Unlock Your Potential
From new grads to re-entry nurses, RNs hold the keys to how their careers develop

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?"

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