Arkansas Times
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Finding where you fit

Baptist Health College

The constant need for nurses in many parts of the country has created unparalleled opportunity for new and veteran nurses alike who virtually have their pick of working environment.

But it doesn’t just happen. Janice Ivers, MSN, RN, CNE, dean of nursing at National Park College, said nurses, like any other professional, need to learn the finer points of networking, professionalism and competence to make the most of available job opportunities.

“I tell students that clinical is like an ongoing job interview,” she said. “Students need to demonstrate respect and interest; always help others, don’t be afraid to ask questions. While in school be available to step up and help out, volunteer, show interest and be engaged.”

Ivers said most instructors and supervisors are willing to accept that a student or new graduate doesn’t know everything about the role, but they are far less forgiving on matters of professionalism, teamwork and devotion to duty.

“Many managers are Baby Boomers and Baby Boomers are notoriously known to be dedicated, loyal, hardworking and determined. Work ethic is a big deal,” she said. “They have no time for lazy nurses with a chip on their shoulder thinking, ‘That is not my job,’ From cleaning up a mess on the floor to feeding a patient and beyond, it is your job.”

“Students must always be aware of how they are being perceived by others,” said Debra Cote, associate professor of nursing at the University of Arkansas at Little Rock. “Foul language and a sloppy physical appearance in a clinical setting or while involved in community activities makes a very poor impression. A potential employer will write them off the list.”

Laura Gillis, MSN, RN, clinical instructor at the University of Central Arkansas School of Nursing said such habits are the natural outgrowth of a mental attitude to do one’s best at all times, an outlook that should be present on day one of nursing school.

“It is important for the new nurse to practice professional behaviors learned from day one in nursing school,” she said. “Having a professional mindset determines professional behavior. Others notice immature behavior very quickly and it can undermine others’ perception of the new nurse.

“It takes a while to build respect from others, but it can be destroyed in just a few minutes. Attitude is quickly assessed by other nurses and it can make or break a new nurse.”

Students should also look for opportunities to network within the nursing field to put those professional behaviors and technical skills on display. The long-held axiom “It’s not what you know but who you know,” is as true in landing the first nursing job as it is in any other industry. It’s also a prime opportunity to “test drive” certain nursing specialties and working environments.

“I advise students to seek out per diem jobs and volunteer opportunities in areas they are interested in working in as a nurse,” said Jenny Janisko, MSN, RN, NE-BC, nursing director of PICU, IMU and sedation services at Arkansas Children’s Hospital.

“Reach out to areas that pique your interest to ask about shadowing opportunities. Follow hospitals on social media to be more aware of these opportunities as well as programs that organizations offer. Attend every job fair you can and, while at those events, ask real questions. A large part of job satisfaction revolves around making sure you find the right fit.”

“During nursing school, I was able to tutor fellow students, shadow different roles including case management, director of nursing, clinical manager and attend a career fair,” said Brittney Jones, RN-BSN with Baptist Health. “I feel getting involved helped me better understand nursing roles and titles within health care. I also feel other nursing professionals interviewing me were pleased with my knowledge, accomplishments and academic status while learning.”

As nurses gain more knowledge about various roles and organizations, they can start to narrow things down to their top choices for the first job. Timing is often crucial, said Paula Spells, RNI in the surgery department at Arkansas Children’s Hospital, so make the most of your final year in school.

“I would recommend in your last semester to make sure to do your senior internship at the hospital where you hope to be employed,” she said. “This will give the employer an opportunity to get to know you and hopefully remember you once you go to apply at their facility or department. The best advice I would give to get noticed during your internship is to be super outgoing and really take in all the knowledge that they offer you.”

Spells also said social media is a good way to network and stay on top of employment opportunities. Students should be aware, however, that social media is a two-way street between potential employees and employers.

“Social media, as usual, does play a major part in this,” she said. “Most major employers are going to see how you present yourself outside of work, which is where social media comes into play.”

Landing one’s first job is an important first step in a fulfilling career, but just because a nurse isn’t going to class every day doesn’t mean he or she isn’t being graded on their professionalism, even in the early stages of a career.

“One make-or-break issue for a new nurse is the support he or she gets from colleagues and nurse managers,” Gillis said. “The new nurse must feel supported from the people he or she works with in order to be successful and content in their new role. One common mistake a new nurse may make is having a ‘know-it-all’ attitude with co-workers. It is important to approach the first job with an openness to learn and a willingness to work as a team member.”

Janisko said a mentor can be invaluable in navigating the early days of a new job, and even if the institutions assigns you one (and especially if they don’t) seek to surround yourself with people who are both knowledgeable and will give it to you straight.

