Ceiling Effect On Your Nursing Career

Your nursing career can get stalled when you hit a ceiling effect.  The ceiling effect occurs about 2-3 years after starting a new role.

Your nursing career can get stalled when you hit a ceiling effect. The ceiling effect occurs about 2–3 years after starting a new role.

When nurses transition into their role there is a very steep learning curve and a specialty knowledge deficit that needs to be bridged. Nurses need to be given the tools to amass and synthesize large quantities of information.

Then after about three years, the nurse reaches a plateau in his/her career. Nurses hit a career ceiling very early on. When they start asking what is next the path seems very narrow and limited. The choices seem to be either you accept your ceiling height or you can go into academics and teach.

Ceiling Effect

Nurses who accept their ceiling height become highly valued subject matter experts (SMEs) at their local facility. The problem with highly valued SMEs who have been in the position for a long time, they tend to become rigid in their thinking and they may even burn out.

They get tired of the constant rotation of interns, new nurses, hospital/office policies that don’t make sense but no one can change, the constant upgrades in computer systems and workflows, etc. Many times the SMEs can become bitter and unapproachable.

This change isn’t always the case, many SMEs are able to evolve their careers and practices by extending themselves beyond just their facility, through local/state/national organizations and being able to find new ways to reinvent their current positions.

The key is to find ways to inject new opportunities into your nursing career.  tweet this

Nurses who get antsy with the ceiling effect but have no clear pathway may consider academics or additional degrees. But academics aren’t for everyone.  More degrees may help open some doors, but a similar effect seems to occur at each level I’ve been in, from RN to NP to PhD.

Those nurses who are antsy but don’t want to go into academics tend to wander from job to job looking for a challenging career and new opportunities. Unfortunately, just changing specialties will provide only a temporizing effect. Simply put, moving from one specialty to another is a lateral move.

Being a neurosurgery nurse isn’t more challenging or prestigious than being an orthopedic nurse or a Palliative Care nurse, it’s just different.

A nurse who makes a lateral move in a specialty will hit the ceiling effect again, but this time it will be faster—maybe even within six months. The learning curve going from inpatient to outpatient or vice versa maybe six months or a little longer like 9–12 months, but still rapid compared to new grad Nurses.

So what can you do to revitalize your nursing career or open up opportunities for yourself?

First, you have to decide what you want to be when you grow up all over again. Being a nurse is a great identity to have. But what other areas of interest do you have?

The trick is going to be to take your RN identities and combine them with another subject matter. This position will give you a unique perspective and a fresh opinion.

Use your training as a nurse to leverage opportunities both inside and outside of medicine. For instance, if you enjoy endless meetings and projects, you might want to go into hospital administration.

If you like informatics and techy-stuff, you might want to go into any number of positions within EMR systems, telemedicine start-ups. If you like business look for positions within retail and urgent care systems.

You don’t necessarily have to get another degree to do a different field, but going back to school might make your current position not feel as suffocating while you figure out what you want to do. Think MBA, JD, MHA, MPH, PhD, DNP.

If you like arts and literature there is a huge movement in narrative medicine that nurses could contribute significantly to.

If you don’t want another degree to consider fellowships in various areas as well. I did an ethics internship at the World Health Organization for an entire summer. Janice Miller, one of my podcast guests did a health policy fellowship through AACN. Work at the International Council of Nurses, get heavily involved in your national specialty associations or look into legal nurse consulting.

Nurses who are really ready to get out of their comfort zone, consider turning your expertise into actionable knowledge as an entrepreneur.  tweet this

An NP run clinic isn’t the only entrepreneurial idea that exists for Nurses. Consider digitializing your knowledge and teaching through membership sites, write books, start a product line. Sell services and/or products.

Once you get antsy as a Nurse it’s quite likely you have attained a level of expertise in a subject area. You should strongly consider how to harness this knowledge, package it and sell it.

Lastly, you will never know what type of opportunities exist for Nurses unless you get out there and check them out. If you don’t know what kind of career you want, it’s ok to experiment.

Try a managerial position for a while, you can always come back to patient care. A nurse is a nurse. You can be retrained in medicine or any specialty, but think how much value you bring back with experience in human resources, project management, legal review, or whatever field you go into.