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What's more, nursing pays better than many jobs. The average wage for registered nurses in 2001 was $22.68 per hour, according to the Department of Labor. That compares to a national average of $16.23 per hour for all private sector and state and local government workers.

Other reasons for pursuing nursing include the relative prestige of the field, the intellectual stimulation it offers and the simple aim of caring for people. That last motivation drove Jean Krueger, RN, PHN, to get both her bachelor's degree in nursing and a public health nursing certificate in the past year. Krueger, who lives in the Northern California city of Yreka, had spent years working as a bookkeeper before retiring at age 55. She went back to school and eventually gravitated toward nursing for its nurturing quality.

"I love what I'm doing," said Krueger, who now works as a public health nurse for Siskiyou County. "I'm helping people, which in bookkeeping you don't do."

For Krueger, getting her BSN at California State University, Chico, fulfilled a dream she had as a young woman-but one that was impossible for her to pursue at the time. "Back in those days, you couldn't be married and go into nursing school," she said.

That barrier has crumbled, of course, but the growing freedoms of women to choose careers also has made it more difficult to recruit women to the nursing field. San Francisco State nursing student Ramona Berven never gave the profession a thought while being taught by feminists at an all-girls grammar-through-high school in the 1970s. "Nursing was not your choice," said Berven, 35. "You were meant to be a doctor, a lawyer, a businesswoman, a banker."

But after owning her own clothing business and working in the nonprofit world, Berven found herself craving a more hands-on service career. The intellectual challenge and diverse pathways possible in nursing also appealed to her. People questioned Berven's choice of becoming a nurse rather than a doctor, but she has discovered a great deal of parity in the two professions. Her feminist teachers, in other words, would be proud. "It's not a subservient role," she said of nursing. "You're an equal in terms of patient care."

Brown was motivated to become a nurse thanks to aspects of her previous careers. As a teacher, she found herself working with students suffering from challenging medical problems, such as spina bifida and seizure disorders. She also was attracted to nursing in the course of a seven-year career as a firefighter and emergency medical technician in Bethesda, Md.

There, she helped rescue people from highway and white-water mishaps. But she longed to follow through on treatments after they got to the hospital. "I wanted to do more," she said.

Still, those who make nursing a second or third career encounter obstacles along the way. Berven, for example, has had to adjust her writing style to the succinct, dry approach used in composing patient care plans. The physical demands also are trying.

"You're literally on your feet for eight hours," Berven said. "It is really hard on your body."

It's even harder on older bodies, Krueger said. Because of knee problems, she found she couldn't do the lifting, pulling and pushing tasks required of hospital nursing. So she headed into public health nursing, where teaching, outreach and prevention duties prevail. "That's the beauty of public health," she said. "You don't do any of that [physical labor]."

Head start

They may struggle at times, but people like Krueger and Berven bring strengths to the nursing profession.

For one thing, as students, they are more focused than younger nursing candidates, says Joanne Disch, Ph.D., RN, FAAN, director of the Katharine J. Densford International Center for Nursing Leadership at the University of Minnesota. "It's just a whole different kind of mind-set," she said.

Yorker of San Francisco State agrees. She adds that students with a bachelor's degree from another field tend to have a leg up in classes. "They already know how to write scholarly papers, they already know how to use the library," she said. "They have a definite academic advantage."

Brown sees still other upsides to second-career nurses, such as the maturity to handle the sensitive topic of patients dying. "At age 20 or 21, you've maybe buried a parent or a friend, but not likely," Brown said. "By 30, you have a lot of people who may have said goodbye to a parent or friend."