By Marijke Durning
Higher education is a key requirement for nurses as the U.S. healthcare environment grows ever-more reliant on technology and specialized skills. There are three common academic pathways toward becoming a registered nurse (RN): the nursing diploma, associate degree (ADN) and bachelor’s degree (BSN).
Following completion of one of these programs, graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and satisfy state licensing requirements to begin work as an RN. Bridge programs, such as LPN-to-RN and ADN-to-BSN, allow nurses to move ahead in their nursing careers.
Each choice of training program is distinct and offers levels of education to qualify graduates for increasingly responsible roles in nursing practice. This guide is designed to break down the step-by-step process for becoming an RN, including the various routes possible on this career roadmap. Included is an overview of potential specializations and certifications for those interested in moving beyond basic nursing duties. Below are estimates for RN salaries and job growth as well as tools to help prospective nurses search for online and traditional educational programs.
WHAT DOES A REGISTERED NURSE DO?
More than 2.7 million registered nurses are employed in the United States, and nearly 30 percent work in hospitals, according to the Bureau of Labor Statistics (BLS). Other RNs work in clinics, physicians’ offices, home health care settings, critical and long-term care facilities, governmental organizations, the military, schools and rehabilitation agencies.
Duties include administering direct care to patients, assisting physicians in medical procedures, providing guidance to family members and leading public health educational efforts. Depending on assignment and education, an RN may also operate medical monitoring or treatment equipment and administer medications. With specialized training or certifications, RNs may focus on a medical specialty, such as geriatric, pediatric, neonatal, surgical or emergency care. Registered nurses work in shifts that run around the clock, on rotating or permanent schedules, and overtime and emergency hours can be unpredictable. Registered nurses are required to complete ongoing education to maintain licensing, and they may choose to return to college to complete a bachelor’s degree or master’s degree with the goal of moving into advanced nursing practice roles or health care administration.
THE STEPS: BECOMING A REGISTERED NURSE
Step 1: COMPLETE AN APPROVED NURSING PROGRAM
Anyone who wants to be an RN must finish a nurse training program. Options include programs that award nursing diplomas, associate and bachelor’s degrees. An associate degree in nursing (ADN) typically takes from two to three years to complete. Accelerated nursing degree programs could potentially shorten the time required. A bachelor’s degree in nursing (BSN) takes about four years of full-time study to complete, or two years for those in an ADN-to-BSN program. While the structure and content of these training programs differs, they should feature the opportunity to gain supervised clinical experience.
Students may initially only have the time and money to complete a two-year program, but they might later decide to convert their ADN to a BSN degree. Or, students may leap directly into a four-year BSN program if they plan on moving into roles in administration, advanced nursing, nursing consulting, teaching or research. Nursing students complete courses such as the following:
- Computer literacy
- Health care law and ethics
- Patient care
A bachelor’s degree program may also include courses on specific health populations, leadership, health education and an overview of potential specializations. A four-year bachelor’s degree program could require liberal arts courses and training in critical thinking and communication to complete the curriculum. Bachelor’s programs can broaden nursing experience beyond the hospital setting. According to the BLS, some employers require newly appointed RNs to hold a bachelor’s degree.
Step 2: PASS THE NCLEX-RN
Accredited undergraduate nursing degree or diploma programs alike are designed to prepare students to sit for the NCLEX examination. Upon graduation, aspiring RNs should register with the National Council of State Boards of Nursing to sign up for the National Council Licensure Examination for Registered Nurses. Candidates receive an Authorization to Test notification before the exam. At the exam, rigorous verification of candidates' identity may include biometric scanning.
This computerized exam has an average of 119 test items to be completed within a six-hour time limit. Examinees who do not pass must wait from 45 days to three months to re-take the exam. According to the California Board of Registered Nursing, students who take the exam right after graduation have a higher chance of passing.
