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Strategies for Moving Ahead in Your Career


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By Nancy Deutsch, RN, contributor

Due to the chronic nursing shortage, nurse graduates have a much wider variety of options than ever before, and have greater flexibility in honing their careers and finding the specialty that’s best suited to them.

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According to Elaine Tagliareni, RN, EdD, nursing graduates have a wider choice of options at their disposal than ever before.

While the unspoken rule may have once been that new nursing graduates should gain experience on a medical-surgical floor, this is no longer the case, according to staffing experts.

“Schools offer such a full curriculum, that nurses are becoming more able to to work wherever they feel the calling, said Elaine Tagliareni, RN, EdD, president of the National League for Nurses. “The undergrad curriculum is a generalist curriculum.”

Surgical experience used to be a prerequisite to working in places like the ER or ICU, she added, but due to the dearth of staff, this is also no longer the case. “Now nurses are often accepted right into the ICU due to the nursing shortages” and trained on the spot.

Other new grads choose specialties that would never have been considered wise choices for new nurses years ago, agreed Brigid Lusk , RN, Ph.D., and chair of nursing at Northern Illinois University. “We have several graduates go right into psychiatry because they just love it. The nursing shortage is so severe that they are welcome anywhere now.”

Most new nurses still choose employment in the hospital setting, Tagliareni noted.

“In most cases, students still graduate to hospital environments. They pay more and have wonderful reimbursement programs,” she said. But a surprising number of graduates make their first nursing job one in the community or clinic or other non-hospital-based environment.

Tagliareni said new nurses have such a wide range of choices that she encourages them to consider what an employer has to offer, such as a good mentoring program or continuing education financial assistance. They should also ask themselves “how will this be a challenging environment?”

New grads are encouraged to give any new position a fair chance by staying put a fair amount of time. While there won’t be a problem to find another job if the chosen one isn’t a good fit, many specialty departments, such as intensive care, offer orientation programs that last six months or a year, she said, so it may be a while before the nurse knows is the job is a good fit.

“For employers, one of the biggest concerns is the rate of staff turnover,” Tagliareni said.

While it’s easy for new grads to think of another opportunity when they are unhappy with their first choice, moving around a lot is not advisable, Tagliareni said. Still, if a new grad is immediately disillusioned with his or her choice, “it’s more indicative of inadequate preparation.”

“I would encourage people to stay at least a year,” echoed Lusk. But, like Tagliareni, she said that “hospitals should be more hospitable.”

Aside from where to work and how long to stay, another way of thinking has changed, Lusk added. If new nurses are at all interested in furthering their education, “we encourage getting grad degrees right away” because there are so many jobs for nurses with advanced education, she said.

That’s why nurses should look at what assistance with education a new work environment offers, Tagliareni said. While there are no good statistics available, only a small percentage of nurses with associate degrees go on to obtain their bachelor’s, she said. “Take advantage of the change to get an advanced degree.”

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