|
Laura Wester, RN, was 7 years old and stuck in the
ER with a nasty cut when she first considered becoming
a nurse.
"I thought, this was kind of a neat place,"
said Wester, now 42. "I can remember thinking,
'This might be something I want to do.' "
One marriage, a bachelor's degree in science, three
kids and 24 years later, Wester is a medical/surgical
staff nurse at Sutter Health's Novato Community Hospital
in Marin County, Calif. She has never seriously considered
any career other than nursing, even though when she
graduated from the College of Marin's nursing program
in 1994, she couldn't find a job.
The nationwide nursing shortage quickly changed that.
Like many of this country's 1.7 million registered
nurses, Wester is grateful to be working in an industry
hungry for her skills, one that offers more career opportunities
than other fields she might have entered.
But the "neat place" Wester experienced as
a child has changed dramatically. Today's nursing workplace
environment is fast-paced with heavy patient loads that
plague hospital floors from Boston to Bakersfield.
"There's been a lot of impact in terms of managed
care. Less autonomy, less freedom. Everything is more
controlled.," said Howard Sambol, president of
Career Crafting, an online job counseling and coaching
service in Larkspur, Calif. "There are also politics
that have affected the relationship with administration
and management."
Sambol believes that many people-usually young women-enter
nursing with a false impression.
"When young people get into the nursing profession
or sign up for nursing school, I think they're sold
a bill of goods, an ideal image of what a nurse is and
what a nurse's job is," he said. "They get
disillusioned later because the environment and working
conditions that nurses actually have do not match up
with that idea."
But, despite the obvious drawbacks caused by the shortage
and managed care, most nurses NURSEWEEK talked with
quickly pointed out the benefits of working as a nurse
today.
Wester says the profession's flexible hours have allowed
her to combine raising a family with performing work
she finds rewarding: providing medical assistance to
people when they need help the most.
"I think the main reason why many nurses would
say they chose to go into this profession is the opportunity
to help people," said Vicki White, RN, chief nursing
officer at Marin General Hospital, a Sutter Health facility
in Greenbrae, Calif. "It's helping people at a
time in their lives that's meaningful and makes a difference."
White, who manages a staff of about 900, describes
nursing as "the work of the heart."
"It's making the personal connection and applying
the scientific process to the crisis," she said.
"Sometimes, when you've had a terrible day, seeing
one patient get relief from pain or seeing them come
out of a cancer surgery or seeing a child that's had
a good day is personally and professionally rewarding."
All of the nurses NURSEWEEK interviewed said hospital
nursing's flexible hours are a key advantage of working
in the field.
"Flexible hours are one of the greatest aspects
of nursing," said Ruth Jenkins, Ph.D., RN, an associate
professor at Barnes College of Nursing and Health Studies
at the University of Missouri-St. Louis. "Days,
evenings, nights, weekend options, plus various shift
hours-eight, 10, 12, doubles [16]-these types of hours
allow the nurse to work longer shifts, fewer days in
a row. Weekend option allows nurses to basically work
full time or enough time to qualify for benefits.
"In addition, some nurses use this option to be
able to go back to school, still have time for family
and be able to support themselves."
Although nurses who work in physicians' offices often
have less-flexible hours than hospital nurses, Jenkins
says job sharing, a practice increasingly accepted by
physician employers, is beginning to give those nurses
more scheduling options.
Maryann Ricardo, president of Praktica in Glendale,
Calif., a company that matches physicians and nurses
in career opportunities, believes nursing offers another
kind of flexibility uncommon in other fields.
"What's exciting about nursing as a career is
that it can accommodate a person, whether or not they
want a career climb or a timeline, as their life shifts
and changes," Ricardo said.
A "timeline" is how Ricardo describes a career
in which breaks are taken "as they pass through
life," such as childbirth and child rearing, travel
and caring for aging parents.
Ricardo said many nursing students and new grads, as
well as nurses who have retired, do not realize how
many job opportunities exist beyond acute care nursing,
something which she impresses upon new recruits.
"About 54 percent of jobs are outside the hospital
environment," Ricardo said.