Step 3: OBTAIN A STATE LICENSE
Every state and the District of Columbia require that employed registered nurses hold current licenses. However, requirements vary by state, so students should contact their state board of nursing or nurse licensing to determine exact procedures. In some states, RNs need to complete the NCLEX-RN, meet state educational requirements and pass a criminal background check. The National Council of State Boards of Nursing maintains a listing of licensing requirements on its website.
Step 4: PURSUE ADDITIONAL TRAINING AND CERTIFICATION (OPTIONAL)
For professionals who decide to become advanced practice registered nurses (APRNs), a BSN degree provides an academic stepping-stone to master’s degree programs. There are also bridge programs for students who only hold a two-year nursing degree and RN licensure but wish to enroll in graduate programs.
Those with master's degrees may qualify for positions such as certified nurse specialists, nurse anesthetists, nurse practitioners (NPs) and nurse midwives. It's important to research evolving professional requirements. For example, the American Association of Colleges of Nursing proposes that NPs should earn a Doctor of Nursing Practice (DNP) degree. A DNP or a PhD degree may appeal to nursing professionals who seek positions as scientific researchers or university professors in the nursing sciences. RNs may also seek certifications in a medical specialty such as oncology. Certifications are offered by non-governmental organizations attesting to nurses' qualifications in fields such as critical care, acute care, nursing management or other advanced areas.
To learn more about RN statistics, jobs, salary and other information CLICK HERE.
By PATTY WIGHT
Some of us are lucky enough to stumble into a job that we love. That was the case for Gabrielle Nuki. The 16-year-old had never heard of standardized patients until her advisor at school told her she should check it out.
"I was kind of shocked, and I was kind of like, 'Oh, is there actually something like this in the world?' "
Since Nuki wants to be a doctor, the chance to earn $15 to $20 an hour training medical students as a pretend patient was kind of a dream come true. Every six weeks or so, Nuki comes to Maine Medical Center in her home town of Portland, Maine, slips on a johnny, sits in an exam room and takes on a new persona.
Third-year medical student Allie Tetreault knows Nuki by her fictional patient name, Emma. A lot of teens avoid the doctor, so it's important for Tetreault to learn how to make them feel comfortable.
"What kinds of things do you like to do outside of school?" Tetreault asks.
"Um, I play soccer, so preseason is coming up soon."
Nuki preps weeks ahead of time for her patient roles. She memorizes a case history of family details, lifestyle habits and the tone she should present. "I've had one case where I was concerned about being pregnant. That was kind of like the most harsh one, I guess."
As Emma, Nuki's playing just a shy, healthy teen.
"How did school finish up for you this year?" Tetreault asks.
"Um, it was good. Yeah, school's been good. Um, yeah."
Emma's an easy role, Nuki says, but she ups the shyness factor because it poses a classic challenge to the medical student: how to get a teen to open up?
"Each case kind of has what's on paper, but then you can come in and kind of add another level," Nuki says. "Depending on how complex it is, you can add your own twist to it."
After asking Emma about her personal history, Tetreault moves on to the physical exam and listens as Emma takes deep breaths.
Tetreault gives Emma a clean bill of health and the practice appointment is over. But the most important part of Gabrielle Nuki's job is about to begin.
The 16-year old now has to evaluate the adult professional. She's smooth and tactful after lots of training on how to deliver feedback. Nuki tells Tetreault she did a good job making her feel comfortable.
"I also liked how you mentioned confidentiality, because for my age group, that's important to touch on," Nuki says. "And I think that maybe you could have had a couple more times where you asked me if I had any questions, but other than that I think you did a really great job."
It's communication skills versus acting skills that really qualify someone to be a standardized patient, says Dr. Pat Patterson, the director of pediatric training at Maine Medical Center.
"A lot of patients want to please their physician," Patterson says. "It's not easy for a patient to say 'That didn't feel right', or 'The way you asked that made me feel bad.' "
Gabrielle Nuki says working with medical students and being forthright about their performance has given her more confidence. In the future, she hopes to take on more complex roles — maybe someone with depression.
But she knows no matter what kind of patient she portrays, this job will prepare her well for when she reverses roles and one day becomes a doctor.
