Changing Lanes
In their search for job stability and greater purpose at work, professionals from all walks of life bring maturity and experience to nursing as a second career

By Ed Frauenheim
January 28, 2003

Entering nursing after stints as a teacher and firefighter wasn't easy for Erin Brown, RN.

Brown was drawn to the nursing profession after working with severely handicapped students and treating accident victims, but the prospect of returning to school as a 30-something with three children intimidated her. "My fear was, 'I'm too old to start,' "she said. "I remember saying, 'I can't do this.' "

But an official at Montgomery College in Maryland encouraged her to stick with it. Brown, 44, is now a registered nurse and clinical leader at University Medical Center in Tucson, Ariz. The advice she received has proved priceless. "I'm so glad I ended up in nursing," she said. "I love it."

Brown is part of a growing army of nurses that has come to the field after years of working in other jobs. The reasons for changing into scrubs range from a desire to help people to the lure of a steady, decent paycheck in today's turbulent economy. Despite the hurdles, including the physical demands of nursing, these career-switchers can make excellent RNs, nursing leaders say. In particular, people turning to nursing as a second or third career often bring maturity, medical experience and time-management skills.

What's more, second-career RNs are playing a vital role in helping to solve the nursing shortage. Not surprisingly, nursing schools are reaching out to older students with programs tailored to transform accountants, entrepreneurs, chiropractors and others into RNs.

Exact figures on the size of the second-career nurse population are difficult to come by, but statistics from the 2000 Sample Survey of Registered Nurses suggest that people are entering nursing school later in life. According to the survey, the average age of an RN who graduated from a basic education program from 1995 to 2000 was 30.9. That compares to an average age of 23.9 for those who graduated in 1984 or earlier.

Motivators

That people would train in one profession and enter another isn't endemic to nursing. As the U.S. economy has become more volatile and layoffs more common, workers are growing accustomed to changing careers. But the instability seems to make nursing more attractive to people tossed around in the job market, suggested Bea Yorker, JD, MS, RN, FAAN, director of the San Francisco State University School of Nursing. "When they read about the nursing shortage, they realize you can go anywhere in the country and never be unemployed again," she said.

In fact, the stability of nursing may be luring more men into the profession, says Amy Nichols, Ed.D., RN, associate director of San Francisco State's graduate program in nursing. In previous years, of the 50 students who enroll each year in a master's of nursing program crafted for people with degrees outside of nursing, just three or four were men. That number has since jumped to 10 to 12 in the past few years.

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."

What's more, the mothering experience of many older students is good preparation for the multitasking challenges of nursing, Brown said: "When you start juggling having children with a job, you have years of time management and [prioritizing] under your belt."

Having been encouraged by a mentor to enter nursing, Brown now plays that encouraging elder role herself. She's part of a program to support nursing students at Pima Community College in Tucson. A study of nursing school dropouts found that the average Pima nursing student was a single mother of 30, Brown said.

In response, two years ago, University Medical Center created a $2,500 annual scholarship for up to 20 nursing students at the community college. The scholarship program lasts up to two years, includes a mentor at the hospital and involves a commitment to working at the hospital after graduation.

"It reassures the students that they have a job when they get out," Brown said. "You've got somebody who already cares about you. You've got a hospital that cares about you."

Advanced class

Given enrollment declines in nursing education programs during the past five years, it's not surprising that nursing schools are reaching out toward older, second-career students. Just this year, for example, the University of Minnesota School of Nursing launched a post-baccalaureate certificate program that allows 21 people with baccalaureate degrees to take an intensive 15-month series of classes. Graduates of the program will receive a certificate enabling them to sit for the National Certification Licensure Examination to become registered nurses. Courses in the certificate program count toward a master's degree, and students are encouraged to continue on to earn their master's in nursing.

A University of Minnesota School of Nursing plan to forge partnerships with local parent-teacher association leaders also may serve as a vehicle to recruit second-career nurses, Disch said.

The University of Michigan School of Nursing has a second-career nursing program. Students with a bachelor's degree in other fields can complete a BSN degree and prepare for the NCLEX-RN exam and licensing after 20 months of full-time study. Students can go on to complete a master's degree in an additional two to four terms.

Other schools, such as Emory University School of Nursing in Atlanta and Wayne State University College of Nursing in Detroit, have second-degree BSN programs for students with undergraduate degrees in other fields.

Then there are the so-called "direct-entry" MSN programs, which allow people with bachelor's degrees to earn a master's degree without having to pick up a nursing undergraduate degree along the way. DePaul University Department of Nursing, Ohio State University College of Nursing and the University of Iowa College of Nursing offer such programs.

The direct-entry program at San Francisco State began in 1988, and Yorker boasts that it was the first of its kind west of the Mississippi. The program now has 50 annual openings, to which 60 to 70 people apply.

Yorker says the school's faculty has workshops to prepare for today's students, including adult learners and those changing careers. One effect of older students is to push nursing educators to move away from a "sage on a stage" teaching style, Yorker said. "We treat them as coming with a wealth of world experience," she said. "Teaching is more of a collaborative process."

Second-career nurses represent a promising solution to the nursing shortage, Disch suggests. Much of the talk about the shortage has focused on reaching out to young people in grade schools, she said, "but, boy, I really think to get people interested later on in life is a far better strategy."

"These people are mature, they're interested in nursing [and] they know what they're getting into."

Contact Ed Frauenheim at eefiv@ix.netcom.net