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Choose your path

Ask anyone who’s done it and they will tell you nursing is at once the toughest and most rewarding field anyone can enter. And many of them also say there’s nothing else they’d rather do.

“You really need to be sure you want to be a nurse because it takes a lot of responsibility to help the people in your care,” said Adam Thannish, senior nursing student at UAMS College of Nursing and clinical care assistant at UAMS Medical Center in Little Rock. “It is also a privilege to do so, because people are putting their trust in you to care for them when they are vulnerable.”

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People are putting their trust in you to care for them when they are vulnerable.  Adam Thannish, UAMS

“A nurse will have to be an excellent communicator not only with their patients, but with the entire care team including the patient’s family. To function effectively as part of a team is very important and multi-tasking and time management are essential.”

Even with a good inventory of these basic interests, the range of the field, not to mention the number of educational options, can be very overwhelming. 

“There are many variances between nursing programs and it’s important to pick a school that is right for you,” said Jon Vickers, academic counselor/enrollment coordinator with the University of Arkansas at Little Rock. “Some programs only accept 20 students a year while others accept hundreds. This information is easy to obtain but I would encourage students to dig a little deeper.”

Vickers said students should learn as much about a program as possible by taking advantage of campus tours, admissions meetings, websites and speaking with advisors. 

“Some good things to find out is if the school’s teaching philosophy is traditional or progressive, how many faculty are fulltime verses adjunct and if the school offers skills labs and simulation hospitals,” he said.

Dr. Rebecca Burris, professor and department chair at Arkansas Tech University said there are some important measurements to pay attention to when considering a school.

“Students should listen to what graduates of the program say about prospective programs and they should consider faculty qualifications, class sizes, and learning resources available at the school,” she said. “Also, prospective students should consider not only NCLEX-RN pass rates, but also the retention and graduation rates for the program. Students would want a program with at least average pass rates, and reasonable graduation rates.” 

Michael Clardy, nursing student and certified nursing assistant, agreed, saying he chose UAMS College of Nursing in part for its pass rate for the NCLEX-RN, a test the state administers to certify nurses to work in the field.  

“UAMS College of Nursing has an excellent pass rate and the fact that it’s attached to a hospital as large as UAMS is key to the practical side of the nursing education provided,” he said. “Even outside of required clinical times, most departments extend an open invitation for observation and ‘shadow’ days. Everywhere you look at UAMS, there are teachers.”

C.J. Newton, RN, director of educational resources at Conway Regional Health System, said shadowing is a good way to get a feel for a program, as well as make decisions later on concerning specialties and continuing education. 

“The initial need (for shadowing) is to determine whether nursing is appropriate for you. Getting a CNA license and working in that role is a good way to assess that,” Newton said. “Once accepted into a nursing program, you will complete clinical experiences in a variety of nursing specialties such as pediatrics, obstetrics, med-surg and critical care. This gives you a good view of possible options. You have to do some or all of them to graduate. 

“Then, once you graduate, it’s best to work in an area at least a year, preferably two, to really learn the role and decide whether it’s the best fit. The beauty of nursing is that if it’s truly not a good fit, there are always plenty of other options. Be willing to learn a new specialty or role.”

Prospective students should also evaluate their nursing school choices based on what type of degree they wish to attain, considering the time and money they are willing to invest in their education. 

“We advise students to be vigilant in taking the required course work and not to waste time and money on courses that are not in our degree plan,” said Janice Ivers dean of nursing at National Park College in Hot Springs. “Our traditional RN program is laid out in a summer-plus-two-years or we have the popular three-year plan. Most students choose (this) option, which allows them to go to school, work part-time and fulfill family obligations.”

The number of options only intensifies during one’s education. Joe Jimmerson, MNSc, director of the nursing quality and magnet programs at UAMS recommends focusing on the foundational elements of your education first and deciding on a training specialty later. 

“Towards the end of the (bachelor) program you can decide what area and role you would like to work in,” he said. “After getting your BSN, you can choose to work for a couple of years or go right back to school for higher education. Whatever path you choose should be individualized to your specific career goals.”