By Michelle Healy
Let them sleep!
That's the message from the nation's largest pediatrician group, which, in a new policy statement, says delaying the start of high school and middle school classes to 8:30 a.m. or later is "an effective countermeasure to chronic sleep loss" and the "epidemic" of delayed, insufficient, and erratic sleep patterns among the nation's teens.
Multiple factors, "including biological changes in sleep associated with puberty, lifestyle choices, and academic demands," negatively impact teens' ability to get enough sleep, and pushing back school start times is key to helping them achieve optimal levels of sleep – 8½ to 9½ hours a night, says the American Academy of Pediatrics statement, released Monday and published online in Pediatrics.
Just 1 in 5 adolescents get nine hours of sleep on school nights, and 45% sleep less than eight hours, according to a 2006 poll by the National Sleep Foundation (NSF).
"As adolescents go up in grade, they're less likely with each passing year to get anything resembling sufficient sleep," says Judith Owens, director of sleep medicine at Children's National Medical Center in Washington, D.C., and lead author of the AAP statement. "By the time they're high school seniors, the NSF data showed they were getting less than seven hours of sleep on average."
Chronic sleep loss in children and adolescents "can, without hyperbole, really be called a public health crisis," Owens says.
Among the consequences of insufficient sleep for teens, according to the statement:
- Increased risk for obesity, stroke and type 2 diabetes; higher rates of automobile accidents; and lower levels of physical activity.
- Increased risk for anxiety and depression; increased risk-taking behaviors; impaired interpretation of social/emotional cues, decreased motivation and increased vulnerability to stress.
- Lower academic achievement, poor school attendance; increased dropout rates; and impairments in attention, memory, organization and time management.
Napping, extending sleep on weekends and caffeine consumption can temporarily counteract sleepiness, but they do not restore optimal alertness and are not a substitute for regular, sufficient sleep, the AAP says.
Delaying school start time is a necessary step, but not the only step needed to help adolescents get enough sleep, Owens says. "Other competing priorities in most teenagers' lives are also components of this problem," she says, including homework, after-school jobs, extracurricular activities and electronic media use. Computers and television screens, she adds, "produce enough light to suppress melatonin levels and make it more difficult to fall asleep."
"The bottom line is if school starts at 7:20 there is no way for the average adolescent to get the 8½ to 9½ hours of sleep they need," Owens says
Research on student performance in schools that have reset the start clock, including Minneapolis Public Schools, "shows benefits across the board," says Kyla Wahlstrom, director of the Center for Applied Research and Education Improvement at the University of Minnesota.
"We've found statistically significant evidence that attendance is improved, tardiness is decreased and academic performance on core subjects, English, math, social studies and science, is improved. And now we have evidence that on national standardized tests such as the ACT, there's improvement there, too," Wahlstrom says.
Obstacles commonly cited to changing school start schedules, include curtailed time for athletic practices and games, reduced after-school employment hours for students and significant impact on bus scheduling and other transportation arrangements, she says, adding, "This is a major policy change that schools have to grapple with if they want to embrace the research about what we know about teens."
According to U.S. Department of Education statistics approximately 43% of the more than 18,000 public high schools in the U.S. have a start time before 8 a.m.; just 15% started at 8:30 a.m. or later.
In some school districts that transport students great distances, buses are picking up students as early as 5:45 a.m., "so there's also a safety element" to early start times, says Terra Ziporyn Snider, executive director of the advocacy group Start School Later.
Other major health organizations, including the American Medical Association and the Centers for Disease Control and Prevention, have all highlighted insufficient sleep in adolescents as a serious health risk, as has U.S. Education Secretary Arne Duncan, Snider says.
"What's unique about the American Academy of Pediatrics' statement is that it's very specific," she says. "It says very clearly that high school and middle schools should not start before 8:30 a.m. for the sake of the health and sleep of our children. They draw the red line."
