Varied career paths, personal rewards available to nurses
Tracey Mehuish knew from the time she was a little girl growing up in South Africa that she wanted to be a nurse. After getting her degree, she worked for a few years in her home country. Then she wanted new challenges and new adventures.
“I decided to use my career to travel the world,” she said.
Mehuish signed up with an international company that places travel nurses, and after being offered destination options, she chose the United States. She spent three years traveling and working in places like Utah, New York, Georgia, Washington State and Florida. Then, after returning for a short time to South Africa, she came back to settle into a career at Holy Cross Hospital in Fort Lauderdale, where she serves as a clinical practice specialist and sepsis coordinator.
Travel is just one many doors that can open for nurses. The profession is dynamic and demanding, challenging and constantly changing, and it offers
varied career paths and multiple opportunities for advancement. Nurses are everywhere: schools, corporations, assisted living and long-term care facilities, hospices, camps and corporations, research facilities and cruise ships. “A lot of people think of nursing strictly in a hospital setting, but nursing can take you anywhere,” said Wendy Stuart, senior vice president and chief nursing officer at Mount Sinai
Hospital in Miami Beach.
PERSONALLY REWARDING
Perhaps best of all, nursing can be deeply rewarding and personally satisfying. Maggie Hansen, senior vice president and chief nurse executive for Memorial Healthcare System in south Broward, had planned to become a teacher. “But I decided I could make a bigger difference by helping people as a nurse,” she said. “When people are sick or injured, they’re at their most vulnerable. It’s human nature to want to find a sense of purpose in what you get up and do every day, and as nurses, that’s what we do.”
“The things we do can be lifechanging,” said Dr. Nichole Crenshaw, DPN, director of the adult gerontology acute care nurse practitioner program at the University of Miami School of Nursing and Health Studies. “At the end of a 12-hour shift, I know I’ve made a difference.”
Taylor Gates, a floor nurse at Boca Raton Regional Hospital and an instructor at Palm Beach State College, remembers watching her grandmother care for patients. “I saw the difference she made in people’s lives,” she said. “When she passed away, the entire church was filled with her patients and family members of patients who had passed.”
NOT JUST FOR WOMEN
Years ago, nearly all nurses were women. Not so today. More and more men are entering the profession. Alberto Garcia, assistant chief nursing officer at Aventura Hospital and Medical Center, decided to become a nurse after watching his mother go through a serious illness. “I was responsible for helping care for her, and I interacted with all the nurses who came to the house,” he said. “What I love about nursing is that you take care of patients in a very special way. You have a stronger bond with them than the doctor does, because you’re with the patients every day.”
Willie Espinosa, a registered nurse at Baptist Hospital in Miami, recalled watching a patient who came to the hospital with a very poor prognosis recover and go home again to enjoy life. “It’s one of those memories you never give up,” he said. “I come from a
family with 16 nurses. Nursing was always a calling for me.”
DRAMATIC CHANGES
The profession has changed dramatically. Gone are the days — if they ever existed — when nurses meekly took orders from doctors.
“Nurses today are an integral part of a dynamic team and take a much more active role in decision-making,” Garcia said. “Physicians expect nurses to provide expertise and collaboration. It’s a much more interdisciplinary model than in the past. Nurses are expected to be highly skilled, assess patients and be able to communicate their findings.”
A team may include a physician, a nurse, a case manager, therapists and other specialists who communicate with each other on a daily basis to coordinate a plan of care and follow up when the patient goes home. These professionals work together to offer observations and insights from a variety of perspectives. “We look at a patient as a whole, including the family,” said Melissa Durbin, vice president and chief nursing officer at Boca Raton Regional Hospital. “Care is very complex today, and it takes a team approach and an interdisciplinary collaborative.”
“We make collective decisions for our patients’ care, and we’re the managers of the team,” Hansen said.
“You’re there with the patient for a long time,” Crenshaw said. “You know what diagnostics to order so you can rule in or rule out the disease process.”
Physicians value the nurse’s important role on the healthcare team. “Nurses have one of the most difficult jobs,” said Dr. Cristina Mata, MD, an endocrinologist and chief medical officer at Boca Raton Regional Hospital. “They are in the middle of everything. I count so much on nurses to be my eyes and ears.”
MANY CHALLENGES
While nursing has many rewards, it also has challenges.
Patients may wait longer today to seek care, so they are often more seriously ill when they arrive at the hospital. And because people are living longer, they may also have more health issues.
“We’re taking care of more people who are sicker than in the past,” Hansen said.
Stuart agrees. “Patients in hospitals are more acutely ill today,” she said.
Medical knowledge is constantly expanding and changing. “You need to stay abreast of it,” Mehuish said. “You need to be able to challenge the physician and be an advocate for the patient. You must be willing to speak up.”
Charts, forms, records and other information are usually filed electronically now instead of on paper, and nurses must stay adept at managing the programs.
NURSES TODAY ARE AN INTEGRAL PART OF A DYNAMIC TEAM AND TAKE A MUCH MORE ACTIVE ROLE IN DECISION-MAKING. PHYSICIANS EXPECT NURSES TO PROVIDE EXPERTISE AND COLLABORATION.
IT’S A MUCH MORE INTERDISCIPLINARY MODEL THAN IN THE PAST. NURSES ARE EXPECTED TO BE HIGHLY SKILLED,
ASSESS PATIENTS AND BE ABLE TO COMMUNICATE THEIR FINDINGS. Alberto Garcia, assistant chief nursing officer, Aventura Hospital and Medical Center
“There’s been a big shift with technology,” Stuart said. “But that’s no different than with the rest of the world.”
Mastering the technology isn’t always easy. “It’s growing and changing so fast, it can be hard to keep up with all of it,” Mehuish said.
The constant need for electronic input also cuts into the nurse’s time that he or she might prefer to spend with patients. “Technology pulls the nurse away from the bedside,” Durbin said.
“It slows us down and takes us away from the patient,” Gates said.
Because nurses may encounter substance abuse, alcohol withdrawal, undiagnosed or untreated mental health problems and other issues, aggression and violent behavior can also present challenges.
“Safety is a big focus,” Stuart said. “We see more aggressive behaviors now.”
Nursing is a demanding career, and it’s important for those in the profession to be aware of the everyday stresses. “We give everything to our patients physically, mentally and emotionally,” Gates said. “We have to step back sometimes and take care of ourselves.”