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Left to right, RN students, Hannah Hollingsworth, Dylan Patton, Dean of Nursing, Janice Ivers, and Kamesha Cannady practicing with the teaching stethoscope in the NPC Advanced Simulation Lab at National Park College.

Brinda McKinney, RN, MSN, PhD, assistant professor nursing and RN-BSN program coordinator at Arkansas State University in Jonesboro agreed, saying it’s important at each step of the educational process for nursing students to take inventory of their skills and interests. She said students shouldn’t stress if they don’t have their whole career mapped out in the first week of nursing school. 

“Nursing students need to consider what pathway is best for them and students may attempt to do this by considering their end nursing goal,” she said. “The problem with this is it may not allow one to discover one’s natural strengths inside the nursing profession. Often students enter the nursing profession thinking they want to be in a certain specialty only to discover that they thoroughly enjoy a totally different specialty. 

“One should know that this is not uncommon and that changing specialties after completing the first nursing program often provides for a better nursing fit and greater job satisfaction.”

NurseJournal.com tagged neonatal, nurse midwife, clinical, critical care and dialysis as their top five respective nursing career specialties for 2016, but in reality the need is so great across the board, students can pursue whatever speaks to them. 

“There are needs for RNs in all areas of nursing, from acute care hospitals, long-term care, school nurses and even cruise ship nurses,” said Wendy Lincoln, RN, BSN, MSN, NEA-BC, assistant vice president of Med/Surg for Baptist Health in Little Rock. “A great place to start a nursing career is on a Medical Surgical floor in a hospital setting. 

“Working in a Medical Surgical unit prepares nurses to go into any specialty area; they are knowledgeable about every body system, familiar with a vast array of medications and become excellent time managers with experience. The skills gained in the Medical Surgical environment gives a wonderful foundation from which nurses can expand into any specialty they desire.”

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Technology helps nurses at Conway Regional Medical Center track patient information much more closely and with higher accuracy.

Nursing careers themselves can span opportunity in other areas, said Beth Williams, director of nursing at The BridgeWay a North Little Rock hospital that provides inpatient and outpatient psychiatric treatment for children, adolescents, adults and families.

“Nursing experience in general can launch into other careers,” she said. “For example, a psychiatric nurse working on the floor might decide to become an advanced practice registered nurse (APRN) continuing working in the behavioral field. Nurses can also use their experience to go into management positions as well. 

“One of the great things about nursing is that there are so many different options within health care, different types of nursing, different populations, specialty fields. One thing that is unique at The BridgeWay is we care for all populations. You might enjoy working with children, teenagers, adults, seniors. We also have inpatient and outpatient services which can appeal to people in different ways.”

Another area showing tremendous growth potential is in rehabilitation services, which help patients recover from accidents and health conditions. HealthSouth is one of the nation’s largest providers of post-acute health care services and an industry leader in home-based care for patients recovering from stroke, amputations, brain injury and multiple trauma, to name a few.

“The importance of nursing to rehabilitation can’t be overstated,” said Kim Collier, Southwest Regional Recruiter. “Rehabilitation is a team effort focused on restoring quality of life and HealthSouth registered nurses are an integral part of the care team on which patients and their families rely. 

“Rehabilitation nurses help patients reach their therapy goals when therapy is not in session and we support these efforts by giving them access to resources needed to deliver the best possible care including the best facilities and equipment.” 

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High-tech classrooms and quality instruction keep students on the leading edge at Jefferson Regional Medical Center.

A student approaching graduation reaches another fork in the road, whether to go into the workforce or to continue their education. As with any industry, a higher degree brings more employment options and more earning power. Conversely, the added time, effort and cost of an advanced degree may be hard for some nurses to justify given the many solid jobs open to them at the RN level. 

“Set a schedule for completion of your education and stick to it,” said Lisa Lightner, employment manager with Washington Regional Medical System in Fayetteville. “Be prepared to make sacrifices and ask for help if you need it. Test the job market for the type of degree or skill you are pursuing. If it is saturated in your area, are you willing to move? Also, look for ways you can do a project that will help your employer while also earning you school credit.