By Teresia Odessey of Bloomfield College
As a nursing student, I have had the privilege of observing many nurses in different units; pediatrics, maternity, the burn unit, hospice, medical surgical, ICU, CCU, wound rounds, and psychiatry. I’ve realized from these experiences that school nurses are by far the most unappreciated and de-valued. As I gathered information on the role of school nurses, and shadowed an elementary school nurse for my senior capstone project, I discovered the challenges faced by school nurses.
Contrary to popular belief, the school nurse’s role is critical to the well-being of students’ health and academic achievements. The scope of practice for the school nurse includes supervision of school health policies and procedures; promotion of health education; health services; competence of interventions; facilitation of health care screenings; making referrals to other healthcare providers; patient advocacy and maintenance of the appropriate environment to promote health. This role requires the nurse to be knowledgeable and competent in various skills and interventions. School nurses provide care, support and teaching for diabetes, asthma, allergies, seizures, obesity, mental health, and immunizations to all students (Beshears & Ermer, 2013). The role of the school nurse as defined by the National Association of School Nurses is as follows: “a specialized practice of professional nursing that advances the well-being, academic success and lifelong achievement and health of students” (Board, Bushmiaer, Davis-Alldritt, Fekaris, Morgitan, Murphy &Yow, 2011).
Clearly, it is not just about Band-Aids and ice packs but still 25% of US schools have no nurse present and 16% of students have a medical condition that warrants a skilled professional (Taliaferro, 2008). One in every 400 children under 20 years is diagnosed with diabetes; 10% of students nationwide have asthma; prevalence of school allergies have increased drastically; 45,000 students are diagnosed with seizures each year; obesity rate has tripled among children 6 to 11 years, and more than tripled for children 12 to 19; and one in five students have mental health issues (Beshears & Ermer, 2013).
Despite having laws allowing disabled children to attend school, increasing the workload on the nurses, there are no laws that mandate a nurse to student ratio. The national recommendation for nurse to student ratio is 1:750 but on average some nurses are responsible for up to 4,000 students (Resha, 2010). Nwabuzor (2007) mentioned that parents and stakeholders cannot truly advocate for more school nurses because most of them do not comprehend the role, responsibilities, and advantages of having a school nurse. The major reason for the school nurse shortage is the lack of legislation on school nursing; not enough funding, and no laws forcing schools to hire nurses. Therefore, many educational facilities have opted to hire unlicensed assistive personnel (UAP) instead.
Yes, it is likely more cost effective to hire UAP’s instead of Registered Nurses but that does not make it acceptable. It is my belief that we have different titles and scopes of practice for a reason. I find it mind boggling that some schools do not have school nurses. How is it that some parents are comfortable with sending their children to a school without a nurse? Is it that they don’t inquire about the presence of a school nurse? Or could it be that maybe they assume that every school has a full-time nurse? I wonder if some parents are aware of the nurse to student ratio at their child’s school. Yes, there are budget cuts due to many reasons but why do these schools say they don’t have enough funding to hire a school nurse but they have six assistant coaches for any one of the sports? So yet my question remains unanswered: what is the priority?
Beshears, V., & Ermer, P. (2013). SCHOOL NURSING: It's Not What You Think!. Arkansas
Nursing News, 9(2), 14-18.
Board, C., Bushmiaer, M., Davis-Alldritt, L., Fekaris, N., Morgitan, J., Murphy, K., &Yow, B. (2011, April). Role of the school nurse. Retrieved from http://www.nasn.org/PolicyAdvocacy/PositionPapersandReports/NASNPositionStatementsFullView/tabid/462/ArticleId/87/Role-of-the-School-Nurse-Revised-2011
Nwabuzor, O. (2007, February). Legislative: "Shortage of Nurses: The School Nursing Experience." Online Journal of Issues in Nursing Vol12 No 2. doi:10.3912/OJIN.Vol12No02LegCol01
Resha, C., (2010, May 31) "Delegation in the School Setting: Is it a Safe Practice?" OJIN: The
Online Journal of Issues in Nursing Vol. 15, No. 2, Manuscript 5. doi:
There are 5.5 million nurses and nurse’s aides in America. That’s 2.6% of the population and yet nursing is still one of the fastest growing occupations. In fact, the country is currently facing a nursing shortage unlike any other before.
