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Registered nurse candidates are graduates from programs that are state approved and, in many cases, accrediated by national accrediting organizations. In the United States, the National League for Nursing Accrediting Commission (NLNAC) accredits nursing programs; the Canadian Association of University Schools of Nursing (CAUSN) accredits baccalaureate programs. The Commission on Collegiate Nursing Education (CCNE) was established in 1996 as an accrediting agency of the American Association of Colleges of Nursing (AACN) to evaluate the quality and integrity of baccalaureate and graduate degree nursing education programs. RNs are prepared for entry into practice typically in three ways: associate degree nursing programs, hospital diploma programs, or baccalaureate degree nursing programs. Educational preparation for entry into practice has been an ongoing debate in nursing since the 1930s and 1940s, when the Brown and Goldmark reports recommended two levels of educational preparation for nurses. (continue reading…)

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. (continue reading…)

When Heather Kaz was a child, she made IVs out of twigs for her dolls. As a 5-year-old, she helped her grandmother, a World War II nurse, take care of her ailing grandfather. As far as she could remember, nursing had been an important part of her life. So it seemed natural that when she was 18 and enrolled in the University of Wyoming, she would choose nursing as her major. Then the doubts set in.

Her family told her she was too bright, too promising for nursing. She couldn’t imagine herself changing bedpans and following orders from a doctor. She changed her major to premed, graduated with a bachelor’s degree in biology in 1996 and took entrance exams before she realized she did not want to go to medical school.

Instead, she took a job as manager of a cancer surveillance program. As part of her work, she traveled the state, teaching people about cancer prevention. She was good at the research, but working with people excited her more.

“You become alive with these people,” her director told her. “You need to rethink where you’re going.” Kaz considered pursuing a master’s degree in public health. “What’s wrong with going back and being a nurse?” her director asked. “You’re meant for it.”

Across the country, people in fields from engineering to psychology, English to computer technology, are taking another look-sometimes a first look-at a career in nursing. For some, like Kaz-now enrolled in an accelerated bachelor’s degree in nursing program at the University of Northern Colorado-it’s a journey back to their heart’s desire.

Some say that after years of just making money, they want to do meaningful work. Others feel trapped in limited professions or have lost their jobs in a sliding economy and see new opportunities in nursing.

To attract and keep their interest, many nursing schools have established accelerated bachelor’s degree programs for students who already have a degree in another field. These programs allow students to earn a BSN in 16 to 20 months, rather than completing a traditional four-year program. Some hospitals sponsor students through these programs and pay tuition in exchange for work after they graduate.

Hospital administrators say second-career nursing students make terrific nurses. They are mature, broadly educated and know how to conduct themselves in the workplace.

But the life experience that makes them great nurses also often leads them to expect more from their careers and their employers than they might as graduates fresh out of school, say health care consultants, nursing school professors and the students themselves.

The American Association of Colleges of Nursing does not have enrollment figures specifically for the accelerated programs at its member schools. But Robert Rosseter, spokesman for the association, said the number of accelerated programs has increased from 60 in 1995 to 72 last year, with 11 schools planning to add accelerated programs.

The Duke University School of Nursing in Durham, N.C., plans to offer an accelerated BSN program next year-its only baccalaureate program-as a direct response to the nursing shortage, said Mary Champagne, Ph.D., RN, FAAN, the school’s dean. So far, the school has had 200 inquiries about the program, she said.

“Young people today go into college and many of them take liberal arts or basic science courses. They’re not committed to a career, and until recently, nursing hasn’t been an option for them,” Champagne said. “This is a real, untapped pool that we might bring into nursing and help ease the severe nursing shortage that this country is going to face.”

Perceptions change
Champagne is referring to people such as Holly Cousins, who works as a secretary for Nursing Student Services at South Dakota State University. Cousins said she has always been interested in health care, but never considered nursing until she began working at the university.

“One concern was going in and having doctors order me around and I’m too much of an independent person to like that very much,” Champagne said.

Cousins has a degree in English. She taught for three years before deciding it wasn’t for her. She admires the skill and dedication of nurses she has met in her present job. Her original perception of nursing has changed, and she plans to apply for the new accelerated program that the SDSU College of Nursing plans to offer next year. (continue reading…)