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Time to Refocus Your Career Lens!

Friday May 2, 2014
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As healthcare evolves to meet the changing patient demographics and health needs of these patients and their families, so is the nursing job market changing and evolving. Hereís a snapshot of whatís developing:

Hospital direct care vs. ambulatory and outpatient service

1. Hospital direct care jobs (bedside nurse) will decrease while care management/coordination (not to be confused with case management) will increase. Roles such as transitional care coordinator, geriatric care manager, nurse navigator, patient advocate and population care coordinator will flourish in the inpatient and outpatient settings affording both employment and self-employment opportunities for nurses. The American Association of Ambulatory Care Nurses (www.aaacn.org), the National Coalition of Oncology Nurses Navigators (www.nconn.org) and the National Association of Professional Geriatric Care Managers Association (www.caremanager.org) are great resources for information, education and certification.

2. While acute care (hospital) inpatient admissions are gradually decreasing, ambulatory and outpatient service utilization is increasing. As more care is delivered in the home (home care, hospice and palliative care and routine health visits), community-based clinics and practice settings, nurses will lead the way. Services will grow and expand as we actively work to foster aging in place (keeping people in their homes), providing patient/caregiver support, education and care coordination.

3. Lower acuity inpatient settings will flourish as an alternative to hospital care, which is expensive and high-risk. These alternatives include rehabilitation ó acute and long-term ó sub-acute, assisted living, long-term care and long-term acute care. Nurses have expanding opportunities for management and care coordination in these settings.

4. Health education and coaching will be front and center. Nurses already are working one-on- one and with groups through insurance companies, corporate wellness programs, occupational health programs, public health programs, medical/nursing clinics, holistic health and wellness centers and other ambulatory practice settings. This might include teaching/coaching mindfulness and meditation practice, stress management, good nutrition, energy balancing and the entire holistic nursing spectrum. Again, both employment and self-employment opportunities abound.

Other hot practices

5. Other hot practice areas include nursing informatics, telehealth nursing, clinical documentation improvement specialist (working with reimbursement, coding and utilization issues), case management and outcomes management (quality, utilization, and risk management).

6. Clinical specialties still thriving include all intensive care specialties (ICU, CCU, NICU, ED, PACU, perianesthesia), medical-surgical, mental health, bariatrics, womenís health, nephrology and gerontology for those with advanced degrees and clinical certification.

7. Advanced practice nurses (NP, CNS, CRNA, CNM) will deliver more and more primary care services and serve in clinical leadership and administrative roles.

What you need to do to prepare for the changes in the job market

So what do you need to do to prepare for the changes in the job market?

1. Join and get active in professional nursing associations. The support, camaraderie, idea exchange, mentoring and information pipeline is the best way to stay current and connected. You can no longer stay isolated in your profession/specialty and thrive, or even survive, in nursing. And your dues and meeting expenses may be tax-deductible. Check with your tax preparer.

2. Further your formal and informal education to stay abreast of industry and care standards. Pay attention to what healthcare futurists and nursing thought leaders are saying about the future direction of nursing and healthcare in general. Everything is changing and education will form the basis for your future career. There is plenty of scholarship money available for those who go after it. Online educational/informational resources abound as well.

3. Get up to date and stay current with technology as it relates to care delivery as well as career tools and communication modes including social media (Facebook, LinkedIn and Twitter). With technology, itís better to keep up rather than trying to catch up, or worse, get left behind. Find a social media consultant or friend or colleague to help with this if necessary.

4. Keep your appearance, communication, network and social skills current. Take classes, read books, observe and model those who are already doing these things well. Clinical skills and credentials are not enough to ride the tide of change. You need to reinvent yourself and your nursing career to fit into the new model of healthcare and nursing, not to mention a new world. Change is never easy but without it there is no growth. If youíre not growing, youíre stagnating.

For personalized career advice

If you have specific career-related questions, send them to Dear Donna at www.Nurse.com/AsktheExperts/DearDonna for a personalized response.


Donna Cardillo, RN, MA, is Nurse.comís career advice columnist and president of DonnaCardillo.com.