Nursing is essential for a smooth running health care system. Nurses are far from one-trick employees – they perform countless vital tasks in hospitals, nursing homes, schools, and more. The number of nurses on hand (or a lower nurse-to-patient ratio) has been directly related to patient survival and recovery without additional complications.
Some of the most in-demand specializations for nurses include:
- Forensic Nursing: Nurses who care for patients that were victims of crime. These nurses assist with collecting evidence from their patient’s injuries in order to build a case against the attacker.
- Infection Control: Nurses who care for patients infected with diseases such as HIV, STDs, or tuberculosis must be specially trained to ensure the contagious disease is not passed along unintentionally to either the nurse themselves or other patients.
- Management: These days, nurses who can educate or manage other nurses are in high demand. These career-oriented positions typically pay better, sometimes even into the six figures, but do require additional education. Management, education, and advocacy are three essential roles in recruiting more high quality professional nurses to the field.
Nursing isn’t an easy job. Over half of nurses report that stress and frustration plague them daily in their job. However, most nurses also agree that their job is very fulfilling. Very few careers are as directly related to public health and serving the community as nursing. Also, the public is genuinely grateful for nurses. For the last eleven years, nurses have been ranked by Americans as the most trusted profession – a pretty impressive feat.
Currently, there is a shortage of nurses in the workplace. This shortage is caused by a range of reasons, but the main ones are:
- Baby boomers are aging and require more intensive care
- The recession forced many people to neglect preventative care or lose their insurance, driving up the demand for health care in the long term
- Fewer nurses are pursuing bachelor’s degree which would enable them to get the best nursing jobs
The shortage is leading to salary wars (hospitals offering hefty bonuses to new nurses and more). At the end of the day, professional, skilled, and intelligent people are desperately needed in the nursing field in the US and around the world.
Despite “measurable progress” in the three years since the release of the Institute of Medicine’s landmark report on the future of nursing, more work remains “to fully realize the potential of qualified nurses to improve health and provide care to people who need it.”
That assessment is part of a commentary by Harvey V. Fineberg, MD, PhD, president of the IOM, and Risa Lavizzo-Mourey, MD, MBA, president and CEO of the Robert Wood Johnson Foundation, on the aftermath of the report.
“The Future of Nursing: Leading Change, Advancing Health” was released Oct. 5, 2010, by the IOM with the support of RWJF. It provided a blueprint for transforming the nursing profession to “respond effectively to rapidly changing healthcare settings and an evolving healthcare system,” according to a report brief.
The key recommendations: allow nurses to practice to the full scope of their education and training, provide opportunities for nurses to serve as healthcare leaders and increase the proportion of nurses with a BSN to 80% by 2020. Following the report, RWJF and AARP formed the Campaign for Action to implement the report’s recommendations at the state level.
Regarding scope of practice for advanced practice registered nurses, Fineberg and Lavizzo-Mourey wrote that 43 state action coalitions have prioritized initiatives to remove scope-of-practice regulations that prevent APRNs from delivering care to the full extent of their education and training. Iowa, Kentucky, Maryland , Nevada, North Dakota, Oregon and Rhode Island have removed barriers to APRN practice and care, and 15 states introduced bills this year to remove physician supervision requirements that can hinder APRN care.
Regarding education and training, the proportion of employed nurses with a BSN or higher degree was 49% in 2010 and 50% in 2011. “Progress is likely to accelerate in the years to come,” Fineberg and Lavizzo-Mourey wrote, “because between 2011 and 2012 along there was a 22.2% increase in enrollment in RN-to-BSN programs and a 3.5% increase in enrollment in entry-level BSN programs.” The authors also noted a recent increase in the number of students enrolled in nursing doctorate programs. Of the 51 action coalitions, 48 have worked to enable seamless academic progression in nursing.
