Community Health Nursing (and a shout-out to Katie!)

In my previous post about job opportunities for new grads, I neglected to mention another career path in nursing that is oft-overlooked by students. Katie R., public health nurse extraordinaire, reminded me that community health and public health nursing are career paths that are available to new nurses. Health care is increasingly being provided in settings other than hospitals, whether it be in a client's home or in the booming business of assisted living or 55+ communities. (It's a little disconcerting to think I'm less than one year away from qualifying...for the 55+ community, that is). Partners has a year long orientation program for new grads who are interested in home care, which suggests that there is still a nursing shortage in that area. And if you doubt that public health nursing is a growing industry, then you've been living in a cave for the past month or so.....

Thoughts on launching my nursing students into the 'real world'

In conversations I've had with many of my nursing students over the past few months, one recurring theme has surfaced. With few exceptions, they are all without firm job offers following graduation. The nursing job market has been impacted by the recession, perhaps not as much as other professions, but impacted nonetheless. Hospitals are cutting back on staff, even in some cases laying off nurses (unheard of until recently!), and those that are hiring, are understandably reluctant to hire new grads that require a huge investment of money to orient. So, panic has set in! Almost unanimously, they have applied to hospitals, and are seeking positions in the ED, ICU, L&D, Pediatrics, etc...in short, critical care areas that require a much higher level of knowledge and experience than new grads possess. Now, perhaps with the nursing shortage of the past ten years, these positions were filled in desperation by hospitals who needed a warm body with "RN" after his/her name, sometimes with unfortunate results. But this is a different time in nursing, and hospitals are unwilling to take a chance the unknown quantity that is a new grad.

So, here is one last piece of advice (not that they ever listened to me anyway!) for all those new grads out there: I know your heart's desire may be working in a hospital in your 'dream' job, but the reality is, very few of you will land that position. You can stress out about, complain about it, whine about it, but (although doing those things may have gotten through the last two or four years) that's not productive. You WILL eventually get there, but for right now, take a look at rehab, long term care, assisted living, nursing homes, etc. (And for the student to whom I suggested this, who answered, "I didn't spend the last four years getting my BSN just to wipe old peoples' asses", well, there is a very hot place in hell awaiting you!). Most of you new grads are young....early to mid-twenties....and you have a long work career ahead of you. Start building your resume....in addition to working in long term care, do volunteer work, take CEU's in the specialty area of your dreams, network, join your state nurses association and attend meetings. The HR person who is going to give you your dream job is NOT going to knock on your door! And, you might just find that you like working in a non-critical care setting, because...and here's a newsflash for you....the growth industry of the future will be in caring for the elderly.

So, I wish all new grads out there the best of luck in their job search. Congratulations, and welcome to the always rewarding, sometimes frustrating, occasionally terrifying, field of nursing.

Apologies

In re-reading my first post, I realize that it portrayed me as a very dark, very unfunny, very serious person...which, as anyone who knows me will tell you, I am NOT. Interestingly, though, it was written just prior to two articles appearing about patient safety and medication errors occurring in Boston hospitals. Medication errors, now THEY are unfunny. Despite all of the safety measures and the new technology in place, medication errors happen with alarming frequency. (Any nurse out there who has never made a med error, raise your hand. Ah, I thought not.) Anyway, my apologies for the tone of the post. I do love my job as a nursing faculty member, although I would throw it all way if I were offered a contract playing second base for the Boston Red Sox. (Are you listening, Scott Boras?). I've pretty much closed the book on that idea, for many reasons, but primarily because I am now old enough to be the mother to most of the Sox players....although being Tim Wakefield's mom would have meant that I was a very precocious twelve year old.

Random......

I'm told blogging is easy and that anyone can do it. Perhaps the physical part of it is. It's easy enough to sit with the laptop and type. But the hard part is deciding what to write. It is said that one should write what one knows, so I will start there. I can say with complete confidence that I "know" nursing. I know what it takes to become a nurse, and I'm not talking about which courses one must take in order to graduate (although I am intimately acquainted with that part of it). The 'becoming' a nurse, now that is a little more difficult but not impossible to convey. I try to explain it to my nursing students, hoping my experience will save them a lot of time and grief later on, but of course, at this point in the academic year (with two months to go til graduation) anything I try to tell them is falling on deaf ears. They are about to leave a very sheltered, very controlled world in which experienced clinical instructors, preceptors, etc have watched over them, held their hands, kept them from making mistakes. The rules are about to change, and I fear for them. The world they are going to enter is one in which they will hold patients' lives in their hands. One in which a medication error can mean the difference between life and death. One in which a call bell left unanswered for too long can mean a patient falls and is seriously injured. One in which the shift is not six hours long, with an hour preconference and an hour postconference, but one in which they will hit the ground running and not stop to eat, drink, or pee for 8, 12, or even 16 hours. And in this new world, not everyone will be 'nice' to them. Their inexperience will be the stuff of staff gossip. The off-hand comment will be repeated by others until it bears no resemblance to the original, innocent comment. I want them to know this, not because I want to scare them, but because I want to make the transition less painful. They are all my children in a way, and like any good mother, I want to protect them from what I know is in store for them.