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For Nurses, the Future is Wide Open

For Nurses, the Future is Wide Open

It’s a great time to be a nurse. Non-traditional opportunities in advanced direct care practice, research, policy making, program development, care coordination and even forensics are attracting non-traditional students and inspiring second careers. But, while opportunities abound, nurses don’t. Baby-boom retirements are thinning the ranks, at the same time a shortage of nursing school faculty is slowing the flow of new graduates.

The same labor market forces that are opening opportunities for aspiring and experienced nurses are creating challenges for hospitals. “We’re on the cusp of a national nursing shortage,” says Paula Johnson, MSN, DA, RN, director of Nursing Professional Practice at Dartmouth-Hitchcock (D-H). “Hospitals across the country are asking ‘How can we encourage new nurses to join us? How can we encourage them to stay?'”

Those are important questions to answer. High-quality patient care depends on building and maintaining a talented, committed nursing team. D-H is doing just that by recognizing the value of nurses, making nurses aware of the array of educational and job opportunities that are available, and investing in their careers.

The first step in helping nurses to navigate the profession is to make sure they know the profession offers tremendous potential. “The general public’s perception of nursing is limited to delivering care at the hospital or working in a clinic,” says Johnson. “Even some nurses and nursing students don’t realize how open the field is.”

The Center for Nursing Excellence is a resource for every D-H nurse who wants to take the next step in his or her career or figure out what the next step might be. “People don’t always know how to find the right programs or how to get started,” says Deb Hastings, PhD, RN-BC, director of Continuing Nursing Education. “Getting information is as easy as dropping in to the office to talk through interests and plans. We can describe available programs, help compare schools and find applicable scholarships. We have information about everything D-H has to offer nurses.”

And D-H has a lot to offer nursing students, people in entry-level nursing professions and experienced nurses. The Idea Network of Biomedical Research Excellence (INBRE) fellowship engages nursing students in bench research and creates a pathway for work at D-H. “INBRE is a federal grant program designed to increase a state’s research capacity,” says Johnson.

“New Hampshire is the only state with a nursing arm of the fellowship and it’s delivered here at D-H. Every summer, four students participate in research, evidence-based practice and quality improvement projects, often as assistants to nurse researchers, and deliver a poster presentation on their work. We track every participant through his or her education and have hired almost all of them after graduation.”

Not every aspiring nurse is in a position to take on the demands of nursing school. D-H offers a path to an entry-level position that will open opportunities for career advancement. Through a partnership with the Red Cross, D-H delivers a Licensed Nurse Assistant (LNA) program at no cost. “Students get acute-care training and experience while they learn about the organization,” says Hastings. “When they complete the program and pass the exam, they’re hired. We invite them to visit units with open positions and meet managers so we can match them with one of the jobs they like best.”

Licensed Practical Nurses (LPNs) who want to advance to Registered Nurse (RN) positions can take advantage of a new program run in collaboration with Vermont Technical College (VTC). “Many LPNs work full-time, which makes it hard to go back to school,” says Hastings. Chosen through the VTC application process, students are released from work once a week (their pay is covered by D-H) and allowed to complete clinical rotations on Saturdays.

The Program for Advanced Clinical Excellence (PACE) program at D-H is geared toward staff nurses who choose to continue practice at the point of care and are interested in advancement. “PACE supports and encourages nurses as they build a portfolio of expertise and follow their chosen career path,” says Johnson. Beginning with the one-year residency program, followed by advancement to the role of clinical nurse, nurses have the option of advancing to nurse practice leader and senior nurse practice leader roles within the organization. “When nurses are credentialed into a nurse practice leader or attain specialty certification, PACE provides a financial bonus, as well as protected time to complete projects that support the strategic priorities of Nursing and the organization.

Support and encouragement begin early for the new nurse graduate in the form of one-year residencies and are ongoing throughout the nurse’s career at D-H. Building on this foundational experience, nurses are encouraged to become involved in more complex clinical experiences. Mastery of these clinically challenging situations can lead to more advanced roles in clinical care and leadership.

D-H provides tuition reimbursement for academic and professional advancement and, in addition, offers the opportunity for nurses to take advantage of additional scholarship opportunities. “We really value certification and education and support these opportunities financially,” says Johnson. “Many D-H nurses are in school.” Financial support is available through several sources including the James W. Varnum Nursing Scholarship made possible by the efforts of D-H Volunteer Services, which distributes about $45,000 each year.

Career guidance, educational programs and financial support have already helped D-H nurses move into a variety of non-traditional roles. For example, in forensics, specially trained nurses care for sexual assault victims by meeting their emotional and physical needs and gathering forensic evidence to provide expert testimony at trials. Other nurses are developing informatics operations that enable clinicians throughout D-H to use, analyze and exchange data to drive evidence-based practice. They’re redesigning care delivery and implementing programs like ImagineCare, an innovative digital health tool and service platform developed here at D-H.

Opportunities abound for nurses who choose to practice at D-H. Many get to do things they might not have imagined when they started out in the profession. “This is great for our patients who continue to benefit from their commitment and expertise,” says Hastings. Adds Chief Nursing Officer at D-H, Karen Clements, RN, FACHE, “No matter what path your nursing career takes, D-H will assist in helping you achieve that goal.”

Roles for the Registered Nurse (not inclusive)

  • Clinical nurse (point of care)
  • Acute Care
  • Ambulatory Care
  • Home Care
  • Nurse Educator
  • Nursing Leadership Roles
  • Nursing Supervisor
  • Nurse Manager
  • Nursing Director
  • Clinical Nurse Specialist
  • Clinical Nurse Leader
  • Nurse Practitioner
  • Nurse Midwife
  • Registered Nurse Anesthetist
  • Nurse Researcher
  • Wound Care Nurse
  • Flight Nurse
  • Community Health Nurse
  • Parish Nurse
  • Risk Management
  • Forensics: Sexual Assault Nurse Examiner (SANE)
  • Continuing Care Coordinator
  • Quality and Safety Specialist
  • IV Therapy Practitioner
  • … and many more …