The authors noted that the influence of the campaign has paid off with a $200 million Medicare initiative to support the training of APRNs at hospital systems in Arizona, Illinois, North Carolina, Pennsylvania and Texas.
Regarding nurse leadership, Fineberg and Lavizzo-Mourey wrote, the “Campaign for Action has tapped established and emerging nurse leaders across the nation and is working to provide them with opportunities for networking, skills development and mentoring. A key strategy is to advocate for more nurses to serve on hospital boards.”
Full commentary: http://bit.ly/176XyZs
Campaign for Action: http://www.rwjf.org/en/topics/rwjf-topic-areas/nursing/action-coalitions.html
“Future of Nursing” report: www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health.aspx
Graduate Nurse Education Demonstration: http://innovation.cms.gov/initiatives/gne/.
Faced with a shift in the healthcare landscape toward outcomes-based practices and quality improvements, the American Association of Colleges of Nursing (AACN) sought to update the scope of nursing practice with a new master's prepared role: the clinical nurse leader (CNL).
The first new nursing role in over 35 years, the CNL grew out of the 1999 Institute of Medicine report "To Err is Human" which challenged care providers to reduce medical errors and focus on patient safety.
Rising to the challenge, the AACN initiated an investigation into the barriers to improved care delivery and in 2005 introduced the new role as a way to prepare nurses to thrive in the changing healthcare system, according to the AACN website. For many, it couldn't have come at a better moment.
"We are at a pivotal time for the role," said Bob LaPointe, MS, MSN, RN, CNL, president, Clinical Nurse Leader Association (CNLA), and MICU staff nurse at Penn Presbyterian Medical Center, Philadelphia.
"Healthcare is increasingly complex, and we need leaders who are trained in complexity theory to be able to navigate that and understand it to have better patient outcomes and that's what clinical nurse leaders are uniquely trained to do."
As defined by the CNLA, the CNL is an advanced clinician who serves at the point of care as the lateral integrator, facilitating, coordinating and overseeing care within the unit while also collaborating across the healthcare continuum.1 The CNL is trained to facilitate evidence based care at the bedside and ensure positive outcomes for even the most complex patients. Such training, especially these days, is a great option for nurses of all kinds looking for a way to make a difference at the bedside.
"The role really is about improving clinical outcomes-improving the care of the patient as well as improving financial outcomes," said Tracy Lofty, MSA, CAE, director, Commission on Nurse Certification (CNC), an autonomous agency of AACN, Washington, DC. "Regardless of practice setting, the ultimate goal is to improve outcomes, so really everyone benefits from the role."
When Veronica Rankin, MSN, CNL, Carolinas Medical Center, Charlotte, N.C., decided to go back to school, she chose to do so through a CNL program after her facility's assistant vice president introduced the role at a town hall meeting. Since graduating in 2011, she and her fellow CNLs have been making a huge difference for patients, colleagues and the hospital as a whole.
"We bring that continuity of care back to the bedside, so that even though the nurses may change every shift every day, you are still going to have the same clinical nurse leader Monday through Friday taking care of that patient," Rankin said.
"It has given me the opportunity to stand back and see the big picture of my patients' journey. I can get in there and see, 'OK, out of everyone that is involved in this patient's care, we have all these hands in this pot, what are we missing and where are the bridges I need to help connect?'"
Rankin's ability to streamline care and improve both patient and hospital outcomes comes directly from her training, and nurses and facilities across the nation are starting to see the difference CNLs can make on a unit-by-unit basis.
"When you take a policy and implement it in your unit, in your hospital, in this city, with the resources you have available, it can be the best evidence based practice out there," LaPointe emphasized. "But we have to apply it to our patients and our staff as well, and that's really where the clinical nurse leader's role really comes into play. How does this make sense for us as a unit, and for our patients."
Since the pilot program that tested in the fall of 2006, more than 2,500 nurses have earned CNL certification from CNC. Part of the success, according to LaPointe, is the fact that anyone inspired to become a CNL can do so.
