Counselor for Undecided Students
There is enough satisfaction as a nurse taking care of others, to last for the entire extent of a career in healthcare. But sometimes, a superior reputation for nursing earns opportunities to get involved with nursing education and administration. FN was willing to work hard and take risks for altering her career path because she knew she could always return to helping patients at their bedsides.
FAMILY BACKGROUND AND THEIR CAREER INFLUENCE
FN is one of 4 sisters, third-born in the ‘batting order’. Her father worked around the ‘open hearth’ furnaces in steel mills. Her mother had worked as a seamstress in a factory until marriage, then was a homemaker. Neither parent attended college but both parents encouraged their daughters to pursue a college education, though without any specific career recommendations.
CHILDHOOD THOUGHTS OF AN ADULT CAREER
During FN’s childhood, the common ‘community expectations’ of career paths for women who wanted or needed to work outside the home, were assumed – by tradition, not by law – to be limited to nursing or teaching. When FN was in high school, the school nurse led a club for students (open to boys and girls but only girls joined) interested in a nursing career. The club would take occasional trips to health care facilities such as a hospital or a Red Cross blood donation center.
During school vacations, FN worked as a volunteer ‘Candy Striper’ at the local hospital, getting comfortable in a hospital setting, interacting with nurses and patients while performing non-medical tasks such as running errands for nurses and for patients, delivering flowers and filling water pitchers.
SCHOOL DAYS
Combining her self-motivation to learn about all her school subjects with her specific ability to understand math and science concepts, FN achieved excellent grades within the advanced science courses, eventually graduating as Valedictorian of her high school’s Senior class. (FN notes that earning such an academic honor is not necessary to qualify for admission to even highly selective colleges, but it did assist her application for college scholarship / financial aid.)
FN was glad she learned typewriting skills as part of her high school education since that manual skill has always been useful in both education and her personal life.
COLLEGE
For her first adventure after high school, FN wanted to attend college but remain close to her home base. With her high GPA, FN correctly assumed that the local campus of the state university would accept her application, so she applied to only that one school and was accepted. Then with that first year of college experience and having achieved a sufficient GPA to qualify for admission to the university’s main campus, FN felt comfortable transferring to the larger campus, a few hours away from home, where she continued to work hard as a pre-nursing major, in such courses as organic and inorganic chemistry, achieving a high GPA to earn her Bachelor of Science in nursing, with the added honor of ‘Cum Laude” (translation from Latin: “With Praise.”)
REQUIREMENTS TO BECOME A ‘REGISTERED NURSE’ (R.N.)
There are three education path options to qualify to take the national nurse licensing exam (‘NCLEX’) to become a Registered Nurse (not listed by FN’s preference):
- Graduate from a four-year college or university to achieve a Bachelor of Science in Nursing (B.S.N.) degree; or
- Graduate from a two-year college (‘community college’) to earn an Associate degree in nursing; or
- Graduate from a hospital-based program to earn a Diploma in nursing.
Following completion of one of those three nursing education options, the graduate is eligible to take the national NCLEX test. Only those who pass the test are authorized to be called a Registered Nurse (R.N.) and work in a nursing capacity.
Not surprisingly, FN passed her NCLEX test on her first attempt. Then, as now, the ‘pass rate’ was approximately 75%. There is no official limit on the number of times an aspiring nurse is permitted to take the exam but as a practical matter, failing to pass after several attempts is an objective sign that pursuing a different career would be the best path forward.
ADVANCED NURSING DEGREE OPTIONS
The basic nursing degree is an R.N., which permits the nurse to be a ‘generalist’ – thus qualified to work within any of the main categories of nursing. If the nurse chooses to work within any of the nursing sub-specialties, a Masters Degree in that nursing specialty is usually required.
If the nurse with a Masters Degree hopes to work in the field of nursing administration or nursing education, a Doctorate degree (Ph.D. or Ph.D.-Ed.D.) is usually required.