“As a new nurse it is important to understand that there is so much that school cannot prepare you for,” she said. “Come with an open mind and a willingness to accept and grow from feedback. A common fear amongst new team members is being perceived as unknowledgeable when they ask questions. A good nurse is a safe nurse and we all learn by asking questions.”

“Having both a formal and informal mentor can strengthen the relationships you build with your co-workers as well as your confidence in a new job. Don’t select a mentor because they are your friend. Choose a mentor that will be honest with you, and will push you to grow.”

New nurses aren’t expected to know everything, but there are a couple of basic things that they are expected to learn early and get right every time. Among these is punctuality, positive servant attitude and protecting patients’ confidential records.

“It is so important to maintain patient confidentiality. I’ve heard so many horror stories of health care workers being sued or even losing their job or credentials due to privacy violations,” said Jones. “It is just not worth the pain and struggle to face this issue. I, like my fellow nurses, have worked too hard for my title and my career to compromise my future.”

Jones said where many new nurses get tripped up by not being aware of their surroundings when accessing or viewing patient records and other sensitive data.

“During my career, I have experienced family members, friends and others close to the patient attempt to watch me chart, look at telemetry monitoring systems and taking pictures of patient information,” she said. “In these situations you, as a nurse, should explain the reasoning behind achieving full patient privacy.”

Violations of the Health Insurance Portability and Accountability Act (HPPA) carry serious consequences, including fines, potential lawsuits and, for the person responsible, immediate termination of employment in most cases. The security breach does not have to be intentional and can occur through the most innocent means.

“Comments on patient and family Facebook pages that are encouraging can unintentionally reveal HIPAA protected information,” said Janisko. “Taking a photo with a patient you have cared for and posting to your social media site can seem harmless, but again is a HIPAA breach. Make sure you familiarize yourself with your organization’s policies on social media. My real advice is to just avoid those pitfalls altogether and do not interact with patients or families you care for in the social media world.”

If all of this seems like a huge burden, keep in mind nursing is one of the most respected professions out there, a reputation that carries with it the high expectations of the general public for conduct and professionalism that one generation hands down to the next.

“According to a Gallup poll, the American people have ranked nurses as the professionals with the highest honesty and ethical standards for the 15th straight year. Trust is the key ingredient to that,” Janice Ivers said. “I tell students that they have chosen a career that puts them in a fishbowl where others are always looking. Not only at work, but during their personal life as well. What you do and how you act matter.”





Three ways to customize your nursing career

The many medical specialties that exist give nurses a lot of latitude for customizing their career path. The same is true for work environment and working hours. The following represent a few examples how, according to those who have lived them.



Like other jobs that deal in the public safety and welfare, nursing has a set of scheduling rules that are different from routine professions. Health care, particularly in hospital settings, is a 24/7 industry and must be staffed accordingly. That said, there’s room for even the newest team member to work out a schedule that helps them keep all parts of their lives in balance.

“The nursing profession offers a multitude of flexibility,” said Leah Varner, RN, BSN with UAMS.  “As a new nurse, one can expect to be matched with their ‘right fit.’ In my experience, we request the scheduling preference of the new nurse and match it with the best fit for the department.”

Varner said UAMS helps new nurses in this process via its new grad RN residency program, whereby new RNs are oriented to both the Neuro/Medical ICU and the Trauma/ Surgical/CV ICU. After this orientation, the new team member is slotted into a permanent schedule based on their preferences and departmental needs, which can be amended to accommodate life changes.

“For years I have been on a 7 a.m. day shift but when my husband chose a second career and started back to school, I switched to a PM shift in order to supplement the family income and still be involved with our son and his school during the week,” she said. ”When this phase is complete, I will then move back to day shift. Nursing allows me this flexibility to accommodate my personal life and still do the profession I love.”

Brent Camplain, nurse manager ICU/Rapid Response Team at Arkansas Children’s Hospital, said such flexibility is relative. In his department, all nurses work three 12-hour shifts, but can achieve some flexibility on what days and what day parts those shifts are scheduled. All nurses rotate through a schedule of working a certain number of weekends, too.

“I remember when I graduated there was such a thing as a ‘pecking order’ (for scheduling preference),” he said. “It seemed like everyone had to pay their dues on night shift until a day position came open. That is not the case in the present times.”

He said while many people fear having to work night shift, just as many see it for its advantages.

