This book describes some negative issues in nursing in the hopes that readers will lobby hospitals and lawmakers to fix these problems. But it is crucial to know that despite these issues, nurses love their jobs and will enthusiastically persuade potential recruits to join the field. Please read the nurses’ testimonials at the end of this chapter to learn more about the rewards of the job.

One resource for aspiring nurses is Johnson & Johnson’s Campaign for Nursing’s Future. The campaign, which focuses on recruitment and retention of nurses and nurse educators, aims to “make nurses feel really good about what they do,” said a spokesperson, and raises funds for scholarships, fellowships, and grants. The campaign’s website, Discovernursing.com, offers steps to take to become a nurse, day-in-the-life videos, career development help, and other interactive tools for nursing students and managers.

For additional advice for aspiring nurses, I asked several nursing school deans what they tell their students and new graduates. Here are some of their tips.

Know your options.

Nursing is a practically limitless field. “Choosing nursing as a profession means that you will have career choices for a lifetime without changing professions,” said Joan Shaver, dean of the University of Arizona College of Nursing. “We practice everywhere—hospitals; retail clinics; community centers; home care; urgent care; hospice; in the military, corporations, and government; in the air, on the water, on the road, on the Web; and more.”

Nurses can also work as scientists, engineers, policy makers, lawyers, researchers, professors, administrators, and businesspeople. “As you learn the basics of nursing practice, observe and learn about where nurses work, their opportunities and impact, and what patients need in each. Your preferred forte will emerge,” Shaver said.

In a hospital, shadowing on various floors “gives you a chance to see how the nurses interact with each other and physicians,” said the Oklahoma nurse supervisor. “We have senior nursing students who will work as nurse techs and float to different floors to check them out. There are so many different job opportunities for nurses that it helps to take some time at the beginning and check out different options.”

Kathleen Potempa, dean of the University of Michigan School of Nursing, recommended that all aspiring nurses “consider no less than a baccalaureate program, which is now required for work at many top hospitals and clinics,” she said. “Studies show that baccalaureate-prepared nurses are first in line for jobs, are best prepared for the challenges of the field, and are exposed to a wide range of options for learning and research.”

Nursing involves more than you might have thought.

Students commonly arrive at nursing school expecting to learn about performing certain tasks. “They have the same perception as the public, that nurses ‘do things’ to people. That’s actually only a very small part of what nurses do,” said Bobbie Berkowitz, dean of the Columbia University School of Nursing. “Most of nursing involves thinking critically, understanding the human condition and how people respond to illness and health, being a mediator, helping people understand what’s happening, and minding the environment and the technology. These are skills that are often hidden from the public. We try to help students understand that nursing is more than giving an injection. It’s a lot more complex than that.”

Never stop learning.

For nurses, learning is a lifelong goal, said Mary Kerr, dean of the Frances Payne Bolton School of Nursing at Case Western Reserve University. Linda Norman, dean of the Vanderbilt University School of Nursing, agreed. “Be avid readers of the latest evidence out there related to healthcare delivery in your practice. You don’t stop that reading and learning when you graduate. To be a great nurse, you’ve got to be able to know what is the best evidence for the care that you’re providing,” Norman said.

Be a team player.

“We’ve got to get away from the doctor–nurse game. Today’s world of healthcare is all about teams; nurses work with a lot of other decision makers,” Norman said. “Nurses need to be comfortable in their own professional skin, and we’ve got to be able to appreciate everybody. We have to be able to appreciate the physicians’ position, but they’ve got to be able to appreciate nursing and that the nurse’s role has changed drastically over even the last five years.”

On giving advice . . .

“Never give advice unless it’s asked for and always give it when it is,” said Judith Karshmer, dean of the University of San Francisco School of Nursing and Health Professions. While some nurse faculty members tell students never to give advice to families or patients, Karshmer had a different take. “People take advice from a lot of different sources. When patients or family say, ‘What do you think I should do?’ if they are asking for expertise from a nurse, it is your responsibility to provide that.”

For nurses

Find your A-team.

“The best coping resource is my fellow nurses. We are dragged through the mud together during these tragic events; who better to debrief with? And my boyfriend, who listens to me go on and on, particularly after a really hard shift,” said a New York pediatric ICU nurse. “I think that’s one of the most important things for a nurse. You need to figure out who your A-team is outside of work and allow yourself to rely on them, because you can’t hold this stuff inside your chest forever.”

One popular resource for nurses is the social-networking site allnurses.com, which offers several discussion forums. “It’s a platform for nurses from around the world to come together with like-minded people, share experiences, get support, and ask questions,” said founder and CEO Brian Short. “A lot of nurses come home from working a tough shift (a patient dies, something bad happens). They don’t really have support systems at home that understand what they just went through. On allnurses.com they can jump on and find thousands of people who understand.”

Volunteer.

“The point of the profession is to improve the overall health of society. One way to do that, which I have found particularly satisfying, is volunteering with a health organization,” such as on an interprofessional board, Terri Weaver said. “It’s an indirect but effective way to impact a population of patients. Being involved in such organizations also showcases what nurses can do. Volunteering is a way to influence the perception of lawyers, businessmen, and other leaders, so that they witness the critical thinking and font of knowledge associated with nursing and realize that nursing is more than the stereotype.”

To be a good nurse . . .

“To be a good nurse you have to have ‘tits,’ the female version of cojones,” a Texas advanced practice nurse advised. “It’s not about you, it’s about the patients. What do you need to do to get their needs met? That requires self-confidence and lack of fear of humiliation by MDs (and PAs, who can also be horses’ patoots). You have to be able to tell a physician that their orders aren’t safe, or the patient’s allergic to X, or that they need to come assess the patient.”

Find a comfortable way to share.

“Many times patients wanted to connect more closely to me, but I held back after the first few times I invested emotionally” in patients who died, said a Washington State nursing professor. “It’s hard to be caring and not give up part of yourself. My solution was sharing one or two things (over and over again) that seemed to meet the need of personal investment for the patient without surrendering my whole self. I learned how to use my ‘polite face’ with patients getting bad news, so I don’t show emotion. I teach it now to my students: eye contact, relax face, and breathe. It works when they are angry at you, their illness, pain, or death, and helps the caregiver be the bridge to comfort for the patient.”