NURSING CAREER ALTERNATIVES
During nursing school, students serve in different ‘rotations’, each lasting several weeks, among four general areas of nursing specialization: maternity, medical / surgical, pediatrics and psychiatric. Within each of those four main categories, there are multiple sub-categories, such as Nurse Anesthetist (administer anesthesia and pain medication), Nurse Educator (teach nursing students), Neonatal Nurse (work in intensive care units with infants), Nurse Midwife (prenatal care and childbirth), Clinical Nurse (e.g. for pediatrics, geriatrics, critical or emergency care), Infection Control / Prevention Nurse, School Nurse, Dialysis Nurse (kidney patients), Public Health Nurse (educate communities re health and safety issues), Informatics Nurse (manage healthcare data), Nurse Advocate (coordinate between patients and their doctors), Nurse Researcher (conduct scientific studies, analyze data and report findings), Psychiatric Mental Health Nurse (for patients with such mental issues as depression, dementia and substance abuse), Trauma Nurse (work in critical care or emergency response teams), Travel Nurse (travel among healthcare facilities, sometimes internationally, to fill staffing needs), Pediatric Nurse (healthcare needs of children through adolescence), Geriatric Nurse (work with elderly patients), Acute Care Nurse (patients with severe or life-threatening issues such as heart attacks), Oncology Nurse (patients involved with various stages of cancer) and Family Nurse Practitioner (examine, diagnose and treat patients of all ages).
There is no need to select a career path until applying for your first nursing job. Thereafter, there is no official restriction for changing the focus of your nursing career from one specialty to another.
FIRST NURSING JOB NOT A BINDING CAREER COMMITMENT
When FN graduated from nursing school with her B.S.N., there was a shortage of nurses (much like the days following the onset of the covid pandemic in early 2020). FN interviewed for four different nursing positions, received offers of employment from each and chose to work as a nurse in a maternity hospital.
FN’s next nursing job was within a children’s hospital, where she remained for two years until an Instructor from a nursing graduate school observed FN in action, got to know FN well and urged FN to apply to a Masters in Nursing program, for which she was accepted with an offer to start her graduate classes as a paid ‘Trainee” (tuition payments were waived plus she was paid a small stipend) while working part-time and attending the graduate school’s classes.
(Editor’s note – FN’s ‘Trainee’ program no longer exists but in many current, nursing employment situations, the employer will reimburse the nurse who successfully passes advanced nursing courses.)
TYPICAL DAILY ACTIVITIES OF A NURSE
To understand the public misperception of a nurse’s role and daily activities, nursing students may be tasked with asking their family and friends to draw a picture of a typical nurse performing their typical activities. That request usually produces a drawing of a female wearing a dress with a nursing cap – with a red cross drawn upon either or both – while the nurse is holding some equipment, such as a stethoscope, syringe or thermometer. No one ever portrays a nurse planning the tasks ahead, including organizing their priority.
The activities of a nurse will vary from day to day, depending on the nurse’s specialty. For example, nursing within a hospital’s pediatric ward will involve different jobs depending on whether the nurse is working in an intensive care unit for children who have just completed surgery or are (hopefully) progressing while spending most time recovering in bed where their food and fluid intake must be observed along with indications of pain and healing from wounds or infections and eventually ability to walk.
GOOD WORK REPUTATION MAY CREATE DIFFERENT CAREER OPPORTUNITIES
NURSING PROFESSOR
FN worked part-time to be able to continue earning money while she took two years to complete her Masters Degree nursing courses. Before graduating, FN was contacted by several nursing education institutions who were looking to hire nursing faculty. Even though FN had not completed her Masters Degree courses, it was obvious from her past educational track record that she would graduate on schedule so the employer – a junior college – hired FN to be a full-time teacher in maternity and pediatric nursing courses.
Thus, began FN’s transition to full time nursing educator, initially teaching both pediatrics and maternity nursing courses. She followed this altered nursing career path to multiple teaching institutions (colleges, universities and hospital systems) while she and her husband moved to different locations related to his changing employment situations.
After one of their residential moves to a different geographic area in the middle of the academic year (September into June), a college in her new location was looking for someone with an advanced nursing degree to supervise nursing students within their clinic for medical / surgical nursing students, which FN was qualified to undertake. Then a full-time position opened at a nearby hospital setting where a state university had established a clinical setting for its nursing students. FN taught nursing students within the med / surg classes and when another faculty member retired from teaching pediatric nursing, FN was qualified to step into that teaching role.