“Night shift is, in general, slower, patients are not coming and going to procedures, therapy is not working with the patients and there are definitely not any doctors around. Definitely less visitors, too,” he said. “This is great for new RN’s in critical care. It allows them time to think, ask questions of peers, hone their new skills and gain confidence in the care they are providing for their patients.”

Joan Tackett, MNSc, RN, APRN, FNP-BC, clinical instructor with UAMS College of Nursing, said there are other advantages to working odd hours.

“There are advantages to working nights and weekends that outweigh the sacrifices of doing so,” she said. “There is incentive pay for working the night shift and weekends. The night shift may be somewhat quieter as far as doctors and specialty teams not rounding, however, there still may be as many emergencies and it may not be quieter.”

This is not to say that working odd hours doesn’t take some adjustment, including getting used to different sleep patterns and ways to conduct personal business outside of work.

“You learn to schedule appointments early in the morning or late afternoon to allow yourself time to sleep,” Tackett said. “Many grocery stores are open 24 hours a day, making it convenient for those working night shifts. There are urgent care clinics open later that provide an opportunity to see a medical professional. Many shifts are 12 hours long, which allows days off during the week as well and that provides time to care for other needs that take place in the daytime.”

 Joel Perry, RN with UAMS, said regardless of what shift a nurse is assigned there are some rules of etiquette that everyone is expected to follow.

“It is imperative to be on time, because other nurses that worked all day or night cannot just leave like in other professions. We have to find coverage to take care of the patients,” he said. “Missing work will bring some frustration from your colleagues because they will not know if you are reliable. Not being on time or missing a shift can delay care to our patients as well and put a huge burden on colleagues increasing the nurse-to-patient ratio above our matrix.”



National Park College students train on advanced simulation mannequins that provide a variety of hands-on learning scenarios.

Choosing to work in a small, rural hospital, remain in one of Arkansas’ larger health systems in the city or something in between is another important element of building a career that fits.

Karan Cox, MSN, APRN, FNP-BC, CDE, clinical assistant professor/FNP specialty coordinator with UAMS College of Nursing, has done both.

“I have worked as a family nurse practitioner in a rural health clinic in a town in the Arkansas Delta,” she said. “It was wonderful to build a relationship with the people in the small community. Besides working in the clinic, I performed school physicals as well as presented health-related topics to a local civic club. There were no other providers in this rural farming area, so much of the health care was entrusted to you.”

The limitations, she said, included proximity to the nearest hospital and ambulance, which was 30 miles away and provided real challenges in emergencies.

Rural hospitals all over the country face the same problem when it comes to providing health care, that being attracting nurses (and physicians for that matter) to communities which often can’t afford to pay as much in salaries or invest in cutting edge facilities and equipment. As a predominantly rural state, these factors are among Arkansas’ leading challenges as well.

Keitha Griffith, DNP, RN, NEA-BC, assistant professor at University of Central Arkansas School of Nursing, said small towns aren’t without their merits, however.

“A significant advantage is the opportunity to quickly become a member of the health care team in small rural hospitals who welcome new registered nurses to their community,” she said. “Rather than only one specialty, nurses may have variety of clinical experiences as they assist in different areas of the hospital and because there are fewer new nurses, you gain clinical experiences quickly.”

In addition, cost of living is generally lower in smaller communities and the quality of life may be higher as is the sense of personal satisfaction, particularly if a nurse is returning to his or her hometown made better by their expertise.

Urban health care options, meanwhile, offer the advantages of more upward mobility which in larger health care systems may include jobs in system hospitals in other cities or states. Nurses work with the latest medical technology and find more opportunities to become highly specialized in their field. They are also often closer to institutions of higher education for advancing their nursing degree.

“Disadvantages can include being only one among many new nurses within a large system and less opportunity to get to know patients and their families compared to rural environments,” Griffith said. “As well, there’s the housing and traffic issues associated with urban living.”

But what if you wanted to combine the best of both worlds, living in one environment and working in another? Thousands of people commute every single day, why not a nurse?

“Being mobile and willing to commute allows you more options for employment,” said Dr. Charles P. Molsbee, associate professor and chairman of the University of Arkansas at Little Rock Department of Nursing. “There are parts of the state that the salary may not be comparable to say, Central Arkansas.”

A nurse’s chosen field of specialty may also dictate whether he or she can practice that type of medicine in their community or if it requires them to make the drive somewhere else to do what they love.

“A willingness to commute or be mobile in the nursing field provides many advantages,” said Teresa Whited, DNP, APRN, CPNP-PC, director of MNSc and specialty coordinator of pediatric nurse practitioner (PNP) program at UAMS College of Nursing. “The most notable advantages are unique working environments not available in your home community.