"Nursing has always had multiple points of entry, which leads to lots of people being able to do it, but it also leads to lots of variability about the training and preparation," LaPointe said. "There is so much more to know and healthcare is so much more complex, that to have training in complexity theory, change management and in the science of outcomes, that's going to be good for anybody."
To make the CNL educational track available to nurses already practicing as well as those looking to get into the field, the AACN created five different models so that regardless of educational background, there is an entry into a CNL education program. The five models are:
- Model A - Master's degree program designed for BSN graduates
- Model B - Master's degree program for BSN graduates that includes a post-BSN residency that awards master's credit
- Model C - Master's degree program designed for individuals with a baccalaureate degree in another discipline
- Model D - Master's degree program designed for ADN graduates (RN-MSN)
- Model E - Post-master's certificate program designed for individuals with a master's degree in nursing in another area of study2
Following graduation of a CNL education program, licensure as a registered nurse, and successful completion of the CNL Certification Exam, candidates may be awarded the CNL credential.
With the role gaining momentum, the CNC decided to revamp the certification exam in 2012 to make sure it reflected the basic competencies of a CNL.
"The new exam is based on a CNL job analysis study that was completed in 2011, so the exam reflects the knowledge, skills and abilities of a competent CNL," Lofty said. "It's all about application, so you may be in an educational program, but then you need to be able to apply the knowledge, and that is demonstrated on the exam."
As new CNL graduates start the search for the right clinical setting, they need to keep in mind that some healthcare organizations have yet to fully integrated the clinical nurse leader into their staffing model.
"There are many healthcare institutions specifically recruiting to full clinical nurse leader positions," said Lofty. "For other institutions, it may not be that title, there may be a different title like care coordinator, or they are still looking for someone with the same skill set and they are still hiring individuals with those competencies and perhaps applying them to other positions."
But CNLs need not worry about their job prospects, because their CNL skills are valuable in just about every care setting. According to a 2012 survey conducted by the CNC, 96% of the respondents indicated that they apply their CNL knowledge in their current role, 92% feel they are an important member of their team and 87% said they are valued as an employee because they are a CNL.3 LaPointe knows from personal experience just how useful being a CNL can be regardless of job title.
"I am not functioning in a job that is called 'CNL' right now, and that is true for many people who currently have the certification," LaPointe said, who was confident he would still use his training despite not being hired specifically as a CNL. "I helped write our successful Beacon Gold application, I was very involved in our hospital's first Magnet designation, I am on the evidence based practice committee for the hospital, and the chair of our unit-based council as part of the shared governance structure of the MICU, so I am using this stuff all the time."
No matter where CNLs end up, they are sure to improve care coordination, communication and hospital-wide outcomes.
"You are basically in there improving care for nurses, patients, and physicians," Rankin said. "You are improving care delivery and the receiving of care for the patient population, so you are in there with your hands so much."
"Bring evidence based practice to your unit to show what the worth of the role is," Rankin advised nurses considering the CNL role. "In the end we are also taught that the clinical nurse leader is the guardian of the nursing profession, so we have to get in there and be the guardian. I would say, go for it, go hard, and be a guardian for the nursing profession."
Source: Advance for Nurses
When it comes to nursing education, African Americans tend to aim for more advanced degrees, yet their percentage among all U.S. nurses is far lower than it is in the general U.S. population. Phyllis Sharps, PhD, RN, FAAN, intends to find out what is behind that disconnect as a key step toward correcting it.
Sharps, associate dean for Community and Global Programs, director of the Center for Global Nursing, and the principal investigator for a $20,000 grant from the National Black Nurses Association (NBNA), will use the funding to conduct a national survey to identify the drivers and barriers to success among African-American nursing students and nurses. Through research funded by the new grant, “Enhancing the Diversity of the Nursing Profession: Assessing the Mentoring Needs of African American Nursing Students,” Sharps hopes to determine what mentoring needs are essential to keeping African-American nursing students on track in their education and their career paths.