(Editor’s note – As FN’s career story demonstrates, one major benefit of working hard within your profession – in addition to your career satisfaction – is the creation of opportunities to revise your career path to meet your personal circumstances. For example, FN was able to transfer her nursing career from one town to another and find a new job in each location because she had earned a good working reputation plus, she was working within a field which was often looking for talented help, either as a nurse or a nurse educator.)
NURSING SCHOOL ADMINISTRATOR
Having initially served as a nurse, earning her Masters Degree to specialize and then involved in nursing education as both a student and a teacher, FN became interested to study the broad aspects of higher education, including its financial aspects. For example, FN wanted to learn what happens to the tuition paid by students; what is the fair and reasonable distribution of income to faculty; how can a school afford to grant scholarships; what is the role and financial impact of athletics within the curriculum; how can a school qualify for grants? To satisfy her self-motivated desire to learn about higher education, FN enrolled in an educational doctorate program, eventually earning her Ph.D. – Ed.D. degree.
While serving at one school as a member of the teaching faculty, FN was asked to serve as the Director of the Center for the Enhancement of Teaching, which involved setting up programs for professional faculty development, including organizing and planning.
NURSING SCHOOL ADVISOR TO ‘UNDECLARED’ STUDENTS
Another opportunity was offered to FN as a result of her successful teaching and faculty leadership experience: a role within the Advisement Center for Undeclared Students. FN noted that some students begin college with no idea of their academic strengths and even if they did well in certain courses, they may not have enjoyed the subject matter involved; other students achieved high grades in all their courses but couldn’t decide among so many possible career paths. For example, should they pursue business or an English major or communication design because they were good at technology? Some students were not accepted into the major of their choice because their overall GPA did not qualify or once they started in that major, they did not maintain the requisite GPA.
So, for each different ‘undeclared’ student situation, how could a counselor assist? First, FN advised the student to remain positive about their futures – they were neither dumb nor unmotivated; they just needed to find the right path for them to pursue.
This aspect of potential negative status attached to undeclared students, also had to be addressed to faculty who occasionally expressed their concerns that undeclared students were lagging in intellect and/or motivation. Not so, said FN! The task for the guidance counselor was to work with each student toward an individual solution best for that student, not to prescribe an overall strategy presumed – incorrectly – applicable to all students. For example, some students could be encouraged to retake an important test while others could be encouraged to revise their career plan, either through a slight alteration or perhaps a total change of direction.
FN found her counseling efforts to be consistent with her nursing experience, where nurses must constantly observe and communicate with each patient as an individual, to understand what was in their different, best interests. Nurses do not merely follow the prescribing physician’s orders without using the nurse’s own critical thinking; for example, the doctor will write an order for a certain medication, but the nurse must closely observe that the dose is correct, then any side effects within the patient and how well the is patient responding and progressing (known as ‘efficacy’).
CAREER SATISFACTION
Nursing is very rewarding but hard work because much of it is emotional, physical and psychological, sometimes all at the same time. Regardless of your nursing specialty, nursing is challenging, not like the version seen on tv where nurses are mostly portrayed walking around with clipboards, doing nothing. Nursing requires a lot of thought and effort, not merely following a physician’s orders because every patient’s needs and reactions are different and must be carefully monitored.
Sometimes, nurses experience hostility from family members, who are angry that their loved one is not progressing according to the family’s hopeful timeline. Violence against nurses is on the rise but fortunately, so is hospital security (including metal detectors). Unfortunately, there is no vaccine to immunize anyone – including nurses – from unpleasant or dangerous people. But nurses are proud to serve and accept the personal risks involved, including proximity to infectious diseases, much like police, firemen and combat soldiers accept the daily risks to their personal safety.
Most of the time, patients and their families are very appreciative of your care, calling nurses ‘angels’ and ‘heroes’ especially during a pandemic. Many nurses were the only ones available to hold the hands of loved ones when they died.
Nurses whose jobs are not on the front-line of patient care, nonetheless, also fill important roles within the healthcare system, ranging from teaching other nurses to supervising healthcare administration.