For those choosing to work, the choice then becomes one of location. While a larger city’s amenities might seem to have an upper hand in attracting graduates, the needs and opportunities in rural Arkansas can also be a powerful draw.

“A lot of new grads choose to work in rural communities because this is home for them, they are closer to family, and they have a connection to the community,” said Pam Green, AAS, CMSRN, unit supervisor Med/Surg for Baptist Health in Arkadelphia. “Some students are married or are planning to get married, and they want to raise their families in a small town. They also feel like they have an opportunity to give back to the hometown and they love the outdoor way of life that rural communities offer.”

Bendi Bowers, MNSc, RN, is one such person. A native of Corning, Arkansas, Bowers has covered a lot of ground in her career, prior to her current role as clinical services manager for UAMS Northeast in Jonesboro. 

“After spending my first two years of nursing in a northeast Arkansas community hospital setting, I set out to travel nurse,” she said. “I spent several years after that in major metropolitan areas in Tennessee, Ohio, Connecticut and Washington DC. I returned back to Arkansas, settling in Little Rock to continue my education and work at University of Arkansas for Medical Sciences. After 15 years at UAMS in Little Rock, I returned back home to northeast Arkansas.

“The advantage of working in smaller communities is the continuity of care working with the same health care professionals and knowing your patients and their needs. The variables are the resources available to both patients and caregivers, but with the continual advancement of telehealth programs and initiatives such as Patient Centered Medical Home, that gap is lessening.”      

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Students review a medical chart before tackling an assignment at Arkansas Techs simulation lab.

Nurses who decide to continue their education past the bachelor’s level do so to avail themselves of additional job opportunities, more earning power or because the type of work they really want to do requires a graduate degree. 

“A nurse desiring to pursue a career as an advanced practice nurse will benefit working in urgent care or the ER if she desires to become a family nurse practitioner. Those seeking the acute nurse practitioner will find advantage by working the ICU,” said Sondra Bedwell, PhD, FNP and director of nursing education at UAMS Southwest. 

“Nurses who choose to pursue their graduate degree in order to become a nurse practitioner, are seasoned nurses and usually aware of the specialty that they desire to pursue.  These nurses have worked for years and have developed skills and a desire to move beyond the role of the registered nurse in order to become advanced practice nurses.”

Neal Reeves, System Analyst Manager for UAMS College of Nursing, is studying for his doctorate in nursing after having already earned a Master of Business Administration. He sees the two fields as advancing both his career goals and the profession as a whole. 

“There are very few doctoral-prepared nurses today and if we are to continue to grow we need to ensure we have doctoral nurses to educate those that come behind us,” he said. “As an Informatics nurse, we are very young in the big scheme of things and I feel I have an obligation to set the standard in my specialty by supporting my practice, as well as those around me, with the highest level of education.”  

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Stephanie Miller and Kaylee Sisokrath with patient at UAMS.

One of the most startling things about advancing through the various levels of nursing education is mastering something only makes you realize how much more there is to learn. For these nurses, combining a little bit of both post-graduation strategies helps gain experience while deciding what additional education to pursue next.

“A student’s sequence is to go from major insecurity and feelings of ‘I don’t know what I’m doing!’ to, somewhere along the way, we begin to think we know a whole lot,” said Jessica Rouse, BSN, chief nursing officer with Rivendell. “Hence, when we take ourselves or others to the doctor, we chime in that we know what they are talking about because we are ‘in nursing school.’ We are met with extreme insecurity upon entering the field, because we again realize how little we know.  

“It is good to figure out what field a nurse wants to go into by graduation, but I recommend doing the ADN or BSN and working a bit before going for a Master’s. It is not until we work that we really often find our passion.”

 

 

 

Nursing Notes

“For advanced degree levels, I see three areas of major opportunity: Nurse Practitioner, Nursing Education and Nursing Informatics. We need practitioners to help cover the gap in the lack of physician coverage, we will need even more educators to continue educating young nurses and we are moving at light speed in many ways making our health care delivery system more electronic.”  

 

Neal Reeves, MSN, System Analyst Manager, doctoral nursing student UAMS College of Nursing
 
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