Some of those nonhospital jobs include case management,
hospice and end-of-life care, correctional facility
nursing, home health care and follow-up, public health
nursing, rehabilitation, forensic and legal consulting,
nurse recruitment, pharmaceutical sales, textbook writing,
college and continuing education teaching, school nursing,
traveling nursing and computer-related informatics.
There are also increased demands for nurse specialists
in such fields as colostomy and skin care, diabetes,
gerontology and pain management, Jenkins said, although
she added that specialists often are the first laid
off if the economy turns sour.
Jenkins also points to a budding new field called telehealth,
in which two-way audiovisual equipment, including telephonic
stethoscopes, blood pressure hookups, cameras and computers,
are placed in patients' home with links to the nurse's
computer screen.
(Learn
more about Telehealth)
"This is live, real-time interaction, assessment,
planning and intervention care," Jenkins said.
It's motivated by the cost savings that result from
keeping sick people safely at home and out of the hospital.
Jane Lawton, a divisional recruiter for GE Long Term
Care Insurance in San Rafael, Calif., regularly hires
nurses as benefits analysts, underwriters and insurance
salespeople.
"We usually go after retired nurses or people
who have said, 'I just can't lift patients anymore,
I just can't deal with the stress of being in the emergency
room or being in the ICU.' "
"There are lots of opportunities for anyone in
the medical field because it's one of those fields that's
growing by leaps and bounds," Lawton said. "The
opportunities are really endless."
Holly Rauen, RN, is a former lay midwife whose income
was unsteady when she performed home births. Now ob/gyn
advice and triage team charge nurse at Kaiser Permanente
San Francisco Medical Center, she says one of the greatest
joys of the nursing profession is the steady paycheck.
Today, Rauen earns about $36 an hour and receives "good
overtime."
"Nursing wages in the [San Francisco] Bay Area
are not bad," Marin General's White said. "A
full-time nurse working for a number of years can earn
$80,000."
Rauen said the money doesn't always offset the physical
and emotional stresses of clinical nursing. "It's
not just hard work on your feet," she said. "Nursing,
whether at a hospital or clinic, is incredible detail
work. You really have to have it together as far as
math goes. Your charting has to be impeccable. A patient's
chart is a legal document."
Jenkins admits that, in recent years, working conditions,
affected by higher patient-nurse ratios, greater responsibility
and increased paperwork and documentation, have made
hospital nursing positions more demanding. But she points
to a growing number of perks now offered by some hospitals.
"More and more institutions are creating perks
such as membership in exercise clubs at a reduced rate,
use of in-house massage therapists at a reduced rate.
Some offer clothes cleaning, and some are creating day
care centers on-site, which can facilitate mothers breast-feeding
and visits by fathers during their shifts."
Higher pay, scheduling flexibility and a growing range
of career paths appear to be luring more men into nursing,
with many gravitating toward management positions, clinical
specialties and agency work, Jenkins said.
"The draw to agency work is the higher pay, fast
pace of going to a number of environments and calling
their own shots about when they will work. However,
they are the first to be canceled should the census
change or if the situation has enough of their own nurses
available or willing to work doubles or extra shifts."
Rauen and Wester said they're glad that more male nurses
are entering the field because they add balance to the
workforce. Rauen also said male nurses allow for more
gender-appropriate nursing care.
"Sometimes, one sex is preferable to another as
a caretaker," Rauen said.
"Gender barriers have been knocked slowly down.
In OB, it's almost weird to have a male nurse. The majority
of the people who work in my department are women."
Uniforms are another perk that nurses say offer greater
comfort and cost savings.
"I miss being in scrubs," said Rauen, who
now wears street clothes and a white lab coat at her
job. "They're like jammies. They're so comfortable...I
think across the United States, there aren't too many
nurses wearing starched white uniforms."
Like many nurses, Rauen says she'll stay in the field
even if she changes jobs, locations, hours or specialty.
"Where there are sick people, there will be a
need for some type of nursing," Jenkins said. "There
will also be a need for nurses to keep people healthy.
The nurse can carve out a means to meet their own interest
and these needs."
Jane Futcher
|