While African-Americans are underrepresented in the profession (5.5 percent of U.S. nurses vs. 13.1 percent of the U.S. population), the 2008 National Sample Survey of Registered Nurses (NSSRN) shows that African Americans as well as other minority groups in nursing are more likely to pursue baccalaureate and higher degrees—52.5 percent pursue degrees beyond the associate level, while only 48.4 percent of their white counterparts seek equal degrees.
“As nurses, we all know what we needed while attending nursing school,” says Reverend Dr. Deidre Walton, NBNA President. “We need to have a better understanding of what this generation of nursing students needs in this new technological and innovative world of nursing.”
Source: John Hopkins University
By Jane Gutierrez
When you think of a nurse, what’s the first image that comes to mind? Chances are, you think of a woman — and for good reason. The vast majority of professional nurses in the U.S. are white women. In fact, only about six percent of nurses are male and, Considering males make up approximately half of the population and minorities are 30 percent, there’s a major disparity in the profession.
That disparity is reflected in equal measure in nursing schools, both in the student population and faculty. Experts argue improving the diversity in nursing education will improve health care by creating a more culturally sensitive healthcare workforce with improved communication abilities, reduced biases and stereotypes and fewer inequities, as well as increasing the diversity of the nurse education faculty.
At a time when the healthcare system is faced with a nursing shortage caused at least partially by a shortage of nurse educators, some argue males and minorities represent an untapped resource for recruiting new educators. They believe that by creating new opportunities to attract traditionally underrepresented populations to the field, we can both solve the shortage and make a measurable improvement to our healthcare delivery system.
Why Diversity Is an Issue
While minorities have made great strides in other traditionally white-dominated fields and women have done the same in traditionally male fields, nursing is one area where diversity initiatives seem to have been ineffective.
In the case of men, much of the resistance to nursing as a profession comes from a cultural perception of nursing being a “female” profession. Men report while they enjoy the care giving aspects of the job, it’s difficult when others ask questions or make comments deriding their career choice. For example, male nurses report being asked why they didn’t choose to become doctors, with the implication that they did not earn adequate grades or were too lazy to become doctors. In addition, men report feeling left out of the profession, with most training and professional development materials referring to nurses as “she” and a female-centric approach to teaching and training.
In the case of minorities, including African-Americans and Latinos, studies attribute the disparity in the nursing profession largely to lower overall academic achievement in those groups. Given that admission to nursing school generally requires at least a moderate level of academic achievement — and earning a
degree in nursing education requires at least a bachelor’s degree and some experience — it’s no surprise that groups that aren’t as academically advanced are lacking in the nursing profession.
Fixing the Problem
Because improving diversity in the nursing profession is a key to solving the nurse shortage — and by extension, the nurse educator shortage — the healthcare field is looking for new ways to recruit, mentor and retain minority nurses, male nurses and educators.
One step is to recruit potential professionals earlier — in some cases, as early as high school. Throughout the country, in the field in exchange for high school credit, with the goal of encouraging them to maintain their academic performance and attend nursing school.
However, academic performance is only part of the equation. The cost of education is another barrier to many potential students, regardless of sex or ethnicity. The cost for a four-year BSN program can be over $100,000 in some cases, while a two-year program generally runs between $5,000 and $20,000. Factoring in the master’s and doctoral degrees required to become nurse educators, and the cost only goes up.
In response, many schools, as well as states and the federal government, have instituted financial assistance programs designed specifically for minorities and males. The Federal Nursing Workforce Diversity program allows minority students to borrow money for school, and have some or all of their loans repaid if they agree to work in specific, undeserved areas. For those who want to become nurse educators, the government’s Nurse Faculty Loan Program offers partial or full repayment of student loans for agreeing to teach for at least two years after graduation.
With the nursing shortage only expected to grow, thanks to increased access to healthcare, reaching out to minorities and males only makes sense. Not only will it solve a serious problem, it will ensure quality, effective health care for future generations.
About the Author: Jane Gutierrez is a nurse educator and a member of her employer’s diversity initiative committee. She visits with local high schools to encourage students to consider careers in health care