“Throughout my career, I have had multiple positions including being NICU Nurse, a PNP in general pediatrics, a PNP both inpatient and outpatient in pediatric cardiology and a faculty member at two major universities. Each of these positions has allowed me grow as a professional and develop my leadership skills.”

Such was precisely the case for Kristina Shelton, BSN, RN, on faculty at National Park College’s BSN program. She said she reaped the rewards of working at Arkansas Children’s Hospital, the only pediatric hospital in Arkansas and the only Level 4 NICU in the state. And, she noticed, many of her fellow employees were doing the same thing.

On the flip side, driving 100 miles a day, three days a week took a toll over time.

“The advantages were a career with the type of nursing you want to do that you can’t get at the hospital close to home. I was going to a facility that supported my educational growth,” she said. “Disadvantages would be the drive time, waking up earlier to get to work, effects on home life and being away from family for that extra two hours per day on top of the 12-hour shift you worked.”

Pamela Ashcraft said such trade-offs are common, thus nurses have to carefully weigh the pros and cons of commuting.

“Know what you are getting into before you agree to take a job that will require you to commute a long distance,” she said. “Not only can a long commute be expensive with gas, wear and tear on your automobile, et cetera, a long commute can also have an effect on your entire day by shaping your attitude for the day.”

“Was it a beautiful day? Where you were able to roll the windows down, relax and enjoy the breeze? Or was there a traffic jam which raised your anxiety level and caused you to be late for work or late getting home? Think about how these encounters might impact your ability to perform your work duties or how they might impact your interactions with your patients.”

Some health care systems have developed services for accommodating employees that commute particularly long distances. These benefits vary widely by employer, but are worth exploring. Lynn Storey, RN, has commuted 110 miles one way for almost 30 years and couldn’t have done it without the support of her family and her employer, UAMS.

“My sister-in-law and I took jobs here at the same time and commuted together for 25 years,” she said. “I drive 110 miles to work on Monday morning and stay until Wednesday night using the housing UAMS offers. The housing has made it possible for me to continue to work here. I know several nurses who commute and utilize the housing.”

Storey is the first to admit this kind of commute isn’t for everybody, but it has meant everything to her career to be able to do so.

“One of the advantages of being mobile is working in a hospital where there are so many opportunities for nurses,” she said. “Being away from family for three days is a lot different than being gone only a few hours and not something everyone can do. I have great family support and it has worked for me.”



Individuals who are looking for adventure and a real change of pace might consider a role as a travel nurse. This professional contracts to work in a specific facility or in a specific unit or group of units and can be deployed across the country or around the world to work for a specified period of time. Travel nurses are often used in situations where a health system is experiencing a severe shortage of nursing and is bringing in an experienced professional as a stop-gap measure.

Angie Cheves, MSN, RN, CCRN, pursued this career path before returning to Arkansas where she is now a clinical instructor with University of Central Arkansas School of Nursing.

“The advantage of being a travel nurse is to improve upon your nursing skills by experiencing different facilities, different regions and diverse populations,” she said. “It also provides a wonderful opportunity for nurses to travel to different areas and regions to experience life and adventures without having a long-term commitment to a specific area or facility.”

“The disadvantages can be that you are the new person on the unit and you may not know many people or be familiar with your surroundings when you first come to a new assignment,” she said. “There is an unfamiliarity with the specific staff members you will be working with and there can be some challenges in learning about the specific policies or processes that may affect your nursing practice at each facility.”

Cheves said a common misconception about travel nurses is that they are younger, single and therefore able to travel at the drop of a hat. The truth is, travels nurses are typically more experienced as they are expected to come in and contribute right away. Therefore, they represent a variety of family situations.

“I learned that just as many, if not more, travel nurses chose to travel with their husbands after their children had moved away from home and even traveled with their entire families,” she said. She said an open mind, helpful nature and sense of adventure are much more important than age in making the most of the job.

“I was fortunate to have the opportunity to live, work and travel to wonderful places and have amazing adventures that a vacation alone just can not provide,” she said. “Travel nursing provides an opportunity to meet amazing people that you would never likely crossed paths with otherwise.”n



—By Dwain Hebda

Nursing Notes

“Find sources for enthusiasm and seek out self-care techniques that work for you. Construct 1-year, 5-year and 10-year plans!! Think of nursing as a career, not a job.”

Sheila Stroman, Ph.D., RN, asistant professor
University of Central Arkansas, School of Nursing
Years in Nursing: 40


Sheila Stroman, Ph.D., RN
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