Have you ever
wondered in a moment of frustration at work,
"How
did I get myself into this?" The answer-or at least the way
to avoid asking the question again and again-lies in career planning.
A career plan
is about where you are today and, more importantly, where you're
going tomorrow. It's the vision that RNs chart in their heads
and hearts, if not on paper. It's about exploration, opportunities
and change.
About 10 years
ago, Linda Myro, RN, of Ringtown, Pa., was studying nursing at
Reading Area Community College. She was sure she wanted to be
a psychiatric nurse and had a simple plan. "I started out
on a med/surg ward to get some experience, then I went to a psychiatric
unit. I did it about two years and that's all I could take,"
she said.
Her career
plan, which ended with psychiatric nursing, was out the window.
Fortunately, opportunity was not.
"I went
to an emergency room and found out I had trouble dealing with
child abuse. You can't work in an ER and have that problem,"
Myro said. "So I went from ER to intensive care and found
my love. That's what nurses do. You try out all the different
phases of nursing. Some people go even further, with nursing in
drug companies and industrial nursing."
Individual
plans are works in progress, meant to be written and rewritten
as doors open and close in nursing school and beyond.
At the University
of Texas at Austin, the exploration begins with freshman orientation.
There, students meet for the first time, and certainly not the
last time, with career planning catalyst Sarah Peters, MSN, CNS,
the nursing school's director of recruitment and placement. She
also coordinates UT-Austin's RN-to-BSN program.
"I tell
them it's a process and as you're moving through academics, I
want you to come in and talk with me. Part of your education is
socialization into the profession so that you can find your way.
As you get a sense of what direction you feel drawn to, we can
build opportunities to support whatever your interests are."
The opportunities, she said, range from classroom study to volunteer
work and matching students with mentors.
One advantage
of nursing schools at research universities such as UT-Austin,
Peters said, is that "our students, from day one, are exposed
to the entire breadth of nursing."
Apart from
preparing for practice settings, "They're all going to be
excellent at bedside," she said. They see faculty in advanced
roles as certified nurse specialists, family nurse practitioners
and researchers. The UT-Austin School of Nursing has about $14
million in research grants, she said.
By students'
junior and senior years, Peters said, "We want them to project
themselves out: 'Where do you want to be in a year?' 'Where do
you want to be in three years?' "
To help them
decide that, to give them a feel for pediatrics, adult care or
whatever they perceive their calling to be, seniors are provided
with what the university calls a "capstone experience."
They are assigned to a mentor in the community and work 120 hours-three
full-time weeks-with that mentor as a preceptor. It's a bridge
from the academic world to the practice world.
"When
you finish a four-year degree, you're a generalist," Peters
said. "You can move from pediatrics to critical care to psych/mental
health. You decide what you're most called to, and the next step
is an advanced practice role.
"The
nursing shortage calls us to prepare nurses to step into entry-level
practice," Peters said. But, "There's also a moral/ethical
calling that we feel we have to prepare each person to the best
of their ability because we think the contribution will be greater."
That means
sending RNs into practice with career plans that at the very least
include a commitment to further their education through mentors,
professional organizations and employers. It also means career
plans developed with an awareness that graduate schools hold open
their arms for nurses who want to teach, gather research data
or construct interventions to deliver health services.
Peters said
she has one piece of advice: "Stay in touch!" for RNs
headed to practice as well as those with plans for graduate school
elsewhere. "While UT-Austin believes it has as much to offer
as any university and is always recruiting graduate nurses, I
think that if we look at the academic institutions across the
nation, we have risen above self-interest to know that we have
to prepare every nurse to the highest level we can," Peters
said.
Toward that
end, it's never too late to prepare or rewrite a career plan,
even for those who have been out of nursing for years.
"Returning
nurses still have a solid understanding of the practice of nursing,"
Peters said. "What they will not have is the technology.
We can look at the pharmaceuticals and drugs. Those things are
going to change. They're the technology. What doesn't change is
that we know how to administer things safely. We are thinking
people. The returning nurse has many strong associations that
are part of the way they have always practiced. They will resurrect
those and pick up the new things."
For re-entry
nurses, a career plan may be no more than getting up to speed
on procedures and technology in a profession where it generally
is agreed that the half-life of information is five years. RNs
often step out of the workforce to rear children or for other
family obligations and, occasionally, because of burnout, said
Barbara Napper, MSE, MSN.
Napper oversees
the RN re-entry program at Los Angeles' Mt. San Antonio College,
where she is director of nursing. The community college's program
features a semester of theory classes, a skills lab in which nurses
are trained on state-of-the-art equipment and assignment to a
clinical preceptor under agreements with Los Angeles-area hospitals.
Career placement for re-entry nurses who complete the program
is 100 percent, Napper said.
"We focus
on our students who are getting ready to graduate, but college-sponsored
career fairs are open to all students," she said.
Re-entry and
associate degree RNs can explore opportunities with potential
employers at the fairs, while beginning students can meet BSN
faculty from California State University, Los Angeles, and other
schools to plan a seamless transition to a baccalaureate degree
program.
At the outset
of the career that eventually led Myro to critical care and a
specialty as a cardiac nurse, she couldn't possibly have planned
her second love in nursing: the Internet. Personal computers were
just beginning to blossom a decade ago and the World Wide Web
was far from a household term.
On the Internet,
Myro goes by the name Vee Tac, which is short for ventricular
tachycardia. "It's a lethal cardiac arrhythmia that always
demands attention, and I always demand attention, " she said,
half-seriously.
She has received
attention, though, as the co-founder of Cyber-Nurse, an online
collection of nursing veterans who freely share education, experience
and expertise. The idea for the Web site came to her, Myro said,
as host of an ICU chat room at another nursing mega-site, www.virtualnurse.com.
Her husband and co-founder, Thomas, handles the computer wizardry.
"What
we do as mentors is let people know that it is not unusual, that
it's OK to feel overwhelmed," as they implement their careers,
moving from academics and clinical preceptorships to the care
of several patients for a full shift, Myro said. "You help
new nurses set priorities."
For example,
mentors and their charges explore questions such as: "When
you have an emergency, how do you deal with everyone else?"
or "What do you do and what do you leave for the next shift?"
Finally, Myro's
question for a career as much as for one workday: "How in
the world do you organize yourself?"