By Debra Wood, RN, contributor
February 16, 2012 - While nursing has long been a profession with a myriad of career options, America’s aging population and an evolving health care marketplace are creating even more possibilities.
Dawn Bazarko, DNP, MPH, RN, said opportunities for nurses are endless.
“There is a whole spectrum of opportunities for nurses that didn’t exist before, simply because the landscape is changing so much,” said Dawn Bazarko, DNP, MPH, RN, senior vice president of UnitedHealth Group’s Center for Nursing Advancement in Minneapolis. “It’s an exciting time to be a nurse. The career opportunities are endless--both in clinical roles and nonclinical settings.”
UnitedHealth employs more than 9,000 nurses, and that number continues to grow as the business expands and prepares for post-health care reform programs and the greater number of patients who will have health coverage and seek care.
Patrick R. Coonan, EdD, RN, NEA-BC, advised nurses to take a broad look at the many opportunities that exist for nurses.
“People have to have a broad vision of the profession,” said Patrick R. Coonan, EdD, RN, NEA-BC, dean of Adelphi University School of Nursing in Garden City, N.Y. “There are lots of opportunities out there if people go and look for it.”
Job prospects are improving for new graduates, as older nurses begin to retire, said Suzette Cardin, RN, DNSc, FAAN, assistant dean of student affairs at the University of California, Los Angeles School of Nursing. She recently completed a study that found the number of newly licensed nurses securing jobs increased 10 percent in 2011 compared to 2010.
Marty Witrak, Ph.D., RN, reported lots of opportunities for nurses willing to work with technologies such as telehealth.
Marty Witrak, Ph.D, RN, dean of the school of nursing at The College of Saint Scholastica in Duluth, Minn., reported that many jobs will open up as the economy improves, older nurses retire and changes in the health care system require more care coordination.
Critical care, the operating room and emergency departments continue to need experienced nurses, Coonan said.
In addition nurses specializing in the care of people at both ends of the age spectrum are in demand. Melissa Madden, nurse recruiter with Children’s Healthcare of Atlanta, said the health system is always looking for experienced nurses and currently has 65 vacancies, with a strong need for intensive care, hematology/oncology and research nurses.
Mary Stowe, RN, MS, vice president and chief nursing officer at Children’s Medical Center Dallas, called the overall job prospects for pediatric nurses very good, with endless opportunities for those with a passion to care for the most vulnerable patients.
“Areas of growth for hospital pediatric nurses continue to be in caring for the more complex child--a child experiencing multiple disease processes,” said Stowe, indicating expansions in neonatal care, intensive care, cardiac services, oncology and psychiatry beds.
Carol A. Mannahan, RN, EdD, NEA-BC, anticipates continued demand for experienced clinical nurses.
Carol A. Mannahan, RN, EdD, NEA-BC, an assistant professor of nursing at Oklahoma City University, reported a growing need for nurses specializing in gerontology. However, she agreed that clinical nurses in all settings would remain in demand in the years ahead.
Coonan on the other hand said that nearly all nurses must be skilled in caring for older adults, since nurses in nearly any adult care setting will care for elders.
He reported an increased need in hospitals for transitional care managers, who telephonically follow patients after discharge, and for nurse informaticists.
“The growing area is on the technology side and is a great track for nurses who want to make a move,” Coonan said.
Technology is creating more opportunities for nurses, as they help with installation of electronic health records and population registries, Bazarko added.
Witrak also expects technology, such as telehealth, will open up opportunities for nurses.
“Telehealth is going to be critical for rural communities,” Witrak said.
Mannahan also reported a shortage of nurse leaders, which creates opportunities for nurses with an interest in management. However, she cautions that it can be a tough job with conflicting demands.
“Nurses get a tremendous amount of satisfaction from our work with patients, but sometimes in leadership positions, the satisfaction is few and far between,” Mannahan said.
But outside of hospitals, employers also are looking for nurses with leadership skills.
“Nurses are everywhere--legal, insurance and managed care,” said Lorie A. Brown, RN, MN, JD, in Indianapolis, Ind.
Brown admits to loving her law practice, where she defends nurses and physicians or helps an injured person receive justice. However she cautions that law may not be for everyone, since it requires business skills to develop a practice and the ability to work for long periods with records, not patients.
Possibilities outside the hospital
Older people with chronic conditions will require more nursing services. Nursing students at UCLA take public and community health coursework, but Cardin said public health departments are not hiring currently. But she expects health reform will require more nurses working in the community, including home care and hospice.
“Coordination is important to keep people healthy and out of the hospital, and nurses do a good job with that,” Witrak added.
As more care moves outside the hospital, due to an emphasis on prevention and cost reduction, nurses will be needed in home care, clinical, group practices and other ambulatory settings.
“We have finally gotten some interest in health promotion and disease prevention, and nurses are particularly equipped to help with those things,” said Mannahan, adding that that spills over into the home setting, where opportunities are booming due to the number of sick patients being cared for at home.
Pernille Ostberg, MBA, RPh, said home health offers huge opportunity for nurses.
“Home health is a huge opportunity for nurses with the ever-increasing aging boomers and their need for care,” said Pernille Ostberg, MBA, RPh, president/CEO of Matrix Home Care in West Palm Beach, Fla. “The hiring environment for home health will require the nurse have broad and current hands-on skills, good clinical and critical thinking skills, social/cultural flexibility and the ability to respond in non-defined situations and settings. It is not a 9-to-5 environment, and that flexibility may appeal to many in the nursing field.”
Growth in outpatient services is expected in the pediatric realm, as well.
“The care of complex patients extends out to the home and to our sub-specialty clinics,” Stowe said. “The care coordination usually done by a nurse can be the driving force for keeping them in their home setting and out of the hospital.”
Education offers additional opportunities
Nurses who continue their education can find increased opportunities and higher salaries, including nurse practitioners providing primary care and nurse anesthetists administering anesthesia.
Coonan reported that nurse practitioners will be needed as health care focuses more on primary care and transitional care. The popularity and proliferation of retail clinics should also keep nurse practitioners in demand, Brown added.
Witrak also projected a greater need for nurse practitioners who are able to coach people to stay healthy. She reported more online programs are available to help rural nurses further their education.
Young men, in particular, seem to be gravitating to master’s-prepared certified registered nurse anesthetist (CRNA) programs, Mannahan added.
“In rural areas, nurse anesthetists are priceless, and now I see them being used in the larger practices,” Mannahan said.
Due to the faculty shortage, Mannahan also sees a number of opportunities for nurses wanting to break into academia, as well as scholarships and financial aid to help nurses secure the additional needed education.
UnitedHealth’s Center for Nursing Advancement is providing a master’s education to 30 nurses to help prepare them for leadership roles and to teach in nursing schools.
“We need to ensure that nurses are engaged in a spirit or plan for lifelong learning,” Bazarko said. “The jobs will be plentiful for nurses with advanced education, starting with a bachelor’s degree. … But these new roles require advanced training and skills and leadership preparation and understanding of the way the system of health care works and the financing of health care.”
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