including hospitals, clinics, medical offices, corporate wellness programs and on cruise ships, said Dr. John McFadden, PhD, dean of the College of Nursing and Health Sciences at Barry University in Miami
Shores.
Many nurses today seek higher degrees and become advanced practice registered nurses (APRN). This allows them to work in different specialties and assume more responsibilities. A nurse practitioner (PN), an individual with a master’s degree, can order prescriptions, diagnose
patients and devise treatment plans, read X rays, suture wounds and insert special IV lines. In Florida, a nurse practitioner can operate his or her own office but currently must have a supervisory relationship with a physician. In some other states, he or she has full practice authority and does not require physician oversight, McFadden said.
Three kinds of doctorate degrees are available to nurses. Two of them, doctor of nursing practice (DNP) and doctor of nursing science (DNS) focus on translating existing knowledge into practice. Nurses with these degrees might become certified as anesthetists or a midwives, or work in leadership roles in clinical or hospital practices. A nurse earning a PhD is likely to focus on research and discovering new knowledge, or he or she may enter the world of academia.
STRONG JOB MARKET
Nurses can usually find jobs fairly easily.
“Nursing is a wonderful career choice,” Norris said. “You can go anywhere in the U.S. and find a job, and the ability to work in different areas of nursing means constant challenges and rewards,” Norris said.
“The job outlook is very positive,” Simmons said. “Registered nurses are in high demand.”
“It’s a great career for both men and women,” McFadden said.
Still, it’s not a slamdunk. “You need to sell your skills and knowledge to whoever is interviewing you,” said Dr. Edgar Garcia, DNP, an associate professor at MDC.
EXPLORE SPECIALTIES
Nurses interested in a particular specialty may want to explore programs offered by hospitals and other healthcare facilities that help them gain needed knowledge.
Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine has developed an accredited fellowship program in oncology for nurse practitioners, one of just a few in the country.
“A lot of nurse practitioners with no oncology experience had been applying for positions in oncology,” said Jessica MacIntyre, Sylvester’s executive director of clinical operations and co-director of the fellowship program. “The field is evolving every day and there’s so much to learn.”
Sylvester’s program includes a year-long rotation through hematology, oncology and other specialties that interact with oncology patients, and has expanded to include a psychosocial oncology, stem cell transplant and cellular therapy track.
Amber Thomassen had a newly minted nursing diploma when she decided to enroll in the fellowship program.
“I was attracted to the fact that I’d be learning about all the different areas of oncology,” she said. “There’s a lot of clinical trial research, so it’s an exciting area of new possibilities.”
The program is competitive. “Over the last few months, we’ve had two positions available and
200 applicants from all over the country,” said co-director Maritza Alencar. “We look for highly motivated individuals who want to pursue a lifelong career in hematology and oncology.”
In addition to traditional specialties, there are newer career possibilities. Telemedicine, in which nurses interact with patients on a computer from a distance, is one.
Another, infomatics involves working with information systems that are so important to the technological aspects of nursing.
With medical science and knowledge changing rapidly, additional avenues are likely to appear.
“Some of the jobs for nurses 10 years from now haven’t been created yet,” McFadden said. “The possibilities are endless.”
WHAT MAKES A GOOD NURSE?
What kind of individual is likely to do well in this challenging profession?
“You have to be curious,” said Dr. Nichole Crenshaw, DPN, director of adult gerontology and acute care nurse practitioner program at UM’s School of Nursing and Health Studies. “It’s not enough to say, ‘I’m going to do XYZ.’ You need to ask why.”
Taylor Gates, a floor nurse at Boca Raton Regional Hospital and instructor at Palm Beach State College, agrees.
“As nurses, we need to always ask the question ‘why?’ Why are we doing what we’re doing? Why did the doctor order this?”
“You need to be someone who has a sincere interest in helping others, and also has an aptitude and ability to do the science,” said Dr. Carolyn Hart, chair of the nursing program at Barry University. “Nursing is both a science and an art.”
“We’re looking for critical thinkers with flexibility and adaptability,” Simmons said. “You need compassion and empathy, but you also need excellent problem-solving skills and attention to detail, a great ability for communication and a strong desire for lifelong learning, because scientific knowledge and healthcare are constantly evolving.”